Colon Lipoma Causing Colo-Colic Intussusception in an Adult: A Case Report from Tanzania.

Intussusception is rarely seen in adulthood but is commonly seen in the pediatric age group. Causes of intussusception in adults are commonly due to tumors and inflammatory diseases. Intussusception in adults accounts for less than 5% of intestinal obstruction. Colonic lipomas are usually asymptomatic and are mostly managed surgically with promising outcomes as seen in our case.

A case report of atypical presentation of a solitary brain metastasis from a primary lung cancer in a low resource setting.

INTRODUCTION AND IMPORTANCE: Brain metastasis is the most common associated consequence of primary lung cancers, and it has a major detrimental influence on patients' survival and quality of life. Modern imaging modalities such as brain MRIs and PET scans are preferred for assessing these lesions. Complete surgical resections have been shown to enhance survival. CASE PRESENTATION: We present the case of a 59-year-old male patient who had a history of progressive left-sided weakness and right-sided headaches with no respiratory symptoms. A solitary brain lesion was noticed, prompting a surgical resection. Histology findings confirmed brain metastases, and a thoracic CT scan revealed a primary lung tumour. The patient was scheduled for chemotherapy. DISCUSSION: Primary lung tumors often disseminate to the brain. The brain metastatic lesions in advanced lung cancer are often numerous and smaller in size, based on MRI imaging. The patient's symptomatology obscured the existence of an underlying lung tumour, delaying focused therapy. The early symptomatology and scans of our patient indicated the probability of a solitary brain tumour, necessitating a surgical excision. CONCLUSION: Prompt management of brain metastatic lesions is crucial. Yet, some patients emerge with atypical characteristics of the lesions that hint to a primary brain lesion and conceal the presence of a lung tumour. Enhancing these patients' prognoses necessitates a targeted therapy that includes a comprehensive examination, radiological imaging, and recognition of the distinctive brain patterns in patients with lung cancer. The merits of complete or incomplete resections for multiple brain metastatic lesions might be a fascinating subject of discussion.

Ocular, scrotal and abdominal trauma in a secondary blast injury.

Blast injuries are subjected to high morbidity and mortality in the general population. They cognate to single or multiple organ-related injuries that may be life-threatening. The unique injury patterns of blast injuries make treatment therapy complex. An adult male patient presented to our setting with multiple severe deep burn wounds resulting from a dynamite explosion. His computed tomography (CT) scan revealed numerous sharp shards around his body and a ruptured hemiscrotum with exposed testicles. Surgery was immediately done and with a good post-operative outcome. The severity of these injuries escalates in relation to the proximity of the explosions. A CT scan is an imperative diagnostic imaging modality. Treatment involves resuscitation, optimization, excision of non-viable tissues and damage control surgery. Delays in management may have detrimental consequences. Therefore, for physicians to manage the diverse injury manifestations that these patients may present with, they must grasp the pathophysiological patterns of blast injuries.

Valentino's syndrome: a bizarre clinical presentation.

A perforated peptic or duodenal ulcer may cause an unusual expression of right lower quadrant pain. In Valentino's syndrome, the chemical fluid from the ulcer flows via the right paracolic gutter to the right iliac fossa, causing peritoneal irritation and chemical appendicitis which will mimic pain in the right lower quadrant. We report a case of a 23-year-old male patient who presented with cramping lower abdominal pain with fevers and vomiting. His pain was mostly in the right lower quadrant and radiated to his back. A perforation-related pneumoperitoneum was found on a computed tomography scan, along with an accumulation of fluid in the abdomen and thickening of the pyloric antrum. Valentino's syndrome's aberrant clinical picture mimicking acute appendicitis is a pathognomonic presentation of the disease. Right lower abdominal pain should also prompt the scrutiny of atypical differentials, such as perforated ulcers. Physicians need to manage these patients with a high index of suspicion.

A large infected urachal mass in an adult: A case report in Tanzania.

INTRODUCTION AND IMPORTANCE: Urachal Mass results from a failure of obliteration of the urachal canal during fetal growth. The aetiology of urachal masses is ambiguous, being either of a cancerous or benign origin. Much literature is stipulated in children presenting with urachal-associated diseases but few in adult patients. This study aims at elucidating the existence of urachal mass with an abscess in a patient and the management modalities. PRESENTATION OF CASE: We present a case report of a 52-year-old female patient with a two months history of abdominal pain and discomfort associated with intermittent low-grade fevers, anorexia and marked weight loss throughout her illness. An abdominal ultrasound revealed the presence of an intra-abdominal mass. A CT scan showed a multilobulated urachal mass. She eventually had a successful operation and quick recovery postoperatively. DISCUSSION: In the adult population, most urachal-associated diseases are malignant, with few being of benign origin. With different presentations between the two aetiologies, the most benign urachal masses may lead to infection and inflammation that typically present with a lower abdominal mass and fever. Diagnosis is made by ultrasound or CT scan of the abdomen. Surgical drainage and excision of the mass are the mainstay treatment modalities. CONCLUSION: Urachal masses are rare in the adult population and are often missed in initial presentations. This will constitute poor management and outcome for patients. Physicians are to be alerted of the knowledge and make a clear assessment of patients perioperatively to avoid the delayed diagnosis, which may have consequent poor outcomes.

A rare case report of perforated viscerothorax in a traumatic diaphragmatic rupture.

INTRODUCTION: Diaphragmatic injuries are a consequence of penetrating or blunt thoracoabdominal trauma. Minor injuries are often masked. However, they are easily picked in the presence of diaphragmatic herniations. Delayed presentation is associated with the influx of visceral contents into the thoracic cavity, which may cause strangulation and obstruction. Viscerothorax is a rare complication of diaphragmatic injuries. PRESENTATION OF CASE: A case report of a 25-year-old male patient with a history of penetrating chest injury. He presented to our setting with a sharp abdominal pain and episodes of vomiting that were later accompanied by chest pains and difficulty breathing. A CT scan revealed the presence of a left hemidiaphragmatic injury with a viscerothorax and mediastinal shift to the right side. Surgery was immediately done and with a good postoperative outcome. DISCUSSION: Diaphragmatic injuries are still uncommon and are often overlooked in initial presentations. The presence of herniation through the defect prompts early diagnosis. Delayed presentations of these injuries are often affiliated with herniations that may be strangulating or obstructing with more severe complications such as viscerothorax causing tension into the thoracic cavity. CONCLUSION: The approach to diaphragmatic injuries at their initial presentation must be handled with an excellent index of suspicion in the evaluation of trauma victims to reduce management delay and avoid detrimental complications in contrast to the involvement of other associated injuries such as haemothorax, rib fractures, and visceral injuries. Early defect diagnosis followed by definitive surgical repair is the most favoured approach.