Research
Subdiaphragmatic Abscess: Complication of Emergency Laparotomy
Intra-abdominal abscesses usually occur following any intra-abdominal surgery, trauma, Gastrointestinal infection or intestinal perforation. In particular, the diagnosis of sub-phrenic collection can be notoriously difficult. This fact is expressed by the well-known aphorism: 'Pus somewhere, pus nowhere else, pus under the diaphragm'. Sub-diaphragmatic abscesses form between the diaphragm and abdominal organs, such as the liver and spleen. Depending on the severity of the sub-diaphragmatic abscess and the cause, treatment method may vary for each case. The abscess may be treated with early percutaneous drainage and empiric intravenous antibiotics. When dealing with post-operative persistent pyrexia that does not react to antibiotics, surgeons must always be careful, and the likelihood of a sub-diaphragmatic abscess must always be considered. If not treated, thoracic and abdominal complications may prevail, in rare cases, death.We present a case of sub-diaphragmatic abscess in a patient with a perforated duodenal ulcer treated by ultrasound-guided percutaneous drainage with a good outcome.
The Enigma of Lipofibromatous Hamartoma: A Deep Dive into a Rare Pathology
lipofibromatous hamartoma (LFH) is a rare condition characterized by the infiltration of peripheral nerves by fibrous and adipose tissues. Patients typically present with gradually enlarging, non-tender lesions in the distribution of the affected nerve, most commonly the median nerve, which is involved in 66% to 80% of cases. Symptoms often include pain, sensory deficits, and motor dysfunction, with affected individuals reporting numbness and tingling along the volar aspect of the wrist and hand. Motor deficits tend to appear later in the course of the condition [1].
Rickettsial Infections: A Clinician’s Diagnostic Dilemma
Rickettsial diseases are arthropod borne zoonotic infections that are being increasingly recognized as one of the causes of pyrexia of unknown origin (PUO). These pathogens are gram-negative bacteria causing fever and rash, usually transmitted to humans by tick or flea bite. These infections must be differentiated from other febrile illnesses such as enteric fever, malaria, dengue, leptospirosis, and infectious mononucleosis. The common clinical presentation includes fever with chills and rigor, headache, vomiting, cough, conjunctival congestion and eschar. Presenting with varied and non-specific symptoms, ignorance, and low index of suspicion, they are often under-diagnosed due to the unavailability of the reliable diagnostic test. Weil- Felix test (WFT) is a non-specific heterophile tube agglutination test in which antibodies against rickettsiae are detected. If timely treatment with doxycycline is instituted the adverse consequences can be well averted.
