Wandering spleen, also referred to as ‘ptotic spleen’, is a rare clinical condition characterized by splenic migration form its normal left hypochondrial position to any other abdominal or pelvic position. Among the multifactorial etiologies proposed, laxity of the spleen’s primary supporting ligaments is the most agreed-upon hypothesis. We present one rare case of wandering spleen in an 11-year-old girl who presented with recurrent abdominal pain with no localizing features. Her abdominal examination revealed an intra-abdominal left iliac fossa lump with restricted mobility, which was confirmed as a wandering spleen by abdominal sonography and contrast-enhanced computed tomography. Intraoperatively, an infarcted spleen was encountered with tortuous, elongated, torsional splenic pedicle and a single dense adhesive band with descending colon. Splenectomy was offered to the patient. Post-operatively, the patient is healthy and symptom free at one-year follow-up. The rare clinical diagnosis of this condition, particularly in the paediatric age-group, makes it an enigma for the surgical world.
Appendicitis is the most common surgical abdominal emergency in the developed world. Most of the surprises encountered during an appendectomy are usually due to the various positions of the appendix tip. Anatomical variations are an extremely rare phenomenon, with only a few case reports scattered among volumes of literature on the vermiform appendix. A new variation is described in which the appendix was intracecal and cause for surprise during surgery. A review of literature of rare anatomical variations of the appendix is also presented.
Cysticercosis is a condition caused by the encysted larval form of Taenia solium (pork tapeworm). The commonest system affected is the central nervous system. Symptomatic primary muscle involvement is a rare phenomenon. We present a case of a 19-year-old male who presented with a solitary cystic swelling in the right infraclavicular area. Magnetic resonance imaging revealed a cystic mass in the right pectoralis major muscle. The cyst was excised and submitted for histopathology. The diagnosis of cysticercosis was confirmed on histopathology of the excised cyst.
Periventricular cavernomas presenting with hydrocephalus and superficial siderosis are uncommon lesions. We report a rare case of one such periventricular cavernoma located in the peritrigonal location of the right lateral ventricle in a 26-year-old male who presented with progressive headache for 3 months. Magnetic resonance imaging showed heterogeneous lesion with “blooming” on susceptibility-weighted imaging and superficial siderosis due to repeated microhemorrhages. The lesion was resected and found histopathologically to be cavernoma. We present this uncommon lesion with a review of the literature.
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