Auro cervical fistula

This is a case report of an auro-cervical fistula. It is a rare congenital anomaly, its understanding is important in dealing with sinus or chronic ulcer in the neck

Malignant lymphomatous rectal polyp

This is a case report of a sixty years old man with rectal bleeding. Originally the patient was diagnosed and treated as a case of haemorrhoids. Proper investigations showed that the bleeding was due to a malignant lymphomatous rectal polyp, which is the soft tissue expression of chronic lymphatic leukemia

Leiomyoblastoma of the stomach, case report

A 35 years old lady presented with anaemia and signs and symptoms of pyloric obstruction.Radiological and endoscopic investigations showed an ulcerating tumor. Laparatomy revealed an antral tumor. Bilroth [1] partial gastrectomy was performed. Histopathology revealed a leiomyoblastoma. A review of literature is also presented. A 35 years old lady was admitted to hospital on the 29th August, 1990, complaining of repeated vomiting of two weeks duration, preceded by two months history of epigastric pain and heaviness. She tolerated fluid diet, otherwise, she vomited ordinary meal. The epigastric pain was moderate in severity, constant, aggravated by meal and radiate to the back. She had also loss of appetite and loss of weight associated with generalized s Patient had no previous major relevant illness nor previous operation. She is married and has three children in good general health. No family history of gastric problem nor significant illness. On examination, she looked pale, emaciated, not jaundiced, not cyanosed, not dysponic, no lymphadenopathy and JVP was normal pulse: 80/mBl-pr 120/70, Temp: 37, 2 °C chest: scattered rhonchi with good air entry, Heart: normal double rhythm. Abdomen: soft, visible peristallic movement, tender epigastric mass which was firm, fixed, oval in shape with irregular margins, succession splash was positive. PR: revealed melena stool. Nervous system and extremitied were intact. Investigations on admission: Hb: 8.3 g/dl, pcv: 28.4%, R.B.C count: 3.76 106 W.B.C count 9.3 10 platelets: 241 10 E.S.R: 25 mm/hr. and a blood film shoewd hypochromic, microcytic with mild neutrophilia 76%, T.S.B: 0.4 mg/dl, SGPT: 8/dl, SCOT: 12/dl, serum alkaline phosphatase: 8 K.A/dl, Blood urea: 28 mg/dl, P.B.S 80 mg/dl, senun.Na 125 megjdl, serum.K: 3.6 meg./dl, Blood group: BRH+ve [for patients of crossed matched blood wee prepared]. Barium meal shows moderately enlarged stomach, filling defect in the prepyloric region, duodenal cap deforrnity. Endoscopy: everted showed no oesophagcal lesion, infiltrating growth in the antrum with everted edges and a centrally placed larg ulcerating lesion Biopsy was taken Histopathological study of endoscopic biopsy 'severe chronic gastritis with marked intestine metaplalsia, area of necrotic slough heavily infiltrated, but no evidence of malignancy". The patient was prepared for surgery operation was performed on the fifth day of admission after stabilization of the general condition of the patient laparatomy through an upper midline incision showed a firm fixed mass of 58 cm in the pyloric region of the stomach It has a smooth surface and adheres postenoly to the upper part of pancreatic head and neck. No lymph nodes were detected in the nearby area liver was free from metastasis. Bilroth 1 partial gastrectoimy was performed The resection involved the distal third of the stomach about 5 cm from the mass and whole pylorus and two centimeter of healthy first part of deodenum. Whole specimen was sent for histopatholgy. Gross: partial gastrectomy 14 10 cm. there is an alcerated tumor in the pyloric region m 66 cm which opened posterioly. Both ends of the resection are not invoiced by tumor. Histology: Malignant leiomyoblastomna of the stomach moderately differndated, infiltrating the full thickness of the gastric wall and reaching the serosa. Patient had Uneventful post- operative recovery, she was discharged on the 7th post- operative day; At two years follow up, patient was free of recurrence