Ashesh Kumar Jha

Pleomorphic variant of lobular carcinoma breast: A rare case report with review of the literature

Pleomorphic carcinoma is a poorly described entity whose phenotype is not well recognized as within the morphological spectrum of breast carcinoma. The purpose of this report is to describe the clinicopathological features of this tumour with review of the literature. We report a case of invasive pleomorphic lobular carcinoma with coexisting classic lobular carcinoma in situ.

Unusual Cause of Orocutaneous Fistula in the Neck

A case of orocutaneous fistula secondary to submandibular sialolithiasis, which was masquerading clinically as branchial fistula is presented. This case highlights the importance of conducting fistulogram in the evaluation of discharging lesions in the neck.

The large adult abdominoscrotal hydrocoele: does it require of posterior inguinal canal wall reinforcement?:

1. Uppal N and Hong LW. Quasi-surgical technique for easy removal of broken roots. Trop Doct 2013; 43: 136–137. 2. Krishnan B. Removal of a fractured palatal root. Br J Oral Maxillofac Surg 2008; 46: 421. 3. Kannan VS, Ahamed AS, Sathyanarayanan GR, et al. A new atraumatic method of removing fractured palatal root using endodontic H-File luted with resin modified glass ionomer cement: a pilot study. J Pharm Bioallied Sci 2014; 6S1: S156–159.

Abdominal wall blow out causing bowel evisceration due to high voltage electrocution: A unique presentation

A 32-year-old male presented to surgical casualty after 3 h of sustaining high voltage electrocution through palm of the right upper limb with prolapse of bowel from the anterior abdominal wall. Apparently, the current flow through the right upper limb exited from the right lower abdomen wall resulting in full-thickness abdominal wall defect causing small bowel to prolapse. He had clawing of right hand and semi-flexion at elbow with blackening and dry gangrene from mid-arm onward with distal two-third of the right upper limb being parched and black. There was 9 cm × 7 cm wound over right abdominal wall through which small bowel had eviscerated with multiple perforations discharging feculent content. Exploratory laparotomy with resections of perforated segments of small bowel with end-to-end anastomosis and right mid-arm guillotine amputation were done. The abdominal wound was debrided and temporarily covered with overlay plastic bag to prevent bowel herniation. A small enterocutaneous fistula arising from the small bowel was noted through the abdominal wound of blow out site, which was managed conservatively. The entry point of electricity is usually the skull or the upper extremity with resultant exit through the lower extremity. The exit point through the abdominal wall with resultant abdominal wall loss is rare and even remorsely seen is the abdominal wall blow out with the evisceration of bowel, a rare phenomenon.

Sudden onset epigastric pain and vomiting

DOI: 10.4103/1319-3767.91727 An 18-year-old male presented with complaints of sudden onset pain in epigastrium and left-sided lower chest followed by nausea and vomiting. Attempts to drink caused retching within 5 to 10 minutes. There was no history of trauma. Patient had a pulse rate of 100/min, blood pressure of 116/76 mmHg and respiratory rate of 22/min. Chest examination revealed markedly decreased air entry on left side. Patient had upper abdominal distension and tenderness. There was no guarding, rebound tenderness or organomegaly. Patient chest X-ray [Figure 1] and Barium study [Figure 2] was done.