BACKGROUND: Trauma has various presentations ranging from common injuries that are easily managed to uncommon presentations such as traumatic hernia that may be missed. METHODS: Despite being operated for fracture of the femur after a road traffic accident, a 50-year-old female patient remained undiagnosed with a right sided traumatic lumbar hernia for nearly six months after the accident. In this period, the patient underwent incision and drainage thrice for swelling in the right flank which was diagnosed as an infected hematoma by a doctor. RESULTS: The patient underwent surgery for repair of traumatic lumbar hernia by combined fascia lata graft and mesh hernioplasty. She remains well on follow-up. CONCLUSION: This case underscores the need for awareness of this entity for correct diagnosis and appropriate management that are the key to avoiding complications.

BACKGROUND: Intestinal obstruction remains a common problem encountered in the surgical emergency, and usually occurs secondary to adhesions, obstructed herniae or tubercular strictures. However, at times, rare causes of obstruction can also be encountered. METHODS: A 24-year-old male patient presented with recurrent episodes of intestinal obstruction that was found to be secondary to an abdominal cocoon on laparotomy. RESULTS: The patient underwent adhesiolysis of the cocoon, and remains well on a follow-up. Histopathological report of the cocoon wall revealed fibrocollagenic tissues with a mixed inflammatory infiltrate, without any evidence of tuberculosis. CONCLUSIONS: Abdominal cocoon can be a rare cause of intestinal obstruction in male patients. Adhesiolysis of the cocoon membrane releases the obstruction and gives good results.

BACKGROUND:Peritonitis secondary to small bowel perforation is a common surgical emergency seen across the globe.METHODS:A young male patient presented with ileal perforation that was repaired primarily. He recovered uneventfully after the operation.RESULTS:Histopathology of the margins of the perforation revealed tuberculosis. A search for evidence of a primary focus of tuberculosis was unsuccessful. The patient was started on anti-tubercular therapy and he was followed up with good results.CONCLUSION:This present case underscores the importance of biopsy specimens taken from the margins of patients with ileal perforation to avoid the misdiagnosis of such condition.

A traumatic abdominal wall hernia (TAWH) is a rare type of hernia, which follows blunt trauma to the abdomen, where disruption of the musculature and fascia occurs, with the overlying skin remaining intact. The case of a sixty five year old female that developed a TAWH, following the collapse of the roof of her house, is reported. She underwent a laparotomy for suspected liver injury, followed by repair of the hernia using a fascia lata graft taken from the thigh. The etiology, pathogenesis and management of this rare hernia are discussed.
Abdominal Wall/*pathology ; Aged ; Fatal Outcome ; Female ; Hernia, Ventral/etiology/*pathology/surgery ; Human ; Laparotomy ; Wounds, Nonpenetrating/*complications/*pathology

Splenic abscess is a rare entity encountered during clinical practice, with a high mortality rate. Formation of gas in splenic abscess is usually localized to the left upper quadrant of the abdomen. Here we report a case where the splenic abscess ruptured and presented with generalized peritonitis. The erect chest radiograph showed free air under the right dome of the diaphragm, thus masquerading a hollow viscera perforation (most common cause of pneumoperitoneum).

Ten patients with gastric scarring and an outlet obstruction secondary to ingestion of corrosive substances were referred to our department for surgical management, between May 1999 and April 2003. Hydrochloric acid was the most common corrosive ingested (4 cases), although many were not aware of the nature of the ingested substance. An associated esophageal stricture was present in 5 cases (50%). All the patients initially underwent feeding jejunostomy, with definitive surgery performed at a later date. A partial gastrectomy was found to be the most satisfactory procedure, and was performed in 90% of the cases (9 patients).
Adult ; *Caustics ; Enteral Nutrition ; Female ; Gastrectomy ; Gastric Outlet Obstruction/*chemically induced/*surgery ; Human ; Jejunostomy ; Male ; Middle Aged

An adenocarcinoma arising in a horseshoe kidney (HK) is rare. The case of a forty five-year-old male patient, presenting with a recurrent, painless hematuria, is reported. On investigation the patient was found to have a horseshoe kidney, with an adenocarcinoma in the left hemi-kidney, which was treated surgically, with a hemi-nephrectomy, of the involved part, being performed to excise the tumor. A brief review of the relevant literature is also presented.
Carcinoma, Renal Cell/*complications/pathology/surgery ; Human ; Kidney/*abnormalities/radiography ; Kidney Neoplasms/*complications/pathology/surgery ; Lymph Node Excision ; Male ; Middle Aged ; Nephrectomy/methods