Colonic metastases 13 years after the primary ovarian cancer: a case study with a brief review of literature.

Metastatic ovarian malignancy is a known and dreaded complication of ovarian malignancy. Ovarian malignancies primarily disseminate through the peritoneal cavity and are only superficially invasive. They rarely metastasise through the haematogenous route, but that occurs in the presence of heavy peritoneal disease. The involvement of the colon in advanced ovarian malignancy is mostly through the peritoneal seedlings. It is very rare for an ovarian malignancy to invade through the serosa into the submucosa and mucosa of an adjacent colonic segment in the absence of active peritoneal disease. This occurring 13 years after the primary malignancy and after receiving a full course of chemotherapy is very interesting. There is always a possibility of a second primary cancer but in this case immunohistochemistry clearly clinched the diagnosis of an ovarian metastasis to the colon.

Rare case of peristomal pemphigus vulgaris in an operated case of carcinoma of the rectum.

Pemphigus vulgaris (PV), in association with malignancy of the rectum, is a very rare presentation. We present here a case of a 58-year-old woman presenting with atypical skin eruptions in the peristomal area, which gradually progressed to her entire body. These lesions were later diagnosed to be PV. She developed these lesions in her postoperative period following an anterior resection with a covering ileostomy for her rectal malignancy. She had received neoadjuvant chemo+radiotherapy for her malignancy.

Duodenal atresia with familial apple peel syndrome: case study with review of literature.

This is a case report of a neonate who was antenatally diagnosed with jejunal atresia which turned out to be duodenal atresia with apple peel syndrome. A previous sibling, who also had apple peel but with jejunal atresia, succumbed to sepsis after surgery. The first sibling had jejunal stenosis and had died of sepsis following surgery. Combination of duodenal atresia with apple peel is extremely rare. This coupled with a familial condition is rarer still. This case was challenging due to the short length of the gut and prolonged need for total parenteral nutrition and sepsis in postoperative period.

Biliary complications of cholecystectomy.

Biliary complications occur because of causes such as obscure or variant anatomy, predisposing conditions such as fibrosis or severe inflammation, equipment failure, and surgeon factors. The aim of this study was to review the optimal surgical treatment. Analysis of 81 patients with bile duct injuries treated in a single referral unit over an 8.5-year period was done. Time of detection of biliary injury and its presentation were ascertained as well as the level of injury (Strasburg's). In 8 patients, injury was detected intraoperatively, and 41 were detected in the early postoperative period with bile leak (n = 25) or obstructive jaundice (n = 10). Those diagnosed in the delayed postoperative period (n = 32) presented with recurrent cholangitis (n = 9), obstructive jaundice (n = 16), and a cholestatic enzymatic profile (n = 1). Roux-en-Y hepatico-jejunostomy was the preferred option (n = 64). One patient died because of biliary peritonitis. Improper treatment is associated with disastrous results, but early recognition and correct management can lead to a successful outcome and good prognosis.