Gastrointestinal mucormycosis is a relatively uncommon opportunistic fungal infection. The classical presentation is that of a rhino-cerebral infection. It is a life threatening, angio-invasive condition typically affecting immunocompromised individuals. Only a handful cases of intestinal mucormycosis have been reported to date. Here, we discuss our experience regarding an adult male patient who succumbed to bowel infarction and perforation with septic shock due to intestinal mucormycosis.
Endometriosis is the ectopic growth of viable endometrium outside the uterus, affecting approximately 7% women. It can occur in the absence of visible pelvic disease. Most common sites are gastrointestinal and urinary tract. Common sites of involvement are rectosigmoid (51%), appendix (15%), small bowel (14%), rectum (14%), cecum and colon (5%). Cyclical hematochezia is a definitive, but rare association of intestinal endometriosis. The diagnosis of colonic endometriosis is also difficult owing to the poor diagnostic yield of colonoscopy.
Primary lymphoma of the testis is an exceedingly rare disease. We present a case of a 65 years old gentleman who presented with a brief history of testicular pain. Imaging studies and serum tumour markers indicated a testicular lesion of suspicious aetiology. High inguinal orchidectomy was performed. Histopathology and immunohistochemistry revealed diffuse large B-cell lymphoma. Positron emission tomography (PET) scan revealed a metabolically active retroperitoneal lymph node in aortocaval location. Subsequently he underwent chemotherapy with Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) regimen plus intravenous Methotrexate, following which PET scan showed disappearance of the previously detected metabolically active lesion.
Background: Cholecystectomy is the most common major abdominal surgery of the biliary tract and the second most common abdominal surgery performed in recent times. Today, laparoscopic cholecystectomy is the treatment of choice for symptomatic gallstones. Ultrasound is a non-invasive, painless investigation that will show stones in the gallbladder with sensitivity and specificity of more than 90%. The study aims at evaluating the accuracy of certain ultrasound parameters to predict a difficult laparoscopic cholecystectomy. Methods: Prospective observational study. The selected patients were explained about the procedures of ultrasonography and laparoscopic cholecystectomy, and about the advantages and disadvantages of laparoscopic cholecystectomy, along with the possibility of conversion to open procedure. Informed consent was taken. General particulars of patients, relevant history & findings on physical examination, laboratory investigations, ultrasonographic features and operative findings were noted in the study proforma. For data analysis, categorical variables were expressed as frequencies and percentages. Sensitivity, specificity and p values were calculated. P value<0.05 was considered to be statistically significant.Results: Significant association was found between all the independent ultrasound parameters and a difficult laparoscopic cholecystectomy. Presence of contracted gall bladder was found to be significantly associated with conversion to open cholecystectomy.Conclusions: It was found that ultrasonography can be a useful tool in predicting a difficult laparoscopic cholecystectomy.
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