Ashwani Kumar Dalal

Traumatic anterior abdominal wall hernia: A report of three rare cases

Traumatic abdominal wall hernia is a rare condition that can follow any blunt trauma. Associated intra-abdominal injuries are infrequent. In this study, we are reporting three cases, diagnosed as abdominal wall hernia associated with herniation of bowel loops due to blunt trauma. In one case, injury of the herniated bowel was seen. In western medical literature, only few cases have been reported especially with intra-abdominal injuries.

Traumatic abdominal wall hernia.

BACKGROUND Traumatic abdominal wall hernia (TAWH) is uncommonly encountered despite the high prevalence of blunt abdominal trauma. The diagnosis is often difficult because of its varied presentation along with lack of awareness of this entity. METHODS The case files of all patients with TAWH who were operated at our hospital were retrospectively reviewed and analyzed. RESULTS A total of 11 patients with TAWH were analyzed (8 males, 3 females). The clinical presentation was varied, with a palpable defect and a reducible swelling (6 patients), localized area of irreducible swelling (3 patients), surgical emphysema (2 patients), and cellulitis/abscess formation (2 patients). All of these patients were operated within 24 hours of hospital admission. Except for the 3 patients who presented late, there was a favorable outcome in all the others. The cause of mortality was septicemia, possibly due to incarceration of bowel in the defect leading to strangulation and perforation. CONCLUSION TAWH, although uncommon, is associated with significant morbidity and mortality when there is a delay in diagnosis and intervention. Early intervention leads to a significantly better outcome.

Primary adenocarcinoma of ureter mimicking pyelonephritis

Tumors of the ureter are rare. We present a case of primary mucinous adenocarcinoma of the ureter diagnosed as chronic pyelonephritis preoperatively. This tumor is postulated to arise from metaplastic glandular mucosa in response to chronic irritation of the urothelium.

Subcutaneous hydatid cyst of the thigh.

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Kimura's disease: clinicopathological study of eight cases

BACKGROUND Kimuras disease is a rare, localised, chronic inflammatory disease. This benign disease involves subcutaneous tissues, the major salivary gland, and lymph nodes primarily in the head and neck area. METHOD Clinical details and stained slides of all cases reported as Kimuras disease over a 10-year period were reviewed. RESULTS There were eight cases of Kimuras disease. The mean age of patients was 22.8 years. One case showed associated nephrotic syndrome and two cases were associated with peripheral blood eosinophilia. All cases showed the typical histopathological features of Kimuras disease. CONCLUSION Kimuras disease was first reported in China in 1937. The cause of Kimuras disease is unknown and many theories have been proposed. The eight cases reported here illustrate some of the variations in the mode of presentation and in the histological features of Kimuras disease. Kimuras disease should be considered in the differential diagnosis of patients who present with head and neck swellings and lymphadenopathy, and investigated accordingly.

Primary Tuberculosis of the Breast Presented as Multiple Discharge Sinuses

Breast tuberculosis is a rare form of tuberculosis (TB). It is mainly classified as primary and secondary forms. Primary form is rare. We are reporting a case of primary TB breast with history of breast lump and multiple sinuses. TB was diagnosed on FNAC. Patient was put on anti-tubercular drugs.

Traumatic diaphragmatic hernia

BackgroundAbdominal trauma is frequently encountered, but traumatic injuries to the diaphragm are often missed.Material and methodsA retrospective review of all the case files of patients presenting with traumatic diaphragmatic injury was performed. These patients were analyzed for their presentation, injury, surgery performed and outcomeResultsA total of 14 patients were thus identified (12 males and 2 females). The average age was 31.5 years. Road traffic accidents were the most common cause, accounting for the majority of cases (12 patients). 10 patients presented within 24 hours of injury; the other 4 presented late (2 1/2 months to 20 years) with the signs and symptoms of acute intestinal obstruction. The left side of the diaphragm was injured more commonly. Herniation of multiple intra abdominal viscera was common, with the stomach being the organ most commonly implicated. There were 2 deaths.ConclusionsTraumatic injury to the diaphragm must be kept in mind while dealing with patients who have sustained abdominal trauma. The diagnosis can easily be picked up on chest x-ray. Treatment is surgical, with simple suturing of the diaphragm with non-absorbable suture giving good result

Solitary plasmacytoma of the rib: A rare case

Localized solitary plasmacytoma of the bone is a rare disease and is characterized by only one or two isolated bone lesions with no evidence of disease dissemination. We report a case of solitary plasmacytoma of the rib in a 43-year-old female. The patient underwent complete en-bloc resection of the chest wall including rib, muscle, and parietal pleura. Patient is asymptomatic without any recurrence after two and half years of follow up.

Enucleation of the solitary epithelial cyst of pancreatic head in an adult: A case report and review of the literature

Solitary true pancreatic cyst is a rare entity, and only a few cases are reported in the literature. We report a case of a 35-year-old woman who had a cyst in the head of the pancreas and gall stones and presented with complaints of pain in the epigastric region. The patient underwent open cholecystectomy with aspiration of the pancreatic cyst at some other private hospital. After 4 months, she presented to us with no relief in pain. Repeat contrast-enhanced computed tomography of the abdomen showed recurrence of the cyst. The patient underwent enucleation of the cyst at our hospital. During a 2-year follow-up after the enucleation, she remained asymptomatic.

Primary hydatid cyst masquerading as pseudocyst of the pancreas with concomitant small gut obstruction—an unusual presentation

Isolated retroperitoneal hydatid cyst is an exceptionally rare entity. Owing to vague and varied symptomatology, it is seldom diagnosed without puncture cytology or surgery. We report an unusual presentation of primary retroperitoneal hydatid cyst with concomitant small gut obstruction. Ultrasonography and computed tomography of the abdomen showed localized abscess or pseudocyst of pancreas. Preoperatively, ultrasound‐guided puncture cytology of the lesion revealed suspicious hydatid pathology. The patient was examined and, peroperatively, the cyst masqueraded as hydatid cyst of pancreas along with an inflammatory band, and the diagnostic dilemma about its exact site of origin was solved by histopathology only. Complete excision of the cyst along with the tail of pancreas was done with concomitant excision of inflammatory band, causing small intestinal obstruction. The patient was discharged in satisfactory condition on albendazole. In follow‐up of 8 months, there was no recurrence.