Foreign Body in the Anterior Chamber Presenting as Inflammatory Mass on the Iris

A 40-year- old male factory worker presented to our eye clinic with left eye pain, redness and blurring of vision, associated with history of an injury sustained while hammering a nail into the wall three days ago. He had mild symptoms at the onset of the injury. Slit lamp examination of left eye showed a small, self-sealed laceration corneal wound at the temporal limbus and a smooth, well defined, oval mass on the iris in the anterior chamber in the lower temporal quadrant. Rest of the anterior segment and fundus were normal. X-ray orbits showed no intraocular foreign body in the left eye. In view of clinical suspicion, we proceeded with a CT scan of orbits which showed the presence of a small metallic foreign body in the anterior chamber of left eye. After giving topical antibiotic, cycloplegic, and corticosteroid eye drops along with systemic antibiotics for three days, we planned surgical removal of the mass in the anterior chamber. After the mass was removed, we noted a small metallic foreign body embedded within the fibrin mass. The same treatment was continued postoperatively. The left eye became white and quiet, and vision improved to 6/6 with above treatment. The key learning point presented is that when the history is suggestive of intraocular foreign body, even though the X-ray orbits does not show the foreign body one has to get CT scan of orbits done to rule out its presence, especially when there is inflammatory mass in the anterior chamber as seen in our case.

Idiopathic Granulomatous Mastitis Presented with Reactive Arthritis and Erythema Nodosum: Case Report from Iraqi

Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease that involves the development of an inflammatory mass in the breast, which may be difficult to differentiate from malignancy. Few patients have been reported in the literature presenting with arthritis accompanying IGM of the breast. Here we report a case of an Iraqi patient who presented as IGM with reactive arthritis and erythema nodosum.

Live ascaris in urinary bladder: a case report

Introduction Ascaris in urinary bladder is an extremely rare phenomenon. It may occur after fistula formation between urinary and gastrointestinal tract or by retrograde migration of adult worm, and is associated with complications. Case presentation A 47-year-old Amhara woman from rural northwest Ethiopia presented with a complaint of difficulty to fully evacuate her bladder of 1 year duration. Ultrasonography showed thickened bladder wall with echo debris. There were also thickened bowel and fluid-filled loops of intestine adjacent to urinary bladder. On cystoscopy examination, there was live ascaris swimming inside the bladder. Enterovesical fistula was entertained and explorative laparotomy performed. Findings confirmed presence of iliovesical fistula. The fistula was divided and the continuity of the intestine restored. The inflammatory mass was subjected to histopathology study and turned out to be benign inflammatory reaction. She was also given antihelminthics. Postoperatively, her course was uneventful, and she was discharged cured. Conclusion Though it is extremely rare to have urinary symptoms from ascariasis, it is important to have a high index of suspicion for all possibilities.

Treatment Modality of Idiopathic Granulomatous Mastitis with Surgery Alone or in Combination with Steroid

Background: Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease. Diagnosis and treatment is still a challenge because of obscure etiology and rareness. Owing to wide spectrum of IGM it is difficult to standardize and optimize the treatment. The aim of our study was to evaluate the outcome of surgical excision or in combination with steroid in treating IGM. Methodology: A randomized controlled clinical trial was done in BIRDEM (Bangladesh Institute of Research and Rehabilitation of Diabetic, Endocrine and Metabolic Disorder) Hospital, Dhaka, Bangladesh from July’2008 to June’2018. Overall 82 patients met the inclusion criteria. We analyzed therapeutic modalities and compared the patients’ outcomes based on treatment. Results: All patients underwent wide excision with clear margin under general anesthesia. Post operatively steroid was given in 41 patients. Duration of steroid therapy was 6 months after surgery. We have seen that recovery time was short in steroid group (Gr-II) average 167.07 days in compared without steroid (Gr l) average 253.28 days. Patients who underwent surgery only (GR-I) about 49.90% patients experienced recurrence (e.g. fistula formation and inflammatory mass etc.) On the other hand, 12.1% patients developed recurrences that were treated with steroid following surgery (Gr-II). Conclusion: Surgery with steroid is more effective in treatment of idiopathic granulomatous mastitis than surgery alone. Bioresearch Commu. 7(1): 924-926, 2021 (January)

Nonspecific orbital inflammation and thyroid eye disease, a rare comorbidity: report of two cases and review of literature

Background To present the very rare comorbidity of developing non-specific orbital inflammation (NSOI) in two patients with histories of definite thyroid eye disease (TED). Case presentation Both patients complained of new-onset progressive proptosis although their thyroid disease was controlled and computed tomography scan revealed an intraorbital inflammatory mass. The pathological assessment indicated that both patients had developed fibrosing NSOI. Therefore, intravenous corticosteroids were administered. The mass regressed and the amount of proptosis was decreased in both patients. Conclusions We reviewed all related cases in the literature and extracted their clinical and radiological characteristics for this paper. Ophthalmologists should consider TED and NSOI in patients with a new-onset complaint of proptosis. Despite rare comorbidity of TED and NSOI, it should be considered especially in patients with refractory proptosis, and lead to its further evaluation and prompt management.

355 Incomplete Intestinal Rotation with Appendicular Abscess Causing Diagnostic Dilemma in An Adult Patient

Intestinal malrotation presents as an emergency in the neonate and within the first year of life. Incomplete intestinal rotation may remain asymptomatic and undiagnosed. Adult patients are usually diagnosed incidentally while being investigated for nonspecific abdominal symptoms. We report a case of a 43-year-old female who presented with a 10-day history of paraumbilical abdominal pain. Computed tomography demonstrated features of incomplete intestinal rotation and a centrally located inflammatory mass related to the appendix. She underwent a laparotomy and appendectomy. Upon a brief literature review of similar cases, there seems to be a conflict of views regarding the management of incidentally diagnosed adult incomplete intestinal rotation.

Combination of ectopic pancreas and intestinal malrotation presenting as non-specific right iliac fossa pain in a SARS-CoV-2 positive patient

We describe the case of a 31-year-old man who presented with a 3-day history of right iliac fossa pain with associated nausea and vomiting. He denied any previous incidents of abdominal pain and had no relevant medical history or family history to note. Given the typical history, examination findings of localised peritonism and infection risk, he was taken to theatre for laparoscopic appendicectomy without diagnostic imaging. Intraoperatively, we noted gut malrotation and an inflammatory jejunal mass which was resected after converting to a mini-laparotomy. The inflammatory mass was reported to be an ectopic pancreatic tissue from histology. Given that this patient had tested positive for SARS-CoV-2 on admission, we propose a possible case of SARS-CoV-2 infection triggering inflammation of the ectopic pancreatic tissue.