Rikki Singal

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.

An incarcerated appendix: report of three cases and a review of the literature

We came across three rare cases of incarcerated hernia, with different presentations. The first case was an elderly female, who presented with an incarcerated incisional hernia on the right lower iliac region diagnosed on contrast enhanced computed tomography (CT); the contents were the small bowel and the perforated tip of the appendix. In the second case of inguinal incarcerated hernia, ultrasonography showed the inflammed appendix in the subcutaneous plane of the hernial sac, which is very rarely diagnosed pre-operatively and was confirmed during surgery. Inflammed appendix with gangrenous tip was found in the inguinal hernial sac. In yet another case of incarcerated inguinal hernia, the contents were a gangrenous part of the ascending colon and transverse colon, with the tip of the inflamed appendix—also only rarely observed. The colon extended to the scrotum in this case. We could find no description within the existing medical literature on either transverse or ascending colon as contents in inguinal hernia although transverse colon alone has been reported in four cases. The surgical options for dealing with the appendix in an Amyand’s hernia depend on the mode of presentation. The presence of a normal appendix does not require an appendicectomy to be performed, but its removal is necessary if inflamed.

Gallstone ileus and jejunal perforation along with gangrenous bowel in a young patient: A case report

Context: Gallstone ileus is an uncommon condition with potentially serious complications including perforation and gangrene of the small bowel. Its diagnosis is difficult and surgery remains the mainstay of treatment. Here we are reporting the complications of this condition along with brief review of literature. Case Report: We report a case of intestinal obstruction due to gallstone in the small gut which was diagnosed preoperatively on ultrasonography and confirmed on exploratory laparotomy. Postoperative period was uneventful. Conclusion: Gallstone ileus is a rare cause of intestinal obstruction and it should be considered in patients who are suffering from gallstone disease and presenting with intestinal obstruction especially when no other obvious cause is seen.

Superior mesenteric artery syndrome: A case report

Context: Superior mesenteric artery syndrome is a life- threatening upper gastrointestinal disorder due to compression of duodenum as it poses a difficult diagnostic dilemma. Third part of duodenum is in fixed compartment bounded anteriorly by the root of mesentery and superior mesentery artery and posteriorly by the aorta and lumbar spine. On barium contrast study and abdominal computerized tomography (CT) showed the dilatation of second part of duodenum and compression of the third part of duodenum between aorta and superior mesentery artery. Case Report: A 22 year young asthenic man admitted with the complaint of recurrent abdominal pain, epigastric fullness, and vomiting and weight loss. Abdominal examination revealed epigastric fullness and hyper peristaltic bowel sounds. Upper gastrointestinal barium study showed a dilated stomach with dilated second part of the duodenum and cut off at the third part of duodenum with no intrinsic mucosal abnormalities. There was no relief of obstruction in the left lateral decubitus or prone position. Conservative treatment was tried for one month but failed. Intra-operative findings confirmed the extrinsic obstruction of third part of duodenum with distension of 2nd part. A retrocolic duodenojejunostomy, side to side anastomosis done. In post-operative follow up, patient was symptom free. Conclusion: Superior mesentery artery syndrome is a life threatening disease. It should be treated as soon as possible. Conservative trial can be given but Surgery is the treatment of the choice.

Report of two cases of subcutaneous lipoma over the finger and review of literature: case series

We are reporting two rare cases of subcutaneous lipoma. One was present over the dorsal aspect of the right index finger, and another was over the volar aspect of the middle finger. In first case, it was extending proximally from the proximal interphalangeal joint. Surgical excision of the tumour was done. In follow-up, patient is doing well with normal finger movements. Although, it is not the only case reported, lipoma of the index finger is very uncommon.

Primary abdominal tuberculosis presenting as peritonitis in a young child–managed surgically

Abdominal tuberculosis (TB) is the sixth commonest extra-pulmonary TB form after lymphatic, genitourinary, bone and joint, miliary and meningeal tuberculosis. We are presenting a rare case in a young female of age 7 year diagnosed as peritonitis and intestinal obstruction. Operative findings revealed dense fibrosis in interloops and perforation of the small bowel. She was put on antitubercular treatment for one year. Patient was discharged in satisfactory condition and is in follow up for 2 months.

Subcutaneous hydatid cyst of the thigh.

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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.

A huge immature cervical teratoma; antenatal diagnosis, and its management - an unusual entity.

Cervical teratomas are not reported quite frequently in medical literature, especially from Indian subcontinent. Prenatal diagnosis of this condition is even rarer, making the management protocols difficult. In absence of prompt intervention in the form of airway decompression, morbidity and mortality is very high. Presented here is the case of antenatal diagnosed cervical mass, which was managed successfully in immediate post-natal period with uneventful survival and normalized tumor marker levels.

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.