Case Report: An Unusual Cause for Recurrent Hemopericardium in a Patient With Dyspnea

The case concerns a female presenting with dyspnoea resulting from recurrent hemopericardium. Pericardiocentesis, coronary angiography, and extensive laboratory and imaging studies did not reveal the underlying etiology of the hemopericardium. Only after repeat and exploratory surgery, diffuse venous pericardial hemorrhages with localized thrombi typical of angiosarcoma were discovered.

Traumatic avulsion of the spermatic cord due to blunt inguinal trauma: A case report

We report an extremely rare case of a patient with a total avulsion of the spermatic cord secondary to a blunt inguinal trauma. Doppler ultrasound was used to identify an absence of vascular flow and an indication for exploratory surgery. The retroperitoneum was accessed for hemostasis. Spermatic cord injury after blunt trauma is extremely rare but should be considered as a cause of an avascular testis after trauma.

Incidentally detected sellar spine in a patient with Cushing’s syndrome: a case report

Sellar spine, a bony spur extending anteriorly from the dorsum sellae, is a very rare anatomical variant. Several hypotheses regarding its etiology have been proposed, including the strongly supported theory of a cephalic ossified notochordal remnant. Sellar spine is usually detected incidentally in patients who have no definite symptoms, but several cases have reportedly accompanied endocrinopathies such as precocious puberty, hypopituitarism, or galactorrhea/oligomenorrhea. However, no published reports have described sellar spine in a patient with Cushing’s syndrome. We herein report a case of sellar spine detected during the evaluation of Cushing’s disease in a 29-year-old woman who underwent inferior petrosal sinus sampling, computed tomography, magnetic resonance imaging, and exploratory surgery. There was no evidence of a pituitary microadenoma, but a sellar spine was present in the operative field. Thus, the sellar spine might have caused Cushing’s syndrome in this case, although the exact mechanism is unknown.

Transitional cell carcinoma of the renal pelvis masquerading as renal tuberculosis

We report a case of transitional cell carcinoma of the right renal pelvis mimicking the signs, symptoms and radiological findings of renal tuberculosis (TB). She had been diagnosed initially for urinary tract infection and radiological diagnosis initially was more towards renal TB and urine cytology and cultures were normal. Specific investigations for tuberculosis all showed negative results. But as neoplasia could not be ruled out by ureterorenoscopy due to presence of multiple ureteric strictures, decision was taken for an exploratory surgery. During surgery it was found that there was a tumour in the upper pole of kidney involving the renal pelvis and was found to be papillary transitional cell carcinoma on histopathological examination.

Gallbladder Agenesis in a Dog: Clinicopathological, Histopathology, and Computed Tomography Findings

ABSTRACT Three cases of gallbladder agenesis (GA) have been previously reported in the English-speaking veterinary literature. Affected dogs can be either asymptomatic or symptomatic with vomiting, retching, and anorexia previously reported. The previously reported cases and the dog in this report had marked elevations in alanine aminotransferase concentrations, and liver histopathology consistently showed bridging fibrosis and biliary hyperplasia. The condition is most often diagnosed in humans during exploratory surgery, which was also the case in the previous three dogs reported with GA. Computed tomography (CT) or MRI is now recommended for diagnosis of the condition in humans, and this is the first report of CT findings in an affected dog diagnosed without surgery. Bile stasis and cholangiohepatits have been proposed as secondary pathologies in both humans and dogs with GA, and histopathology and CT findings in this case support those theories.

Plant Thorn Synovitis of the Hand in an Adult Patient: A Case Report and Review of the Current Literature

This is a case of plant thorn synovitis of the hand in an adult following a plum tree thorn injury, the first reported case in the hands in the past decade. The patient initially presented with persistent joint discomfort following removal of a retained plum thorn fragment from the skin overlyin the proximal interphalangeal joint of the left middle finger. Initial radiography and sonography imaging following the removal revealed no foreign bodies. However, the patient’s symptoms were worsening and refractory to anti-inflammatory and antibiotic treatment. An exploratory surgery was carried out, which revealed multiple plant thorn fragments within the synovium, each measuring approximately 1 mm in size. A synovectomy was performed and the patient recovered with full function. Our case of plant thorn synovitis is discussed along with a review of the current literature on plant thorn synovitis in the hands.

Intramural Abscess Causing Obstruction at a Previous Jejunal Enterotomy Site in a Dog

ABSTRACT This case report documents a novel late surgical complication in a 2 yr old dog following an enterotomy to remove a jejunal foreign body. Twenty-six days following the original surgery, the dog was re-presented with signs consistent with an intestinal obstruction. A mural intestinal abscess was found as the cause of the obstruction during exploratory surgery, and the site was successfully removed with a resection and anastomosis. Histopathology showed multifocal abscessation with cyst-like structures partially lined with mucosa. The dog recovered without complication and remains healthy 4 mo later. The exact cause of the lesion is not known; however, local contamination through a focal mucosal defect or complications related to the use of barbed suture in the original enterotomy repair may have contributed.

Fact file 13: Surgery

From the Greek ‘χ‎ ε‎ ί‎ ρ‎’ meaning hand and ‘ἔ‎ ρ‎ γ‎ ο‎ ν‎’ meaning work, surgery investigates and/or treats diseases and injuries either for functional or cosmetic purposes. Elective surgery is carried out for non-life-threatening conditions at the patient’s request, whereas emergency surgery has to be carried out quickly; exploratory surgery is used to aid or confirm diagnoses, while therapeutic surgery is used to treat a diagnosed condition. Although ‘surgery’ is typically used to refer to the period in the operating room, there are important pre-operative stages, including phlebotomy (blood tests) and anaesthesia, and sometimes complex post-operative care....