Evisceration of the intestine following blunt force impact: Highlighting management

Aims and objectives: Evisceration of the abdominal parts following traumatic injury with high velocity impact is a rare entity. We are reporting five cases of high velocity injury with different findings. Our objectives are to present the potential clinical impact of injury and requirement of early management

Materials and Methods: The present study was conducted in the Department of Surgery at Maharishi Markandeshwar Institute of Medical Sciences and Research, Maharishi Markandeshwar University, Mullana, from March 2010 to March 2013. A total of 150 cases were admitted, diagnosed with blunt and penetrating abdominal wall injury. We are presenting five cases diagnosed as eviscerated abdominal injury. Ultrasonography [USG] and computed tomography was done which helped us in their management

Results: A total of five cases were admitted with evisceration of the abdominal parts. One case presented with a rare finding as the stomach and intestine were lying outside and on surgery, multiple perforations of the small intestine were seen. Ultrasonography and computed tomography [CT] helped in the management of the patient

Conclusion: High velocity impact due to road side accidents can lead to severe abdominal organ injury or evisceration of the abdominal parts. It can cause morbidity and mortality, if not treated on time. USG and CT scans are the important diagnostic tools for diagnosing and preventing further complications. We came out with better prognosis as cases were operated on time. We treated the patients successfully without any mortality

Primary germ cell tumor of the mediastinum

Germ cell tumors compromise 15-20% of all anterior mediastinal masses; 50-60% of these are benign mediastinal teratoma. There may be mature, immature, and rarely with malignant component within the tumor mass. There are more chances of malignancy with immature type. We are reporting a case in 20-year young male diagnosed as giant benign cystic teratoma which was adherent to superior vena cava. The patient underwent surgical excision. In follow up of 2 years, the patient is not having any complaints

rare clinicopathological presentation of the breast carcinoma; implications and outcome

In females, the most common cancer is breast carcinoma in which squamous cell carcinoma [SCC] is a rare type of malignancy. Histologically, infiltrating ductal carcinoma is the most common type and lobular, mucinous, and medullary types have lower incidence. Pure SCC of the breast can originate from the skin, nipple, or epithelium of a deep-seated dermoid cyst or squamous metaplasia on chronic inflammation background. We are reporting a rare case of primary SCC of the breast in a 45-year-old female. In follow-up of 8 months, patient is doing well. We discussed our approach for treatment with review of the literature. We have treated this patient successfully with surgical and adjuvant chemotherapy

Primary abdominal tuberculosis presenting as peritonitis in a young child-managed surgically

Abdominal tuberculosis (TB) is the sixth commonest extra-pulmonary TB form after lymphatic, genitourinary, bone and joint, miliary and meningeal tuberculosis. We are presenting a rare case in a young female of age 7 year diagnosed as peritonitis and intestinal obstruction. Operative findings revealed dense fibrosis in interloops and perforation of the small bowel. She was put on antitubercular treatment for one year. Patient was discharged in satisfactory condition and is in follow up for 2 months.

Primary sternal tuberculous ulcer with dissemination to the bone marrow: a clinical rarity

Primary tubercular osteomyelitis of the sternum with dissemination to bone marrow is a rarely described entity even in countries where tuberculosis is endemic. Delayed presentations can be in the form of sinus formation, spontaneous fracture of the sternum, extrasternal spread, and sepsis. Diagnosis can be made by CT of the chest wall and Ziehl-Neelsen staining of aspirate from the lesion or by tissue biopsy. We present a case of tuberculous osteomyelitis of the sternum with sinus formation along with widespread involvement of bone marrow, which was successfully treated with antituberculous therapy. Sternal osteomyelitis is difficult to diagnose on chest radiography and ultrasonography, but we were able to make the probable diagnosis of sternal tuberculous osteomyelitis. CT showed erosion of part of the sternal bone. Diagnosis was confirmed on histopathology and by bone marrow trephine biopsy. During the follow-up period of 3 months, the patient showed a satisfactory response to treatment