Pseudoangiomatous stromal hyperplasia (PASH) is a benign breast entity described first by Vuitch et al., in 1986. PASH is a benign stromal lesion containing complex anastomosing channels lined by slender spindle cells. It can be mistaken with fibroadenoma on ultrasound examination and histologically with low-grade angiosarcoma and phyllodes tumor. Here, presented is a case report of a 30-year-old female who presented with huge palpable lump in left breast. Ultrasonography revealed the lesion as giant fibroadenoma and fine needle aspiration cytology report was suggestive of cystosarcoma phyllodes. Excision and reduction mammoplasty was done and histopathology report was suggestive of PASH.
Mesh inguinal hernioplasty is one of the most commonly performed surgery by general surgeons. One of the significant problems following hernia repair is recurrence. Prosthetic materials like polypropylene mesh has been used for inguinal hernia repair and has many advantages like low recurrence rates, less postoperative pain, decreased hospital stay and fewer complications. MATERIALS AND METHODS: In this prospective study, 432 open Lichenstein tension-free inguinal mesh hernioplasty was performed between June 2004 and May 2014. Various parameters regarding postoperative complications were studied. RESULTS: In 432 cases, inguinal hernia was indirect in 59.03% of cases (255 cases), direct in 36.57% (158 cases) and of the pantaloon (mixed) type in 4.39% (18 cases). Mean age of patients was 50.8 years (range 19-92). The median follow-up period was 2.1 years (range 1 month-5 years). Seroma and hematoma formation requiring drainage was observed in 9 and 11 patients, respectively, while transient testicular swelling occurred in 28 patients. We have not observed acute infection or abscess formation related to the presence of the foreign body (mesh). There was one recurrence of the hernia. Residual neuralgia was observed in 3 patients. CONCLUSION: Lichtenstein Tension-free mesh hernioplasty has many advantages of being simple, effective, low recurrence rate, early return to daily activities and good patient compliance and satisfaction. This technique is preferable for hernia repair in our setting.
Breast abscess is defined as an acute soft tissue infection which is characterized by localized pain, swelling and redness associated with a mass that may or may not be fluctuant. [1,2] Most breast abscesses develop as a complication of lactational mastitis. OBJECTIVES OF STUDYTo assess the feasibility and effectiveness of percutaneous needle aspiration of breast abscesses as a day care procedure. METHOD AND METHODOLOGYThis prospective study was conducted in patients with breast abscess attending the surgical OPD of a tertiary centre. A total of 100 patients with breast abscess giving consent to participate in study were included in the study. Percutaneous needle aspiration of pus under local anaesthesia was done with 18/16G needle. Empirical antibiotic therapy with amoxicillin+clavulanic acid was started. Aspirated pus was sent for bacteriological study. The antibiotics were changed in accordance to sensitivity report if needed. RESULTSThe mean age of the patients was 28.11 years and youngest patient was of 17 years married female. Most of the patients were lactating female in age group of 25-30 years followed by age group of 20-25 years. Topographically, most breast abscess were located in upper outer quadrant in 38 patients followed by 32 patients having abscess in central region. The mean volume of pus on ultrasonography was 57.32 mL and mean volume of pus on aspiration was 45.75 mL. The mean number of aspiration was 2.18. All of the aspirated pus was sent for culture and sensitivity. Among these, 12 samples of pus were sterile and 88 samples showed growth of organism. CONCLUSIONWith appreciable cure rate by repeated needle aspiration, this method can be preferred as treatment of breast abscess in selected patients.
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