Gastrointestinal stromal tumours (GIST) are rare tumours arising from mesenchyme of gastrointestinal tract and overexpress C-kit protein. Mainly seen in stomach and small bowel. Mesenteric GIST are rarely reported as they constitute less than 1% of total GIST. We here report such a rare case of GIST arising from mesentery of small bowel and presenting as acute abdomen. Good surgical clearance ensures good survival whereas incomplete resection results in a high incidence of recurrences with distant metastasis.
The common bile duct stenting has been a common endoscopic procedure practiced worldwide for the treatment of benign or malignant bile duct obstruction. Although the procedure has shown a very low morbidity, it is not free from complications. Stent migration has been a common late complication seen in 10% of cases presenting with various manifestations depending on the site of impaction. Here, we present a rare case of distal stent migration with impaction in the sacral foramina due to perforation through sigmoid diverticula with review of literature.
Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion. Preoperative diagnosis of this condition is rarely made.
Bone is an uncommon site of metastasis in patients with hepatocellular carcinoma (HCC), but an increase in the incidence of bone metastasis in HCC has been reported. We report a case of HCC presenting with metastasis to the humerus which, along with a review of literature, reinforces the idea that HCC should be considered in the differential diagnosis in patients presenting with metastasis to bone.
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