from the midline extending 5 cm above and below the ABSTRACT Umbilical hernia is one of the commonest ventral hernias constituting ten percent of all hernias. It affects obese individuals and has a high recurrence rate if repaired by suture techniques. Incarceration of the colon in an umbilical hernia is quite rare. A case of colonic incarceration in an umbilical hernia is presented to highlight the diagnostic and technical challenges in managing such a hernia. Contrast enhanced computerized tomography is essential to ascertain the contents. Open surgery is the main stay of treatment especially in such rare cases. A combined tissue and mesh repair provides excellent results.
Acute pancreatitis is a severe disease with considerable morbidity and mortality. A variety of causes have been cited, the commonest being alcoholic and gallstone pancreatitis. However in a few cases, no distinct etiology can be identified. These are termed acute idiopathic pancreatitis. In such patients, microlithiasis and sphincter of Oddi dysfunction have been attributed to the development of acute pancreatitis. The pathophysiology and management of acute idiopathic pancreatitis due to microlithiasis and sphincter of Oddi dysfunction are discussed in the paper.
Association of an abscess with breast cancer is quite uncommon. Breast abscess encountered in a nonlactating woman should be considered as a malignancy until proven otherwise. A case of malignancy of the breast presenting as an abscess is presented along with a novel technique of mastectomy in such uncommon cases.
Testicular torsion is a serious scrotal emergency having a negative impact on fertility and in its most severe presentation, there is potential loss of the testicle if not diagnosed early. The condition needs to be diagnosed promptly with immediate surgical intervention. Intermittent testicular torsion (ITT) is a forerunner or a red flag for an impending frank testicular torsion. ITT is characterized by sudden onset of testicular pain which may resolve spontaneously before further investigation and treatment. Testicular torsion in adults is usually intravaginal in location and can be diagnosed clinically if the patient presents early with typical clinical signs. A case of ITT who presented with frank unilateral testicular torsion diagnosed clinically and surgically treated with salvage of the affected testes is presented to highlight the importance of history of ITT and typical clinical features. The anatomical aspects and pathophysiology of testicular torsion including the aftermath is discussed. ITT is a forerunner to frank testicular torsion. If offered prophylactic orchidopexy then a frank episode of testicular torsion with all its sequelae can be averted.
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