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Background: Rarely seen, gastric mucormycosis mostly occurs in people with weakened immune systems. Among whom diabetes mellitus often plays a key role, and rare case reports exist.

Case Presentation: We describe a 31-year-old woman with poorly controlled type 1 diabetes mellitus who had abdominal pain with shock with tachycardia leading to Intensive Care Unit admission. The endoscopic exam revealed wide-ranging involvement of the stomach from the fundus to the antrum, and also involving the GE junction and distal esophagus. Such extensive involvement has not been reported yet. Intensive treatment with antifungal drugs and supportive therapy failed to stop the severe sepsis, and the patient passed away after 20 days in the hospital.

Conclusion: Extensive gastric mucormycosis is marked by its aggressiveness and difficulty in diagnosis, so health professionals should be especially careful in identifying patients at risk. Different studies on early recognition and effective approaches for management are discussed.

Background:
Pneumatosis portalis and pneumatosis intestinalis, when seen in conjunction, are rare but ominous findings on imaging of the abdomen, frequently indicating severe intra-abdominal disease such as intestinal ischaemia. We present a case of pneumatosis portalis and intestinalis following cardiac surgery without evidence of significant intra-abdominal disease.

Case presentation:
A 62-year-old male underwent open bioprosthetic aortic valve replacement for severe aortic stenosis. Four days post-operatively, the patient developed severe abdominal pain and distension. Contrast computed tomography (CT) of the abdomen demonstrated a significant degree of gas within the portal venous system and within the intestinal wall. At exploratory laparotomy, no evidence of significant bowel ischaemia or intra-abdominal disease was evident, a finding confirmed after re-look laparotomy 48 hours later. The patient was eventually discharged with no further sequelae noted.

Conclusion:
This case demonstrates the often pre-terminal finding of pneumatosis portalis and intestinalis, seen in a patient without evidence of any significant abdominal disease. We report a previously undescribed case of pneumatosis portalis and intestinalis following open cardiac surgery. Exploratory laparotomy should be performed if there is any clinical concern given the potential mortality associated with these findings.

Background: Complications from cardiopulmonary Resuscitation (CPR) are common and can add to morbidity and mortality. A pneumoperitoneum after CPR is an uncommon complication. The majority of previously reported cases of gastric perforation after CPR were associated with difficult airway management or positive pressure ventilation in association with chest compressions.

Case Presentation: We present a case of a massive pneumoperitoneum in a 53-year-old woman after resuscitation following attempted hanging. During and following basic and advanced life support, a massive swelling of the abdomen due to massive pneumoperitoneum was observed, most likely caused by gastric perforation after bag-valve mask ventilation on an obstructed airway. The pneumoperitoneum resolved after conservative measures and insertion of an intra-abdominal drain; no surgery was necessary. The patient made a good and full recovery.

Conclusion: This case emphasizes the importance of maintaining vigilance for gastric perforation with abdominal distention after CPR, in particular when difficult airway management is encountered. Prevention of gastric dilation and perforation can be achieved by diligent airway management and prevention of high inspiratory pressures. Conservative management using only an abdominal drain can be effective in selected cases when perforation is limited and in the absence of peritonitis.

Background: Osteomas are benign, slow-growing bony tumors that usually occur as solitary, incidental findings. When multiple craniofacial osteomas are present, Gardner syndrome (GS), an Adenomatous Polyposis Coli-associated hereditary disorder, must be considered. Craniofacial osteomas may precede intestinal polyposis by several years, making them important early diagnostic indicators. However, attenuated GS and sporadic familial osteomas can present with similar features, creating a diagnostic dilemma. Early identification, genetic counselling, and surveillance are therefore essential to exclude delayed gastrointestinal or extracolonic manifestations.

Case presentation: We report two first-degree male relatives with multiple craniofacial osteomas but no systemic features. The proband, a 15-year-old boy, presented with mandibular, palatal, and paranasal swellings that were radiologically and histopathologically confirmed as compact osteomas. His 52-year-old father also exhibited multiple craniofacial osteomas, including mandibular and sinus involvement, but remained asymptomatic. Comprehensive systemic evaluation, including colonoscopy, abdominal imaging, dermatologic, and ophthalmologic examinations, was negative for intestinal polyposis or extracolonic manifestations.

Conclusion: These familial cases highlight the diagnostic dilemma between attenuated GS and sporadic familial osteomas. Genetic testing, counselling, and long-term surveillance are essential to exclude delayed gastrointestinal or systemic involvement.

Background: Giant ameloblastoma is a rare, benign but locally aggressive odontogenic tumor characterized by massive jaw enlargement, accounting for 1% of all jaw tumors, often affecting the mandible. It presents with slow but relentless growth, causing significant facial deformity and functional impairment.

Case Presentation: We report two cases of Giant Ameloblastoma. The first patient reported to the outpatient department an expansile swelling involving the mandible crossing the midline, extending approximately from the right side of the angle to the left side angle. 15.2 cm x 10.5 cm x 11 cm. The second case was reported to the outpatient department, with an expansile swelling involving the right mandible and maxillary region, which was 10 cm x 12cm x 7cm. Both patients had an extraoral draining sinus on the lesion, and both had a previous history of surgery in that region, 20 years back and 11 years back, respectively. The pre-operative investigation included an OPG, CT scan, and haematological parameters. Surgical treatment involved Hemimandibulectomy with adequate margins and microvascular reconstruction with fibular free flap in a single stage.

Conclusion: Tumor histology, anatomical location, and adequacy of tumor resection with safety margins are various factors that influence tumor recurrence and thus must be considered along with the possibility of malignant transformation while formulating a treatment plan for revision cases.

Background: Dengue fever is a common arboviral infection that is typically self-limiting, but rare complications such as myositis, rhabdomyolysis, and electrolyte disturbances can pose diagnostic and therapeutic challenges.

Case Presentation: We report a patient with dengue confirmed by non-structural 1 antigen who initially improved with supportive care but re-presented with severe myalgia, tea-colored urine, and markedly elevated creatine kinase (54,000 U/l), consistent with rhabdomyolysis. Her symptoms were refractory to hydration and analgesia but responded rapidly to corticosteroids. Subsequently, she developed polyuria and profound hypotonic hyponatremia with inappropriately concentrated urine and high urinary sodium, consistent with renal salt wasting syndrome (RSW). Management required careful fluid resuscitation to maintain euvolemia and intermittent desmopressin to control polyuria. Autoimmune screening revealed positive anti-ribonucleoprotein antibodies and anti-Ro antibodies, suggesting an immune-mediated process. She achieved full recovery with normalization of muscle enzymes and electrolytes.

Conclusion: This case highlights the diverse and clinically significant complications of dengue, including immune-mediated myositis and RSW. Importantly, distinguishing RSW from SIADH is crucial, as their treatments differ substantially and misclassification may worsen outcomes.

Background:
Trichophagia, the compulsive ingestion of hair, is most commonly linked to trichotillomania. However, isolated trichophagia without hair-pulling behavior is extremely rare, especially in children.

Case Presentation:
We report a nine-year-old girl with isolated tonsillar trichophagia presenting with sore throat and dysphagia. Physical examination revealed dark hair strands embedded in the bilateral tonsillar crypts. Tonsillectomy confirmed localized hair bezoars. The patient’s mother had obsessive–compulsive disorder, and her father had generalized anxiety disorder, suggesting strong familial psychiatric vulnerability. The child underwent cognitive-behavioral therapy and family-based psychoeducation after surgery.

Conclusion:
This rare case demonstrates that trichophagia may occur independently of trichotillomania and can manifest in unusual locations such as the tonsils. Early psychiatric evaluation combined with surgical management is crucial to prevent recurrence and address underlying psychopathology.

Background: 
Episiotomy, a perineal incision during labor to facilitate vaginal delivery, is now selectively used in instrumental births like vacuum-assisted procedures to lessen severe perineal trauma, though it risks rare extensions into the rectal wall. Such full-thickness rectal tears, classified as fourth-degree injuries, occur more commonly with midline incisions and can lead to fecal incontinence, pain, or sepsis if not addressed swiftly. 
Case Presentation:
A 32-year-old woman with an unremarkable prenatal history underwent vacuum-assisted vaginal delivery complicated by a mediolateral episiotomy extending to a full-thickness anterior rectal tear 10 cm from the anal verge. She presented hemodynamically stable with perineal pain, bleeding, and stool spillage; digital exam confirmed the injury without soiling. Under anesthesia, a triple-layer closure was used with absorbable sutures for mucosa, muscularis, and serosa, avoiding colostomy. Broad-spectrum antibiotics continued for two weeks, with nil per os for 48 hours followed by enteral feeding. Postoperative monitoring showed no infection or incontinence; discharge occurred on day 10. Follow-up MRIs at six weeks and six months revealed intact rectal integrity and normal sphincter function, with pelvic exercises aiding recovery.
Conclusion:
This case demonstrates that timely recognition and layered repair of rectal tears after episiotomy can achieve excellent functional outcomes without the need for diversion colostomy.