Hydatid cyst is a parasitic disease caused by tapeworm Echinococcus. It affects the liver and lung most commonly, but may rarely affect fallopian tube, broad ligament and other structures. One such peculiar case is where a 17 years old female presented with a rapidly growing cystic mass in lower abdomen, clinically suspicious of ovarian mass or mesentric cyst. Investigations failed to identify the nature. On laparotomy, excision of the mass was done. Suprisingly histopathological examination identified the lesion as hydatid cyst arising from the broad ligament. Patient responded well to surgical excision followed by albendazole administration. Female genital tract hydatidosis is a rare entity and in most cases the involvement is secondary. Primary hydatid disease of female genital tract is even very rarer and generates considerable diagnostic difficulty. examination, a cystic mass of 15×12 cm with smooth surface was palpable in the left lower abdomen with restricted mobility. The mass was non tender. There was no hepatosplenomegaly or ascitis.Routine blood and urine examination, chest X-ray revealed no abnormality. Serum CA 125, alfa foeto protein (AFP), carcino embryonic antigen (CEA) was within the normal limits. Ultrasonography (USG) of whole abdomen, suggested.
Isolated colonic injuries are unusual following blunt abdominal trauma, and often have a delayed presentation. Associated or isolated mesentric injuries of small bowel although more frequent than the former, tend to present late as well. Due to the atypical presentation, these injuries are often missed and lead to significant morbidity and mortality. We present a case of blunt abdominal trauma that presented 7 days after primary injury with fecal peritonitis leading to septic shock. Patient had a sigmoid perforation with associated mesentric tear, devascularising its corresponding bowel. Patient underwent exploratory laprotomy. A resection of perforated sigmoid colon with descending-sigmoid anastomosis along with resection of devascularised ileum and double barrel stoma were performed. Patient required intensive care in the early perioperative period. He recovered well and was discharged on post operative day 10.
Stoma creation is not a trivial undertaking. A good stoma can be life saving, but a stoma associated with complications can have a profound impact on the patient’s physical, psychological and social well being. Stomas are created for various indications, such as bowel obstruction, bowel perforation, treatment of anastomotic leak, diverticular disease, rectal injury, inflammatory bowel disease, infections, motility disorders, to name a few. We studied 100 patients with stomas over a period of 4 years to determine the early and late complications associated with them and establish an association with certain patient, pathology and surgical factors that bore an emphasis on the outcome.
BACKGROUND Type 2 diabetes mellitus (DM) and thyroid dysfunction have long term sequalae on cardiovascular health. The present study was conducted to assess the spectrum of abnormalities in patients of type 2 DM with thyroid disorders. METHODS This case-control study included 52 patients of type 2 DM with thyroid dysfunction (cases) and 52 patients of type 2 DM without thyroid dysfunction (controls). Laboratory investigations like thyroid profile, lipid profile and glycosylated haemoglobin were measured for all the patients. RESULTS Subclinical hypothyroidism was the most common thyroid abnormality. Mean body mass index (BMI) was found to be similar in the two patient groups. We observed a higher mean HbA1c levels in patients with thyroid dysfunction as compared to those without thyroid dysfunction (8.75% vs 7.16%, P value < 0.01). Among the lipid profile parameters, mean triglyceride levels and total cholesterol levels were also found to be significantly higher in patients with thyroid dysfunction as compared to those without thyroid dysfunction. Urine Protein Creatinine Ratio (UPCR) was also found to be significantly higher among patients with thyroid dysfunction. Furthermore, we observed mean BMI, HbA1c, mean total cholesterol and UPCR to be significantly higher among cases with hypothyroidism as compared to those with hyperthyroidism. Mean triglyceride levels were similar in the two patient groups. CONCLUSIONS We recommend that all type 2 DM patients should have a baseline evaluation of thyroid function. KEYWORDS Diabetes Mellitus, Dyslipidaemia, Hypothyroidism
Melanomas are primarily tumours of the skin, but rarely occur at other sites like retina and anal canal. Anorectal melanoma is an uncommon condition associated with a very poor prognosis. The patient usually presents with per rectal bleed or mass. These are often misdiagnosed on presentation. Diagnosis is confirmed by biopsy. Treatment is abdominoperineal resection or wide local excision if tumour free margins can be obtained. We present a case of a 60 years old female who presented to the outpatient department with per rectal mass and bleed since 4 to 5 months and was diagnosed with melanoma anal canal on biopsy. CT scan abdomen and pelvis was done. Patient underwent abdominoperineal resection as wide local excision with sphincter saving was not possible due to the location and extent of tumour as seen on CT scan. Patient had an uneventful recovery after the procedure.
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