Retained gossypiboma is a rare and under-reported complication of surgery, which can present in a variety of ways. Thus, a very high index of suspicion is required by the clinician to clinch the diagnosis in a postoperative patient. A 45-year-old woman, who was otherwise asymptomatic, presented to the General Surgery outpatient department (OPD) with a contrast-enhanced CT suggestive of a retained intra-abdominal foreign body from previous surgery. An exploratory laparotomy was planned on elective basis. Intraoperatively, dense inter-bowel adhesions were found in the upper abdomen. After a meticulous adhesiolysis, an ileoileal fistula and an intraluminal surgical sponge were discovered. Resection and anastomosis of the involved ileal segment was done. An asymptomatic patient with a migrated intramural gossypiboma with an ileoileal fistula is an extremely rare occurrence. In these circumstances, it becomes almost impossible for the surgeon to clinch the diagnosis of a gossypiboma in an otherwise asymptomatic patient, without the aid of radiological investigations.
Hydatid disease is a prevalent parasitic infestation caused by the cestode
Echinococcus
granulosus
in predominantly rural areas of the Mediterranean region, South East Asia, Australia, and South America. This report discusses a unique case of a 32-year-old lady who presented to the Emergency Surgery Department with complaints of abdominal pain, distension, and constipation for five days. Radiological investigations showed air-fluid levels within a large cyst originating from the liver. Surgical exploration revealed a large hepatic hydatid cyst communicating with the transverse colon with the presence of multiple peritoneal hydatid cysts. Evacuation of the cyst contents, lavage, and excision of the rest of the hydatid cysts was done. Dense adhesions were present involving the liver, large bowel, and duodenum. Therefore, a terminal ileum diversion loop ileostomy was made. Ileostomy was reversed after checking the large bowel anatomy with a distal loopogram.
Background: There is paucity of data on the spectrum of breast diseases in India due to lack of reporting system. This study was conducted to understand the pattern of breast diseases in northwest India. It is by far the largest study to provide epidemiological data on breast disease spectrum in India.
Methods: Total of 8604 breast pathological reports were obtained from four major diagnostic centers in North West India. These included benign and malignant breast lesions.
Results: There were 5985 (69.56%) lesions in the benign group and 2619 (30.43%) lesions in malignant group. Women formed 92.73% (7978) of the study group. Among benign lesions, most common were discrete benign lumps 59.19% (3543) followed by fibrocystic changes 16.02% (959). The most common age group was ≤20 years for discrete benign lumps and gynecomastia whereas 31-40 years for fibrocystic changes. Among malignant lesions, the most common was infiltrating duct carcinoma (not otherwise specified) with 32.72% (857) followed by infiltrating duct carcinoma (moderately differentiated) 26.84% (703) with the most common age group of 41-50 years. Among breast lesions in men, male breast carcinoma formed 2.25% (59) of malignant breast lesions. Gynecomastia formed 0.65% (560) of all breast lesions.
Conclusions: Most common breast lesions were discrete breast lumps. Benign lesions are more common in early 20’s while malignant lesions are more common in the 5th decade. The study revealed a higher proportion of male breast carcinoma.
Cancers survivors with second tumour mass. The difficult thing in these situations is definitive diagnosis. One sentence which shapes the future of a patient-a steep see saw of definitive and palliative treatment. What saves the clinician in this scenario is the immunohistochemistry (IHC). It single handedly brightens the path and leads to conclusion. This case report demonstrated the same in breast cancer survivor.
Background: Gynecologic cancers form a huge burden of morbidity and mortality around the world. This study was undertaken to study the
pattern, histopathological types and relative frequencies of gynaecological malignancy cases reported at four major hospitals and pathology
centers in Jaipur region. Method: Retrospective review of records of gynecologic cancers obtained from four major pathology departments in
Jaipur region in which histopathological data of all female diagnosed with the genital tract malignancies for a ve year period were included in the
study. Results: Most common genital tract malignancy was cervical cancer (51.8%) followed by ovarian cancer (24.6%), uterine cancer (17.6%)
and vaginal cancer (3.96%). Mean ages for ovarian, uterine, endometrium, fallopian tube, vulva and cervical cancers were 42.79±15.84,
50.93±13.14, 61.21±7.61, 63.50±19.09, 56.05±17.89 and 51.29±11.95 years respectively. Conclusion & Recommendations: Cervix carcinoma
is the most common female genital tract malignancy followed by ovarian carcinoma and uterine cancer. Squamous type of cervical cancer was the
commonest type. Hospital facilities for screening and regular gynecological examinations and well-dened follow-up surveillance system can
change disease morbidity and mortality.
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