Ikhwan Sani Mohamad

Anterior Abdominal Wall Abscess as a Complication of Appendicular Massin Elderly

Appendicitis in the elderly continues to be a challenging surgical problem. Patients usually present late with atypical presentations. The diagnosis of appendicitis is often difficult to establish and there are increased rate of perforation and mortality. Abscess formation with extension to anterior abdominal wall as reported in this case is rather rare. Older patients also tend to undergo more complicated operative procedures and higher rate of postoperative morbidity and mortality. We reported a case of atypical presentation of appendicitis as anterior abdominal abscess and postoperative challenges in geriatric surgery.

Primary Osteogenic Sarcoma of the Breast: A Rare Breast Cancer Presentation in Malaysia

Osteogenic sarcoma are malignant mesenchymal neoplasms in which the neoplastic cells produce osteoid and it is the commonest primary bone tumour. However, cases of extra-skeletal osteogenic sarcoma has been reported worldwide occurring in breast, colon and even myocardium Extra-skeletal sarcomas tend to occur in patient over 50 years old. Primary osteogenic sarcoma of the breast is very rare and accounted less than 0.1% of breast cancer. This is a case of a 44-year-old lady who was diagnosed with primary osteogenic sarcoma of the breast and the difficulty encountered in managing it. The long-term prognosis is uncertain due to the small number of cases reported in the medical literature worldwide.

Pancreatic Pseudocyst with Gastric Outlet Obstruction: A Case Report and Literature Review

Management of pancreatic pseudocyst is controversial.Surgical therapy has been clasically considered the treatment of choice for those pseudocysts. However, several studies have shown good results with percutaneous drainage. Percutaneous drainage can be performed easily, with minimal complication and may facilitate the resolution of a pseudocyst. We presented a case of a 20-year-old boy who sustained blunt abdominal trauma following motorvehicle accident. A large pancreatic pseudocyst developed within 3 weeks after the accident. Percutaneous drainage under ultrasound guidance was performed. The drainage flow decreased gradually until ceasing, and the pseudocyst disappeared.

Lipomatous Caecal Polyp Causing Ileocaecal Intussusception in an Elderly Lady: A Case Report and Literature Review

Intussusception is an uncommon cause of intestinal obstruction especially in adult. Adult intussusception accounts for only 5% of all cases of intussusceptions. We presented a case of a 63-yearold lady who presented with 1 week history of rightsided colicky abdominal pain which gradually became generalized, associated with vomiting out bile stained fluids. After series of investigations and worsening condition, emergency exploratory laparotomy was performed an(d unfortunately ileocolic intussusception was found. The patient underwent right hemicolectomy. Histopathological report confirmed lipomatous polyps arising from ileocaecal junction. Most recommendations of management are going towards resection of the involved segment without attempt of reduction as the causes of the intussusceptions in adults are usually due to pathological conditions within the involved segment.

Delayed Presentation of Traumatic Diaphragmatic Hernia: A Case Report

Traumatic diaphragmatic hernias are an unusual presentation of trauma. The diagnosis is often missed because of non-specific clinical signs, and the absence of additional intra-abdominal and thoracic injuries. Thus, a delay in diagnosis may occur which, in the presence of obstruction and/or strangulation, is associated with a high mortality and morbidity.