Cases of split pons and double encephalocoeles in combination with other spinal anomalies are very rare, and to the best of author's knowledge, this is the first case report of these multiple anomalies in world literature.
Multiple neural tube defects are relatively rare. They account for less than 1% reported neural tube defects. Cases of limited dorsal myeloschisis (LDM) and diplomyelia (two cords in single sac without intervening bony or fibrous septae) with dorsal bony spur are also a rare event. Here, the authors report a rare case of neonate with thoracic LDM, diplomyelia with dorsal bony spur, sacral meningocoele with syringohydromyelia, and low-lying tethered cord. The child also had a ventricular septal defect (VSD) and bilateral rocker bottom feet. Various environmental factors and genetic mutations in transmembrane proteins have been studied in animal models explaining the origin of neural tube defects. To the best of author's knowledge, this is the first case of varied multiple neural tube defects with diplomyelia reported in world literature.
Transurethral resection of prostate (TURP) remains the gold standard surgical therapy for symptomatic benign prostatic enlargement, with reported International Prostate Symptom Score reduction of up to 70%. However, as many as 20% of patients can have significant complications including sexual dysfunction, perioperative bleeding requiring blood transfusion, and incontinence. Intractable hematuria from the prostate can be life-threatening, and its management remains a difficult clinical problem. Prostate artery embolization (PAE) is occasionally indicated in such patients when all other measures have failed. PAE has been used to treat benign prostatic hyperplasia; however, literature related to its use for bleeding following TURP remains limited. We report a case of an elderly male who presented with recurrent episodes of hematuria following TURP and was successfully treated by endovascular management.
Angiomyolipoma is a benign neoplasm of the kidney, and is the most common renal tumour associated with haemorrhage. Risk of bleeding increases with the size of the angiomyolipoma. We report a case of spontaneous bleeding from an upper polar renal angiomyolipoma mimicking a spontaneous adrenal bleed from a pheochromocytoma.
Trichobezoar is a very rare condition that is usually diagnosed at a late stage due to etiology of the condition. It is usually seen in young females who invariably have a psychiatric disorder like trichotillomania, trichophagia or depression. Here we report a case of trichobezoar which presented in the surgical out-patient department of our hospital.
Introduction: Renal replacement lipomatosis is a rare condition that occurs at the end of the spectrum of renal tissue replacement by fat. It is usually unilateral and occurs as a result of severe renal atrophy or destruction usually due to chronic calculus disease, chronic pyelonephritis and renal tuberculosis. The most commonly used diagnostic investigation remains CECT (contrast enhanced computed tomography) scan. Herein we report our series of patients with total renal replacement lipomatosistreated by nephrectomy. Materials & Methods: We retrospectively reviewed our hospital data for cases of RRL, presented and treated during the period Jan. 2006-Dec. 2015. The age, gender, presenting symptoms, clinical and laboratory findings were noted. The indications for surgery, postoperative outcomes and complications were similarly noted and analyzed. Results: Five patients (three females and two males) with a mean age of 48.4 ± 3.2 years presented with symptoms of pain. Computed tomography (CT) in these patients showed the affected kidney to be completely distorted and replaced by ill-defined fatty attenuating lesion. Open nephrectomy was done in all these patients. Histo-pathological report (HPR) revealed features of RRL with renal calculi. Conclusions: Renal replacement lipomatosis is an uncommon entity, and one should have a high index of suspicion when dealing with suspicious lesions similar to xanthogranulomatous pyelonephritis. Specific imaging, operative, and pathological differences may provide clues for the differential diagnosis.
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