Publications by authors named "Raghunath Prabhu"

27 Publications

  • Page 1 of 1

Hard nodular lesions over the chest wall.

J Fam Pract 2016 Jan;65(1):53-5

Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

Thirteen years after undergoing a mastectomy for breast cancer, this patient developed lesions near the scar.
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January 2016

Primary Subcutaneous Hydatid Cyst of the Thigh: An Unusual Site With a Diagnostic Dilemma.

J Cutan Med Surg 2016 May 28;20(3):266-8. Epub 2015 Dec 28.

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India.

Background: Hydatid disease, or echinococcosis, affects several organs in the body and can pose a major diagnostic dilemma. Musculoskeletal involvement occurs only in 1% to 6% of patients. Clinically, the condition mimics a soft tissue tumor, and a preoperative diagnosis (blood and radiology) is necessary to avoid biopsy, management, and recurrence. In endemic areas, a differential diagnosis of hydatid disease should be considered for every soft cystic mass in any anatomic location.

Methods: The investigators report a rare case of primary subcutaneous hydatid cyst of the thigh, which was an incidental clinical and radiologic finding that led to a diagnostic dilemma in a 62-year-old woman with diabetes admitted for management of a nonhealing foot ulcer.

Results: The patient underwent successful complete surgical excision with pre- and postoperative antihelminthic pharmacotherapy, and at the end of 2-year follow-up, there has been no local recurrence or systemic disease.
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http://dx.doi.org/10.1177/1203475415623778DOI Listing
May 2016

Malignant peripheral nerve sheath tumour in a patient with a plexiform neurofibromatosis.

Indian Dermatol Online J 2015 May-Jun;6(3):225-6

Department of Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

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http://dx.doi.org/10.4103/2229-5178.156431DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4439761PMC
May 2015

Diffuse idiopathic calcinosis cutis in an adult: a rare case.

Eurasian J Med 2014 Jun;46(2):131-4

Department of Surgery, Manipal University Kasturba Medical College, Karnataka, India.

Idiopathic calcinosis cutis is a condition involving the deposition of calcium salts in the skin and subcutaneous tissue. The disease is a pathological condition of unknown origin and hence is idiopathic. The salt deposition is confined to areas such as the breast and vulva in females and scrotum and penis in males. Diffuse calcification with multiple complications in an adult is a rare entity. Only one such case has been reported in literature. A 59-year-old female presented to us with swelling of the right elbow, multiple calcific nodular lesions all over her fingers approximately 0.5x0.5 cm in size, and ulcers on her left great toe and right thumb with pain for the past two months. The ulcers were 2x2 cm and were observed to be healing without active discharge or signs of inflammation. The elbow was diffusely swollen and tender. Flexion deformity was present at the elbow. X-ray of hand and feet revealed calcinosis of the elbow and interphalangeal joints of the foot and hand. Blood tests revealed elevated C-reactive protein levels of 24 mg/dL, elevated Erythrocyte Sedimentation Rate (ESR) of 52 mm/hr., serum calcium of 9.7 mg/dL and a serum phosphorous of 5 mg/dL. Cultures from the foot ulcer were positive for methicillin-resistant staphylococcus aureus (MRSA). Workup for collagen vascular disease was negative. Histopathology confirmed calcinosis cutis. Treatment involved a conservative approach, including physiotherapy for the flexion deformity, antibiotics for MRSA, analgesics for pain relief and daily dressings. This case demonstrates that if a patient presents with multiple chalky nodular lesions with or without ulceration, pain and discharge involving areas of the upper limb or lower limb, diagnosis of idiopathic calcinosis cutis could be considered as a differential, despite its common confinement to the scrotum, breast, vulva and penis.
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http://dx.doi.org/10.5152/eajm.2014.29DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261459PMC
June 2014

Non-functioning Aortocaval Paraganglioma Masquerading as Celiac Lymphnodal Metastasis.

Eurasian J Med 2014 Feb;46(1):53-6

Department of Pathology, Kasturba Medical College, Manipal University, Manipal, India.

An extra-adrenal paraganglioma is a rare tumour derived from chromaffin cells of sympathetic ganglia. This report documents a rare case of a non-functional aortocaval paraganglioma in a 24-year-old woman with persistent abdominal pain. Computed tomography revealed a solid mass, measuring 2.5x3cms, localized between the celiac trunk and superior mesenteric artery in aortocaval location along with right ovarian cystic mass. A clinical diagnosis of malignant ovarian tumour with celiac nodal metastasis was made. Excision and pathological analysis of both revealed an aortocaval extra-adrenal paraganglioma and benign ovarian cyst. On serial follow-up the patient was in a good health, asymptomatic and without evidence of tumour recurrence. This case emphasizes the necessity of including extra-adrenal paraganglioma in the differential diagnosis and management of retroperitoneal tumours, despite its rarity.
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http://dx.doi.org/10.5152/eajm.2014.10DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261444PMC
February 2014

Plasmodium vivax infection impersonating Plasmodium falciparum malaria.

Eurasian J Med 2014 Feb;46(1):50-2

Department of General Surgery, Kasturba Medical College, Manipal, India.

A 73-year-old woman came to the casualty ward with symptoms of syncopal attacks, weakness, fever with chills and rigors. A provisional diagnosis of Plasmodium vivax malaria was made after the blood investigations. She had deranged renal function tests, altered sensorium and low platelet count. Repeated tests for P. falciparum (Card test) were negative. Glucose-6-Phosphate dehydrogenise (G6PD) levels were within normal limits. Treatment for P. vivax was started with intravenous quinine initially followed by oral quinine for a period of seven days and patient responded to the treatment and was discharged within 2 weeks of admission. Most of the cases of P. vivax present with typical and predictable features, although atypical cases with characteristics of P. falciparum can occur, especially in the elderly.
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http://dx.doi.org/10.5152/eajm.2014.09DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261441PMC
February 2014

Adenocarcinoma of the duodenojejunal flexure presenting as a stricturous lesion.

BMJ Case Rep 2014 May 19;2014. Epub 2014 May 19.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 50-year-old woman was referred with a colicky upper abdominal pain of 3 months duration. She experienced an increase in pain 2 weeks prior to presentation. This was associated with bilious vomiting about 5-6 times/day with no change in bowel habits. She had no history of any abdominal pathology. A review of systems showed she had a weight loss of 20 kg over a period of 4 months with recent onset of loss of appetite. Physical examination revealed a soft distended upper abdomen with non-radiating pain in the epigastrium. CT of the abdomen showed a heterogeneously enhancing stricturous growth in the proximal part of the jejunum with gross dilation of the stomach and duodenum. She underwent resection and anastomosis of the proximal jejunum. Histopathology revealed the lesion to be an adenocarcinoma.
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http://dx.doi.org/10.1136/bcr-2013-200546DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4039815PMC
May 2014

Be Careful with an IV Line.

J Clin Diagn Res 2014 Mar 15;8(3):166-7. Epub 2014 Mar 15.

Intern, Department of Surgery, Kasturba Medical College, Manipal University , Manipal, Karnataka, India .

Obtaining an intravenous (IV) access is a simple procedure which can be done in almost any hospital setting. One of the most dreaded complications of this procedure is an inadvertent intra-arterial cannulation. This can result in an accidental injection of medications intra-arterially, which can potentially lead to life altering consequences. In the hope that these types of events can be prevented, we are presenting a case of a 57-year-old male who underwent bougie dilatation for an oesophageal stricture and was accidentally given medication for pain management intra-arterially through an improperly placed IV line, which resulted in ischaemia, gangrene and subsequent loss of the hand. Those who try to obtain an IV access should always be on the lookout for possible clues that can prevent an inadvertent IA injection, especially if cannulation is in an area where an artery is in close proximity to a vein; these clues include but are not limited to the following: a bright-red flash of blood in the cannula, pulsatile movement of blood in the IV line, and intense pain or burning at the site of injection. These signs, as well as educating the patient on early symptoms of ischaemia, may allow early action to be taken, to prevent irreparable damage. We always have to be careful when we insert an I.V line.
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http://dx.doi.org/10.7860/JCDR/2014/7937.4150DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4003627PMC
March 2014

Primary colonic signet ring cell carcinoma in a young patient.

BMJ Case Rep 2014 Mar 20;2014. Epub 2014 Mar 20.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 28-year-old woman presented with colicky abdominal pain for 3 months. Pain was associated with episodes of vomiting, abdominal distension and constipation. She also had loss of weight for this duration. General physical examination was unremarkable and the abdomen was soft, with no palpable organomegaly. A CT of the abdomen showed small bowel and ascending colon dilation with multiple air fluid levels. There was also a short segment of circumferential bowel wall thickening and luminal narrowing in the hepatic flexure with sudden transition of bowel diameter. She underwent a right hemicolectomy after necessary preoperative investigations. Histopathology revealed signet ring cell carcinoma (SRCC). This case highlights the importance of detecting such a lesion in a young, otherwise fit woman. The challenge lies in early diagnosis and awareness of general practitioners about this aggressive form of colonic tumours.
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http://dx.doi.org/10.1136/bcr-2013-200587DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3962910PMC
March 2014

Open versus closed lateral internal anal sphincterotomy in the management of chronic anal fissures: a prospective randomized study.

Asian J Surg 2014 Oct 14;37(4):178-83. Epub 2014 Mar 14.

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India.

Objective: Chronic anal fissure is a benign disorder that is associated with considerable discomfort. Surgical treatment in the form of lateral sphincterotomy has long been regarded as the gold standard of treatment. This study compared the open and closed techniques of lateral sphincterotomy in terms of their postoperative outcomes.

Methods: A prospective, randomized comparative study was conducted between October 2010 and August 2012. A total of 136 patients were randomly assigned to each of two groups. Patients were followed up postoperatively for more than 1 year to assess any complications. The outcomes were compared among the two groups using the Chi-square test and Student t test.

Results: The mean age at presentation was 40.13 years. The male to female ratio was 1.47:1. The typical presentation was painful defecation. Fissures were most often located in the posterior midline and associated with a sentinel pile. Delayed postoperative healing was found in 4.4% of the group of patients undergoing open lateral sphincterotomy. The mean pain score and duration of hospital stay were lower with the closed technique.

Conclusion: Closed lateral internal sphincterotomy is the treatment of choice for chronic fissures as it is effective, safe, less expensive, and associated with a lower rate of complications than the open sphincterotomy technique.
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http://dx.doi.org/10.1016/j.asjsur.2014.01.009DOI Listing
October 2014

Acute large bowel obstruction secondary to stage 4 colonic carcinoma in an elderly man with severe aortic stenosis: a therapeutic challenge.

BMJ Case Rep 2014 Feb 20;2014. Epub 2014 Feb 20.

Department of Surgery, Kasturba Medical College, Manipal, India.

Colonic adenocarcinoma is a common gastrointestinal malignancy affecting the elderly, and has a multifactorial aetiology. Depending on the individual circumstances, surgical resection is the treatment of choice for colon cancer even for oligometastasis. Metastatic evidence as well as presence of comorbidities, particularly in the elderly, make surgical management difficult and often present a clinical challenge for clinicians. This is a case report exploring the treatment options for an 80-year-old male patient presenting with acute large bowel obstruction secondary to colonic adenocarcinoma with disseminated metastases and severe aortic stenosis.
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http://dx.doi.org/10.1136/bcr-2013-201186DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3931969PMC
February 2014

Pancreatic cancer presenting as a Sister Mary Joseph's nodule.

BMJ Case Rep 2013 Nov 29;2013. Epub 2013 Nov 29.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 69-year-old man presented with a painful umbilical nodule of 1 month duration. On examination the nodule was blackish in colour with a serous discharging fluid and was 2×2 cm in size, tender and fixed to the skin. There were no scars or sinuses at the umbilicus and no palpable mass or organomegaly on systemic examination. The patient underwent wide local excision of the skin nodule and on histopathology was reported as metastatic adenocarcinoma of the skin. A CT of the abdomen was performed to look for the primary site, which showed a 5×4 cm lesion in the tail of the pancreas. A biopsy from the pancreatic lesion was taken which was reported as an adenocarcinoma. CA19-9 was more than 1000 U/mL. The patient was advised palliative chemotherapy with gemcitabine. He was unwilling to take any further treatment in view of the advanced nature of the disease.
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http://dx.doi.org/10.1136/bcr-2013-201020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847646PMC
November 2013

Primary perineal hernia: a differential diagnosis for Bartholin's cyst in women.

ANZ J Surg 2014 Sep 29;84(9):686-7. Epub 2013 Oct 29.

Department of Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

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http://dx.doi.org/10.1111/ans.12265DOI Listing
September 2014

Small bowel carcinoid: a rare cause of bowel obstruction.

BMJ Case Rep 2013 Sep 24;2013. Epub 2013 Sep 24.

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

Carcinoid tumours though commonly affect the appendix, are a rare cause of small bowel obstruction, causing a diagnostic dilemma. We presented a 70-year-old man with small bowel obstruction, not responding to conservative management, which required an emergency laparotomy and was found to have a mass encasing the mid-jejunal loops and mesentery that was resected and reported to be a carcinoid tumour.
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http://dx.doi.org/10.1136/bcr-2013-200875DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3794238PMC
September 2013

Primary colorectal non-Hodgkin's lymphoma in a retropositive patient.

BMJ Case Rep 2013 Sep 6;2013. Epub 2013 Sep 6.

Department of General Medicine, Kasturba Medical College, Karnataka, India.

A 43-year-old man known case of retropositive illness presented with abdomen pain of 15 days and loose stools for 10 days. Loose stools were foul smelling and blood stained. The patient was a known case of type 2 diabetes and retroviral illness on highly active antiretroviral therapy (HAART). General physical examination was normal. On examination an irregular mass was palpable in the right iliac fossa and right flank. The mass was hard in nature; irregular with restricted mobility. There was no palpable liver or spleen. CT of the abdomen and pelvis revealed a well-defined heterogeneously enhancing hypodense mass lesion measuring 16 × 11.7 × 12 cm involving the ileocaecal region and extending medially and inferiorly to sigmoid colon and rectum. A colonoscopy showed a proliferative highly vascular mass 15 cm from anal verge at the rectosigmoid junction. Histopathology revealed sheets of neoplastic lymphoid cells in rectal wall suggestive of non-Hodgkins lymphoma.
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http://dx.doi.org/10.1136/bcr-2013-200442DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3794223PMC
September 2013

Endometriosis of extra-pelvic round ligament, a diagnostic dilemma for physicians.

BMJ Case Rep 2013 Aug 19;2013. Epub 2013 Aug 19.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 49-year-old multiparous woman presented with a swelling in the left groin of 6 months duration. The swelling was associated with a dull aching pain. The patient reported increase in size of the swelling during lifting of heavy weights. Menstrual history was normal and there was no increase in pain over the swelling during menstruation. She underwent a caesarean section 20 years ago and the scar had healed by primary intention. She was provisionally diagnosed to have a left-sided inguinal hernia. Ultrasonography showed a multiloculated cyst measuring 5.3×1.5×5.2 cm within the inguinal canal. The patient had excision of the cyst under spinal anaesthesia. Intraoperatively the cyst was found to arise from the left round ligament. It measured 7×6 cm extending to the left lateral vaginal wall. Histopathology revealed endometriosis of the round ligament. Her gynaecological assessment was normal and they recommended no further treatment. On follow-up the patient was asymptomatic and wound had healed well.
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http://dx.doi.org/10.1136/bcr-2013-200465DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3762512PMC
August 2013

Non-pancreatic retroperitoneal pseudocyst: a benign disease with non-specific symptoms.

BMJ Case Rep 2013 Jul 2;2013. Epub 2013 Jul 2.

Department of Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 76-year-old man presented with abdominal pain and constipation for 1 month. The pain was dull aching in nature and over the right upper abdomen. He also reported decreased appetite. The patient had no previous attacks of acute pancreatitis or history of trauma. There was no history of fever or melena. On visual inspection of the abdomen, there was a mass effect protruding out of the right mid-abdomen. The mass was approximately measuring 15×15 cm, firm in consistency, non-tender, non-mobile and not moving with respiration. Haematological investigations were normal. Both amylase and lipase were within normal limits. A CT of the abdomen revealed a large well-defined thin-walled cystic lesion measuring 10.3×13.9×14.3 cm in the right lumbar and iliac region without calcification or haemorrhage. A diagnosis of retroperitoneal cyst was made and the patient was taken up for surgery. Histology of the cyst showed the absence of epithelia and was reported as pseudocyst.
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http://dx.doi.org/10.1136/bcr-2013-200184DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736523PMC
July 2013

Aggressive fibromatosis (desmoid tumour) of the head and neck: a benign neoplasm with high recurrence.

BMJ Case Rep 2013 Jun 28;2013. Epub 2013 Jun 28.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 50-year-old man presented with a 5-month history of swelling over the right side of neck. The swelling was associated with dull aching pain radiating to the forearm without associated weakness of upper extremity or sensory loss. There was no history of trauma. On examination a fixed mass approximately 8×6 cm in size, smooth, firm in consistency, with ill-defined margins was present in the right posterior triangle. MRI scan of the neck revealed well-defined, lobulated, heterogeneously enhancing altered signal intensity mass at the root of neck. Debulking of the tumour was performed in view of its close proximity to the brachial plexus. Histopathology revealed aggressive fibromatosis (AF). AF is a benign fibrous neoplasm arising from fascia, periosteum and musculoaponeurotic structures of the body. AF in the head and neck region tends to be locally aggressive with a nature to invade bone and soft tissue structures.
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http://dx.doi.org/10.1136/bcr-2013-200156DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703068PMC
June 2013

Portal pyaemia secondary to open haemorrhoidectomy: need for prophylactic broad spectrum antibiotics.

BMJ Case Rep 2013 Jun 27;2013. Epub 2013 Jun 27.

Department of General surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

A 70-year-old man presenting with long standing grade 3 Haemorrhoids, underwent open haemorrhoidectomy under spinal anaesthesia. The patient passed stools on subsequent day and there was no bleeding per rectum. On day 5, he complained of dull aching upper abdominal pain. On physical examination, the abdomen was soft and there was mild tenderness in the epigastric region. Subsequently, he developed high temperature with chills and rigors. His condition failed to improve and the abdominal pain increased in severity. There was no pain in the perianal region and per rectum examination was normal. Leucocyte count rose to 12×10(9)/L and there were toxic changes on peripheral smear. Blood culture grew Staphylococcus aureus. Liver enzymes were mildly elevated. Coagulation profile was deranged. Fibrin degradation products were positive. D-dimer was high. CT revealed acute thrombosis of left portal vein and microabscesses suggestive of portal pyaemia.
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http://dx.doi.org/10.1136/bcr-2013-200222DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703088PMC
June 2013

Jejuno-jejunal intussusception: an unusual complication of feeding jejunostomy.

BMJ Case Rep 2013 Jun 27;2013. Epub 2013 Jun 27.

Kasturba Medical College, Manipal, Karnataka, India.

The jejuno-jejunal intussusception is a rare complication of jejunostomy tube placement. We are reporting a case of 33-year-old man who was suffering from absolute dysphagia due to carcinoma of cricopharynx with advanced metastatic disease, who underwent Stamms feeding jejunostomy as a part of palliative care. After 1 month he presented with colicky type of pain in the abdomen and vomiting. Sonogram of abdomen revealed a target sign and a feeding tube in a dilated jejunum. Abdominal CT proved the sonographic impression of jejuno-jejunal intussusception. He, therefore, underwent exploratory laparotomy and resection and anastomosis of the intussuscepted bowel. New feeding jejunostomy (FJ) was done distally from the anastomotic site. As per the literature this complication has been reported in Witzels jejunostomy. In our case the patient had undergone Stamms jejunostomy with placement of a Ryle's tube. Intussusception should be considered if a patient comes with abdominal pain and vomiting following FJ.
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http://dx.doi.org/10.1136/bcr-2013-200219DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703069PMC
June 2013

Rhabdomyosarcoma of spermatic cord in a 65-year-old man presenting as a groin swelling.

BMJ Case Rep 2013 Jun 24;2013. Epub 2013 Jun 24.

Department of General Surgery, Kasturba Medical College, Manipal, Karnataka, India.

A 65-year-old man presented with a swelling in the right groin of 6 months duration. The swelling was associated with dull aching pain and the patient reported of increase in size of the swelling during lifting of heavy weights. The swelling was 6×5 cm, hard in consistency, mobile and there was no impulse of cough. Ultrasonography showed a solid mass measuring 5.3×1.5×5.2 cm arising from the spermatic cord. High-inguinal orchiectomy was performed. Histopathology revealed rhabdomyosarcoma (RMS) of the spermatic cord. Patient was advised adjuvant chemotherapy but he refused. Spermatic cord RMS is a rare tumour derived from the undifferentiated mesoderm. It is most often observed in children and adolescents. It rarely appears after the second decade of life. It usually manifests as a painless, firm to hard mass in the inguinal canal or scrotum. Radical high-inguinal orchiectomy is the treatment of choice.
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http://dx.doi.org/10.1136/bcr-2013-010499DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703094PMC
June 2013

Iliac crest bone graft donor site hernia: not so uncommon.

BMJ Case Rep 2013 Jun 12;2013. Epub 2013 Jun 12.

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, Karnataka, India.

A 73-year-old man, who had undergone fracture fixation of humerus with LCP plating and bone grafting, presented again with a peri-implant fracture after 1 year. A repeat surgery was contemplated and replating was performed with tricortical bone graft harvested from the iliac crest. In the postoperative period the patient developed a tender swelling at the graft site with nausea and abdominal discomfort. It was managed conservatively thinking it to be a haematoma at the graft site. In the following 2 days his symptoms worsened. A CT abdomen showed the herniation of caecum from the bone graft donor site with obstruction. The patient was taken up for emergency surgical repair, the caecum was reduced and polypropylene mesh hernioplasty was performed. The patient recovered well without recurrence in the follow-up period. Iliac crest bone graft site hernia is not so uncommon and care has to be taken while harvesting.
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http://dx.doi.org/10.1136/bcr-2013-010386DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3702860PMC
June 2013

Intracranial cystic metastases from breast cancer.

Eurasian J Med 2012 Apr;44(1):60

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India.

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http://dx.doi.org/10.5152/eajm.2012.14DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261416PMC
April 2012

Adult intussusception: a six-year experience at a single center.

Ann Gastroenterol 2012 ;25(2):128-132

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India.

Objective: Adult intussusception (AI) is a rare entity and differs from childhood intussusception in its presentation, etiology, and treatment. It accounts for 1/30,000 of all hospital admissions, 1/1300 of all abdominal operations, 1/30-1/100 of all cases operated for intestinal obstruction and one case of AI for every 20 childhood ones. This study was designed to review the mode of presentation, diagnosis and appropriate treatment and finally the etiology of cases presenting in our hospital over a period of 6 years.

Methods: A retrospective review of 15 cases of intussusceptions in individuals older than 18 years presenting to a tertiary referral center of South India during a period of 6 years (2004-2010) was done in respect to mode of presentation, diagnosis, etiology and treatment.

Results: There were 15 cases of AI. Mean age was 45.5 years. Abdominal pain, nausea and vomiting were the commonest symptoms. There were 8 enteric, 6 ileocolic, and 1 colonic intussusceptions. 73% of AIs were associated with a definable lesion. Only 1 case of enteric lesions had malignancy. All ileocolic lesions were malignant. Twelve of 15 patients underwent surgical intervention.

Conclusion: AI is a rare entity and requires a high index of suspicion. Small-bowel intussusception should be reduced before resection whenever possible if the underlying etiology is suspected to be benign or if the resection required without reduction is deemed to be massive. Large bowel should generally be resected without reduction because pathology is mostly malignant.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3959399PMC
January 2012

A blue-domed cyst of bloodgood.

Eurasian J Med 2011 Aug;43(2):132

Department of General Surgery, Kasturba Medical College, Manipal University, Manipal, India.

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http://dx.doi.org/10.5152/eajm.2011.30DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4261351PMC
August 2011

Stump Appendicitis following Laparoscopic Appendectomy.

Sultan Qaboos Univ Med J 2011 Feb 12;11(1):112-4. Epub 2011 Feb 12.

Departments of Surgery and.

Stump appendicitis (SA) is a rare clinicopathologic entity characterised by inflammation of the appendiceal remnant after incomplete appendectomy. The diagnosis is not routinely suspected in patients who have previously undergone appendectomy. We report a case of SA in an adolescent boy who had previously undergone laparoscopic appendectomy. The case necessitated surgical completion of the appendectomy.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074687PMC
February 2011
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