Liposarcoma of the Spermatic Cord: A Rare Entity

Primary malignant tumours of spermatic cord are rare. The liposarcoma of spermatic cord is a rare entity and only a few cases have been reported in the literature. We report a case of forty five-year-old male with huge left inguinoscrotal swelling. Fine needle aspiration cytology (FNAC) of swelling revealed the diagnosis of a liposarcoma. The patient was subjected to radical orchidectomy and wide excision. Histopathological examination (HPE) of the resected specimen reported a well-differentiated liposarcoma of the spermatic cord and confirmed the diagnosis

Retroperitoneal Bronchogenic Cyst Mimicking Hydatid Liver: A Case Report

Bronchogenic cysts frequently occur in the mediastinum. They may be rarely encountered in the abdomen and retroperitoneum. Bronchogenic cysts can in fact mimic hydatid cysts. We report a case of retroperitoneal bronchogenic cyst below the right hemidiaphragm mimicking a hydatid cyst of the liver in a 30-year-old female

Primary Pelvic Hydatid Cyst: A Case Report

This is a case report of a young man who presented to us as a case of hypogastric pain and frequency of micturation. General physical examination and radiological evaluation confirmed a multiloculated pelvic swelling. Patient was subjected to laparotomy which confirmed the diagnosis of a primary pelvic hydatid disease. Patient was put on chemotherapy after surgery and is doing well on follow up

Nontraumatic terminal ileal perforation

BACKGROUND: There is still confusion and controversy over the diagnosis and optimal surgical treatment of non traumatic terminal ileal perforation-a cause of obscure peritonitis. METHODS: This study was a prospective study aimed at evaluating the clinical profile, etiology and optimal surgical management of patients with nontraumatic terminal ileal perforation. RESULTS: There were 79 cases of nontraumatic terminal ileal perforation; the causes for perforation were enteric fever(62%), nonspecific inflammation(26%), obstruction(6%), tuberculosis(4%) and radiation enteritis (1%). Simple closure of the perforation (49%) and end to side ileotransverse anastomosis(42%) were the mainstay of the surgical management. CONCLUSION: Terminal ileal perforation should be suspected in all cases of peritonitis especially in developing countries and surgical treatment should be optimized taking various accounts like etiology, delay in surgery and operative findings into consideration to reduce the incidence of deadly complications like fecal fistula

Emergency Pancreaticoduodenectomy in Duodenal Paraganglioma: Case Report

Duodenal gangliocytic paraganglioma (DGP) is a rare tumor that characteristically occurs in the second part of duodenum. These appear as submucosal masses that protrude into the lumen of a duodenum. Gastrointestinal bleeding is the commonest manifestation of DGP. Metastatic spread to regional lymph nodes occurs rarely. Surgical resection is the treatment of choice for DGP. A case of a DGP is reported in young female who presented with a recurrent upper gastrointestinal bleeding. Upper gastrointestinal endoscopy (UGIE) documented a mass in the ampullary region with ulceration in its middle which was bleeding. Recurrent gastrointestinal bleeding necessitated an emergency pancreaticoduodenectomy. Histopathology of specimen documented gangliocytic paraganglioma

Transanal Total Mesorectal Excision for Rectal Cancer: Short and Midterm Results

Background: Colorectal cancer is the third most common cancer affecting men and women in most Western countries and is the leading cause of cancer-related deaths. The primary goal of surgery is complete removal of rectal cancer. Total mesorectal excision (TME) is the cornerstone of curative therapy for rectal adenocarcinoma. Transanal total mesorectal excision (TaTME) was introduced for mid and lower rectal cancer and is proposed to allow a precise mesorectal dissection through better visualization in the anatomically limited pelvis. We aimed to check the feasibility of TaTME in terms of the quality of TME, circumferential resection margin positivity, lymph node yield, operation time, mean blood loss, postoperative complications, conversion rate, and hospital stay.Methods: This was a cohort study from July 2018 to June 2020 to validate the efficacy of TaTME in our setup. It included biopsy-proven low and mid-rectal cancers (4-8 cm from the anal verge), T1 with node-positive disease or T2 and T3 with or without nodal disease. Statistical analysis was done by using SPSS software v24.Results: Out of the total patients studied (n=35), 30 (85.7%) were men, and the rest were women. 14 patients received neoadjuvant therapy (40%). Overall, 30 (85.7%) had complete mesorectal excision, 4 (11.5%) patients had near complete mesorectal excision, and one had poor excision. 25 (71.4%) had moderately differentiated adenocarcinoma, 7 (20%) had poorly differentiated adenocarcinoma, and 3 (8.6%) had well-differentiated adenocarcinoma. 34 patients (97.2%) had normal distal resection margins, and only one (2.8%) had positive distal resection margins. Only 2 (5.8%) patients had positive circumferential resection margins (CRM). The mean tumor distance from the anal verge was 4.97 cm. The mean lymph node yield was 7.86±1.73. The mean operation time was 2.095 ±0.461 hours. The mean blood loss was 48.57±11.92 ml. Most patients (71.4%) had no postoperative complications at one month. However, urinary tract infection (8.6%), surgical site infection (5.7%), acute kidney injury (2.9%), anastomotic leak (2.9%), incontinence (2.9%), stromal retraction (2.9%), and rectovaginal fistula (2.9%) were noted. After three months, most patients had no complications (88.6%), though subacute intestinal obstruction occurred in 2 (5.7%) and sexual dysfunction occurred in 2 patients (5.7%). The mean hospital stay was 11.09±2.08 days.Conclusion: The present study suggests TaTME might be a feasible method for oncologic resection of locally advanced mid- and distal-rectal cancer with curative intent. Intraoperative outcomes regarding conversion, surgical times, and intraoperative complications were very satisfactory. Short-term morbidity and oncologic outcomes were as good as in other laparoscopic TME series

Breast Gangrene

<p>Abstract</p> <p>Background</p> <p>Breast gangrene is rare in surgical practice. Gangrene of breast can be idiopathic or secondary to some causative factor. Antibiotics and debridement are used for management. Acute inflammatory infiltrate, severe necrosis of breast tissue, necrotizing arteritis, and venous thrombosis is observed on histopathology. The aim of was to study patients who had breast gangrene.</p> <p>Methods</p> <p>A prospective study of 10 patients who had breast gangrene over a period of 6 years were analyzed</p> <p>Results</p> <p>All the patients in the study group were female. Total of 10 patients were encountered who had breast gangrene. Six patients presented with breast gangrene on the right breast whereas four had on left breast. Out of 10 patients, three had breast abscess after teeth bite followed by gangrene, one had iatrogenic trauma by needle aspiration of erythematous area of breast under septic conditions. Four had history of application of belladonna on cutaneous breast abscess and had then gangrene. All were lactating female. Amongst the rest two were elderly, one of which was a diabetic who had gangrene of breast and had no application of belladonna. All except one had debridement under cover of broad spectrum antibiotics. Three patients had grafting to cover the raw area.</p> <p>Conclusion</p> <p>Breast gangrene occurs rarely. Etiology is variable and mutifactorial. Teeth bite while lactation and the iatrogenic trauma by needle aspiration of breast abscess under unsterlised conditions could be causative. Uncontrolled diabetes can be one more causative factor for the breast gangrene. Belladonna application as a topical agent could be inciting factor. Sometimes gangrene of breast can be idiopathic. Treatment is antibiotics and debridement.</p