Bile duct injury is a complication seen during cholecystectomy. Here, we highlight the occurrence of bile duct injury (BDI) during an open cholecystectomy who underwent hepaticojejunostomy (HJ), later presenting with a stricture of HJ. Percutaneous transhepatic biliary drainage (PTBD) was performed which led to the development of hepatic artery injury.
Facial puffiness as a consequence of superior vena cava syndrome (SVCS) can be a presentation from which the physician would have to conjecture a diagnosis of a mediastinal mass including lymphomas. Pediatric SVCS can rapidly progress and pose a greater challenge for airway protection as was in our case.
Mesenteric ischemia is a fatal vascular emergency of the small intestine which, if not diagnosed and treated in time, has a very high mortality rate. Presenting with nonspecific symptoms such as abdominal pain, nausea, constipation, tachycardia, and gastrointestinal bleeds, it can masquerade as other causes of acute abdomen, particularly bowel obstruction. Ideal laboratory tests and markers are still lacking due to complexity in bowel’s anatomy, physiology, blood supply, and drainage. We report 10 cases of mesenteric ischemia presented in our center with their demography, laboratory findings, approach to diagnosis, and treatment along with their outcomes at discharge. Out of the ten cases, six cases presented with signs and symptoms of acute bowel obstruction without passage of stool and one with passage of black stool. These seven patients underwent laparotomy, while the remaining three cases who either presented with milder symptoms or refused surgical interventions were managed conservatively. All patients were diagnosed with either acute or chronic mesenteric ischemia based on their operative and/or radiographic findings.
Extrapulmonary small cell carcinoma is a rare entity. Here, we report a case of small cell carcinoma of left ethmoid sinus, in a 32 years old female. She underwent left medial maxillectomy and excision of the mass via lateral rhinotomy approach with post operative chemoradiation.
Isolated vulvar edema is a rare complaint during pregnancy with a long list of differential diagnosis. Here, we describe a case of vulvar edema due to obstructed labor presenting to a rural primary healthcare center in Nepal.
Facial puffiness as a consequence of superior vena cava syndrome (SVCS),
can be a presentation from which the physician would have to conjecture
a diagnosis of a mediastinal mass including lymphomas. Pediatric SVCS
can rapidly progress and pose a greater challenge for airway protection
as was in our case.
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