Open Access Case Report

Isolated Hydatid Cyst of the Pancreas: An Unusual Location

Taoufik Elabbassi, Issam Hamrerras, Hasna Benghait, Mohamed Rachid Lefriyekh

Asian Journal of Research in Surgery, Page 1-4

Isolated pancreatic localization of hydatid cyst is very rare and unusual. The most probable mode of infestation is by hematological tract after passage of hepatic and pulmonary filters, but the peripancreatic lymphatic ducts and pancreatic-biliary ducts have also been reported.

Diagnosis is mainly based on imaging and treatment is mostly surgical.

An unusual observation of a primitive pancreatic hydatid cyst has been reported.

Open Access Case study

Digital Squamous Cell Carcinoma: Case Report and Review of Literature

Amira Gallas, Rami Ben Arab, Monia Boussen, Walid Bouaîcha, Nesrine Attia, Riadh Maalla, Mohamed Ali Sbai

Asian Journal of Research in Surgery, Page 1-5

Squamous cell carcinoma (SCC) is one of the most common primary malignancies affecting the upper limb and especially the hand. Digital SCC is infrequently reported in the literature and presents a diagnostic challenge because of its relatively rare occurrence and mimicry of benign conditions. Many risk factors have been identified including immuno suppression, Human Papilloma Virus (HPV), trauma, chronic scars, and exposure to radiation and carcinogens. Treatment varies from Mohs micrographic surgery to amputation.

After review of literature, rates of recurrence and metastasis seem to be higher for SCC affecting the hand compared to other sites and digital SCC has a high rate of recurrence with a low metastatic rate.

Through this paper we report the case of a 70-year-old woman with SCC of the fourth right finger that extended from the proximal nailfold to the ventral finger, and we aim to highlight the importance of an early diagnosis, leading to an early treatment which is the only guarantor of an effective treatment with digit preservation and good function.

Open Access Case study

Carpal Tunnel Syndrome Caused by a Ganglion Cyst of the Wrist: Report of a Case and Review of Literature

Amira Gallas, Mohamed Ali Sbai, Walid Saidane, Rami Ben Arab, Walid Bouaîcha, Monia Boussen, Nesrine Attia, Khaled Bchir, Riadh Maalla

Asian Journal of Research in Surgery, Page 1-5

Carpal tunnel syndrome is usually idiopathic and presents bilaterally. An etiologic factor should be suspected in patients with unilateral symptoms, Ganglion cysts are the most common tumours of the wrist and are often listed among the possible causes of carpal tunnel syndrome but cases of carpal tunnel syndrome caused by ganglion cysts are underreported in literature. The clinical presentation consists of swelling and pain of the wrist with paresthesia in the median nerve distribution. Tinel’s sign and Phalen’s manoeuvre are positive. Electromyogram (EMG) should be accompanied by ultrasonography or magnetic resonance imaging (MRI) investigation before surgery. Although the current trend is to perform endoscopic carpal tunnel release, this technique can’t allow a good exploration of the carpal tunnel, and open carpal tunnel release surgery with removal of the ganglion cyst remains the gold standard of treatment with an excellent prognosis.

We present the case of a 45-year-old woman with carpal tunnel syndrome caused by a ganglion cyst to highlight its characteristics, the interest of imaging studies (ultrasonography or MRI) in patients with unilateral symptoms, and the importance of early recognition with adequate treatment.

Open Access Case study

A Case of Nasopharyngeal Tuberculosis

Tuck Kit Chow, Zheng Hao Loh, Periyathamby A/L Sinnathamby

Asian Journal of Research in Surgery, Page 1-4

Introduction: Nasopharyngeal tuberculosis is rare even in endemic tuberculosis areas.

Presentation of Case: A 22 year old woman presented with right neck swelling for 3 weeks. She worked as a chest clinic nurse. Examination revealed a right level II and III cervical neck swellings Rigid nasoendoscopy revealed a huge friable nasopharyngeal mass. Biopsy of the nasopharyngeal mass showed caseating granulomatous inflammation. Cytology of the lymph node revealed granulomatous lymphadenitis. Contrasted CT showed fullness of the nasopharynx with cervical lymphadenopathy. No pulmonary lesions were found. Patient has been started on anti-Tuberculous drugs and after treatment the lesion disappeared. Nasopharyngeal tuberculosis is a rare and unique variation of tuberculosis. The most common presenting symptom is neck lymph node enlargement followed by nasal obstruction. Such a presentation together with the findings of a nasopharyngeal mass makes it indistinguishable from nasopharyngeal carcinoma especially in endemic areas. It is therefore of utmost importance that a nasopharyngeal biopsy is done which will show caseating granulomatous inflammation characteristic of tuberculosis. It is considered an extrapulmonary tuberculosis and responds well to a minimum of 6 months duration of treatment with anti-Tuberculous drugs.

Conclusion: Histological studies are important in patients presenting with cervical neck swelling and nasopharyngeal mass. This is especially important in places where nasopharyngeal carcinoma and tuberculosis is endemic such as Southeast Asia.

Open Access Original Research Article

Audit on Roadside Accident Cases and Severity Happening in Indore City, Presenting to MYH Casualty, Indore

Sumit Shukla, R. K. Mathur, Ankur Maheshwari, Priyanka Bamoria

Asian Journal of Research in Surgery, Page 1-7

Introduction: Road traffic accidents take away the right to life of 3,000 people every day worldwide. This is a global humanitarian disaster, it is man-made and preventable. Accidents are a drain on the national economy and may lead to disablement, death, damage to health and property, social suffering and general degradation of the environment. India had earned the dubious distinction of having more number of fatalities due to road accidents in the world. Road safety is emerging as a major social concern around the world, especially in India.

Materials and Methods: The prospective observational study was carried out on 1000 RTA cases presented in MYH trauma centre, INDORE from May 2018 to April 2019. All patients of roadside accidents presenting to trauma centre underwent a detailed history taking including general examination after their primary management.

Results: Out of 1000 cases 277 were fatal, 385 were considered under grievously injured & 338 cases had a simple injury. Among the fatalities, 32 cases were brought dead. The vehicle majorly found to be involved in the RTAs were 2-wheeler (76.90%), 3-wheeler (3.35%), 4-wheeler (6.2%) and others (13.6%). Out of total no of accident cases of 2 wheelers (769), only 27.1% person was using the helmet and 72.6% persons were not using the helmet. In the comparison of the severity of the injury and use of helmet, among the total no of fatality in 2 wheelers, 36% fatal injury occurred in person not wearing the helmet.

Conclusion: Road Traffic Accident problem is increasingly becoming a public health problem. The result not only in death but disability among survivors who can burden to the society. RTA victims predominantly belonged to the younger age group.