A rare presentation of idiopathic small bowel diaphragm disease - A case report.

INTRODUCTION: Diaphragm disease, typically associated with long-term non-steroidal anti-inflammatory drug (NSAID) use, manifests as diaphragm-like small bowel strictures, often resulting in bowel obstruction. CASE DESCRIPTION: A 75-year-old male presented with features of recurrent subacute intestinal obstruction, later diagnosed with multiple small bowel strictures via CT imaging. Surgical intervention, including resection and anastomosis, was performed to alleviate the obstruction. Histopathological examination of the resected specimen confirmed diaphragm disease, challenging its traditional association with NSAID use. DISCUSSION: Diaphragm disease, characterized by mucosal and submucosal diaphragm-like strictures, is typically attributed to NSAID usage. However, this case underscores the possibility of diaphragm disease in the absence of NSAID exposure. Pathological findings supported the presence of diaphragm-like strictures, despite the patient's denial of NSAID use. CONCLUSION: This case emphasizes the importance of considering diaphragm disease as a differential diagnosis in patients with intermittent bowel obstruction, even in the absence of NSAID history.

Neuroendocrine Carcinoma of Duodenum-an Uncommon Tumour at an Unusual Site.

Neuroendocrine carcinoma rarely occurs in the duodenum, and most cases of neuroendocrine carcinoma in the duodenum show rapid progression of the disease. Such cases have poor prognosis even with radical surgery with or without chemotherapy with low 5-year survival rate. We present a case of a 52-year-old man who presented with abdominal pain of 1-month duration and one episode of vomiting. Upper gastrointestinal endoscopy revealed polypoidal lesions in the first and second part of the duodenum. Whipple's procedure was performed. Diagnosis of poorly differentiated neuroendocrine carcinoma was made with extension to pancreas with peripancreatic lymph node metastases. The patient expired on post operative day 17 following cardiac arrest.

An Unusual Presentation of a Breast Lump.

Trichilemmal cyst also known as pilar cyst is a rare cyst arising from the external root sheath of the hair follicle. These cysts are observed on the scalp most commonly in females. The occurrence of trichilemmal cysts in areas other than the scalp is extremely rare. We report a case of an 80-year-old female with trichilemmal cyst of the breast which was first misdiagnosed as a sebaceous cyst because of the unusual disease site and our unfamiliarity with the disease. The patient underwent excision of cyst along with the cyst wall and histopathological diagnosis was trichilemmal cyst of the breast. A review of literature shows that trichilemmal cyst of the breast is an extremely rare condition which accounts for 0.1 % of the skin biopies reported till to date. We report a case of trichilemmal cyst of the breast with relevant discussion on trichilemmal cysts.