Giant splenic hemangioma in a 10-year-old boy treated with a spleen saving surgery.

Tumors of spleen are rare. The most common benign tumor of spleen is hemangioma. Most splenic hemangiomas (SH) tend to be discovered in mid-30s to mid-50s. SH are discovered incidentally in most of the cases as they are usually asymptomatic. Small asymptomatic SH can be managed with observation. The treatment options for large hemangiomas are embolization of the splenic arterial branch, splenectomy by laparotomy or laparoscopy. Partial splenectomy can be done if the lesion is small and located at the poles of the spleen. We present a rare case of splenic hemangioma in a 10-year-old boy who presented with a painless palpable mass in the left upper abdomen. On CT scan-A large well-defined cystic lesion with few thin enhancing septa within it is seen involving the spleen. Laparotomy was done followed by Partial splenectomy. The histopathology report was suggestive of Cavernous Hemangioma of spleen.

Oral teratoma.

For congenital teratomas, oropharyngeal cavity is one of the rarest sites (2% of all teratomas). They are rarely picked up by prenatal ultrasonography. Postnatally, newborns present with respiratory distress and at this point role of pediatricians is very crucial in establishing secure airway after which they need to be carefully evaluated and surgically managed. We present a female neonate with palatal teratoma which was treated successfully with surgery.

Isolated pancreatic tail injury: A rare presentation.

INTRODUCTION: Pancreatic injuries occur in up to 10% of all major blunt abdominal trauma events. Due to the retroperitoneal location of the pancreas, isolated pancreatic injury occurs in less than 5% of cases. PRESENTATION OF CASE: A 12 year old male child was brought to the emergency department with epigastric pain 12 days after alleged history of fall from bicycle. On admission, he had tenderness in the epigastrium. CT scan revealed a transection through the tail of the pancreas with no injury to any other organ. As there was no evidence of duct injury, he was treated conservatively. DISCUSSION: Morbidity and mortality rates for isolated pancreatic trauma are directly related to the presence of damage to the pancreatic duct. Helical multislice CT scan represents the best noninvasive diagnostic method for the detection of pancreatic injury. Hyperamylasemia should at least be considered as a sign of probable pancreatic injury in the setting of blunt abdominal trauma. CONCLUSION: Trauma to the pancreas is not common, and isolated pancreatic trauma is even less common. An isolated pancreatic injury may be missed or the diagnosis may be delayed because the initial symptoms and signs of pancreatic injury are subtle.

A comparative study of colostrum dressing versus conventional dressing in deep wounds.

INTRODUCTION: Deep wounds are extending deeper, across deep fascia into muscles or deeper structures. Understanding of nutrition, immunology, psychological issues, the physiology and the metabolic interactions require for optimal treatment of deep wounds. Wound dressing plays one of the important roles in wound healing. Newer type of wound dressings - Biological dressings like colostrum powder, collagen granules create the physiological interface between the wound surface and environment which is impermeable to bacteria. AIM: To compare the efficacy and safety of colostrum dressing and conventional dressing in deep wounds. MATERIALS AND METHODS: Data was collected from all patients with deep wounds (stage II-IV), admitted during the period of April 2013 to March 2014, considering the inclusion and exclusion criteria. RESULTS: Less number of dressings, short healing time, rapid healing and decrease pain seen in colostrum dressing group compared to conventional dressing group. CONCLUSION: Colostrum powder dressings are safe, promoter of wound healing, more patient compliance in terms of less pain, less number of dressing required. This treatment though found to be more expensive than conventional dressings; results indicate that colostrum powder dressings may be used as an adjunct in management of deep wound.

Multiple giant intra abdominal lipomas: A rare presentation.

INTRODUCTION: Solitary or multiple lipomas, composed of mature fat, represents by far the most common benign mesenchymal neoplasm occurring throughout the whole body, but they rarely originate in the intestinal mesentery. PRESENTATION OF CASE: A 60-year-old male presented with left sided abdominal distension and pain since 4 months, ultrasonography and computerized tomography abdomen was suggestive of multiple well-defined fat density lesions in the lower abdomen and pelvis. USG guided fine needle aspiration cytology was conclusive of a spindle cell lesion. Exploratory laparotomy was performed and multiple major fat tissue swellings were excised. Histopathology confirmed it to be spindle cell type of lipoma. DISCUSSION: Because of the silent nature the exact prevalence of lipomas is unknown. It can arise in any location in which fat is normally present, reported intra abdominal lipomas have been very rare. Clinical manifestations depend on the size and location of the growth. In most patients, symptoms are few or absent. USG and CT scan abdomen are used for the diagnosis. Complete surgical excision being the only treatment. CONCLUSION: Intra abdominal lipoma is a very rare entity, and many cases might be ignored due to their silent nature. They might or might not present with any symptoms. Complete surgical excision being the only treatment, with a very good prognosis.