We report a 20-year-old boy presenting in OPD, after two and half month's history of assault and stab wound in left axilla with complaint of weakness and tingling in the left little and ring fingers. A knife blade retained in his chest wall was initially missed in emergency department. This case reminds us that, careful examination on all trauma patients is mandatory, especially those with penetrating injuries. Lack of apparent sign and symptoms, and a seemingly stable patient should not be an excuse for stopping further necessary assessment.
Here we present a 43-year-old man who was brought with a self-inflicted cut throat injury; 18 hours after the suicidal attempt. On examination a deep 12 cm cut at the level of the hyoid bone exposing the posterior pharyngeal wall was seen. Emergency surgery with primary repair, tracheostomy and feeding gastrostomy was done. Post-operative period was uneventful and patient recovered without any speech or swallowing abnormalities. Through this article we would like to stress that even in cases of frightening ghastly wounds, by maintaining simple surgical principles we can achieve good outcomes.
Lymphoepitheliomas are a type of undifferentiated carcinomas primarily described in the nasopharyngeal cavity. In the urinary tract, they are typically, but uncommonly seen in the urinary bladder, although occasional cases have been reported in the renal pelvis, ureter and urethra. Lymphoepithelioma-like carcinoma of the urinary bladder, fi rst reported by Zuckerberg, et al. in 1991, is uncommon with a reported incidence between 0.4 and 1.3% of all bladder carcinomas. We report the case of an 82 year old gentleman, who presented with a bladder mass, which was post surgical intervention, diagnosed to be a Lymphioepitelioma like carcinoma, with an aim to add to the available literature, and help re-visit and establish appropriate treatment strategies.
A 70 year old male who was under treatment for lymphoma, presented with a 2 day old history of not passing stool, flatus, associated with vomiting and abdominal distension. Patient was diagnosed as subacute intestinal obstruction and put on conservative management. However since his condition worsen exploratory laparotomy was performed. On laparotomy a midgut volvulus was detected and subsequently de-rotation of small gut was done. Through this paper we would like to stress out the difficulties in diagnosis and the challenges that we faced.
Fibroadenoma is a common abnormality which every surgeon has been exposed to, and there are several international guidelines regarding its management. However giant fibroadenomas, especially in the premenarche setting has been a rare occurrence, even for the experienced surgeon. Various reports have shown that we need to treat this condition more aggressively than the normal fibroadenoma, and issues of cosmesis in a developing breast along with the aim to preserve lactation functionality becomes an issue. Since these cases remain a single life time experience for most surgeons, there is a sparsity of treatment protocols even in literature. Through this paper we hope to shed some valuable insight to this rare disorder and help surgeon colleagues, when dealing with similar cases.
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