Teratoid Wilms' tumor - a rare renal tumor

Teratoid Wilms' tumor is an extremely rare renal tumor. We report a case of unilateral teratoid Wilms' tumor in a 4-year-old girl. The patient was admitted with a right-sided abdominal mass. The mass was arising from the right kidney. Radical nephrectomy was done and the patient had an uneventful recovery. Histopathology report showed teratoid Wilms' tumor

Intestinal injury from blunt abdominal trauma: a study of 47 cases

To determine the cause, presentation, anatomical distribution, diagnostic method, management and outcome of intestinal injuries from blunt abdominal trauma. The study included 47 patients who underwent laparotomy for intestinal injuries from blunt abdominal trauma over a period of 4 years. A retrospective study was conducted and the patients were analyzed with respect to the cause, presentation, anatomical distribution, diagnostic methods, associated injuries, treatment and mortality. 47 patients with 62 major injuries to the bowel and mesentery due to blunt abdominal trauma were reviewed. The male to female ratio was 8.4:1 and the average age was 34.98 years. There were 44 injuries to the small intestine including 1 duodenal injury, 11 colonic injuries and 7 injuries to the mesentry. 26 patients were injured in road traffic accidents. Out of 29 patients with intestinal perforation, free peritoneal air was present on plain abdominal and chest radiography in 23 patients. 18 patients underwent laparotomy on the basis of clinical findings alone. The commonest injury was a perforation at the antimesentric border of the small bowel. Treatment consisted of simple closure of the perforation, resection and anastomosis and repair followed by protective colostomy for colonic perforations. 3 [6.38%] deaths were recorded, while 8 [17.02%] patients developed major complications. Although early recognition of intestinal injuries from blunt abdominal trauma is difficult, it is very important due to its tremendous infectious potential. Intestinal perforations are often associated with severe injuries which are probably be the determining factors in survival

Biliary ascariasis in the indian subcontinent: a study of 42 cases

History of ascariasis is known to stretch back many centuries. One quarter of the world's population is known to be infected by ascariasis. It is endemic in various parts of the Indian subcontinent and the gangetic plain of West Bengal is one of them. We aimed to study the various types of clinical presentations, complications and different diagnostic tools and to assess various options for the management of biliary ascariasis. Forty-two cases of hepatobiliary ascariasis were studied over a period of 3 years. All the patients were adults aged between 20 and 50 years and all but two were admitted with acute upper abdominal pain. In this study, biliary ascariasis was found to be more common in females, 73.8% [31 patients]. The most common presentation was upper abdominal pain in 95.2% of the patients [40 patients]. Complications observed were obstructive jaundice in 28.56% [12 patients], cholangitis in 16.7% [seven patients], acute pancreatitis in 2.4% [one patient] and hepatic abscess in 2.4% [one patient]. History of worm emesis was present in 38.1% [16 patients]. History of previous cholecystectomy was present in 16.7% [seven patients] and endoscopic sphincterotomy in 4.8% [two patients]. Ultrasound was the diagnostic tool of choice with 100% results. Conservative management was successful in 83.3% [35 patients]. During follow-up, worm reinvasion of the biliary system occurred in 7.1% [three patients]. In endemic countries, ascariasis should be suspected in patients with biliary disease, especially if a cholecystectomy or sphincterotomy has been performed in the past. Most of the patients respond to conservative management