Ashok B. Shetty

Symptomatic Morgagni's hernia in an elderly patient

Hernia of Morgagni occurs through an anterior defect in the diaphragm. Symptoms of these hernias are attributable to the herniated viscera. In our case, there was partial obstruction due to herniation of the distal stomach and pylorus into the right hemithorax that was reduced surgically through a right thoracolapaorotomy. Of special emphasis are the various modalities used to diagnose this condition in our case.

A rare complication of an impacted foreign body in the cricopharynx

Foreign body impaction in the gastrointestinal tract is not rare. The majority (up to 90%) of these impacted foreign bodies are passed spontaneously.* Bloom et al2 found that most of the foreign bodies that fail to pass through the gastrointestinal tract lodge in the esophagus. A foreign body impacted in the esophagus should be removed as soon as the diagnosis is made, for the following reasons3: the chance of spontaneous passage is small; edema from local trauma grips the object firmly, making later manipulation difficult; and perforation of the esophagus is a very serious complication, with high mortality and morbidity.

Presentation and management of deep neck space abscess

ObjectiveTo study the presentation, etiology, microbiology and morbidity of deep neck space infections.Study DesignRetrospective study Methods: 29 patients admitted in Kasturba Medical College Hospital, Mangulore, India between January 1997 and December 2002 with deep neck space infections.,were included in the study.RemitsThe most common space involved was the parapharyngeul space. No specific etiology was determined in .38%; an odontogenic cause was discovered in 28% of the patients; tonsillar/pharyngeal infections in 24% of patients and foreign body impaction in 7% of cases. The main morbidity was due to mediastinitis (5 patients). I patient succumbed to the disease. Mixed flora with aerobic and anaerobic infections was identified in most of the cases.

Congenital cystic adenomatoid malformation of lung type 1.

Congenital cystic adenomatoid malformation, a rare developmental, hamartomatous abnormality of the lung, usually is unilateral, is localized, and presents in early infancy. Delayed occurrence in older children and multilobar involvement are rare. We describe a case of congenital cystic adenomatoid malformation type 1 with multilobar involvement, associated emphysema, and coexistent tracheobronchopathia osteochondroplastica in an adolescent girl for whom the correct diagnosis was achieved only on histologic examination. The importance of an accurate diagnosis of this entity enables proper subtyping, management to minimize the risk of infections and malignancy, and exclusion of associated malformations.