Background: Baker's cyst is usually degenerative in origin, infective etiology is rare and tubercular origin is exceptional. Tuberculosis (TB) of the musculoskeletal system is an uncommon infection caused by tuberculous bacilli and constitutes 1% - 5% of all forms of TB. About 30% of skeletal TB involves the joints, the knee being the 3rd most commonly affected after the spine and the hip. Knee tuberculosis commonly presents as synovitis or arthritis. We are presenting a case of a young female with clinico-radiological features suggestive of Baker's cyst. Complete excision of Baker's cyst and histopathology was done. Histopathological examination revealed multiple epitheloid granulomas pointing toward a tubercular etiology. Standard ATT protocol with rehabilitation was followed. The patient was asymptomatic at 1st year with complete resolution of symptoms and full range of motion. This case highlights the need to maintain high index of suspicion in cases hailing from endemic region with unusual intra-operative findings; also, the importance of routine histopathological examination.
Delta Med Col J. Jul 2020;8(2): 101-104
Appendicitis epiploica or epiploicae appendagitis, an uncommon cause of abdominal pain, is usually per-operatively diagnosed. The pedunculated fat-filled small pouches or appendices epiploicae on the serosal surface of the colon often become twisted and sometimes spontaneous thrombosis occurs. Such events lead to ischemia and inflammation at the base of the fatty lobes i.e., Appendicitis epiploicae. Symptoms include sharp localized pain in either iliac fossae and in some cases there is elevated temperature and white blood cell count. In a quarter of the patients there is rebound tenderness and very rarely nausea and vomiting, diarrhoea or constipation. This condition is more common among middle aged males and given its non-specific symptoms. It is usually confused with other more common conditions such as Meckel’s diverticulitis and appendicitis. Less than 8% of patients suspected of having appendicitis or diverticulitis are found to actually have appendicitis epiploicae. Here we report two extremely rare cases of appendicitis epiploica in Bangladesh.
Journal of Surgical Sciences (2019) Vol. 23(2): 95-97
Otolaryngologists frequently encounter nasal foreign bodies, particularly among children and mentally retarded patients. Many unusual foreign bodies in the nose have been reported like nuts, plastic toy parts, beads and even button batteries. Several symptoms may be present in the case of a nasal foreign body which includes nasal discharge, epistaxis, infection, halitosis, foul breath or body odour and chronic sinusitis. We present a case of 19 years old girl with left sided nasal blockage, foul smell from left nostril and mouth with occasional nasal bleeding for last 13 years. She was treated conservatively but was not improved. On anterior rhinoscopy some blackish material covered with exudates was revealed which was very foul smelling and bleeds on touch. After nasoendoscopy we suspected that it would be an old foreign body which had already formed rhinolith. The large foreign body was fixed with floor, lateral and medial wall (nasal septum) and was removed by 0˚nasoendoscope and also through oral cavity under general anaesthesia.
Delta Med Col J. Jan 2019 7(1): 49-52
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