Occult papillary carcinoma of thyroid presenting as cervical lymphadenopathy in a young male: case report

Papillary carcinoma of thyroid accounts for 80% of all thyroid malignancies. They tend to have a female preponderance and present in the 4th to 5th decade of life, as a slow growing midline mass. Cervical metastases are common, blood borne being rare. We present a case of a 29 years old who presented with cervical lymphadenopathy that was secondary to an occult papillary carcinoma of thyroid. Patient underwent total thyroidectomy with bilateral neck node dissection for the same.

Adult idiopathic hypertrophic pyloric stenosis: an infrequent cause of gastric outlet obstruction

Hypertrophic pyloric stenosis is a congenital disease, presenting within two weeks of birth. However adult idiopathic hypertrophic pyloric stenosis (AIHPS) presents in middle age, predominantly in males and usually without any antecedent cause. Secondary variant may be due to intra gastric causes or extra gastric post-operative adhesions. Patient presents with symptoms of gastric outlet obstruction. Diagnosis depends on clinical, radiological and endoscopic findings. Treatment is subtotal gastrectomy. Pyloroplasty and endoscopic dilatation may be tried in debilitated patients. We present a case of AIHPS presenting as gastric outlet obstruction in a 16 year old female, that was surgically managed with an antrectomy.

Purple urine bag syndrome: an unusual clinical presentation

Purple Urine Bag Syndrome (PUBS) is a rare presentation of urinary tract infection caused by certain bacteria that produce sulphatases and phosphatases that bring about metabolism of tryptophan, leading to production of pigments indigo and indirubin that together impart purple colour of urine. It is a benign condition, most often associated with long term urinary catheterization, renal diseases, chronic constipation and female gender. Commonly implicated organisms include Proteus mirabilis, Klebsiella pneumoniae, Providencia stuartii. Diagnosis is made on urinary culture. Treatment includes reassurance and antibiotics for UTI. We present a case of purple urinary bag syndrome in a female patient of carcinoma stomach presenting with gastric outlet obstruction.

Actinomycosis of male breast: a rare case report

Actinomyces is a commensal of gastrointestinal and genital tract that may cause subacute or chronic granulomatous inflammation. Primary actinomycosis of breast is an extremely rare disease. It may present as a mass or as discharging fistulae. It is often diagnosed after biopsy. It may mimic inflammatory carcinoma or mastitis. Treatment is with a prolonged course of antibiotic. Authors present a case of a 70-year-old male with a palpable breast lump, that was suspected to be malignant. Wide local excision was performed, histopathology confirmed the diagnosis of actinomycoses breast. Patient was given antibiotics post operatively.

Encysted hydrocele of the cord presenting as a groin swelling in an adult: a case report.

The hydrocele of the cord presents as a translucent swelling in the inguinal canal or scrotum, separately above the testis. It is more commonly seen in childhood and is rare in adults. It comprises of two varieties based on their communication with the peritoneal cavity. The encysted hydrocele of the cord does not communicate with the peritoneal cavity above or the tunica vaginalis below. The other variety known as the funicular hydrocele communicates with the peritoneal cavity above but does not communicate with the tunica vaginalis below. This case report presents the case of a 22 year old young male with an inguinal swelling. Clinical differential diagnoses were of inguinal lymphadenitis, encysted hydrocele of the cord and irreducible hernia. The aim of this report is to highlight the role of ultrasonogram in early diagnosis and surgical excision as mainstay of treatment.

Dengue presenting as gastric perforation: first case reported till date.

Gastrointestinal perforation is one of the common complications of various illness that is associated with high mortality and morbidity. The common sites of perforation in GIT (gastrointestinal tract) are stomach, duodenum, ileum and colon, but in dengue perforation in any of the above site is rare. Here we report an interesting case of gastric perforation that occurred in a young male patient post dengue fever. To our knowledge, this is the first such case of gastric perforation that occurred in our patient with dengue that we are reporting in the literature.

Sigmoid perforation post laser ablation of fistula in ano.

Laser ablation of fistula tract is a safe, effective, sphincter-preserving therapy that can be successfully performed by surgeons. Various studies and papers have been published advocating the use of lasers. However clinical experience and technical expertise is necessary for the use of lasers. Here we present a case of a 45 year old male presenting with acute abdomen following laser ablation of fistula in ano. The patients X-Ray abdomen showed free gas under the diaphragm and was explored. The exploration revealed a pyoperitoneum and a sigmoid perforation for which closure of perforation and a diverting colostomy was done. The patient was further operated for fistula excision and Seton suturing and is planned for colostomy closure.