Snigdha Goyal

Single jejunal blowout perforation following blunt abdominal trauma: Diagnostic dilemma

Single isolated jejunal perforation (IJP) due to blunt abdominal trauma is uncommon and most often occurs with road traffic accidents. The diagnosis of traumatic single IJP is challenging as there are minimal clinical features initially. For most favorable results, strict monitoring, a high index of clinical suspicion, and the help of available appropriate diagnostic tools like diagnostic peritoneal lav age (DPL)/focused abdominal sonography for trauma (FAST) are preferable. Here we report a case of IJP following blunt trauma abdomen.

Primary tuberculous granuloma in axillary lymph node draining breast cancer: A rare coincidence and review of recent literature

Enlarged axillary lymph nodes in case of breast carcinoma patients are not always due to metastases and can be reactive in nature. Very rarely enlarged axillary lymph nodes may be due to reactivated dormant axillary tubercular lymphadenitis. A case of infiltrating ductal carcinoma of breast along with metastasis to axillary lymph node harboring primary tubercular granuloma in the same lymph node is being reported due to rarity.

Pulmonary lymphangitic carcinomatosis from squamous cell carcinoma of the cervix:A retrospective study with review of literature

Background: Pulmonary lymphangitic carcinomatosis (LC) secondary to cervical squamous cell carcinoma (SCC) is an uncommon cause of diffuse infiltrative lung disease. Its reported incidence is quiet low. Materials and Methods: Fifty cases of cervical carcinoma were studied from 2005 to 2014. There was only one case of squamous cell carcinoma cervix that developed pulmonary lymphangitic carcinomatosis subsequently. Clinical manifestations of LC such as dyspnea and non-productive cough can mimic with clinical picture of pneumonia, pneumonitis, pulmonary embolism, congestive heart failure, asthma, and sarcoidosis and thus can be a diagnostic dilemma for treating physician. A review of world literature was also done to examine all the reported cases of cervical carcinoma which presented as pulmonary lymphangitic carcinomatosis. A few cases have been reported so far. Concussion: Pulmonary lymphangitic carcinomatosis is a rare manifestation of metastatic Squamous Cell Carcinoma (SCC) of the cervix and is associated with a poor prognosis. Increased clinical alertness of such patterns of metastases in cervical cancer along with accurate pathological diagnosis is compulsory to guide proper therapy in these patients.

Right psoas muscle hydatid cyst causing giant hydronephrosis

Hydatid disease is a common disease in sheep and cattle raising countries and affects most of the body organs. But hydatid cyst of psoas muscle with pressure on ureter, and thus causing hydronephrosis is uncommon and only few cases have been reported so far in literature. Here, we present a rare case with right giant hydronephrosis as a result of ureter compression by psoas hydatid cyst.

Role of once-daily tadalafil in men with concomitant erectile dysfunction and symptomatic benign prostatic hyperplasia: A prospective randomized placebo-controlled study

Background: Majority of men over age 50 are sexually active and sex is an important part of overall quality of life. Both benign prostatic hyperplasia (BPH) with lower urinary tract symptoms-BPH (BPH-LUTS) and erectile dysfunction (ED) are often found in this age group simultaneously. Pathophysiological mechanisms for both these diseases are almost common. All males presenting with LUTS should be assessed for sexual dysfunction and viceversa. The aim of this study is to evaluate the effects of once-daily tadalafil on erectile function in men with ED and benign prostatic hypertrophy with LUTS. One drug for treatment of both diseases and better patients compliance are important issues for proper management. Materials and Methods: We did a study of 60 men. All patients were divided in two groups: 30 in group A who were given tadalafil 5 mg (megalis-5 mg of Macleods Pharmaceutical Company) and 30 patients in group B who were on placebo (plain sugar pills) for 12-week. This was a randomized, placebo-controlled study of once-daily tadalafil, which was carried out in men with BPH-LUTS in a rural Medical College of Northern India during June 2009 to November 2011. Results: International index of erectile function-erectile function (IIEF-EF) domain score improvements from baseline with 5 mg once-daily tadalafil were significantly greater throughout the study for tadalafil groups versus placebo (all P ≤ 0.001). International Prostate Symptom Score (IPSS) improvements from baseline to end point were significantly greater with 5 mg tadalafil dose versus placebo (all P Conclusion: There are encouraging results with tadalafil. It was used in 30 patients who were suffering with both ailments of BPH and LUTS simultaneously and is effective in both diseases.

Fibroadenoma in male breast: Case report and review

Fibroadenoma is very common in females, but rare in male breast. Gynecomastia and/or lobular differentiation have been known to coexist in both types of fibroepithelial lesion in men. We report a young adult having gynecomastia associated with fibroadenoma.

Spontaneous rupture of normal spleen: A diagnostic dilemma -

Spontaneous rupture of normal spleen poses a diagnostic dilemma for the treating clinician. Bacterial, viral, or parasitic infection, and malignancy of the spleen are predisposing factors for atraumatic spontaneous rupture. Severe and sudden pain in the left upper abdomen with radiation to the left shoulder is the most common presenting symptom. Ultrasonography (USG) and computed tomography (CT) are important diagnostic imaging modalities. Here we present the case of a 60-year-old female who presented with severe upper left abdominal pain just after a heavy meal. Emergency USG diagnosed the patient as a case of ruptured spleen and it was further confirmed with contrast enhanced computed tomography (CECT) and paracentesis of perisplenic collection. The patient was managed conservatively with success.

Pseudopancreatic cyst invasion into spleen: Case report and review

Splenic parenchymal complications in pancreatitis are uncommon and these vary from invasion of pseudopancreatic cysts into spleen to hemorrhages, infarctions and splenic rupture. Spleen is prone to complications in both acute and chronic pancreatitis due to the anatomical relation of splenic hilum with the tail of pancreas. As clinical picture is non-specific, a high index of suspicion is mandatory for early detection to avoid shattering complications. Conservative management is feasible in patients with small and resolving pseudocysts of pancreas as well as of spleen. Surgery is a treatment of choice for large non-resolving and complicated cyst. We present a 26-year-male with huge pseudopancreatic cyst, which invaded into spleen. Patient was operated by open technique. The case is being presented because of uncommon occurrence along with review of the literature regarding the pre-operative evaluation and various treatment options

Umbilical cutaneous nodule: A diagnostic dilemma

Umbilical cutaneous nodule can be due to infection, skin ailments and tumors. It can be primary or secondary in origin. When it is secondary due to metastasis from visceral malignancy then it is named as Sister Mary Joseph nodule. It can be a presenting symptom and sign of hidden malignancy and thus poses a diagnostic dilemma for physician. Our case presented to us with ulcerated umbilical nodule and subsequent ultrasound revealed accompanied urinary bladder malignancy. Mostly, these nodules are adenocarcinoma but our was an unusual case of transitional cell carcinoma.

Male breast carcinoma and review of the literature

Male breast cancer is a rare disease with unclear etiology. Its incidence is about 0.5-1%. Usually, these male patients present in advance stages due to non-specific clinical features and due to lack of awareness. Treatment scheduling is similar to female breast cancer.