Shekhar Tandon

Esophageal Injuries Due to Aluminum Phosphide Tablet Poisoning in India

Aluminum phosphide is a lethal systemic poison with 80%–90% mortality. Survivors have taken either a very small amount or the tablet had been exposed to air, rendering it less toxic, but often causing severe esophageal injuries. The presentation and treatment of 11 cases of esophageal injury due to aluminum phosphide are described. Ten patients had esophageal stricture, and 1 had tracheoesophageal fistula with stricture. Endoscopic bougie dilatation was sufficient in 7 patients, and surgical intervention was required in 4 who underwent definitive repair via gastric tube or feeding jejunostomy with a 2nd stage repair planned in 2. There was no mortality but significant morbidity. Mortality and morbidity might be prevented by withdrawing this pesticide from the market, making its sale difficult, or modifying the packaging.

Gastropleural fistula: rare entity with unusual etiology.

Gastropleural fistula is a rare condition. We report a case where fistula developed iatrogenically during repeated intercostal drainage tube insertions for empyema.

Esophagopleural Fistula following Spontaneous Rupture of Traction Diverticulum

A rare case of esophagopleural fistula following spontaneous rupture of a traction diverticulum of the esophagus in a 25-year-old man was successfully treated by diverticulectomy.

Hydatid Cyst of the Right Atrium: A Rare Presentation

Hydatid cyst of the heart is an uncommon lesion. Reported is the case of a 24-year-old female patient admitted with a history of chest pain and hemoptysis, and a mass lesion in the right atrium. Investigations and intraoperative intervention revealed the mass to be a hydatid cyst located in the right atrium, along with hydatid cysts of the liver and both lungs. The right atrial mass was successfully removed under cardiopulmonary bypass.

Unusual sternal mass: Adenocarcinoma with unknown primary site

We are reporting a case of sternal mass-histologically proven high-grade adenocarcinoma. Despite exhaustive investigations, no other primary site was detected. It was difficult to differentiate from metastasis or from primary skin adnexa, but whatever diagnosis is made, wide surgical excision with reconstruction is recommended for improvement of life quality.