Mohit Bhatia

Schwannoma over submandibular region: A rare presentation

Schawannomas (neuromas, neurilemmomas) are benign tumors originating from Schwann cells or nerve fiber sheet cells. They are solitary, encapsulated tumors usually attached to, or surrounded by, a nerve. Most schwannomas of the hypoglossal nerve originate from the intracranial portion, but they may extend extracranially. Solitary and extracranial schwannomas are extremely rare. The peripheral hypoglossal schwannomas are extremely rare. Treatment of these tumors depends on the extension of the tumor. We present the case of a 44-year-old male with swelling over left submandibular region. Patient was successfully treated surgically.

Verruca vulgaris of the buccal mucosa: A case report

Oral verruca vulgaris is caused by human papillomavirus (HPV) infection. Verruca vulgaris most frequently occurs on the fingers, toes, soles, and dorsal surfaces of hands and is mostly asymptomatic. Varieties of verrucous and papillary lesions affect the skin as well as oral mucosa which may be either benign or reactive. Common wart is one of the most commonly observed skin growths and a lesion of childhood. Intraoral warts can occur at any age with equal incidence in both genders but are most commonly seen in the third to fifth decade. It is found commonly on the palate followed by lip, tongue, buccal mucosa, and rarely seen on gingiva. Surgical excision with adequate margins is the treatment of choice.

Cystic hygroma: A surgical challenge

Cystic hygroma (CH) is a congenital malformation of lymphatic system. The incidence of CH is approximately 1 in 6000 live births. In most of the cases, it presents as a painless, fluctuant swelling. Due to its variable presentation its optimum treatment often poses a potential challenge.

Mysterious inguinal swellings disguised as hernia: Series of four cases

A hernia surgeon may encounter unexpected intraoperative findings. It is important to be prepared to detect them and apply the appropriate treatment. We retrospectively studied twenty patients with inguinal swellings who were admitted to our surgical department over a 2-year period including patients without a definitive diagnosis of inguinal hernia upon admission. Our aim was to present our experience with the unexpected findings during inguinal hernia surgery, either unusual hernial contents or pathologic entities, such as neoplastic masses, masquerading as a hernia.

Incidental finding of meckel's diverticulum in a patient with ascaris-induced intestinal obstruction

Ascaris lumbricoides is a large parasite that infests the human bowel, especially in regions with poor environmental sanitation in the tropics. Meckels diverticulum is mainly an asymptomatic congenital intestinal anomaly. Rarely, it becomes symptomatic when it is associated with complications such as diverticulitis, perforation, and bleeding. It may be associated with a heavy worm load. We report a case of 7-year-old female child with intestinal obstruction and incidental finding of Meckels diverticulum with gangrenous bowel.

Splenic abscess: a rare presentation

Splenic abscess is a rare clinical entity with an incidence of 0.2-0.7% in autopsy-based studies. When untreated, splenic abscess is associated with nearly 100% mortality; in treated patients, the mortality rate is 16.6% during the first 90 days. It mostly occurs in patients with neoplasia, immunodeficiency, trauma, diabetes or splenic infarct. The incidence of splenic abscess is thought to be growing because of the increase in the number of immunocompromised patients who are particularly at risk for this disease and also because of the widespread use of diagnostic modalities. However, the optimal treatment for this remains unclear. We present a case of a 42-year-old man diagnosed with multiloculated splenic abscess and was subjected to splenectomy.

Silent traumatic hernia

Incidence of abdominal trauma is on an increasing trend but abdominal content herniation due to blunt trauma is rare. Traumatic disruption of the abdominal wall has only about 50 reports worldwide, and only one from India. We report here a case of 65 year old male who underwent blunt trauma due to bull horn injury and presented with a swelling in the left lumbar quadrant of anterior abdominal wall, without as much as an abrasion on the overlying skin. We conclude that a low impact, prolonged presentation, case of traumatic abdominal wall hernia can be managed electively by open anatomical repair.

Saree cancer: A diagnosis!

Saree cancer is a type of skin cancer that occurs along the waistline of Indian women wearing the traditional costume of ′saree′. The incidence of malignancy in scar tissues is 0.1-2.5%. Highly hypopigmented and thickened scars are more likely to progress into malignant lesions. Khanolkar and Suryabai described a new type of skin cancer - ′dhoti cancer′ in 1945. Persistent and long term use results in chronic friction/irritation in the region of waist which in term leads to waist-dermatosis.

C-reactive protein with sequential organ failure assessment score: Valuable parameters in managing acute pancreatitis

Introduction: Acute Pancreatitis (AP) is an acute inflammation of the pancreas and the clinical evolution is frequently unpredictable. Multiple scoring systems have been developed to discriminate between patients with mild acute pancreatitis and those at high risk for developing severe pancreatitis. The assessment of the severity of pancreatitis is important for the proper management of this challenging disease. A highly accurate system that could predict the severity and identify the local extent and complications of a serious inflammation is beneficial for patient outcome. Aims and Objectives: The aim is to study the role of the C-Reactive Protein (CRP) in assessing the severity of acute pancreatitis, to evaluate the correlation between the CRP levels and response to the treatment, and to correlate between the serum CRP levels and increased risk of organ failure. Study Design: A Prospective study. Patients and Methods: Fifty patients with a clinical and laboratory diagnosis of acute pancreatitis, more than 65 years of age, were excluded from the study along with patients having an immunocompromised status or with other existing inflammatory conditions. Main Outcome Measures: Serum CRP levels were estimated at the time of admission (48 hours from the onset of symptoms) and were recorded on the third, fifth, seventh, and fourteenth days, and the patients were assessed by using the Sequential organ failure assessment (SOFA) scoring system. Results: Twenty-three patients were in the age group of 31-45 years and 36 patients (72%) were alcoholic. Ten patients had CRP levels of more than 50 mg/L. The mean CRP level at the time of admission was 36.45 mg/L. Thirty-nine patients (78%) had a SOFA score in the 0-3 range. Nineteen patients had a complicated course, with two deaths, in or study. A strong association was noted between the CRP levels and SOFA. Conclusion: The CRP levels at admission can help in predicting the outcome of the disease when used along SOFA.

Sebaceous carcinoma over cheek: A rare presentation

Sebaceous carcinoma, an uncommon cutaneous tumor first described by Allaire in 1891. This arises mostly from sebaceous glands in the skin and thus may arise anywhere in the body where these glands exist. Approximately, 75% of these tumors arise in the periocular region, which is rich in sebaceous glands. Fewer than 120 cases of sebaceous cell carcinoma have been reported at the extraocular sites as in our case.