RÉSUMÉ
INTRODUCTION: Cystic lesion of the omentum and mesentery are rare. The incidence of both cyst types has been variously reported to vary from 1/27,000-100,000 hospital admission. Omental cysts occur three to ten times less frequently than mesenteric cyst. Preoperative diagnosis is infrequently made because of lack of characteristic symptoms and signs. CASE PRESENTATION: We present our diagnostic and management challenges in a 43-year-old man with an unusually giant omental cyst confirmed as fibrosarcoma at histology. The cyst gave the abdomen an anteroposterior diameter of about 74 cm that could not be penetrated sufficiently by X-ray photons to produce diagnostic image even at maximum attainable output. Patient benefited from surgical excision. The removed cyst contained about 35 litres of fluid. CONCLUSION: Neglected omental cysts as in this case may grow to enormous size, undergo malignant transformation and poses serious diagnostic and surgical challenges.
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INTRODUCTION: Giant meconium cyst resulting from antenatal bowel perforation is rare and hardly reported in multiple gestations. We found only four documented cases in the electronic literature. CASE PRESENTATION: We report a giant meconium cyst in an 11-hour-old Nigerian boy of a discordant twin having ultrasonographic and plain radiographic diagnosis and surgical confirmation. Increasing abdominal girth from 35 cm to 41 cm within four hours of admission without ascites, pneumoperitneum and significant bowel distension make us assumed the meconium cyst to be "growing" in size. We reviewed the literature and proposed that where the fibrinous wall of meconium cyst allows for distensibility and the communication between the perforated bowel and meconium cyst persists, the meconium cyst acting as reservoir may continue to "grow" in size without remarkable intestinal distension probably, until the elastic limit is lost. CONCLUSION: Meconium cyst can occur in twin pregnancy, grow to occupy the abdomen almost completely and may cause neonatal apnoea. The outcome is good post surgery.
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We present two sporadic cases of complete ulnar hemimelia, a rare congenital defect. In one case, ulnar hemimelia was associated with tridactyly and elbow malrotation with radiohumeral synostosis; in the second case, ulnar hemimelia was assciated with mono-metacarpal bidactyly and anterior cubital webbing of the elbow with fixed flexion. To the best of our knowledge, there is dearth of information on these combinations of anomalies in the literature and their management remains a challenge.
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INTRODUCTION: Foetus-in-foetu is a very rare congenital abnormality where a malformed foetus is included within the body of another foetus. Less than 200 cases have been reported with over 80% occurring in the abdomen. Only three cases of cervical foetus in foetu have been reported. The present case of giant orocervical foetus-in-foetu appears to be an index case. CASE PRESENTATION: This is a report of an extremely rare orocervical foetus-in-foetu with grotesque oddity diagnosed on prenatal ultrasonography at 35 weeks gestational age in a 28-year-old, G2P1+0, Nigerian woman who was unsure of her last menstrual date or month. The included foetus had two eyes, cranium, nose, long bones and a spine. The mother's attempts at vaginal delivery rather than the elective Caesarean delivery she was offered resulted in obstructed labour and intrauterine foetal demise. CONCLUSION: Giant cervical foetus-in-foetu is extremely rare. It could result in obstructed labour if vaginal delivery is attempted.
RÉSUMÉ
OBJECTIVES: Thanatophoric dysplasia (TD), the most common of the congenital lethal skeletal dysplasias occurs sporadically in 1/64,000-100,000 live births. To the best of our knowledge, the in utero attitudes and behaviours of such babies with serial ultrasound scans have not been previously described. We present the in utero third trimester sonographic behaviors of TD in a 22-year-old primigravida diagnosed at '32weeks' gestational age along with the clinical and radiographic characteristics. METHODS: The same radiologists to observe the behavior of a thanatophoric dwarfs did three fortnights serial ultrasound scans. RESULTS: The baby was found to have short limbs that were constantly in rigid abduction, flexed at both elbows and knees, and demonstrated poverty of synchronous movements. The upper limbs were perpetually in embracing position during all scans. In addition, he was hyperactive, showing "yoyo" body movement and constantly hyper-extended neck. Postmortem radiograph was diagnostic of TD. CONCLUSION: Though he baby died intra partum, the observed attitudes and behaviors on serial prenatal ultrasonography, which provided us with sufficient information to counsel the family, managed the pregnancy, and direct the postnatal evaluation could possibly add to the in utero diagnostic sonographic features of TD.