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
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
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
Congenital lung malformations can result in significant morbidity and mortality in children. Pulmonary sequestration is an uncommon congenital malformation of the lung that can cause complications even in fetal life. We herein present a newborn with extra-lobar sequestration (ELS) that lead to hydrops fetalis necessitating fetal intervention.
Extra-lobar pulmonary sequestration; Fetal pleural effusion; Congenital lung malformations
Pancreatic pseudocysts in children are not uncommon. Non-resolving pseudocysts often require surgical intervention. Endoscopic cystogastrostomy is a minimally invasive procedure which is recommended for this condition. We report a large pancreatic pseudocyst in a 4-year old child, which developed following therapy with PEG-Asparaginase for acute lymphoblastic leukemia. It was managed with minimally invasive procedure.
Pancreatic pseudocyst; Paediatric patients; Endoscopic cystogastrostomy
Segmental dilatation of ileum (SDI) is a rare clinical entity and so is anterior thoracic meningomyelocele (AMC). There has been no reported association between these two clinical entities. We hereby report a very rare presentation of these two in a 4 year old boy who presented with swelling in the right lower abdomen. Preoperative diagnoses were partial cecal volvulus and duplication cyst. At operation, SDI along with AMC was found.
Segmental dilatation of ileum; Anterior meningomyelocele; Undescended testes
Actinomycosis is a rare chronic bacterial infectious disease in childhood. A 14-year-old boy admitted with cramping abdominal pain and vomiting. Physical examination revealed right lower quadrant tenderness. Appendectomy was performed. On the histological section, typical actinomycotic (sulfur) granules in the appendiceal lumen were observed.
Appendicitis; Actinomycosis; Diagnosis
Giant omphalocele is difficult to manage and is associated with a poor outcome. A male newborn presented to our hospital with a giant omphalocele. We performed a staged closure of giant omphalocele using synthetic mesh to construct a silo and then mesh abdominoplasty in the neonatal period that led to a successful outcome within a reasonable period of hospital stay.
Giant omphalocele; Staged closure; Silo; Synthetic mesh
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
Appendicular band syndrome is an exceedingly rare surgical emergency that may lead to intestinal obstruction and strangulation. We report a case of 2-year-old boy who presented with acute intestinal obstruction with a mass in right iliac fossa (RIF). At exploration, an inflamed appendix had entrapped a loop of terminal ileum leading to its strangulation and gangrene. The appendectomy and resection of gangrenous gut were done with formation of an ileostomy.
Appendicular Band; Knot; Appendicular Mass; Strangulation
Sternal cleft is a very rare congenital anomaly, which can occur as an isolated or associated with other anomalies. We report a patient with a mesh-repaired complete sternal cleft complicated by infection with a multi-resistant Pseudomonas aeruginosa. The patch was surgically removed.
Sternal cleft; Mesh; Infection
Pneumothorax, though rare, is a recognized cause of respiratory distress in the immediate newborn period. It may occur spontaneously or secondary to various underlying lung diseases. Here we share our experience of a neonate with spontaneous pneumothorax with mild to moderate respiratory distress, who recovered completely with conservative management with an oxygen-enriched atmosphere and no surgical intervention.
Intercostal drain; Newborn; Oxygen supplementation; Spontaneous pneumothorax
Clear cell sarcoma of kidney (CCSK) is an aggressive renal neoplasm. We report two boys aged three and half, and three years with CCSK, one of whom had a disease free survival of four years and eight months. These patients were managed with surgery, chemotherapy and radiotherapy. One of the patients discontinued treatment early and lost to follow up. Aggressive multimodality therapy is the keystone to improved outcome.
Clear cell sarcoma; Kidney; Wilm's tumor
Lipomas can occur almost anywhere in the body, but retroperitoneal lipomas are extremely rare. They are slowly growing benign tumors and can attain an enormous size due to silent course of the disease. Total excision of the mass is the treatment of choice and is curative for benign retroperitoneal lipomas. We treated an 11-month-old female patient with giant retroperitoneal lipomas by surgical excision. Histopathology confirmed it as fibrolipoma.
Retroperitoneal lipomas; Liposarcoma; Infant