A Rare Case of Obstructed Recurrent Incisional Hernia With Incidentalomas.

Incisional hernias (IHs) are the most common postoperative complication of incisions during laparotomy and contribute to a significant burden. The aetiology of IHs varies depending on the surgical technique, patient's condition, and surgeon's experience. Many patients present with abdominal swelling and some degree of discomfort, and in an emergency, the presentation is usually as bowel obstruction or strangulation, necessitating immediate exploration. Hernias can be repaired by closing the defect with a nonabsorbable suture or using mesh. Amidst the use of invasive techniques and mesh, the rate of recurrence remains high for IHs, with pain and infection being the most common symptoms. The consequence of IH repair is affected by comorbid conditions such as chronic cough, constipation, urethral stricture, benign prostate hyperplasia, ascites, and obesity. We present a case of a 63-year-old male with an IH, adrenal adenoma, and adrenal cyst, which was an incidental finding.

Gastric Necrosis: A Rare Complication of Gastric Mucormycosis.

Mucormycosis is an invasive fungal infection. The prevalence is low for this disease, and the most common site of its occurrence in the gastrointestinal system is the stomach. The clinical signs and symptoms of gastric mucormycosis are vague such as pain in the abdomen, nausea, vomiting, haematemesis, etc. In the current study, a 42-year-old male patient came with complaints of pain in the abdomen associated with vomiting and mild-grade fever based on vague clinical presentation and imaging like upper gastrointestinal endoscopy and computer tomography angiography of the abdomen. Our preoperative diagnosis was gastrocolic fistula secondary to acute on chronic pancreatitis, which was managed by emergency exploratory laparotomy, resection, and anastomosis. Histopathological examination was successful in confirming the diagnosis of mucormycosis. Through this case report, we intend to draw surgeons' and physicians' attention to gastrointestinal mucormycosis, an emerging cause of gastric necrosis in young patients in the post-coronavirus disease era, and that physicians need to be more aware of the consequent high mortality and morbidity. Early diagnosis followed by aggressive debridement, antifungal therapy, and managing the underlying disease is the most efficient way to reduce mortality associated with the disease.

A Giant Epidermal Cyst in the Gluteal Region: A Case Report.

Epidermal cysts are the most commonly occurring cysts in the subcutaneous plane and are usually asymptomatic, small, and slow growing. When the size of an epidermal cyst is greater than 5 cm, it is considered a giant epidermal cyst. Common etiologies include sun-damaged skin and acne vulgaris, and they can appear anywhere in the body, but preferably over the face, neck, and trunk. Unusual sites include the breast, penis, spleen, bones, subungual region, palms, soles, and buttocks. In this report, we presented the case of a 31-year-old female having a large, painless, gradually progressing swelling for two years in the left gluteal region, which was insidious in onset and slow-growing. The patient eventually described a discomfort that made it impossible for her to sit for long hours or sleep in a supine position. Clinical examination revealed circumscribed mass over the left gluteal region from which diagnosis of giant lipoma was confirmed, but due to its large size and involvement of the whole left buttock, we considered it important to perform an ultrasound examination to reinforce our diagnosis, which revealed a large cystic mass in the left gluteal subcutaneous plane that was excised. As a definitive management, surgery was performed with excision of the swelling, which was extracted in toto and was identified as a cyst, and on histopathological examination, the cyst wall was lined by stratified squamous epithelium. Hence, this case report highlights a rare case of a giant epidermal cyst in the gluteal region.

Bilateral Phyllodes in a 12-Year-Old Adolescent: Report of a Rare Case.

Phyllodes tumors, previously known as cystosarcoma phyllodes, are fibroepithelial tumors that consist of epithelial and cellular stromal components. These tumors have a predilection to recur after wide local excision and to attain massive sizes. They account for less than 0.5% of cases of all breast neoplasms and are primarily found in the third to fourth decade of life, and rarely in adolescence. However, less than 25 cases are reported to date wherein this tumor is found in adolescent females, with this case being one of those. This is a report of a rare case of a 12-year-old premenarchal female with bilateral phyllodes tumor, highlighting its peculiarities, diagnostic features, and surgical management in view of the patient's age and quality of life.

The Dilemma in the Diagnosis of Paratesticular Lesions.

Intra-scrotal swellings are commonly encountered all over the globe. Common causes include hydroceles, hernias, lipoma, cysts, etc. Rarely manifested as scrotal swelling is paratesticular swelling arising outside the testis. Clinically, they may mimic a tumour arising from testis either benign or malignant with grave consequences. Diagnosis hence is of paramount importance. It has to be ruled out as a diagnosis of exclusion. Knowledge of such swelling those other than the ones originating from the testis is thus crucial in order to have a better patient outcome in the absence of any mandated published guideline.