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Title: Evisceration of the small bowel through a perforated and prolapsed sigmoid colon: an unusual presentation of rectal prolapse Author:Ahmad, Arshad; Kumar, Suresh; Sonkar, Abhinav Arun; Kumar, Sanjeev Subject:Colon, Sigmoid ; Intestine, Small ; Intestinal Perforation -- Complications ; Rectal Prolapse -- Complications ; Sigmoid Diseases -- Complications Description:
Spontaneous prolapse of the sigmoid colon and evisceration of the small bowel through a rupture in the rectosigmoid is a rare presentation. We report a case of a 60-year-old man presenting with massive small bowel evisceration through a perforation in a prolapsed sigmoid colon. The patient had a 2-year history of rectal prolapse. He was also incontinent for flatus and liquid stool. There was no other significant medical history. After reduction of the small intestine, a large perforation was seen in the prolapsed sigmoid colon. The sigmoid colon was identified by presence of appendices epiploicae and taeniae coli. After initial resuscitation, an emergency laparotomy was performed. The perforated sigmoid colon was resected and a Hartmann's colostomy was created. This resulted in complete recovery. Reversal of the Hartmann's colostomy was performed after 6 weeks.
Is part of:
BMJ case reports, 15 April 2016, Vol.2016, pp.10.1136/bcr-2016-214811
1757-790X (E-ISSN); 27084900 Version (PMID); 10.1136/bcr-2016-214811 (DOI)
Title: Morel-Lavallee seroma (post-traumatic pseudocyst) of back: a rarity with management conundrum Author:Singh, Anshuman; Anand, Akshay; Mittal, Sanchit; Sonkar, Abhinav Arun Subject:Accidents, Traffic ; Back Injuries -- Complications ; Seroma -- Etiology ; Soft Tissue Injuries -- Complications Description:
Morel-Lavallee seroma (MLS) or post-traumatic pseudocyst is a soft tissue seroma developing due to closed degloving injury by a shearing force that causes separation of subcutaneous fatty layer from the deeper muscular fascia resulting in collection of fluid in the created space. Presentation is usually fluctuant swelling following history of injury. More frequently described in orthopaedic literature, it occurs more commonly over gluteal and trochanteric regions, knee and flanks with occurrence over back, thorax being a rare entity. Despite mimicking several other similar presenting conditions, diagnosis of MLS can be made by meticulous history and physical examination with classical findings on ultrasonography, CT scan and MRI. Treatment modality may vary from conservative management to open surgical debridement of the wound with percutaneous aspiration and sclerodhesis forming useful adjuncts to conservative management.
Is part of:
BMJ case reports, 18 July 2016, Vol.2016
1757-790X (E-ISSN); 27435850 Version (PMID); 10.1136/bcr-2016-216122 (DOI)
Title: Primary disseminated extrahepatic abdominal hydatid cyst: a rare disease Author:Kushwaha, Jitendra Kumar; Sonkar, Abhinav Arun; Verma, Ajay Kumar; Pandey, Satendra Kumar Subject:Rare Diseases ; Abdominal Cavity -- Parasitology ; Echinococcosis -- Diagnosis ; Echinococcus Granulosus -- Isolation & Purification Description:
Hydatid disease (HD) is a parasitic disease, most frequently caused by Echinococcus granulosus or Echinococcus multilocularis and rarely by Echinococcus vogeli or Echinococcus oligarthus. Mostly, hydatid cyst is primarily in liver (75%) and lung (15%). Peritoneal HD (13%) is usually secondary. Dissemination of HD may occur following rupture of the hydatid cyst into the peritoneal cavity. Primary peritoneal hydatid cyst disease is a rare phenomenon. We present a case of primary disseminated abdominal HD presenting with the complaint of a pain in the epigastric region along with intermittent fever. Radiological evaluation and serological examination confirmed it as primary disseminated HD involving pancreas, a cyst anterior to the left lobe of the liver just below the peritoneum and the left kidney.
Is part of:
BMJ case reports, 30 May 2012, Vol.2012
1757-790X (E-ISSN); 22669859 Version (PMID); 10.1136/bcr.02.2012.5808 (DOI)
Title: Solid pseudopapillary tumour of pancreas Author:Singh, Ashish; Agarwal, Akshay Anand; Sonkar, Abhinav Arun; Kushwaha, Jitendra Kumar Subject:Pancreatic Neoplasms Description:
Solid pseudopapillary tumour of the pancreas is a rare neoplasm (1%). This tumour primarily affects young women and is usually treated with surgical resection with a relatively favourable prognosis. We report an 18-year-old female patient presenting with moderate grade abdominal pain for 5 weeks. Abdominal examination revealed a lump palpable in the right upper abdomen. Contrast-enhanced CT abdomen reported soft tissue lesion arising from uncinate process of pancreas causing adjacent compression. Endoscopic ultrasound-guided fine-needle aspiration biopsy yielded a cellular sample comprising pseudopapillary arrangement with bland appearing tumour cells consistent with benign neoplasm. And because of unusual location, Whipple procedure was performed. The patient was discharged under satisfactory conditions. Final histology confirmed the diagnosis. Solid pseudopapillary tumours of the pancreas are a rare but treatable pancreatic tumour. Complete surgical excision is the treatment of choice...
Is part of:
BMJ case reports, 17 April 2014, Vol.2014
1757-790X (E-ISSN); 24744063 Version (PMID); 10.1136/bcr-2013-200747 (DOI)
Title: Penile strangulation due to plastic bottle neck: a surgical emergency Author:Agarwal, Akshay Anand; Singh, Kul Ranjan; Kushwaha, Jitendra Kumar; Sonkar, Abhinav Arun Subject:Edema -- Etiology ; Foreign Bodies -- Complications ; Penile Diseases -- Etiology Description:
Use of various metallic and non-metallic constricting objects on the external male genitalia for increasing sexual performance or because of autoerotic intentions is an unusual practice that can potentially lead to penile strangulation with severe consequences. Depending on the type of constricting material, emergency removal of such an object is a challenge. We report a case of a 45-year-old man who presented to our hospital with a hard plastic bottle neck at the base of his penis that led to penile strangulation. The constricting agent was successfully removed. The patient had an uneventful recovery.
Is part of:
BMJ case reports, 26 November 2014, Vol.2014
1757-790X (E-ISSN); 25427935 Version (PMID); 10.1136/bcr-2014-207338 (DOI)
Title: Left-sided transmesocolic herniation of small bowel in an otherwise unaffected abdomen Author:Agarwal, Akshay Anand; Sonkar, Abhinav Arun; Singh, Kul Ranjan; Rai, Anurag Subject:Colon -- Pathology ; Hernia, Abdominal -- Diagnostic Imaging ; Intestinal Obstruction -- Diagnostic Imaging ; Intestine, Small -- Diagnostic Imaging ; Mesocolon -- Pathology Description:
Transmesocolic hernia is an uncommon type of internal hernia with incidence ranging from approximately 5-10%. To the best of our knowledge, this is the first reported case of a transmesocolic hernia through a gap within the descending mesocolon presenting clinically as an intestinal obstruction. A 75-year-old man was admitted with clinical features of intestinal obstruction. An abdominal X-ray showed multiple small bowel loops with air fluid levels. Contrast-enhanced CT of the abdomen revealed small bowel obstruction not only on the right, but also on the left side of the collapsed descending colon. Emergency surgery was performed. Strangulated bowel loops with gangrenous changes were resected and double-barrel ileostomy was carried out. The postoperative period was uneventful. Restoration of bowel was performed after 6 weeks. Preoperative diagnosis of bowel obstruction caused by a transmesocolic hernia remains difficult despite the currently available imaging techniques. Prompt surgery...
Is part of:
BMJ case reports, 15 May 2015, Vol.2015
1757-790X (E-ISSN); 25979958 Version (PMID); 10.1136/bcr-2014-207499 (DOI)
Title: Gestational hypertrophy of the breast Author:Agarwal, Akshay Anand; Sonkar, Abhinav Arun; Kushwaha, Jitendra Kumar; Singh, Suyash Subject:Breast -- Pathology Description:
A 22-year-old woman, parity 1, 24 weeks pregnant, presented with massive diffuse enlargement of both breasts, since, second trimester. Her earlier pregnancy was uneventful. Multiple ulcerations as a result of pressure necrosis were also present for the last 3–4 months (figure 1). Her breasts were normal on ultrasonography with no evidence of cancer. Fine-needle aspiration revealed hyperplasia of the mammary glands with foci of increased fat and connective tissue. The patient was managed conservatively with antibiotics and dressings and she improved. The ulcerations and the huge size were affecting the morbidity of the patient. The patient was advised to have an abortion followed by reduction mammoplasty but she refused and has not since returned for follow up.
Is part of:
BMJ case reports, 25 July 2013, Vol.2013
1757-790X (E-ISSN); 23887986 Version (PMID); 10.1136/bcr-2013-009911 (DOI)
Papillary Thyroid Cancer and Hashimoto’s Thyroiditis: An Association Less Understood