Comparative study of prevalence of hypothyroidism in cirrhotic patients and normal individuals

Background: Alcoholic cirrhosis has worse prognosis than primary billiary cirrhosis and cirrhosis due to hepatitis. The risk of death due to all cause is increased 12-fold with cirrhosis. Alcoholic liver cirrhosis develops between 10-20% of individuals who drink heavily for a decade or more. Chronic hepatitis B is probably the most common cause of cirrhosis worldwide. The aim and objective of thisstudy was tocompare the prevalence of hypothyroidism between cirrhotic patients andnormal healthy individuals.Methods: The present study constitutes of 50 patients with cirrhosis of liver who met our inclusion criteria. They were selected from the patients admitted in medical wards and gastroenterology ward of RNT medical college, Udaipur.Results: Majority of patients were of serum albumin level class III about 67%. Increased TSH level as compare to level of serum albumin in cirrhotic patients. When serum albumin level decreases then percent of TSH level increases. Majority of patientswere from serum bilirubin class III (71%). Majority were from serum bilirubin class III about 70%. Conclusions: All cirrhotic patients should undergo for evaluation of endocrinological evaluation as these patients are associated with development of hypothyroidism. After diagnosis the treatment of endocrinological disorder especially hypothyroidism may increase survival.

Gas Under Right Hemidiaphragm: A Rare Presentation of Unruptured Liver Abscess

A perforated liver abscess mimics hollow viscus perforations. It may be accompanied by pneumoperitoneum and peritonitis. A hollow viscus perforation appears to be the most common cause of gas under diaphragm. In about 10% of the cases, it can be due to rare abdominal and extra-abdominal causes. One of the causes could be intra-abdominal infection caused by gas-forming organisms. We are reporting a rare case of pneumoperitoneum resulting from an unruptured liver abscess in an old male with no comorbidity. An unruptured pyogenic right lobe liver abscess in a 70-year-old male was accompanied by X-ray flat plate abdomen features suggestive of free gas under the right hemidiaphragm. Culture of the pus drained from liver abscess grew Klebsiella sensitive to piperacillin and tazobactam, and antibiotic treatment was administered.

Epithelioid inflammatory myofibroblastic sarcoma: the youngest case reported

Epithelioid inflammatory myofibroblastic sarcoma (EIMS) is a rare variant of the inflammatory myofibroblastic tumor. It has an aggressive clinical course and a high rate of recurrence. EIMS primarily affects children and young adults. Hereby, we report this entity in a 4-month-old infant who presented with an abdominal mass. Imaging studies revealed a large hypodense mesentery-based lesion involving the right half and mid-region of the abdomen. The mass with an attached segment of the small bowel was excised in toto. Grossly, a large encapsulated tumor was identified arising from the mesentery of the small bowel. The histological examination showed a tumor consisting of epithelioid to spindle cells loosely arranged in a myxoid background with numerous blood vessels and lymphoplasmacytic inflammatory infiltrate. On immunohistochemistry, the tumor cells showed positivity for ALK1 (nuclear), desmin, SMA, CD68, and focal positivity for CD30. A final diagnosis of EIMS of the small intestine was rendered. To the best of our knowledge, this case is the youngest reported case in literature.