A case of bowel obstruction resulting from bael fruit (Aegle marmelos) in the rectum is described in an Indian Hindu elderly man. To our knowledge, this is probably the first reported case with such a presentation in available literature. Dilemma at unsuspecting clinical history and finding of clinical examination and imaging evaluation made the case more interesting and challenging to manage. The case also highlights the need for awareness, education about prevailing unregulated practice of traditional herbal medical therapy leading to disastrous consequences. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Variants of hepatic duct anomalies are widely discussed in the literature. Duplication producing a double and/or aberrant extrahepatic bile duct is one of the rarest congenital variants that have been sparingly reported. A 71-year-old female presented with right-sided abdominal pain. Computerized tomography demonstrated an enhancing soft tissue thickening in the gastric pylorus with extension into the left lobe of the liver and invasion of the left intrahepatic bile ducts and dilatation of the left intra- and extrahepatic biliary tract. Further examination led to a diagnosis of a double common bile duct with ectopic drainage into the gastric antrum. Recognition of this rare anomaly is of great importance because of the implications in respect of concomitant pathology, the potential short- and long-term sequelae and crucially for operative planning. Failing to appreciate the extent of anomalies may result in significant complications with the attendant morbidity. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.We report herein a 14-month-old boy with a left-sided peeping testis. At the age of 1 month, the left testis was palpated between the inguinal canal and the scrotum. When he was 6 months old, ultrasonography showed the left testis in the inguinal canal. At the age of 13 months, the left testis was not palpable. At the age of 14 months, he underwent surgery for a planned inguinal orchidopexy with a preoperative diagnosis of an undescended testis. When the inguinal canal was opened, a patent processus vaginalis was observed and the testis was found inside the abdominal cavity. The patent processus vaginalis was closed, a dartos pouch was created and the testis was guided into the pouch and fixed to its wall. We describe a case of a peeping testis moving from the inguinal position into the abdomen. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Angioleiomyomas are defined as benign dermal or subcutaneous tumours consisting of smooth muscle cells arranged around vascular channels. Head and neck angioleiomyomas are rarely encountered as they usually occur in the extremities. We report a case of a 71-year-old male, who presented with a 3-month history of a painless lateral neck lump. Ultrasound and computed tomography scans localised the suspicious hypervascular tumour to the right supraclavicular fossa between the two heads of sternocleidomastoid muscle. He subsequently underwent an excisional biopsy, where histological analysis determined that the lateral neck mass was a venous subtype angioleiomyoma. To the best of our knowledge, this is only the third reported case of an angioleiomyoma in the supraclavicular fossa. Although supraclavicular masses are typically synonymous with malignancy, this case report highlights that angioleiomyoma should be considered as a differential diagnosis when investigating patients with a lateral neck lump. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Bowel obstruction in pregnancy is a high risk situation for both the mother and baby. We present a case of a 30-week-pregnant woman who presented with abdominal pain and vomiting and was diagnosed with adhesive small bowel obstruction (SBO). Oral contrast media was successfully used as a treatment. The patient was discharged home and 10 weeks later delivered a healthy baby girl. We were unable to find any cases in the literature describing oral contrast media to treat adhesive SBO in pregnancy. From our experience and research, we consider oral contrast media as a method of treating adhesive SBO in pregnancy under the proviso that there are no signs that indicate urgent surgical intervention. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Giant inguinoscrotal hernia is typically defined as hernia extending below the midpoint of the inner thigh, in the standing position. These hernias can be a demanding surgical problem as replacing bowel contents into the abdomen that can cause a life-threatening increase in intra-abdominal pressures. Various techniques such as preoperative progressive pneumoperitoneum (PPP), debulking of abdominal contents with visceral resections with or without omentectomy and phrenectomy have been suggested. We report the case of a 65-year-old patient with giant bilateral inguinal hernia. We applied a novel two-stage combined approach consisting of PPP with simultaneous single shot injection of botulinum toxin Type A into the anterior abdominal wall, and a second stage laparotomy with hernia repair (Stoppa technique). This technique makes possible the successful treatment of giant inguinal hernias without the need for visceral resection. To our knowledge, this is the first presented case of this combined treatment modality. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Epidermoid inclusion cysts of the perineal region are a rare entity, which require appropriate diagnosis and management. https://www.selleckchem.com/ Here we describe the unusual case of a large protruding epidermoid inclusion cyst originating from the intersphincteric anal plane, which was mobilized and excised successfully. Essential investigations to ensure accurate diagnosis in addition to surgical technique to reduce recurrence and patient morbidity are described in this case report. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.
A case of bowel obstruction resulting from bael fruit (Aegle marmelos) in the rectum is described in an Indian Hindu elderly man. To our knowledge, this is probably the first reported case with such a presentation in available literature. Dilemma at unsuspecting clinical history and finding of clinical examination and imaging evaluation made the case more interesting and challenging to manage. The case also highlights the need for awareness, education about prevailing unregulated practice of traditional herbal medical therapy leading to disastrous consequences. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Variants of hepatic duct anomalies are widely discussed in the literature. Duplication producing a double and/or aberrant extrahepatic bile duct is one of the rarest congenital variants that have been sparingly reported. A 71-year-old female presented with right-sided abdominal pain. Computerized tomography demonstrated an enhancing soft tissue thickening in the gastric pylorus with extension into the left lobe of the liver and invasion of the left intrahepatic bile ducts and dilatation of the left intra- and extrahepatic biliary tract. Further examination led to a diagnosis of a double common bile duct with ectopic drainage into the gastric antrum. Recognition of this rare anomaly is of great importance because of the implications in respect of concomitant pathology, the potential short- and long-term sequelae and crucially for operative planning. Failing to appreciate the extent of anomalies may result in significant complications with the attendant morbidity. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.We report herein a 14-month-old boy with a left-sided peeping testis. At the age of 1 month, the left testis was palpated between the inguinal canal and the scrotum. When he was 6 months old, ultrasonography showed the left testis in the inguinal canal. At the age of 13 months, the left testis was not palpable. At the age of 14 months, he underwent surgery for a planned inguinal orchidopexy with a preoperative diagnosis of an undescended testis. When the inguinal canal was opened, a patent processus vaginalis was observed and the testis was found inside the abdominal cavity. The patent processus vaginalis was closed, a dartos pouch was created and the testis was guided into the pouch and fixed to its wall. We describe a case of a peeping testis moving from the inguinal position into the abdomen. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Angioleiomyomas are defined as benign dermal or subcutaneous tumours consisting of smooth muscle cells arranged around vascular channels. Head and neck angioleiomyomas are rarely encountered as they usually occur in the extremities. We report a case of a 71-year-old male, who presented with a 3-month history of a painless lateral neck lump. Ultrasound and computed tomography scans localised the suspicious hypervascular tumour to the right supraclavicular fossa between the two heads of sternocleidomastoid muscle. He subsequently underwent an excisional biopsy, where histological analysis determined that the lateral neck mass was a venous subtype angioleiomyoma. To the best of our knowledge, this is only the third reported case of an angioleiomyoma in the supraclavicular fossa. Although supraclavicular masses are typically synonymous with malignancy, this case report highlights that angioleiomyoma should be considered as a differential diagnosis when investigating patients with a lateral neck lump. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Bowel obstruction in pregnancy is a high risk situation for both the mother and baby. We present a case of a 30-week-pregnant woman who presented with abdominal pain and vomiting and was diagnosed with adhesive small bowel obstruction (SBO). Oral contrast media was successfully used as a treatment. The patient was discharged home and 10 weeks later delivered a healthy baby girl. We were unable to find any cases in the literature describing oral contrast media to treat adhesive SBO in pregnancy. From our experience and research, we consider oral contrast media as a method of treating adhesive SBO in pregnancy under the proviso that there are no signs that indicate urgent surgical intervention. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Giant inguinoscrotal hernia is typically defined as hernia extending below the midpoint of the inner thigh, in the standing position. These hernias can be a demanding surgical problem as replacing bowel contents into the abdomen that can cause a life-threatening increase in intra-abdominal pressures. Various techniques such as preoperative progressive pneumoperitoneum (PPP), debulking of abdominal contents with visceral resections with or without omentectomy and phrenectomy have been suggested. We report the case of a 65-year-old patient with giant bilateral inguinal hernia. We applied a novel two-stage combined approach consisting of PPP with simultaneous single shot injection of botulinum toxin Type A into the anterior abdominal wall, and a second stage laparotomy with hernia repair (Stoppa technique). This technique makes possible the successful treatment of giant inguinal hernias without the need for visceral resection. To our knowledge, this is the first presented case of this combined treatment modality. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.Epidermoid inclusion cysts of the perineal region are a rare entity, which require appropriate diagnosis and management. https://www.selleckchem.com/ Here we describe the unusual case of a large protruding epidermoid inclusion cyst originating from the intersphincteric anal plane, which was mobilized and excised successfully. Essential investigations to ensure accurate diagnosis in addition to surgical technique to reduce recurrence and patient morbidity are described in this case report. Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2020.
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