Usually, in acute on chronic mesenteric ischaemia, the safest option is resection of infarcted bowel and exteriorisation of both ends. This allows inspection of both bowel ends for their viability. Anastomosis and restoration of continuity of bowel is delayed for 4-6 months is done in favour of healing. If the viability of bowel is unclear, second look laparotomy maybe needed, which may maximize intestinal salvage. In this case, we have done massive resection of small bowel with end-to-end anastomosis, which survived in spite of more than 50% thrombosis of two major vessels.
Testicular abscess with reactive hydrocele can be challenging to differentiate from malignancy or epididymo-orchitis. We present a case of 60 year male with complaint of swelling right scrotum for 6 months without any other symptoms and comorbidities. USG impression heterogeneous enlarged right testis suggestive of right testicular abscess with fluid collection in tunica vaginalis sac? Pyocele; proceeded with right high orchidectomy in suspicion of malignancy per-operatively cord was thickened. On examining the specimen gross hydrocele was found and on incising testis frank pus extruded, HPE-acute on chronic xanthogranulomatous epididymo-orchitis with foreign body giant cell reaction testis shows atrophic changes. Epididymo-orchitis or testicular abscess or pyocele usually presents with fever and pain scrotum. In our case, it was asymptomatic and chronic.
Impalement injury is one of the most gruesome forms of injury that can occur and death of the individual at the site of happenstance is almost certain due to trauma to major visceral and vascular structures and if at all he does manage to survive to be brought to an emergency room, he incurs the storm of uncontrolled haemorrhage, severe sepsis, metabolic and haemodynamic disturbances which pose a considerable threat for intra-operative and post-operative wellbeing. A timely, systematic, prudent multimodality can be of great assistance for patient survival as is presented in this case of impalement abdominal injury in the right iliac fossa region. KEYWORDSDouble Impalement, Transabdominal Trauma, Absent Visceral and Vascular Injury. HOW TO CITE THIS ARTICLE:Devadhason DB, Narendran TC, Kashyap AR, et al. Double transabdominal impalement injury without major vascular and visceral trauma: a sui generis.
BACKGROUNDIsolated testicular tuberculosis is a bizarre entity and it can present with atypical clinical features and its radiological signs remain elusive. Owing to its unusual occurrence and presentation, it can be confused with testicular tumour as has been presented in this case of a 54-year-old male patient who presented with absolutely no clinical symptoms other than a painless progressive left scrotal swelling.
BACKGROUNDCholesterolosis is an uncommon surgical condition characterized by abnormal and excessive deposition of cholesterol esters and triglycerides within the macrophages in gallbladder. Cholesterolosis is more common in females around 6 th decade and relatively rare in young individuals. Cholesterolosis can occur due to increased uptake of cholesterol from supersaturated bile. Cholesterolosis need not necessarily show high levels of serum cholesterol levels or presence of cholesterol stones. This indicates that it is possible for a patient to develop cholesterolosis even in absence of risk factors presenting as acute cholecystitis, which warrants further need to understand this rare form of an uncommon disease. We present a young female who had complaints of only right hypochondrial pain first episode, she was diagnosed as cholecystitis clinically. Her ultrasound report showed multiple gallbladder polyps. She underwent elective laparoscopic cholecystectomy and postoperative recovery was uneventful. Her histopathological report revealed cholesterolosis with chronic calcific cholecystitis. Case presented for its occurrence at early age with no risk factor and it needs to be differentiated from gallbladder malignancy and other disorder of gallbladder where management differs.
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