New Indian Journal of Surgery

Adenomyomatosis of gall bladder is seen in 2% - 5% of cholecystectomies. It presents either as a diffuse wall thickening (adenomyomatous hyperplasia) or as a localized or focal lesion of the gall bladder (adenomyoma) which may mimic gall bladder carcinoma. Adenomyomas are most often located in the fundus of gall bladder and the usual size described is 1-2 cm. Herein we report a case of adenomyoma of the gall bladder which presented as an unusually large polypoidal mass measuring 7.8x6x4 cm and located in the neck region of gall bladder thus clinically and radiologically mimicking malignancy. Although adenomyomas can present as a pseudotumour in the gall bladder, our search of literature revealed this to be the the first case of adenomyoma of such a large size and situated in the neck of gallbladder.

Keywords: Gallbladder; Giant; Adenomyoma; Pseudotumour; Polyp.

Rhabdomyosarcoma (RMS), a cancer of connective tissue is the most common soft tissue sarcoma of childhood and adolescence. Head and neck region is being most common site followed by genitourinary tract, retroperitonium, and the extremities. After neuroblastoma and Wilms tumor, RMS is the third most common extra cranial malignant tumor that affects childhood age group. These tumors arise from mesenchymal tissue(skeletal muscle progenators) with a tendency of myogenic differentiation. Morphologically, RMS are classified into embryonal RMS, alveolar, undifferentiated and anaplastic RMS. Alveolar type is the most common type. Recently various treatment modalities for rms are introduced which has increased the survival of patients with RMS and some investigators have associated the prognosis with the location, evolution and histological type and spread of the tumor. RMS are also associated with high rates of recurrence and metastasis. Here we present a case report of RMS over posterior chest wall in a 6 months old female child .

We reviewed the records of our patients admitted at Zliten University Hospital over past 23 years, from 1991 to 2013. 6000 patients were admitted & cholecystectomy was performed. All cases had routine investigations. Most of them had cholelithiasis with chronic cholecystitis. Those with acute cholecystitis were not included in the series. Mainly surgery of was done by junior doctors under the supervision of seniors. 13 cases had injury of common bile duct, in 5 cases it was reconciled postoperatively by bile leak & peritonitis & jaundice, in 8 cases the injury was recognized on table & repair was done by reux en y method, one had choledo chodudenostomy, one case died after 6 years due to septicemia from cholangitis, One case died after 16 years due to secondary biliary cirrhosis, one case died due to septicemia though after a normal course of two months & one case had repetition of reux en y method for stone removal after 6 years. 

Pelvi-ureteric junction (PUJ) obstruction is a well-recognized entity that may present at any time – in fetal life, infancy, childhood, or early or late adulthood. As the most common site of obstruction in the upper urinary tract. There has been an improved understanding of the pathophysiology of primary congenital PUJ obstruction that has been reflected in the evolution of surgical options, from open surgical repair to minimally invasive surgery. This article discusses the surgical management of this condition along with the pathogenesis, clinical presentation, and diagnosis of PUJ obstruction.

Keywords: Kidney; Kidney pelvis; Ureteral obstruction; Surgery; percutaneous.