Polyorchidism is a rare congenital anomaly. Approximately 100 cases have been published to date. We report a case of triorchidism in a 20-year-old man who presented to us with inguinal hernia. There is more than 30% incidence of histological abnormalities in polyorchid testes and 4-7% present with malignancy. The management of polyorchidism is controversial. Some authors prefer conservative approach to increase the chances of spermatogenesis and others suggest excision to prevent malignancy. In our case, a biopsy of the testes was performed and was found to be normal. This patient was placed on follow-up with regular self examination, six monthly clinical examination and yearly scrotal sonogram.
Enterolithiasis, or presence of stone concretions in the gastrointestinal tract, is an important but relatively uncommon clinical condition. It is most commonly found in animals especially equines. In humans clinical presentation of this condition is varied and sometimes masquerading other intra abdominal pathologies. Clinically insignificant incidentally noted enteroliths may shift attention from primary non-enterolith related pathology of the patient that may be responsible for a current clinical presentation. Here we are reporting four cases of incidentally detected enterolithiasis at our hospital with review of literature.
Background: Thyroidectomy is one of the most commonly performed procedure for thyroid disorders. The mortality and mobidity of thyroidectomy was very high. Sterile surgical arenas, advent of anaesthesia, and improved surgical techniques have reduced it considerably. Patients must be appropriately counseled in the preoperative period regarding the potential complications. They must be well aware of the surgical risks they are to undertake. A thorough understanding of anatomy and with experience, the surgeon can minimise the risk associated with the procedure. Aim: Study the incidence of complications of thyroidectomy with special reference to recurrent laryngeal nerve injury. Methods: This is a hospital based prospective study, from 2008 to 2015.823 cases who underwent thyroidectomy for any indications at a tertiary care institution at north Malabar .Data collection: A detailed clinical evaluation was done. Intra operative documentation of surgical details was done. Post operatively the patients were monitored for any complications. Follow up serum TSH was monitored in second post op week, and then every month till six months. Results: The overall incidence of complications is 35.76%. Commonest complication is transient hypoparathyroidism(21.87%), followed by transient RLN injury (3.4%), permanent hyoparathyroidism (3.2%), flap edema (2.3%), EBSLN injury (2.06%), hematoma (1.45%), hypothyroidism (0.97%) and wound infection (0.73%). Conclusion: Meticulous dissection, absolute hemostasis, and a thorough knowledge of neck anatomy are the key in reducing the post thyroidectomy complications. Identification and preservation of the laryngeal nerves and parathyroids are mandatory. Incidences of other complications are on the decline.
Background: The identification and preservation of parathyroid glands (PT) with its intact blood supply is of utmost importance during thyroid surgery. To preserve the PT with intact blood supply, a medial to lateral dissection is advocated, with plane of dissection along the thyroid capsule. One of the earliest and feared complications of thyroidectomy is hypoparathyroidism (HPT). Aim was to study the incidence of temporary and permanent hypoparathyroidism during thyroidectomy.Methods: This was a hospital based prospective study, from 2008 to 2015. 472 cases who underwent thyroidectomy (182 near total and 290 total thyroidectomies) for any indications in general surgery department of a tertiary care centre were included.Results: The incidence of permanent and transient HPT after total thyroidectomy was 3.8 and 09%, where as it was 2.75 and 3.85% after near total thyroidectomy. The results of present study were comparable with other studies.Conclusions: Meticulous dissection, absolute hemostasis, and a thorough knowledge of neck anatomy are the key in reducing the post thyroidectomy complications. Transient or permanent hypo parathyroidism is due to inadvertent gland removal or injury to its vascular pedicle. Dissection close to the thyroid capsule and ligation of capsular branches of thyroid avoiding the main trunk of inferior thyroid artery holds the key.
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