functional ectopic vaginal anus: a rare clinical entity

A case of functional ectopic vaginal anus is presented in a 20 years old girl. Patient complained of passage of stool through her vagina. She was continent and had no complaint of constipation. Her examination revealed imperforated anus with functional ectopic vaginal anus. Her surgery was performed in two stages. In first stage, anoplasty was performed at midpoint between the vulval and anal opening. The posterior vaginal wall was repaired in two layers and protective loop colostomy was made. In the second stage, after a period of 3 months loop colostomy was closed. Patient's recovery was smooth, she is not constipated and continent with Wexner score of 3. She was advised pelvic floor rehabilitation exercises. She improved within a month with Wexner score of zero

Fibrolamellar hepatocellular carcinoma- a rare clinical variant

Fibrolamellar type is a rare variant of hepatocellular carcinoma [FLHCC]. A 20 year old boy presented with pain and mass in the epigastric region for the last six months. Early diagnosis and confinement of the lesion to a lobe made it possible to perform complete resection of tumour along with subtotal gastrectomy. Patient recovered well and was sent to oncologist for further treatment

study of typhoid bowel preformation in balochistan

A prospective study was carried out for two years in Surgical Unit II of Civil Hospital, Quetta on 57 patients with typhoid perforation. Of these 47 were males and 10 females. The peak incidence was in the second and third decade of life. Abdominal pain, fever, vomiting, constipation and loose motions were the major presenting symptoms. Abdominal distension, tenderness, rigidity, and absent gut sounds were the main signs observed. Wide differences were observed in haemoglobin, total leucocyte count, urea, creatinine and electrolytes. Specific diagnostic tools were Widal test and radiography. All patients underwent emergency surgical procedures like wedge resection, resection and end to end anastomosis, ileostomy and right hemicolectomy with an overall mortality of 33%. Major causes of mortality were shock, septicaemia, renal failure and postoperative respiratory tract infection