Mohd Ilyas

Small Bowel Obstruction Due to Migration of a Transrectally Inserted Foreign Body

A 55-year-old woman presented to the emergency department with complaints of abdominal pain, abdominal distension, retching, vomiting, and constipation for 3 days. There was no history of fever. Clinical examination revealed tender and distended abdomen with no palpable mass. Ultrasonography was inconclusive due to abdominal distension by extensive gut gases. Contrast-enhanced computed tomography revealed features of small bowel obstruction with an oblique air-density structure in the jejunal loops surrounded by oral contrast (Figure 1). After imaging and prolonged counselling, the patient confessed the actual history. The patient’s husband had inserted a long hollow stick through her anus 17 years before. The patient stated that she had removed half of the stick by breaking it, but she was not able to remove the remaining part. Due to social taboos, she did not seek medical attention at the time. Exploratory laparotomy revealed a long, hollow, wooden stick, which was removed from the intestines by opening the jejunal loops (Figure 2).

Recurrent Unexplained Cystitis Due to an Ingested Foreign Body–An Extremely Rare Case

We present the images of a 4-year-old male child with history of recurrent unexplained urinary tract infections which was found to be due to an ingested wooden foreign body which had perforated the small bowel into the posterior bladder wall. Such cases are very rare, usually due to domestic abuse or in patients with psychiatric illnesses. The adults usually report early but in children these cases go un-noticed. These patients may present with features of bowel obstruction, perforation, or hematochezia.1 as recurrent urinary tract infections seems to be the first case to be reported.

Herlyn-Werner-Wunderlich syndrome – a rare genitourinary anomaly in females: a series of four cases

We present case series of four patients with an important syndrome known as Herlyn-Werner-Wunderlich syndrome. Herlyn-Werner-Wunderlich syndrome is a rare congenital anomaly characterised by uterus didelphys with blind hemivagina and ipsilateral renal agenesis. It usually presents after menarche with progressive pelvic pain during menses secondary to haematocolpos. Awareness is necessary to diagnose and treat this disorder properly before complications occur. Magnetic resonance imaging is the preferred modality for the delineation of uterine malformation. When renal anomalies are encountered, a screening should also be made for congenital abnormalities of the reproductive tract and vice versa.

Rupture of Non-communicating Rudimentary Horn of Unicornuate Uterus with Pregnancy

Unicornuate uterus with a non-communicating horn is a rare anomaly and even rarer pregnancy in its non-communicating horn. The incidence of pregnancy in the non-communicating horn is 1 in 76,000 to 1 in 150,000. Due to non-compliant uterine musculature in the non-communicating horn, it is prone to rupture in cases of pregnancy. The rupture occurs usually in the second trimester. We describe a case which presented with the rupture of non-communicating horn with live fetus inside it. The present case had a 22xa0week fetus floating in the peritoneal cavity following the rupture of non-communicating horn with normal other uterine horn.

Sincipital Encephalocele, a Rare Anomaly Diagnosed Antenatally in the Late Pregnancy

A case of sincipital encephalocele with intracranial cyst is presented which was diagnosed at 35xa0weeks gestational age in a patient who had undergone no ultrasound examination earlier. The purpose of this article is to make the radiologists and the obstetricians aware of this condition, prognosis, and complications.

Twin Pregnancy in Bicornuate Uterus–One Fetus in Each Horn

A 32-year old primigravida female of approximately 20xa0weeks gestation by her last menstrual period (spontaneous conception) was referred for anomaly scan. The ultrasonography revealed two uterine horns separated by thick (12xa0mm) uterine tissue with a fetus (average Gestational age 22xa0weeks each) in each horn.

Hepatic abscess rupture into the pyelocalyceal system of right kidney

A 42-year old male patient presented with the complaints of right lumbar pain, high-grade fever, burning micturition and pyuria for past 4 days. He was diagnosed with a liver abscess which had ruptured into the superior pole of right kidney.

Anterior mediastinal neurofibrosarcoma—a rare manifestation of neurofibromatosis type-1

Anterior mediastinal neurofibroma and neurofibrosarcoma form a rare class of tumors seen in patients of neurofibromatosis. We describe a case of anterior mediastinal neurofibrosarcoma in a known case of neurofibromatosis type-1.

Truncus bicaroticus and arteria lusoria—a rare combination of aortic arch anomalies

A 54-year-old female presented to the outpatient Department of Internal Medicine with the history of progressive mild dysphagia for past 3 to 4 months with no history of significant weight loss. She had no significant past history. Her blood pressure, heart rate, respiratory rate, and body temperature were within normal limits. The complete blood counts, hemogram, and coagulation profile were also normal. Her chest radiograph and barium swallow studies were unremarkable. She was referred for contrast-enhanced computed tomography (CECT) of the neck and chest. The CT was performed using 64-slice Somatom Sensation (Siemens Healthcare, Germany). After the baseline non-contrast study, aortic arch anomalies (aberrant right subclavian artery and truncus bicaroticus) were suspected, and that is why CT aortogram was performed by injecting 90 ml of Iopromide (Ultravist370) at a rate of 4 ml/s, followed by delayed venous phase to look for the esophageal lumen, neck, mediastinum, and lungs. The aortic angiography findings were as follows (Figs. 1, 2, and 3):

Primary pulmonary leiomyosarcoma—case report of a rare aggressive neoplasm

A 50-year-old male non-smoker and non-alcoholic was presented to the Emergency Medicine with the chief complaints of chest pain, cough, and hemoptysis for 2 days. There was no history of fever. The patient was non-smoker and nonalcoholic with no history of similar complaints in the past. A chest radiograph from 2-months back which was obtained as a part of routine pre-anesthetic checkup for cholecystectomy did not show any abnormality. He had no previous history of any radiotherapy or chemotherapy. The general physical examination revealed no evident abnormality. The respiratory and heart sounds were normal. The blood pressure and pulse rate were 120/80 mmHg and 78 bpm, respectively. The patient had a temperature of 99 °F with respiratory rate of 16/min. A chest radiograph was done which revealed a radio-opaque irregular mass-like shadow in the right para-hilar region (Fig. 1). To evaluate further, contrast-enhanced computed tomography (CT) of the chest was performed using 64-slice SOMATOM Sensation scanner (Siemens Healthcare, Germany). The CT findings revealed a large heterogeneously enhancing soft tissue mass lesion located in the lumen of the right pulmonary artery and infiltrating into the posterior segment of the upper lobe of the right lung (Figs. 2 and 3). There was no associated calcification. There was no evidence of distant metastasis. The preliminary diagnosis of a lung mass was formulated. This was followed by CT-guided biopsy of the mass. The biopsy examination findings revealed the features suggestive of an aggressive leiomyosarcoma (Fig. 4). Immuno-histochemical studies were positive for Desmin. With the evidence of radiographic, CT, and histologic findings, the diagnosis of pulmonary leiomyosarcoma was finalized, and the patient was started on chemotherapy. The patient was planned for elective surgical resection of the tumor. Unfortunately, the patient died due to cardiac arrest after receiving just 2 cycles of chemotherapy.