Primary lumbar hernia: a rarely encountered ventral hernia

Ventral hernia is a fascial defect located on the abdominal wall. Primary ventral hernias are named as umbilical, epigastric, spigelian and lumbar hernias. A lumbar hernia is a parietal wall defect that may occur anywhere in the lumbar region between the 12th rib and the iliac crest. A 47-year-old female, came with complaints of mass in left lower abdomen since 2 months. On clinical examination a defect of 8 × 8 cm was felt in the left lumbar region with positive cough impulse. CECT abdomen and pelvis was done to confirm lumbar hernia. Patient underwent mesh repair for the same. Lumbar and flank hernias are uncommon and are a challenge to treat for any general surgeon. Surgery is considered gold standard either an open mesh repair or laparoscopically.

Jejunal intussusception in an adult due to small intestine lipomatosis: a case report and review of literature.

Intussusception is rare in adults. Benign neoplasm are common causes for intussusception in adults, lipoma is the commonest. Lipomas are usually solitary but 5% are multiple. Lipomatosis of small bowel is rare condition and presenting, as intestinal obstruction is even rarer. A 55 year old male patient presented with pain abdomen, distention and constipation. CECT revealed intussusception due to multiple lipomas of jejunum causing jejunojejunal intussusception. On exploratory laparotomy bowel was gangrenous and hence a resection and anastomosis was done. On 12 months fallow up patient was normal. First described by Helmstrom in 1906. Fat deposition in intestine are classified as isolated lipoma, multiple lipomas, nodular lipomatosis and diffuse fatty infiltration of wall without projecting into lumen. Usually present as malena or intussusception, volvulus. Radiologically identified by “pseudo kidney sign” and “target sign”. Reduction should not be attempted in the signs of ischemia or malignancy. Lipomatosis should kept in mind as one of the cause for intussusception in adults and CECT is the best modality to ascertain the nature of lesion in most of the cases.

Papillary Cystic and Solid Tumour of Pancreas.

A 15-year old female presented with a progressively increasingly right hypochondrial mass since 3 months. CECT abdomen showed a large well-defined, heterogeneous lesion with specks of calcification and areas of cystic degeneration in the region of head of pancreas. Successful enucleation of the tumour from the head of pancreas was achieved. Histopathology confirmed solid cystic papillary epithelial cystadenoma of pancreas.Papillary cystic and solid tumours of pancreas are a rare, low-grade malignant tumour, typically found in young women. The etiology and cell of origin of this tumour are still not clear. It is important to differentiate this tumour from other pancreatic tumours, as this tumour is amenable to cure after complete surgical resection.