CASE REPORT OF GASTRO-INTESTINAL STROMAL TUMOR (GIST)

GISTs are the most common sarcomatous tumors of GI tract, usually found in stomach and duodenum. Mostly GISTs arise as a de novo. Frequently present with hematemesis, melena and abdominal pain but sometimes diagnosed incidentally. CECT abdomen with pelvis is important to see the origin and extension of the tumor and to assess for metastasis. A 52 year old male admitted for left sided abdominal pain for 7 to 8 year and on examination lump is palpable in epigastrium, umbilical and left hypochondriac region. CT abdomen suggestive of mass arising from proximal jejunum. The patient underwent a surgical resection with free margins and had an uneventful recovery.

Varied presentation of tuberculosis adenopathy: an immunological and diagnostic contemplation

Tuberculous lymphadenitis is the most common presentation of extra pulmonary tuberculosis EPTB. Clinical and radiological presentation of disease may vary and differential diagnosis includes both benign and malignant conditions such as lymphomas and sarcoidosis. We present two case reports of tuberculous lymphadenitis with varied presentation. In case report Ⅰ, patient had undergone splenectomy due to traumatic splenic rupture had classical symptoms of tuberculosis, chest X-ray, CT thorax showed mediastinal and cervical lymphadenopathy. FNAC showed a picture of granulomatous lesion. In case report ⅠⅠ patient came with complaints of abdominal pain in hypochondriac region. CT and USG abdomen showed multiple enlarged retroperitoneal lymph nodes which led to a provisional diagnosis of lymphoma after which lymph node biopsy showed a granulomatous picture. This case report stresses the importance of early and quick diagnosis of tuberculosis in immunocompromised patients and highlights the risk of misdiagnosis of tuberculous lymphadenitis with other benign and malignant causes of lymphadenopathy and the importance of humoral mediated immunity in tuberculosis.

Spontaneous cholecystocutaneous fistula: an uncommon complication of acute cholecystitis

A 78-year-old man presented to the hospital with acute right upper quadrant pain, fever and nausea. A focused abdominal ultrasound and abdominal CT scan were performed demonstrating an acute calculous cholecystitis with gallbladder perforation. Although a CT-guided cholecystostomy was performed and a pericholecystic abscess was relieved promptly, the patient developed a cholecystocutaneous fistula in the right hypochondriac region. A cholecystocutaneous fistula is an extremely rare complication that may occur in patients with acute calculous or acalculous cholecystitis, chronic gallstone disease, gallbladder carcinoma or prior hepatobiliary surgery.

Gallbladder volvulus and hernia through the foramen of Winslow: a case report

Gallbladder hernia through the foramen of Winslow is an uncommon condition and gallbladder hernia combined with volvulus is even rarer. A 70-year-old patient was hospitalized with the clinical signs of pain in the right hypochondriac region associated with fever. The computed tomography scan images showed some signs of gallbladder herniation through the foramen of Winslow. We decided to remove the gallbladder and found the gallbladder infundibulum twisted and necrotic. This was the first case of a male patient who suffered from gallbladder herniation with volvulus after three cases of female patients reported in the literature.

Hepatoblastoma in an 18- Year Old Female; Rare Entity

Hepatoblastoma is a rare malignant hepatic tumor in adults. It is associated with poor prognosis as it is usually diagnosed late when the tumor is completely unresectable. Presented here, is a case of an 18-year old female with pain abdomen, vomiting, and mass over the right hypochondriac region for one month. CT scan revealed soft tissue density mass on the right lobe of liver suggestive of focal nodular hyperplasia with differential diagnosis of atypical hemangioma. Liver angiography also suggested a vascular tumor of giant hemangioma with inferior exophytic extension. The patient underwent a right extended hepatectomy. Histopathological examination revealed hepatoblastoma with predominant fetal pattern and small focal areas of embryonal pattern. The patient had an uneventful postoperative recovery and is currently undergoing chemotherapy. We present this case for its rarity and ability to masquerade other primary liver tumors in the adult age as seen in our patient.

Cyriax syndrome: a misdiagnosed condition of the chest wall

Cyriax syndrome is a rare entity of the chest wall, which mainly affects young people. It can manifest as abdominal pain in the right or left hypochondriac region, which may be very intense, and often causes problems in the differential diagnosis. We report the case of a 36-year-old man who presented with intense left hypochondrial pain, worsening on exercise. After multiple specialized consultations and several unnecessary and expensive investigations, a diagnosis of Cyriax syndrome was obtained. A thorough physical examination might have been sufficient to evoke the diagnosis.

A 12-year-old boy presented with fever and left-sided upper abdominal pain

This article has no abstract. The first 100 words appear below: A 12-year-old boy of non-consanguineous parents presented with the history of fever and left sided upper abdominal pain for 1 month. His fever was high grade, intermittent, associated with chills and rigor. The abdominal pain was dull aching in nature without any radiation, aggravating or relieving factors. His bowel habit was normal. The child had no history of jaundice, cough, respiratory distress, burning sensation during micturition, earache, skin infection, contact with tubercular patient, blood transfusion or parenteral medica-tion. On examination, she was fretful, febrile, mode-rately pale, and anicteric. Tachycardia was present. Per abdominal examination revealed tenderness at the left hypochondriac region.