ABSTRACT
Background: Gastrointestinal tuberculosis is one of the commonest sites of extra pulmonary involvement. Most of the studies in the literature are on abdominal tuberculosis as a whole, which to a certain extent is responsible for confusion. Hence this study aims at a fresh look into Gastro intestinal tuberculosis as a separate entity. Aim and objectives: 1) to analyze the clinical features of Gastro Intestinal Tuberculosis. 2) To study the pathological features.3) to evaluate the role of surgery and to choose procedures in management of this disease. Methods: A total of 32 patients were included into this prospective study and divided into 4 groups based on the type of presentation namely, Obstruction – 18, Mass- 4, Perforation – 4 & Atypical – 6. They were subjected to thorough clinical evaluation and appropriately investigated. Results: Pain abdomen was the commonest symptom, 94% of the patients. 56% of the patients with obstruction. Commonest abdominal sign was abdominal distension, 66% of the patients. Ileocaecal region was the most common site, 50% of the patients. Ulcerative form was the most common gross pathology, 59% of the patients. Patients were subjected to either conservative management – 5 patients, Or Surgery , emergency in 17 patients and elective in 10 patients, depending on the Mode of presentation. Limited Ileocaecal resection was done in 9 patients and Right Hemicolectomy in 4 patients. Stricturoplasty was done in 8 patients. Complications were more common in emergency surgery. Conclusion: Patients commonly present with complications as intestinal obstruction. Ileocaecal region is the commonest site of disease .Conservative mode of management is preferable in patients not presenting with complications. Patients presenting with acute obstruction or perforation need emergency surgery.
ABSTRACT
Background: The retrograde dissection for doing parotidectomy is technically easier and surgeon can limit the dissection to 1 or 2 branches of facial nerve if required and hence avoids injury to the trunk or other branches of facial nerve, aiming at removal of only the parotid parenchymal area that bears the tumour. Objectives: To compare our results with those of similar studies in the recent literature. To compare nerve recovery rates when zygomatic branch is used as landmark with that of other techniques from literature. Methods: In this study 40 patients with pleomorphic adenoma of parotid gland underwent superficial parotidectomy at V.S.S Medical College hospital Burla and S.C.B medical college Cuttack in a 4 year period between 2013 and 2016. All 40 patients underwent retrograde superficial parotidectomy. We compared our results with results of similar studies in the recent literature. Results: Although all 40 patients experienced paresis immediately after surgery, 25% patients completely recovered and 75% patients had facial nerve weakness at the end of first week. Among this 60% patients were having H.B-2 weakness, 7.5% had H.B-3 weakness, 5% had H.B-4 and 2.5% had H.B-5 weakness. Any injury equal to or more than H.B-3 was considered serious. 15% patients were having serious injury. None of the patients had H.B-6 (severe) facial nerve weakness. Conclusion: Transient nerve weakness after retrograde parotidectomy is common but recovery will be faster than that of ante grade technique and within 6 months to 1 year all patients should recover nerve function completely.
ABSTRACT
Liposarcoma of spermatic cord is rare. As for every rare case preoperative diagnosis of liposarcoma of the spermatic cord is rarely possible for which high index of suspicion is needed. Usually one among the more common inguino-scrotal swellings like hernia, hydrocele, lipoma etc. will be the initial diagnosis and a definitive diagnosis will be made by histopathologist. As some of the histological varieties are relatively more aggressive an accurate histological sub typing of this malignancy carries importance and they must be treated with post-operative radiotherapy and adequate follow up. Here we present a case report of liposarcoma of spermatic cord followed by a discussion with literature review on management of the same