Sarcomas of the genitourinary tract are extremely uncommon and accounts for only 1-2% of genito urinary malignancies. Sarcomas of the para testicular region, comprising tissues such as the epididymis, spermatic cord, inguinal canal and testicular tunica are also extremely rare. epidydimal leiomyosarcoma accounted only for 4 percentage of all para testicular tumours and only 16 cases are reported so far in literature and they account 4% of all Para testicular sarcomas. We are presenting a 61-year-old patient presented with a hard welling of 1 year duration, with no other associated symptoms. On ultrasound evaluation, it was reported as extra testicular lesion, possibly from epididymal tail. We performed a high inguinal orchidectomy. Histopathological examination revealed a para testicular leiomyosarcoma arising from epididymis. This case has discussed because of the rarity of the disease and possible cure if diagnosed early and treated aggressively.
Eventration of diaphragm is a rare entity and often is characterized by a developmental abnormality of the diaphragm musculature. The acute presentation of organoaxial volvulus with impending gangrene of stomach is a life-threatening event and requires emergency diagnosis and surgical intervention. A 45-year-old man visited our hospital for evaluation of upper abdominal discomfort. He had a feeling of fullness and discomfort in the upper abdomen for 3 years. These attacks lasted about 2 hours and were not usually severe but eventually presented with severe abdominal pain. The patient was explored as general condition was deteriorating. On exploration, it was found that there was huge organoaxial stomach volvulus with impending stomach gangrene. Emergency exploration, gastropexy, and plication of diaphragm was done. Early diagnosis and prompt intervention may avoid consequent gastric volvulus and complications,improving the overall outcome and mortality.
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