Minocycline black bone disease in arthroplasty: a systematic review

Background Minocycline black bone disease is a rare finding that can cause concern when unexpectedly encountered during routine arthroplasty. Prolonged minocycline use can cause selective staining of subchondral bone, whilst peri-articular soft tissue and cartilage appear uninvolved. Methods A systematic review according to PRISMA guidelines was performed to identify all reported cases in the literature. Results Including the patient we present, eleven cases of minocycline black bone disease encountered during arthroplasty have been reported in the literature. All cases have had an excellent outcome, with no complications reported to date. Conclusions Minocycline black bone disease can be a concerning intra-operative finding when unexpectedly encountered during routine arthroplasty, but should not affect the operative plan. Surgeons should exclude alternative causes of bone discolouration when the history is unclear.

Intra-Abdominal Multicentric Inflammatory Myofibroblastic Tumors Mimicking Ruptured Appendicitis.

Inflammatory myofibroblastic tumors (IMTs) are a rare soft tissue neoplasm, usually seen in children and adolescents, which are predominantly found in the pulmonary region. The extrapulmonary multicentric lesions are exceedingly rare. We herein report the case of a 19-year-old female who developed acute bowel obstruction which caused by multicentric IMTs. We described her clinical presentations, operative finding, and pathological finding.

A Rare Intra-Operative Sighting of Appendiceal Diverticulitis

Appendiceal diverticulitis is a rare diagnosis and culprit for acute appendicitis. The majority of these cases are diagnosed post-operatively on histopathology. In the following case it was grossly identifiable intraoperatively. Our treatment was appendicectomy. The purpose of this article was to provide pictorial evidence of this exceedingly rare intra-operative finding.

Evaluation of pre-operative clinical finding and per-operative assessment of carcinoma stomach in tertiary settings of Bangladesh

Background: Carcinoma stomach, a major killer cancer all over the world, is still presenting late in developing countries due to delay in early diagnosis, lack of awareness, infrastructure etc. Objectives: To establish the importance of preoperative evaluation on operability of carcinoma stomach. Methods: Sixty clinically and histopathologically diagnosed ca stomach cases who underwent surgery in department of Bangabandhu Sheikh Mujib Medical University, Dhaka, and Dhaka Medical College Hospital, Dhaka in 2011 were assessed with clinical picture, investigations, preoperative evaluation and peroperative findings were recorded. Z test for proportion was used to assess clinical decision predictability with a p value of :s;0.05 as significant. Results: Male (73.33%) predominant with 2.75:1 male:female ratio was observed. Mobility, fixity and abdominal lymphadenopathy were not well detected through clinical assessment (p=0.001) while ascites, metastasis and Shelf of Slummer were similar in both clinical and operative finding. The endoscopy of upper GIT finding gave a unique picture as the findings were almost same as were found during operation. USG detected a lesser proportion of the clinical condition compared to peroperative condition whereas CT performed better than the USG except for the lesion detection. Though Computed Tomography (CT) detected higher percentage of lesion, metastasis, ascites and lymph node involvement compared to ultrasonogram (USG), it was significantly higher only for lesion detection (p=0.002) and lymph node involvement (p=<0.001). In the similar manner USG assessment of lesion detection (p=<0.001) and lymph node involvement (p=0.003) was significantly low compared to operative finding. When we looked between CT and operative finding only lesion detection was significantly low (p=0.01) indicating CT to be most effective predictor of clinical picture for operative decision. Preoperative plan were mostly not in accordance with peroperative decision except for total gastrectomy. Conclusion: The study indicates weakness in clinical detection and pre-operative plan compared to per-operative finding. Hence combination of clinical feature and investigation tools especially endoscopy of upper GIT combined with CT is recommended to predict a better operative decision. Journal of Surgical Sciences (2018) Vol. 22 (1): 43-46

Spinal intramedullary cysticercosis mimicking spinal tumour

Neurocysticercosis is a relatively uncommon entity with even more rare spinal intramedullary variety. We present a case of cervico- dorsal intramedullary NCC mimicking spinal tumour with per operative finding mimicking abscess.