“Giant breast lipoma” an unusual presentation: a rare case report.

Lipomas are most common benign tumour derived from adipose tissue. Lipoma breast is somewhat difficult to diagnose clinically because of fatty consistency of breast. So preoperative diagnostic work up like FNAC, USG, mammography are important to confirm the diagnosis. Lipoma breast measuring more than 10cm in diameter or weighining more than 1kg is called giant lipoma of breast are tumour infrequently observed. Because of rarity, size & location we presented a case report of giant breast lipoma including USG, mammographic FNAC and intraoperative finding with review of literature.

Giant cell tumor of right thumb: a rare case report.

Giant cell tumour of soft tissue (GCT-ST) resembling osseous giant cell tumour is a distinct and uncommon entity. Here we present a 58 year old woman with a 1 year history of swelling located on the base of right thumb diagnosed on histology as giant cell tumour of soft tissue. The surgeon should keep a differential diagnosis as GCT-ST for any swelling of the finger.

Study of comparison between skin sutures and skin staplers: 400 case studies.

Background: There are various ways the skin approximation whether be it sutures, staplers, glues, sterile tapes all of these have the same purpose of but the one which provides the best scar with least wound infection and consumes least time is the one that should be used. So here we have studied 400 patients over a period of 20 months comparing skin sutures with staplers and their outcome with respect to time consumed and percentage of complication. Methods: A prospective type of study was conducted from January 2013 to August 2014 at Dr. D Y Patil Hospital, Nerul for comparison between skin sutures and skin staplers in terms of effectiveness and complications in 400 patients who underwent various surgical procedures. The patients included in this study were randomly selected from those who underwent various surgical procedures which were either elective or emergency with various incisions. Results: The average time taken for skin closure by staplers is 1.84 min per 10 cm of wound & for skin sutures, it is 6.61 min per 10 cm of wound and complication rate for suturing is 30% & for staplers it is about 12%. Conclusion: Outcome of staplers is cosmetically superior to skin sutures with overall less complication as compared to skin sutures.

Study of diabetic ulcer with surgical complications of diabetes, their outcome and management modalities in 72 cases studied in Navi Mumbai.

Background: Diabetes and its long term major complications include septic, vascular (either micro vascular or macro vascular) and neuropathic lesions which affect the various anatomical regions of the body. Majority of admissions to surgical wards is due to these surgical complications of diabetes. So this is a study of these surgical complications of diabetes, their outcome and management modalities. Methods: This “Clinical study of surgical complications of diabetes” consists of a study of minimum of 50 or more cases admitted to surgical wards of Dr. D Y Patil hospital & research centre, from June 2010 to Oct 2012. A series of 72 cases were compiled for this study during this period. This study is to know more about the mode of presentation, clinical features and outcome of management of surgical complication of diabetes mellitus. Results: In present study, 30 cases were conservatively managed with meticulous debridement. 13 cases underwent incision & drainage and came for regular follow-up. 10 cases underwent disarticulation of toes. Four patients underwent below knee amputations whereas 8 patients underwent above knee amputations and 7 patients needed split skin grafting for covering of raw area. Conclusions: Patients on irregular medication usually from age group 51-60 majorly male who undergo trauma (lower limb >>upper limb) are prone to diabetic ulcer complication. Mortality in these patients is due to complications. Conservative management is the mainstay of this condition followed by I & D and finally amputation.

Study to evaluate the role of laparoscopy in chronic abdominal pain.

Background: Patients with chronic abdominal pain can undergo numerous diagnostic tests with little change in their pain. This study was under taken to assess the efficacy of performing diagnostic and therapeutic laparoscopy in patients with chronic abdominal pain for longer than 12 weeks. Methods: All patients undergoing laparoscopy for chronic abdominal pain were included in the study for a period of 1 year from Nov. 2011 to Oct. 2012. The patient’s demographic data, length of time with pain, diagnostic studies, intraoperative findings, interventions and follow-up were determined. Results: A total of 25 patients (19 women and 6 men) with an average age of 34.64 years underwent diagnostic laparoscopy for the evaluation and treatment of chronic abdominal pain. The average length of time with pain was 32.96 weeks (range 12-96). 2 cases required conversion to an open procedure and no complications occurred. Findings included abdominal Koch's in 9, appendicitis in 8, cholecystitis in 1, cirrhosis in 1; ovarian cyst in 1, bilateral fimbrial cyst in 1 and 4 patients had no obvious pathology. 82.6% of patients had pain relief at the time of follow up. Conclusion: Laparoscopy has a diagnostic and therapeutic role in patients with chronic pain abdomen.

A rare case of bilateral bifid ribs: a case report.

Bilateral bifid (bifurcation) rib is very rare malformation of thoracic wall. In this case, we observed variation involving right 6th and left 7th rib in 21 year female. The right 6th and 7th rib and its costal cartilage were bifurcated enclosing a small oval additional intercostal space.

Scrotal cystocele presenting with renal failure.

Extensive bladder herniation is rare. We hereby present a case of scrotal cystocele with chronic renal failure. It was managed successfully by initial nephrostomies and then definitive corrective surgery.

Case of foreign body as a broom handle in the rectum.

A 68 yrs old male patient with a foreign body (broom handle cover 11’inch) introduced as sexual perversion presented with lower abdominal pain, the management emphasis is a transanally retrieval and ruling out of rectal and colonic perforation under colonoscopy guidance under local anesthesia in pad.