Metal bezoars are uncommon foreign bodies (FB) in the gastrointestinal tract (GIT) and comprised of a wide variety of objects. A 17-year-old schizophrenic presented with abdominal pain and distension along with non-bilious vomiting for 2 weeks. Physical examination revealed dullness to percussion in the epigastrium. Plain radiographs revealed objects of metal density contained within a dilated stomach. Laparotomy was performed revealing metal objects in stomach.
Keywords: Metal bezoars, Psychiatric illness, Intestinal obstruction
How to Cite: Siddiqui Z. Metal bezoars causing upper gastrointestinal obstruction in a schizophrenic. APSP J Case Rep 2011; 2:14
Isolated hydatid cyst of kidney is very rare. Hydatid cyst of a duplex renal system is even more rare. We report a 13-year old girl with duplex system of right kidney with isolated hydatid cyst in upper moiety. Right nephrectomy was done to cure the condition.
Hydatid cyst; Echinococcosis; Duplex kidney
Fetus-in-fetu (FIF) is a rare and interesting entity characterized byincorporation of a malformed, monozygotic, diamnionic parasitic twin into the body of other normal twin partner. FIF is differentiated from teratoma by its embryological origin, its unusual location in the retroperitoneal space and the presence of vertebral column (axis) often with appropriate arrangement of other organs or limbs around this axis. We report two cases of FIF. Our first case presented at 18 months, while second at 9 year of age. FIF derived their blood supply directly from aorta in both the cases.Our FIF had distinct fetoid features, well developed axial skeleton with a complete spinal column, trunk, intestinal loops, four limbs, well developed fingers and toes, male external genitalia and abundant scalp hairs. Their weightwas 600 grams and 800 grams, respectively. Postoperative period was smooth and on long-term follow up no evidence of recurrence was seen in both the patients.
Fetus-in-fetu; Monozygotic diamnionic twinning; Teratoma
When vermiform appendix is found in the inguinal hernial sac, the condition is called Amyand’s hernia (AH). Appendix in hernial sac can be normal, inflamed or perforated. It can present as complicated hernia or acute scrotum. We present a case of Amyand’s hernia in a 25-day-old male who presented with an obstructed hernia having perforated appendix in the hernial sac.
Amyand's hernia; Appendix; Neonate
Segmental dilatation of the intestine in pediatric age group is a rare entity. Patients usually present with partial intestinal obstruction which may delay surgical decision. Our case was an 18-month-old girl, who presented with partial intestinal obstruction, provisionally diagnosed as a case of Hirschsprung’s disease. Diagnostic evaluation with contrast study gave a clue of small intestinal obstruction with a dilated segment.
Intestinal obstruction; Intestinal dilatation; Segmental dilatation
Extra-adrenal myelolipoma is a well-described entity in adult population, however it is extremely rare in paediatric age group. An unusual case of intra-peritoneal extra-adrenal myelolipoma in an 8-year-old child is presented here. The lesion was incidentally detected while evaluating the patient for spasmodic abdominal pain. Ultrasonography followed by CT scan and MRI imaging suggested the diagnosis which was confirmed by histopathology. A non-surgical approach was adopted and there was no progression of the lesion on follow-up imaging.
Extra-adrenal myelolipoma; Pain in abdomen; Child
Urinary bladder hemangiomas are rare, accounting for 0.6% of the urinary bladder tumors. Hemangioma is considered arising from embryonic stem cells of an angioblastic lineage. A 3-year old boy presented with hematuria. He had past operative history of excision of extensive lymphatic malformation involving retroperitoneum, pelvis and upper thigh. Computed tomography scan of abdomen and pelvis with contrast revealed a large soft tissue mass arising from the dome of the bladder. Partial cystectomy was done. Histopathology confirmed the mass as cavernous hemangioma of urinary bladder.
Hemangioma; Stem cells; Urinary bladder; Cystectomy
Laryngeal squamous cell carcinoma (SCC) is rare in children. Usually, laryngeal SCC in children has a poor prognosis. A 9-year-old boy is reported who was diagnosed as having poorly differentiated laryngeal squamous cell carcinoma with neck metastasis. This report aims to highlight the importance of a comprehensive knowledge of differential diagnosis, putting great attention to the onset of symptoms, early application of flexible laryngoscopy, and intensive studies on similar cases.
Squamous cell carcinoma; Larynx; Child
Fungal infection of the orbit is rare especially among immunocompetent patients. We present a 9-year–old girl with peri-orbital, eyelid and internal canthus swelling of the left eye. Clinical impression was suggestive of malignant tumor such as rhabdomyosarcoma or lymphoma. Histopathological examination of biopsied tissue revealed necrotizing granulomatous inflammation confirmed as fungal infection. Complete response to antifungal therapy was noted after four months.
Orbit; Malignancy; Fungal infection; Eye
Pyogenic granuloma is a benign vascular tumor that may affect the gastrointestinal tract. This report describes a rare case of sigmoid-colon pyogenic granuloma in a 4-month-old boy causing intussusception. Resection and anastomosis were curative. The mother had history of high dose of progesterone exposure during initial weeks of conception for vaginal bleeding. This may point towards etiology of the lesion.
Pyogenic granuloma; Progesterone; Pregnancy; Sigmoid tumor; Intussusception; Infant
Plexiform schwannoma is an unusual peripheral nerve sheath tumor. It can mimic plexiform neurofibroma. A five-year-old girl presented with painful swelling in left lumbar region. Radiologic investigations showed a multinodular tumor in the subcutaneous plane of lumbosacral region. A complete excision and histopathologic examination revealed a plexiform tumor composed of hypocellular and hypercellular areas with verocay bodies. The tumor cells showed strong positivity for S-100 protein, rendering a final diagnosis of plexiform schwannoma. The child has been free of recurrence in 12-month follow-up.
Schwannoma; Plexiform; Soft tissue; Lumbar
The diagnosis of extra-renal Wilms’ tumor is often missed at initial clinical presentation leading to a delay in initiating appropriate therapy. A 5-year-old girl presented with a 3-week history of a painless lump in the pelvis. Radiological investigations suggested an ovarian neoplasm. Tumor markers for ovarian malignancy were in normal range. Trucut biopsy also suggested the possibility of an ovarian neoplasm. The tumor was excised and final histopathology revealed it a Wilms’ tumor.
Wilms' tumor; Extra-renal; Pelvic mass
Right sided traumatic diaphragmatic rupture in children is uncommon and may escape early detection. Missed injuries are associated with high mortality and morbidity due to incarceration and strangulation of abdominal viscera. We report a 15-month-old child with blunt trauma chest and abdomen, who presented with bilateral hemothoraces and liver laceration seven days after the incident. Diagnosis of right diaphragmatic rupture was confirmed after another week. The surgical repair of diaphragmatic rupture was undertaken successfully.
Traumatic diaphragmatic rupture; Thoraco-abdominal trauma; Hemothorax
Presence of multiple calculi in ureterocele is rare in children. A 6-year-old boy presented with hematuria in whom on x-ray and ultrasound multiple calculi were noted in the urinary bladder. At surgery a ureterocele containing multiple calculi was found. The postoperative (99m) Tc-Dimercaptosuccinic acid scan (DMSA) reported normal renal function.
Ureterocele; Urolithiasis; Hematuria