Biomedical subjects
Publications and source records attributed to A Supe.
Hepatic hydatid cysts are common entities. We present an unusual case of a hepatic hydatid cyst which had ruptured into the subcutaneous tissues of the anterior abdominal wall. The possible causes, imaging features and recent literature are reviewed.
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Fetus in fetu occurs due to aberration of monozygotic twinning. A 16-year-old boy presented with abdominal pain and mass. Laparotomy revealed an anencephalic fetus within an encapsulated retroperitoneal mass. Pathologic examination confirmed rib formation with a primitive vertebral column with bone marrow. There was no other organogenesis.
A 48-year-old woman presented with symptoms of distal bowel obstruction. On examination she had abdominal distension and a lump in the left lumbar and iliac regions. X-ray revealed distension of the colon with dilated small bowel. Exploration revealed an enlarged ptotic spleen whose pedicle caused obstruction of the colon. There was concomitant partial volvulus of the splenic flexure around the splenic pedicle. The splenic vein was thrombosed. Splenectomy was performed.
We report four cases in whom post-traumatic or post-surgical biliary leak was detected using dynamic 99mtechnetium-iminodiacetic acid (IDA) cholescintigraphy. This technique is a non-invasive, safe, simple and sensitive method of documenting the presence, location and extent of biliary leaks. Further, it can be repeated and hence, is useful in evaluating the response to treatment. Surgery is indicated when a moderate extravasation of labeled bile suggests that the leak is the chief pathway of bile drainage, with relatively little bile entering the intestine.
A 35 year old man presented with massive lower gastrointestinal hemorrhage due to typhoid enteritis. After confirming the site of bleeding on a selective superior mesenteric angiogram, a vasopressin infusion was given at the rate of 0.2-0.4 units/min initially, followed by tapering doses over 36 hours. Cessation of bleeding was achieved immediately. The patients did not have any complications due to the procedure. Continuous vasopressin infusion is an effective method for the treatment of uncontrolled bleeding from typhoid enteritis.
Thirty cases of uncomplicated duodenal ulcer treated by anterior superficial lesser curvature seromyotomy and posterior truncal vagotomy were studied to evaluate the efficacy of this procedure. There was completeness of vagotomy in all the cases as shown by endoscopic Congo Red test. Twenty-seven cases were asymptomatic at 1-48 months (Mean 22.3) follow up, while 3 patients had controllable side effects such as dumping and diarrhoea. There was no mortality. This procedure is safe, effective and is a favourable alternative to highly selective vagotomy.
We report a patient with isolated splenic peliosis. She presented with massive splenomegaly; contrast-enhanced CT scan showed multiple hypodense, well-circumscribed shadows in the spleen. Splenectomy specimen showed multiple cysts with white fibrous walls ranging from 1-4 cm in size, containing gelatinous fluid. The patient is asymptomatic at 6 months' follow up.
Four patients underwent splenectomy for various clinical and radiological diagnoses and were found to have primary splenic lymphoma at surgery and histology. The diagnosis was classical Hodgkin's lymphoma, mixed cellularity type (one case); marginal zone B-cell non-Hodgkin's lymphoma (one case); and large B cell type non-Hodgkin's lymphoma (two cases). The first two patients had multiple nodules in the spleen measuring 0.1-0.5 cm while large cell lymphomas had large nodules (largest measuring 11 cm x 7 cm x 4 cm). The diagnoses were confirmed by immunohistochemical analysis. Mean follow up of these patients was 11 months; all patients received chemotherapy. One patient died, of causes not related to the disease process.
To study the effect of hyperbaric oxygen therapy in chronic diabetic foot lesions, a prospective controlled study was undertaken. Thirty diabetics with chronic foot lesions were randomised to study group (conventional management and 4 sessions of hyperbaric oxygen therapy) and control group (conventional management). The patients were assessed for average hospital stay, control of infection and wound healing. The control of infection spread was quicker. Positive cultures decreased from initial 19 to 3 in study group as against from 16 to 12 in the control group. (p < 0.05). This difference was most pronounced for Escherichia coli. Also, the need for major amputation was significantly less in the study group (n = 2) as against the control group (n = 7) (p < 0.05). The average hospital stay was not affected. We conclude that hyperbaric oxygen therapy can be safely used and is beneficial as an adjuvant therapy in chronic diabetic foot lesions.