Hydatid cyst of unusual sites, an experience at Chandka medical college Larkana

Hydatid cyst occurs throughout world but more in endemic areas where human beings live in close contact with cattle and dogs. Common organs affected by hydatid cyst are liver and lung but rarely occurs in other organs as well. To evaluate the unusual sites of hydatid cyst in human beings, this will help the clinicians in early diagnosis and management. Observational. The study was conducted in the Department of Pathology, Chandka Medical College Larkana from January 1995 to December 2009. Total of 191 patients, admitted in various hospitals of Larkana, and operated for hydatid cyst or incidental findings at hisptopatholgical examination were included. All the fixed biopsies were cut into representative tissue blocks, processed, stained for haematoxylin and eosin and examined under light microscope. Total of 191 cases of hydatid cyst were received in 15 years, out of which 119 [62.3%] cases occurred in liver with mean age 41.27 years +/- 16.27 SD, 44 [23%] in lung with mean age 44.04 +/- 15.81 SD and remaining 28 [14.7%] in other uncommon organs. The presence of hydatid cyst in uncommon sites in Larkana is 14.7%, hence possibility of hydatid cyst in almost every organ of the body should be suspected

Congenital soft tissue Ewing's sarcoma

A 15 days old female baby presented with a 6 x 7 cm reddish lump with irregular margins on her right scapular region, since birth. Histopathology and immunohistochemistry of excised tissue revealed it to be soft tissue Ewing's sarcoma. Postoperatively, she received only one dose of chemotherapy but could not survive and expired at the age of one month

Identification of recurrent laryngeal nerve during thyroidectomy decreases the risk of nerve injury

To determine the effect of Recurrent Laryngeal Nerve [RLN] exposure on the incidence of nerve injury, and compare the injury rate with that when nerve is not exposed during thyroid surgery. This prospective observational study was carried out in department of general surgery, at Liaquat University of Medical and Health Sciences, Jamshoro, from January 2005 to December 2006. A total of 120 patients were included, with 24 males and 96 females [male: female of 1: 4]. Mean age of our patients was 30.85 years [range 14-68 years]. The different surgical procedures, performed on thyroid gland included total thyroidectomy 23, near total thyroidectomy 58, subtotal thyroidectomy 28, and hemi-thyroidectomy 11. The RLN was exposed in 60 patients, in other group of 60 patients thyroidectomy was carried out without exposing RLN, and incidence of nerve injury was compared between two groups. RLN identification decreased the nerve injury incidence from 5% to 1.6%. When recurrent laryngeal nerve is not identified during thyroid surgery the chance to incur damage to RLN is statistically significant [Chi square at 1df 0.000] We believe that RLN identification during thyroidectomy would be the best approach to avoid nerve injury

Perforated ileal duplication cyst: a diagnostic dilemma

Alimentary tract duplications are rare congenital anomalies. We report a case of a 14-year-old boy, who presented with acute abdomen, with features favouring acute appendicitis. Laparotomy revealed perforated ileal duplication cyst. Resection of ileum along with cyst and anastomosis was undertaken, and proximal ileostomy performed. Postoperative recovery was uneventful and ileostomy was reversed successfully. Histopathology revealed the presence of gastric mucosa at the site of perforation

Obstructed Bochdaleck diaphragmatic hernia in a child girl

A five-year-old female child presented with intestinal obstruction. X-ray abdomen and chest showed multiple air-fluid levels in abdomen and a single gas shadow with air-fluid level in left hemithorax. Ultrasound confirmed the presence of gut loop in left side of chest. Laparotomy was carried out with repositioning of intestinal loops in abdominal cavity and closure of posterolateral diaphragmatic defect with non-absorbable suture. Patient recovery was uneventful. As soon as diagnosis of diaphragmatic hernia is made, surgical intervention should be made to prevent fatal complications

Umbilical perforation: a rare complication of entriculoperitoneal shunt

A female baby of one-and-a-half-year old presented with extrusion of ventriculoperitoneal [VP] shunt through umbilicus. On exploration, the urachal remnant was found perforated by VP shunt and the tube exteriorized through umbilicus. Child was managed successfully with excision of urachal remnant, removal of VP shunt, antibiotic treatment and re-insertion of shunt

Small bowel haemangioma: a rare cause of intestinal obstruction in infant

Haemangiomas of small bowel are rare benign tumors. They present diversely, with intestinal obstruction being rare. We describe a two years old female baby with intestinal obstruction. Exploration revealed a diffusely infiltrating haemangioma of middle one third of ileum. Resection of affected segment and end to end bowel anastomosis was made. Post- operative recovery was un- eventful. Histopathological report was consistent with capillary haemangioma of small intestine

Segmental defect of intestinal musculature: a rare cause of intestinal obstruction in children

A 3 years old female child was brought in emergency department with acute abdomen. Laparotomy disclosed multiple segmental dilatations in middle Third of ileum. Which was resectied and anastomosed. Post operative recovery was uneventful. Histopathological findings showed lack of smooth and longitudinal muscles in dilated segments of intestine with intact mucosa without any evidence of necrosis and inflammation

Persistent mullerian duct syndrome with transverse testicular ectopia

A case report of a 3 months old male child is presented, who had right inguinal hernia with left impalpable testis. During herniotomy we found both testes on right side [transverse testicular ectopia] with presence of mullerian duct structures