New Indian Journal of Surgery

Kimura’s Disease is a rare chronic benign lymphoproliferative disorder with varied presentation. It usually presents as subcutaneous swellings and lymphadenopathy in head and neck region.[1] Various other sites like orbits, mediastinum and retroperitoneum have also been reported. [2] Here we present a case of a 35-year old male with supratrochlear lymphadenopathy, which on histopathological examination revealed the diagnosis of Kimura’s disease. 

Keywords: Chronic benign lymphoproliferative disorder;  Lymphadenopathy; Retroperitoneum.

Transiliac hernia is a rare complication of autologus bone graft harvest from iliac crest. This new term is used to describe herniation of abdominal contents through the bony defect of iliac crest. A rare case that was managed successfully is reported here and literature on the subject is reviewed. 

Keywords: Bone graft; Iliac crest; Hernia; Hernioplasty.

Introduction: Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis) is a rare, benign, self limiting syndrome characterized by tender regional lymphadenopathy, fever and night sweats. Highest prevalence is seen among Japaneese population. Case Report: We report a case of a young male presenting with fever with chills and tender cervical lympadenopathy not responding to the traditional treatment. A fine needle aspiration cytology of the lymph node was done, which was inconclusive. An excision biopsy showed features suggestive of Kikuchi Fujimoto’s disease. Patient was started on low dose steroids with anti inflammatory drugs. Patient became symptom free within a week and has no recurrence in 6 months of follow up. Discussion: Kikuchi disease is mainly a diagnosis of exclusion. It is self-limited, and lasts 1 to 4 months with a low, but possible, recurrence rate of 3% to 4%. Only 3 fatal cases have been reported, occurring in the active phase of probably genuine disease. It has no specific treatment. Only symptomatic treatment measures to relieve local and systemic complaints should be used. Patients with a more severe clinical course or with relapsing signs and symptoms could benefit temporarily from corticosteroids. Conclusion: Kikuchi Fujimnoto disease is rare and a self limited disease, diagnosis of which is based on histopathological findings. It should be suspected in all the cases of unexplained fever and tender lymphadenopathy thus avoiding cumbersome investigations. It usually responds to symptomatic treatment and in unresponsive patients, low dose steroids for 10 days helps to prevent relapse and recurrence, as in our case. 

Keywords: Kikuchi Fujimoto disease; Histiocytic necrotising lymphadenitis; Pyrexia; Lymphadenopathy; Corticosteroids.  

Background: Although congenital anomalies are higher in twins than in singletons but the incidence of congenital indirect inguinal hernia with umbilical hernia in twins on the same side is extremely rare condition and is unusual. Although it is accepted as developmental anomaly, genetic factors cannot be excluded due to probability of existence in siblings. Case Report: One year old Monozygotic identical twins presented with swelling on the left side of the groin and swelling in the umbilical region since birth. Birth history –full term normal vaginal delivery. Left groin swelling was non tender, and used to increase when the child cried, extended from groin up to base of scrotum and was reducible in both the twins. Umbilical swelling was non tender, and used to increase when the child cried & was reducible in both. Conclusion: Inguinal  hernia in twins are extremely rare, as there are only a few cases on record. Little is known about its etiology, and prevalence, owing to the difficulties in tracing  the twins with hernia. It needs extensive further study involving  a wider study group and inclusion of  genetic factors  to find out prevelance & cause. 

Keywords: Congenital Inguinal Hernia, Genetic Factors,  Identical Twins  

Laparoscopic appendectomy is conventionally performed using three ports. However, we have adopted this modified two port exteriorization technique by using minimum number of ports as well as disposables and got an excellent result. Hence aiming to document. Between May 2012 and Dec 2013, fifty laparoscopic appendectomies were performed of which 25 were operated using contemplated technique. Technical challenges, conversion, operative time, complications, post operative recovery and cosmoses were analyzed. Twenty five (13 females and 12 males) patients with age of 07 years to 67 years underwent port exteriorization interval appendectomy. The operative time was from 10 to 45 minutes. Two cases needed conversion to open appendectomy due to dense adhesions. Post operative pain was less than 25 by visual response score. One (4%) patient developed surgical site infection. Post operative recovery and cosmoses were excellent.  Port exteriorization appendectomy appear simple, safe, economical, and effective if condition favors its performance. However, difficult appendices requires conversion to three port/open procedure. 

Keywords: Laparoscopic appendectomy; Out technique; Port exteriorization appendectomy; Two port appendectomy.