Two patients (one male and one female) recently under went total thyroidectomies using a standard laparoscope at the department of surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Three ports (one mid line and two laterals) were employed and a harmonic scalpel was used for the dissection. To the best of our knowledge, there was no report of endoscopic total thyroidectomy from Bangladesh. Both patients were fed on the first post operative day. They were discharged between the 3rd and 4th post operative days. There was no hypocalcaemia but one patient developed temporary unilateral vocal cord palsy. Endoscopic thyroidectomy appears to be a technically feasible patient friendly modality of treatment for the selected cases of thyroid swelling in an experienced hand with excellent out come. Key Words: Endoscopic; laparoscopic; thyroid surgery; total thyroidectomy. DOI: 10.3329/jbcps.v26i1.4233 J Bangladesh Coll Phys Surg 2008; 26: 46-49
Abstract:A 19 years old married female presented with severe upper abdominal pain, repeated vomiting having history of swallowing a knife 7 months ago was admitted in Mordern Clinic and Diagnostic center, Joypurhat, Bangladesh. USG abdomen & X-ray (fig-1) abdomen were done when presence of a large foreign body (knife fig-3) in abdomen was made which latter on confirmed by Endoscopy of upper GIT (fig-2). Surprisingly the patient kept it in her abdomen for 7 months without any symptoms until the symptoms got worse and compelled her to seek medical help. The knife was removed by laparotomy, gastrotomy with uneventful recovery.
Splenic cysts are rarely detected, and clinically diagnosed commonly as spleenomegaly . Thenature of the cyst could not be diagnosed pre-operatively because of its’ anatomical location andonly be confirmed by the histopathological assessments. These cysts are found as a sequel ofsplenic infarct followed by the abscess formation. This is a very rare condition of a minor boy ofonly 10 years’ old who presented with a hugely enlarged spleen. The common investigation(s)did not prove that it was in the haematological conditions. Ultrasonogram (USG) investigationshows spleenomegaly due to the cystic lesion. CT scan of the abdomen showed large andwell defined cystic mass which was 13.4cmX7.9cmX15.3cm in size, multi-loculated, septated,sharply demarcated as such well delineated cyst. After necessary preparation like vaccination,blood grouping, cross matching and other fitness, laparotomy and total spleenectomy was doneas the cyst occupied most of the Splenic tissue. The post operative recovery was uneventful andthe final diagnosis was confirmed by histopatholgical examinations as epidermoid cyst of thespleen. The patient was followed up for two consecutive months and not a single complicationwas noticed. Bangladesh Journal of Medical Science Vol.20(1) 2021 p.177-180
Introduction Thyroid cysts are a common finding with the bulk of cases being benign and approximately only 5% being malignant. The majority of these cysts are managed conservatively in the absence of malignancy or compressive symptoms. Case presentation A middle-aged female patient presented with sudden onset anterior neck bruising but minimal specific symptomatology. On examination, the patient had bruising around the anterior neck and chest wall. CT and MRI scanning of the neck revealed the bruising was attributed to a ruptured thyroid cyst. On follow up, an ultrasound guided fine-needle aspirate revealed the histology to be inflammatory follicular thyroid tissue. D iscussion The case demonstrated a rare presentation, given the lack of trauma in her history nor the presence of more sinister conditions as demonstrated by the fine-needle aspirate. Normally hemorrhage of thyroid cysts are due to trauma or abnormal thyroid vasculature. There are a few previous case reports of similar presentations where ruptured thyroid cysts led to life-threatening airway compromise requiring intubation. Early recognition of these thyroid cyst complications is crucial. Conclusion Neck and anterior chest wall hematoma can be a sign of thyroid cyst rupture/hemorrhage. It is important to recognize this sign to prevent life-threatening airway compromise.
Primary hyperparathyroidism typically presents with skeletal and renal manifestations. In most (80-85%) cases, the cause is a single parathyroid adenoma. We present a case of 36-year-old lady of primary hyperparathyroidism presented with multiple fractures, nephrolithiasis, and nephrocalcinosis. All of the imaging techniques to localize the cause were negative. She underwent surgical neck exploration with detection of left parathyroid adenoma. Her post-operative period was uneventful with significant clinical and biochemical improvement. Keywords: Primary hyperparathyroidism, hyperparathyroidism, hypercalcemia, parathyroid imaging. DOI:10.3329/jom.v11i1.4281 J Medicine 2010: 11: 83-85
Introduction Choristomas are rare, benign, tumour-like growths with histologically normal morphology in an ectopic location. Choristomas can constitute of various tissue types including cartilage, bone and muscle. Chondroid tissue choristomas are referred to as cartilaginous choristomas. Case Presentation: A 69 year old gentleman presented with three weeks’ history of foreign body sensation in his throat. No other red flag symptoms were present. Fine nasal endoscopy was unremarkable. Magnetic resonance imaging (MRI) scan revealed mild bilateral prominence of the lingual tonsils. Patient underwent Panednoscopy and biopsy. This confirmed the presence of a cartilaginous choristoma in base of tongue. Discussion: This is a rare case of cartilaginous choristoma in base of tongue. It was investigated as per potential head and neck cancers. The majority of previous cases in the literature were managed using surgical resection of the lesion. In this particular case, the patient was discussed in multi-disciplinary team (MDT) meeting and managed conservatively due to the benign nature of the lesion and symptoms. Conclusions Cartilaginous choristomas are rare benign lesions, which can present similarly to malignant head and neck tumours. Their size and symptoms should be carefully considered before management. There is a role for conservative management in select cases.
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