Title: Spontaneous enterocutaneous fistula due to femoral hernia Author:Kumar, Awanish; Pahwa, Harvinder Singh; Pandey, Anand; Kumar, Suresh Subject:Cutaneous Fistula -- Etiology ; Hernia, Femoral -- Complications ; Intestinal Fistula -- Etiology Description:
Spontaneous enterocutaneous fistula is a rare entity. We encountered a case of spontaneous enterocutaneous fistula in the groin region due to femoral hernia. A 60-year-old man presented with spontaneous enterocutaneous fistula in the left groin region without signs of peritonitis. He was kept on conservative treatment, but on third postadmission day, he developed a swelling in his right groin, which became firm and irreducible with signs of intestinal obstruction. On exploratory laparotomy, bilateral femoral hernias were noted with formation of enterocutaneous fistula on the left side. Reduction and repair of hernia was performed. In view of the rarity of this complication, this case is being reported here.
Is part of:
BMJ case reports, 10 October 2012, Vol.2012
1757-790X (E-ISSN); 23060376 Version (PMID); 10.1136/bcr-2012-006939 (DOI)
Title: Unsuspected pheochromocytoma of the urinary bladder: reminder of an important clinical lesson Author:Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Rai, Anurag Subject:Headache -- Etiology ; Hematuria -- Etiology ; Hypertension -- Etiology ; Pheochromocytoma -- Diagnosis ; Urinary Bladder Neoplasms -- Diagnosis Description:
Bladder pheochromocytoma creates an extremely rare situation (0.06% of all bladder tumours). We came across a case with a complaint of intermittent episodes of haematuria. Cystoscopy revealed a solid, bluish submucosal growth with increased vascularity. Immediately after taking biopsy, the patient developed a sharp headache, chest heaviness and marked rise in blood pressure. The procedure was abandoned. Later, serum and urinary markers for pheochromocytoma were within normal limits. The histopathology report came out to be pheochromocytoma of the bladder. Later, partial cystectomy was carried out under general anaesthesia and histopathology confirmed the same. Thus, a surgeon/urologist should have a high index of suspicion for bladder pheochromocytoma while dealing with such cases if he comes across the characteristic symptoms of sharp headache, hypertension, palpitation, sweating, fainting or blurring of vision immediately after voiding or during the cystoscopic manipulation of tumour...
Is part of:
BMJ case reports, 08 August 2012, Vol.2012
1757-790X (E-ISSN); 22878991 Version (PMID); 10.1136/bcr-2012-006377 (DOI)
Cytodiagnosis of cutaneous metastases from gall bladder carcinoma on scalp
Kumar, Madhu, Goel, Madhu Mati, Pahwa, Harvinder Singh, Kumar, Awanish
Journal of cytology, October 2012, Vol.29(4), pp.277-8
[Peer Reviewed Journal]
Title: Trans-anal barotrauma by compressed air leading to sigmoid perforation due to a dangerous practical joke Author:Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit; Rai, Anurag Subject:Anal Canal ; Laparotomy ; Abdominal Pain -- Etiology ; Barotrauma -- Complications ; Colon, Sigmoid -- Injuries ; Compressed Air -- Adverse Effects ; Intestinal Perforation -- Diagnosis ; Peritonitis -- Etiology Description:
To present a case report of trans-anal barotrauma by high-pressure compressed air jet as a dangerous practical joke, that is, playful insufflation of high-pressure air jet through the anal orifice resulting in sigmoid perforation. The patient presented to emergency a day later with complaints of severe pain in the abdomen and abdominal distension following insufflation of high-pressure air jet through the anus. On examination, he had signs suggestive of perforation peritonitis and x-ray of the abdomen showed gas under the diaphragm. An emergency exploratory laparotomy was performed which revealed a 4-cm perforation in the sigmoid colon. Resection of the segment containing perforation along with the surrounding devitalised part was done with double-barrel colostomy. Reversal of colostomy was done after 8 weeks. Follow-up was uneventful.
Is part of:
BMJ case reports, 01 August 2012, Vol.2012
1757-790X (E-ISSN); 22854240 Version (PMID); 10.1136/bcr-2012-006548 (DOI)
Title: Laparoscopic cholecystectomy in situs inversus: points of technique Author:Pahwa, Harvinder Singh; Kumar, Awanish; Srivastava, Rohit Subject:Cholecystectomy, Laparoscopic -- Methods ; Gallstones -- Complications ; Situs Inversus -- Complications Description:
Laparoscopic cholecystectomy is one of the most common surgical procedures carried out in the world today. Rarely do patients present with undiagnosed situs inversus with cholecystitis. Symptomatic gallstones in patients with situs inversus pose diagnostic and therapeutic challenges. We had one such patient who presented with episodes of pain in the left upper abdomen. She was found to be suffering from situs inversus with gallstones in a left-sided gall bladder. After thorough preoperative evaluation, we performed laparoscopic cholecystectomy by modifying the operative technique adopting a mirror image of port placement on the left side using the left subcostal port (5 mm) for dissection with the right hand and the subxiphoid port for retraction of Hartmann's pouch by the left hand of the surgeon. We can summarise that laparoscopic cholecystectomy in patients of situs inversus can be safely performed by an experienced surgeon.
Is part of:
BMJ case reports, 05 June 2012, Vol.2012
1757-790X (E-ISSN); 22675150 Version (PMID); 10.1136/bcr-2012-006170 (DOI)