Indian J Surg
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Solitary plexiform neurofibroma of the penis is an extremely rare peripheral nerve lesion with only about 20 cases reported all around the world. Here, we are reporting a case of solitary penile plexiform neurofibroma with sexual dysfunction due to difficulty in penetration. This 47-year-old gentleman presented with a swelling on the dorsal side of the penis. He was aware of the swelling for the last 15 years. The swelling was slow growing and there was no associated loss of sensation or sexual dysfunction. For the last 2 months, he noticed that the tumour is rapidly increasing in size. He was also having difficulty in penetration during sexual intercourse which forced him to seek medical attention. He underwent excision of the swelling from our department. After 18 months of follow-up following excision, there has been no evidence of recurrence of the tumour. ⋯ Penile plexiform neurofibromas are a rare type of lesions and are usually associated with neurofibromatosis. Solitary penile plexiform neurofibromas are extremely rare. Excision, when done properly, gives good results, without erectile dysfunction.
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Chylous ascites is a very rare occurrence in a patient with gallbladder cancer (GBC), and only six cases have been reported. We report here one such case in a 55-year-old lady who presented to us with upper abdominal pain for 6 months. A polypoidal gallbladder mass with minimal liver invasion but with multiple subcentimeter pericholedochal, common hepatic, mesenteric, and para-aortic lymph nodes was found on contrast-enhanced computed tomography scan. ⋯ She was discharged when drain output was nil. Chylous ascites could be a result of abdominal malignancy, post surgery, cirrhosis, and disseminated infections like tuberculosis and filariasis. Treatment is primarily conservative and includes paracentesis/drainage of the peritoneal cavity supplemented by fasting, total parenteral nutrition, and/or diet modification with medium-chain triglyceride diet.
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The ossification of ligamentous structures in various part of the body may result in clinical problems. The complete sella turcica bridge corresponds to the complete ossification of the interclinoid ligaments. Fifty dry adult skull bones were studied for presence of ossified interclinoid ligaments. ⋯ The knowledge of detailed anatomy of the interclinoid ligament can increase the success of diagnostic evaluation and surgical approaches to the region. The existence of a bony caroticoclinoid foramen may cause compression, tightening, or stretching of the internal carotid artery. Further, removing the anterior clinoid process is an important step in regional surgery; the presence of a bony caroticoclinoid foramen may have high risk.
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Gouty knee arthritis refers to a form of inflammatory diseases caused by deposits of needle-like crystals of uric acid in knee joint. The aim of this study was to assess the efficacy and safety of arthroscopic debridement in combination with oral medication versus oral medication alone for the treatment of gouty knee arthritis. A total of 60 patients with gouty knee arthritis were randomized to receive either arthroscopic surgery in combination with oral medication or oral medication alone. ⋯ Significant differences in these indices were detected at different time points in each group (P < 0.05), except between weeks 24 and 48 (P > 0.05). Arthroscopic surgery in combination with oral medication is superior to single oral medication in the flexion and extension of the knee joint, lymphoma scores, and pain relief (VAS) before 24 weeks, although no statistical differences were detected in the efficacy after 24 weeks, and in medication-related safety between the two groups. Although arthroscopic debridement cannot replace systemic uric acid-lowering treatments such as medication and dietary control, it is still an effective approach.
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Rectus sheath hematoma is a clinical entity characterized by the presence of blood within rectus abdominis muscle sheath. The aim of this study was to analyze clinical characteristics, diagnostic approach, treatment strategy, and outcomes of patients with rectus sheath hematoma. Patients diagnosed and treated for spontaneous rectus sheath hematoma between March 2010 and March 2014 were included in the study. ⋯ Spontaneous rectus sheath hematoma is associated with anticoagulant therapy. Cases with abdominal pain and a non-pulsatile abdominal mass particularly in elderly women should be kept in mind. Treatment is mostly based on supportive care to preserve hemodynamic stability.