Rare case of paracaecal hernia with intussusception presenting as small bowel obstruction: case report

Primary internal hernias are very rare in adults. They are an unusual cause of small intestinal obstruction and lead to high morbidity and mortality if left untreated. Clinical presentation of internal hernia is highly nonspecific. Imaging has limited role in diagnosing the cause of acute intestinal obstruction. Internal hernias are usually detected at laparotomy. We report a case of a 61-year-old male who presented with acute intestinal obstruction which was attributed later to a very rare type of internal hernia on exploratory laparotomy. A loop of ileum was found to enter the retroperitoneum through a hernia gate which was located lateral to the caecum and ileo ileal intussusception was noted proximal to the herniated loop. The segment of intestine was resected and anastamosed then hernial defect was closed. Paracaecal hernias are the rare type of hernias in internal hernia. In our case, intussusception was noted proximal to the herniated ileal loop which is a very rare presentation. Intussusception was reported previously with paraduodenal type. One should always keep in mind while conducting emergency laparotomy, internal hernias can be a cause for intestinal obstruction.

Uncommon occurrence of pleomorphic adenoma in submandibular salivary gland in old age males: case series

Pleomorphic adenoma is the most common tumor of the benign salivary gland neoplasms, the submandibular gland is the second most common site of PA after the parotid gland. Authors present 3 series case of pleomorphic adenoma in submandibular salivary gland in institution which were admitted in institution within a month interval. Fine needle aspiration cytology (FNAC) of all 3 cases proved to be benign lesion arising from submandibular salivary gland. All 3 cases underwent excision in to and the postoperative period was uneventful. DT removed on 3rd POD and discharged in POD 10. Biopsy report proved to be pleomorphic adenoma in all cases. past studies showed pleomorphic adenoma most commonly occurs in the parotid gland and its occurrence in the submandibular salivary gland is uncommon. Also, age occurrence involves 30s-50s and is more common in females. But all this case was male and occurred in older age group. Early intervention with surgical excision in toto after definite confirmation with FNAC is the treatment of choice in preventing its malignant transformation.