Umbilical Region Research Articles

On the features of the preperitoneal space multifascial structure in clinical and anatomical issues

AIM: to determine the prospects for the preventive endoprosthetics of the abdominal wall at preventing the development of postoperative ventral hernias.
 MATERIALS AND METHODS: A meta-analysis of the literature data performed to determine the effectiveness of preventive endoprosthetics for the prevention of ventral hernia formation. Topographical study has been conducted to explore the most promising levels of the mesh location.
 RESULTS: During the meta-analysis it has been found that performing preventive endoprosthesis of the anterior abdominal wall t in the preperitoneal space reduces the frequency of ventral hernias. There were no significant differences in the frequency of infectious complications and serom in the experimental and control groups according to studied publications. During the preparation it has been distinguished that between the transverse fascia and the peritoneum there is a preperitoneal fascia consisting of two leaves, which is most manifest in the lateral parts. In the umbilical region above linea arcuata the preperitoneal fascia is thinned and represented by separate fibers that are difficult to differentiate as a structure between the transverse fascia and the peritoneum. In the lateral parts of the abdominal wall, the preperitoneal fascia is well expressed. It has been distinguished that the retroperitoneal fascia, formed by the junction of two sheets of the Gerot fascia continues into the fascia between the transverse fascia and the peritoneum.
 CONCLUSION: Preventive endoprosthesis of the anterior abdominal wall is an effective and safe method of preventing the formation of postoperative ventral hernias. The anterior abdominal wall is characterized by a complex multifascial structure, which is of fundamental importance for various types of surgery. Between the transverse fascia and the peritoneum there is preperitoneal fascia which is represented by two leaflets. Its continuation is the retroperitoneal fascia (5 figures, 2 tables, bibliography: 8 refs).

A new approach to the treatment of patients with fungal dysbiosis

Objective — to elaborate efficient complex treatment of intestinal dysbiosis with the increased Candida spp. proliferation with the use of physiotherapeutic methods. Materials and methods. The study involved 228 patients with intestinal dysbiosis with the increased Candida spp. proliferation. The diagnosis was verified on the basis of general clinical, bacteriological and immunological investigations. Depending on the physiotherapeutic treatment, patients were divided into three groups, receiving the same type of drug therapy (polyene antibiotics orally in a dose of 1 million IU 4 times a day, according to indications they were administered systemic antimycotic drugs, diet therapy, biological products containing live bacteria, adsorbents, multivitamin complexes per os) in combination with electrophoresis with zinc and sulfur according to the 3‑electrode technique on the projection of the liver and pancreas, microwave therapy of the centimeter range in two fields simultaneously per procedure: the projection of the gallbladder and the umbilical region. The control group included 62 patients who received drug therapy only. Results. The positive result was achieved after all types of treatment in three groups, however its intensity varied. In the group of patients treated with complex therapy with inclusion of microelements’ electrophoresis according to the 3‑electrode technique on the projection of the liver and pancreas, the pronounced positive dynamics was revealed, in particular, quick relief of all complaints: flatulence disappeared in 68 % of patients, stomach ache in 81 %, and stool normalization was observed in 61 % of subjects. The significant improvement of the general condition was established in the rest of patients, confirmed by the considerable attenuation of the above listed symptoms. In case of the drug therapy only, flatulence disappeared in 5 % of patients, stomach ache in 38 %, and stool normalized in 15 % of subjects. Flatulence sustained in 36 % of patients, stomach ache in 48 %, unstable stool in 37 % of subjects. After complex therapy using microelements electrophoresis according to the 3‑electrode technique, almost complete sanitation of feces from Candida spp. (growth decrease almost in 40 times), increase in the growth of lactobacilli and bifidobacteria in the intestine has been established. These changes significantly differed from the results, obtained in the control group (decreased growth of Candida spp. was in 20 times less than in the main group, the increase in the growth of lactobacilli and bifidobacteria was in 10 times less). According to the results of laboratory tests, the significant improvement in digestion processes and in general condition was observed in the main vs. control group. Conclusions. The analysis of obtained results convincingly proves higher therapeutic efficacy of therapeutic measures in patients with intestinal dysbiosis with increased proliferation of Candida fungi when using microelements’ electrophoresis on the projection of the liver and pancreas or microwave therapy in the centimeter range on the projection of the gallbladder and the umbilical region (two fields simultaneously) in comparison with the drug therapy only.

Endometriosis of the anterior abdominal wall: ultrasound imaging data

Endometriosis of the anterior abdominal wall is a rare disease comprising 0.3–3.5 %. In turn, its diagnosis is quite challenging due to the nonspecific picture, including pain in the anterior abdominal wall during menstruation. Upon clinical examination, a thickened area may be observed in the anterior abdominal wall, usually in the area of tissue involved in surgery. Ultrasound examination is a simple, economical, and reliable method of choice to diagnose extragenital endometriosis. Here we describe a case report of the patient after surgery of anterior abdominal endometriosis localized in the rectus abdominis muscle in the umbilical region and confirmed by ultrasound test and morphological examination of excised macroscopic sample.

A Case Report of Non-specific Symptoms of Takayasu's Arteritis in a 17-year-old Female Patient

Takayasu's arteritis (TA) is a major chronic vasculitis disorder that its etiology is unknown. Patients are mostly Asian women who often show nonspecific symptoms such as fever, myalgia, arthralgia, weight loss, and anemia. The report relates to a 17-year-old girl suffering from complaints, permanent and uncontinental pain starting from a month earlier, with loss of appetite and weight loss (4 kg), and night sweats. She had no diarrhea or gastrointestinal symptoms but had a pain in the shoulder and chest area since the last 5 months. She got better after seeing a physician and receiving supplements. She had a history of pain in the ear from the last five months leading to otitis, and was treated as a case of brucellosis with a score of 1.20 in the Coombs Wright test. According to the physical examination findings, the patient's left, radial, ulnar, and proximal pulses, and blood pressure were unexplained, and in the supraclavicular region of the left and the umbilical region, bruit was heard and the shape of the left nail was changed. Laboratory tests and imaging were performed for the patient, and after angiography, the left subclavian artery stenosis was detected. Given the age and sex of the patient and the results obtained, she was diagnosed with Takayasu's arteritis.

Papillon-Lefèvre Syndrome: A Case Report

Takayasu's arteritis (TA) is a major chronic vasculitis disorder that its etiology is unknown. Patients are mostly Asian women who often show nonspecific symptoms such as fever, myalgia, arthralgia, weight loss, and anemia. The report relates to a 17-year-old girl suffering from complaints, permanent and uncontinental pain starting from a month earlier, with loss of appetite and weight loss (4 kg), and night sweats. She had no diarrhea or gastrointestinal symptoms but had a pain in the shoulder and chest area since the last 5 months. She got better after seeing a physician and receiving supplements. She had a history of pain in the ear from the last five months leading to otitis, and was treated as a case of brucellosis with a score of 1.20 in the Coombs Wright test. According to the physical examination findings, the patient's left, radial, ulnar, and proximal pulses, and blood pressure were unexplained, and in the supraclavicular region of the left and the umbilical region, bruit was heard and the shape of the left nail was changed. Laboratory tests and imaging were performed for the patient, and after angiography, the left subclavian artery stenosis was detected. Given the age and sex of the patient and the results obtained, she was diagnosed with Takayasu's arteritis.

Unhappy new year: mochi-induced small bowel obstruction

In the evening of 4 January a 70-year-old man presented to the hospital with signs of acute abdomen. On examination, he was afebrile. Deep palpation in the umbilical region elicited...

Aspectos imaginológicos e clínico-patológicos de panvasculite umbilical em bezerro: relato de caso

The diagnosis of umbilical infections in neonates can be obtained from clinical signs, but the intracavitary involvement of structures and associated complications can be underestimated, compromising the establishment of adequate therapeutic approaches or prognosis. This case report presents the clinical, imaging, pathological and microbiological aspects of an umbilical infection in calves. Physical examination of the animal identified apathy, low body score, increased volume in the umbilical region and joints. The abdominal palpation identified firm structures in topography of the arteries and umbilical vein. Imaging examinations of the abdomen and joints were performed. Multiple, hyperechogenic focal structures have been identified in the liver, as well as cylindrical and firm structures in topography of the arteries and umbilical vein. In the joints, osteolytic changes, periosteal reactions, subchondral sclerosis and formation of osteophytes were seen. Umbilical panvasculitis triggered arthritis and an infectious process in the liver, the case being assessed as having an unfavorable prognosis and the animal being referred for euthanasia. At necropsy, multifocal abscesses were observed in the pleura, ribs, omentum, spleen and liver. There was granulomatous exudate in the urinary vesicle. The affected joints presented thickening of the joint capsule with the presence of exudate. In the microbiological analysis of liver fragments, urinary vesicle content and joint exudate, Proteus mirabilis with resistance to antimicrobials was identified. Imaging studies collaborated with the establishment of the prognosis and conduct adopted, and must, whenever possible, be included in the clinical examination. In case of death, necropsy allows a correct association of clinical signs and imaging findings.

Optimization of the Soft Tissue Envelope of the Nose in Rhinoplasty Utilizing Fat Transfer Combined with Platelet-Rich Fibrin.

A thin or damaged skin soft tissue envelope may cause concerns in primary and secondary rhinoplasty. During postoperative healing, unpredictable scarring and contraction may occur and lead to significant aesthetic and trophic sequelae. Besides a meticulous surgical technique, there are no reliable techniques to prevent long-term skin damage and shrinkage. Fat transfer with addition of platelet-rich fibrin (PRF) harbors the possibility of local soft tissue regeneration and skin rejuvenation through growth factors and mesenchymal stem cells. It may also facilitate the creation of a thin fat layer on the dorsum to prevent shrink-wrap forces and conceal small irregularities. The goal is to provide evidence for the feasibility, durability, and beneficial effect of diced macrofat transfer bonded with PRF on the nasal dorsum. We present the technique of fat transfer conjugated with PRF as a nasal dorsal graft. Clinical endpoints were the prevention of trophic disturbances and atrophy at a 1-year postoperative follow-up. We present the skin mobility test as a clinical indicator of a healthy soft tissue envelope. The presented case series consists of 107 rhinoplasties. Fat was harvested in the umbilical or costal region. PRF was created by centrifugation of autologous whole blood samples. Macrofat was diced, cleaned, and bonded with PRF. The compound transplants were transferred to the nasal dorsum. There were no perioperative complications or wound-healing issues. Mean follow-up was 14 months. Clinical inspection showed good skin quality and no signs of shrinkage, marked scarring, or color changes with positive skin mobility test in all patients. Survival of fat was confirmed by ultrasonography and magnetic resonance imaging. Diced macrofat transfer in conjunction with PRF to the nasal dorsum is a feasible and safe method. A beneficial effect on the soft tissue envelope is demonstrated as well as the prevention of shrink-wrap forces.

Hernia incisional umbilical (M3). ¿Son diferentes las hernias de trócar? Análisis comparativo del registro EVEREG

IntroductionIncisional hernia (HI), in open and laparoscopic surgery, is a very frequent complication. HI located in the umbilical region are called M3. The main aim of this study is to compare HI produced by the placement of an umbilical laparoscopic trocar (M3T) with those located in M3 in open surgery (M3O) in terms of basal characteristics, complications and recurrences; and secondarily the identification of risk factors. MethodCross-sectional observational study based on the national prospective registry EVEREG during the period of July 2012 - June 2018. The main variables were recurrences and postoperative complications. Both groups (M3T and M3O) were compared. Multiple logistic regression was performed to identify the risk factors of the entire cohort. Results882 had a follow-up time longer than 12 months. M3O group presented superior ASA-Class, more complex HI and previous repair. It also presented a higher recurrence rate at 12 and 24 months (8.6 vs. 2.5%; p < 0,0001 and 9.3 vs. 2.9%; p < 0.0001) and higher postoperative complications rate (21.9 vs. 14.6%; p = 0.02).Previous repair, intervention length and associated procedures requirement were identified as risk factors for postoperative complications. Absence of a specialist present during surgery, previous repair, and the absence of complications were identified as risk factors for recurrence. In the PSM analysis no differences were detected in of complications and recurrences. ConclusionsHI M3O is more complex than M3T. The complexity is not related to the origin of the hernia but to its characteristics and those of the patient.

Umbilical Fascial Defects are Common and Predict Trocar Site Hernias After Laparoscopic Appendectomy.

Investigations have demonstrated that trocar site hernia (TSH) is an under-appreciated complication of laparoscopic surgery, occurring in as many as 31%. We determined the incidence of fascial defects prior to laparoscopic appendectomy and its impact relative to other risk factors upon the development of TSH. TSH was defined as a fascial separation of ≥ 1 cm in the abdominal wall umbilical region on abdominal computerized tomography scan (CT) following laparoscopic appendectomy. Patients admitted to our medical center who had both a preoperative CT and postoperative CT for any reason (greater than 30 days after surgery) were reviewed for the presence of TSH from May 2010 to December 2018. CT scans were measured for fascial defects, while investigators were blinded to film timing (preoperative or postoperative) and patient identity. Demographic information was collected. 241 patients undergoing laparoscopic appendectomy had both preoperative and late postoperative CT. TSH was identified in 49 (20.3%) patients. Mean preoperative fascial gap was 3.3 ± 4.3 mm in those not developing a postoperative hernia versus 14.8 ± 7.3 mm in those with a postoperative hernia (P < .0001). Preoperative fascial defect on CT was predictive of TSH (P < .001, OR = 1.44), with an Area Under the Curve (AUC) of .921 (95%CI: .88-.92). Other major risk factors for TSH were: age greater than 59 years (P < .031, OR = 2.48); and obesity, BMI > 30 (P < .012, OR = 2.14). The incidence of trocar site hernia was one in five following laparoscopic appendectomy. The presence of a pre-existing fascial defect, advanced age, and obesity were strong predictors for the development of trocar site hernia.

Abdominal Positron Emission Tomography Combined With Magnetic Resonance Imaging in Chronic Granulomatous Disease

Abdominal Positron Emission Tomography Combined With Magnetic Resonance Imaging in Chronic Granulomatous Disease

207 Proteomic analysis of umbilical cord in fetal growth restriction and preeclampsia

Fetal growth restriction (FGR) is associated with adverse perinatal outcomes. Pre-eclampsia (PreE), a risk factor for FGR, independently increases the associated perinatal morbidity and mortality. The structure of the umbilical cord in the setting of FGR and FGR in with PreE is understudied. We aimed to examine changes in the umbilical cord (UC) composition in pregnancies complicated by FGR and FGR + PreE. UC from 15 gestational age-matched pregnancies with isolated FGR (n=5), FGR + PreE (n=5) and controls (n=5) were collected, and a standardized portion of the UC was processed for histologic and proteomic analysis. Manual segmentation image analysis was performed to measure cross-section areas of umbilical cord regions. Wharton’s Jelly samples were analyzed on a tims-TOF Pro. Spectral count and ion abundance data were analyzed using intersection data from a combination of multiple mass spectrometry search and inference engines. A p-value <0.05 represents statistical significance. UCs from FGR and FGR+PreE had lower cross sectional area and Wharton’s Jelly area compared with control (p = 0.03 for both). 28 proteins were significantly different in abundance measurement and 34 in spectral count in FGR vs controls (p-value < 0.05). Gene ontology analysis showed the majority of changes were in extracellular matrix proteins. 48 proteins were significantly different in abundance measurement and 5 in spectral count between PreE + FGR vs controls with the majority of changes occurring in inflammatory pathways. This study suggests significant changes in the structure and composition of the umbilical cord in FGR and FGR+PreE pregnancies. These differences represent distinct etiological pathways. Further work in validating these proteomic differences may enable identification of novel molecules as therapeutic targets for FGR and FGR + PreE.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

The Effectiveness of Goksuradi Guggulu and Varunadi Kwath with Goksuradi Guggulu in the Management of Mutrasmari w.s.r. to Urolithiasis

Introduction: Mutrasmari is considered as Astamahagada in Ayurveda in which there is formation of stone in the Mutravaha srota. It is an ancient disease with global distribution. The symptoms of Mutrasmari are excruciating pain in urethra, ureter, urinary bladder and over umbilical region, haematuria etc and later that may lead to emergence by the obstruction in urination. Hence on the basis of pathology and its clinical presentation the disease is correlated with Renal calculus or Urolithiasis in modern Urology.&#x0D; Methodology: 38 patients diagnosed as Mutrasmari were randomly divided in two groups as per the lottery system of randomization. The patients of Group A were given 1000mg Goksuradi guggulu twice a day for 45 days. The patients of Group B were given 1000 mg of Gokshuradi guggulu along with 45 ml of Varunadi kwatha twice a day for 45 days. The patients of both the groups were advised to follow the dietary regimen and lifestyle modification. The effect of the intervention was assessed before and after treatment.&#x0D; Result: The treatment outcomes were statically analyzed and found that both treatment groups were significant in relieving the symptoms like abdominal pain, burning micturition, dysuria and expulsion of renal culculi. 100% relief noted on Surudhir mutrata (Hematuria) where only single patient complaint had been registered as Hematuria in Group B. In case of Mutradaha (Burning micturation) there was mild improvement in group A and moderate improvement in group B. Similarly there was complete remission in Mahati vedana (Dysuria and Pain in abdomen) case in both Group A and Group B after the treatment. Conclusion: Gokshuradi guggulu along with Varunadi Kwatha shows more significant result than Gokshuradi guggulu.

Study on Effectiveness of Chakramarda (Cassia tora) Ghrit and Go-Ghrit in the Management of Parikartika (Fissure in Ano)

The term Parikartika is used for the condition of Guda (anus) where cutting and burning pain occurs, also alongwith this pain occurs in anus, penis, umbilical region and neck of urinary bladder with cessation of flatus. In modernmedicine trend of the management depends on the type of the disease, e.g. in cases of acute variety with short historyof the problem can be treated on the conservative lines, which results in healing of almost all acute and majorityof chronic fissures. Priority must be placed normalization of bowel habits such that the passage of stool causes lesstrauma to anoderm. The addition of fiber to the diet to bulk up the stool, stool softener and adequate water intake arethe simple and helpful measures. In the present study, an effort was made to derive a standard and easily accessibletreatment for fissure-in-ano. Chakramarda is having vra?a shodhana and ropa?a properties which can help the Vra?a(ulcer) to heal rapidly. Its base is Ghrit which itself is having Samskaranuvarti (i.e. it enhances the properties of drug)and healing properties. Chakramarda Ghrit is economically beneficial by virtue of easily available ingredients anda time tested classical formulation. Hence, it was selected for the clinical evaluation in the present study. It provedto be significant in managing Fissure in ano, it reduced pain, itching, bleeding and promoted healing. Properties ofits chemical constituent’s probable mode of action can be derived that Chakramarda is efficient in healing any ulcerlike anal fissure.

Single-incision Laparoscopic Cholecystectomy: A New Classification for Shape of the Navel and Modification of the Method for Incisions in the Umbilical Region

Single-incision Laparoscopic Cholecystectomy: A New Classification for Shape of the Navel and Modification of the Method for Incisions in the Umbilical Region

Clinical significance of umbilical region involvement in pemphigus vulgaris in a series of 81 ethnic Poles: a comparative analysis of the distribution of lesions in two infrequent locations.

IntroductionAutoimmune bullous diseases are potentially life-threatening dermatoses which present with cutaneous and/or mucosal blisters, diagnosed on the basis of clinical manifestations, direct immunofluorescence of perilesional tissue, and serum testing for circulating autoantibodies. Sometimes, lesions in the navel can lead to the diagnosis of a bullous disease.AimTo assess the frequency of occurrence of pemphigus lesions located in the navel area and nail apparatus in pemphigus vulgaris (PV) in ethnic Poles.Material and methodsEighty one patients (31 males and 50 females, mean age 59 years) with dermatoses of the PV group diagnosed in 2002-2020 were retrospectively analysed using their photographic files. Statistical analysis was performed using the difference test between two proportions to check the difference between the percentage of PV patients with navel area involvement and nail apparatus involvement.ResultsThere was no statistically significant difference between PV patients with nail apparatus involvement (12.3%) and navel area involvement (14.8%) (p = 0.4632). Only females had lesions in the navel area in our series of PV patients.ConclusionsIt is speculated that the causal relationship may exist between the female reproductive system and the pattern of expression of PV lesions around the umbilicus. The awareness that PV can infrequently affect the umbilical region and the nail apparatus should help in some cases to establish the diagnosis of PV. The periumbilical involvement can facilitate the performance of DIF in individuals with lesions in less accessible areas.

Surgical Approach in Calves with Omphalitis

Background:Pathological changes in the umbilical region are common in calves. Among such alterations, omphalitis is included. This term is used to define inflammation and infection of the external structures of the umbilicus. According to the affected structures, it can be subclassified into omphalophlebitis, omphaloarteritis, omphalourachitis and panvasculitis. These inflammations are usually associated with bacterial infections. There are predisposing conditions that include inadequate handling such as poor hygiene and neglect of primary care. Omphalitis can affect the animal in a multisystemic way, compromising its well-being and bringing economic losses. In treatment, the use of antimicrobials does not always solve the problem. Thus, surgical treatment can be used, which has good results and should be the choice in the disease. The objective of this work is to report 30 cases of omphalitis in calves, submitted to surgical or conservative treatment.Materials, Methods &amp; Results: Thirty cases of omphalitis in calves treated in the routine of the Veterinary Hospital of the Paranaense University was analyzed. On physical examination, the animals presented fever, apathy, hyporexia or anorexia and increase of umbilical volume, usually with purulent secretion. Some animals had sepsis and arthritis. In animals with sepsis, hyperemia of the episcleral vessels, dehydration and severe apathy were observed. In calves with arthritis, increased joint volume, pain on palpation and lameness were observed. In animals where the owners did not authorize the surgery, treatment was instituted with sulfadoxine and flunixim meglumine. In dehydrated calves, fluid therapy was used. Animals that were surgically treated received the same clinical treatment protocol as non-operated animals. The surgical procedure was performed under general anesthesia and consisted of resection of the affected umbilical structures. Omphalophlebitis was the most common illness. The most frequent complication was sepsis. Calves treated surgically had a higher survival rate (86.66%) than those treated clinically (46.67%).Discussion: The clinical signs presented by all animals converged with the literature, allowing for clinical diagnosis. Clinical examination is essential for diagnosis in omphalitis cases. Complementary methods include ultrasound, thermography and laparoscopy, which are important to identify changes in intra-abdominal umbilical structures. Accurate diagnosis of the involved structures was only possible in animals surgically, as well as alterations in organs such as the liver and bladder. There is great variability related to the umbilical structures involved, according to initial care, breeds, seasonality or even the method of conception. Unlike what is observed in the literature, in the present study, there was a higher prevalence of omphalophlebitis, demonstrating variability in relation to the umbilical structures involved. Sepsis, observed in 16.7% of cases, results from bacterial ascension of the umbilical structures. Lameness due to polyarthritis was found in 10% of animals. Meningoencephalitis was observed in 3.3%. Hepatic and retroperitoneal abscedation were observed in 6.7% and 3.3% of cases, respectively. Conservative treatment with antibiotics and local antiseptics has a limited effect on this type of condition, which was proven in the presentstudy, since the survival rate was statistically higher in animalssurgically treated.Keywords: surgery, umbilical structures, bovine, neonate.Descritores: cirurgia, estruturas umbilicais, bovinos, neonato.Título: Surgical Approach in Calves with Omphalitis

Gigantic Abdominal Pseudocyst: An Unusual Evolution of the Ventriculoperitoneal Shunt

Background: The ventriculoperitoneal (VPS) shunt is the most common procedure in the treatment of hydrocephalus in children. Abdominal cerebrospinal fluid pseudocysts are a rare complication of the ventriculoperitoneal shunt with an incidence ranging from less than 1% to 10% and are more prevalent in children. The malfunction of the ventriculoperitoneal shunt can cause headaches, nausea, vomiting, altered level of consciousness and abdominal pain due to the accumulation of cerebrospinal fluid. There is no consensus on which type of treatment is better in this case, but there are several available methods. Aim: To report an unusual case of a giant abdominal cerebrospinal fluid pseudocyst as a complication of the VPS. Case Presentation: Female 1 y/3 months old patient, less than 7 kg, that has been diagnosed with hydrocephalus prenatally, confirmed postnatally associated with an esophageal atresia and distal tracheoesophageal fistula (AE/FTE, Gross III), was admitted to our service with progressive abdominal distention without obstructive intestinal signs or peritoneal inflammatory signs. The CT scan of the abdomen showed a large liquid collection (estimated volume of 600 ml), centered on the umbilical region, diagnosed as a giant abdominal cerebrospinal fluid (CSF) pseudocyst from the VPS. All of data and information were obtained from her medical records at the infirmary of the Conjunto Hospitalar de Sorocaba (CHS), São Paulo. Conclusion: Abdominal CSF as a cause of these giant pseudocysts should be considered as a diagnostic hypothesis for cases of large abdominal distensions without intestinal involvement in patients with a VPS. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

A Rare Case of Pediatric Gastrointestinal Stromal Tumor

Aim: To discuss the management of rare pediatric tumor, Gastrointestinal Stromal Tumor (GIST)Methods: We report a case of 1 year old male child with transverse colonic GIST. Child presented with upper abdominal lump of one month duration with no other constitutional symptoms. On examination solitary intra-abdominal lump of size 10cm and 8cm, non tender, firm, freely mobile in the umbilical region was found. Contrast enhanced CT abdomen revealed 8.3cm and 6.2cm heterogenous enhancing mass at root of the mesentery. On exploration an exophytic pedunculated mass was arising from mid transverse colon, tumor excised along with 2 cm colonic margin. Counselling done as chemotherapy was not available in children. Child has been under regular followup for the last 18 months. Results: Histopathological examination revealed GIST with high mitotic index, immuno-histochemistry (IHE) markers CD117,CD34 and DOG 1 were positive.Conclusion: Pediatric GIST is very rare and there are no well established therapeutic guidelines for the management of pediatric GIST, so needs close long term followup after surgery and further guidelines need to be established.

Clinical, radiological and morphological spectrum of squamous cell carcinoma

Squamous cell carcinoma is malignancy of the squamous epithelial lining. it has been a major cause of morbidity and mortality worldwide as well as in Indian population. This study was undertaken to analyse the spectrum of squamous cell carcinoma cases presenting at G.G.G. Hospital, Jamnagar to understand the clinical presentation, morphological patterns and anatomical site distribution pattern of squamous cell carcinoma lesions.Over a 2-year period, 115 cases were retrieved from the files of cytopathology and histopathology laboratory, Department of Pathology and Radiology of M. P. Shah. Government Medical College, Jamnagar.Out of total 115 cases, maximum cases- 103 (89.56 %) were of squamous cell carcinoma. The incidence was observed to be high in &amp;#62;40 years of age. In our institute, we studied total 115 cases of various sites which were diagnosed as squamous cell carcinoma. Of these 115 cases, 47 (40.86%) cases were of lung, 57 (49.46%) cases were of metastasis of Squamous cell carcinoma to lymphnode with maximum 31 (54.38%) cases presented to us as unknown primary. In our study 11 cases involving miscellaneous sites such as oral cavity, lip, cheek, midline neck, pre-auricular region, anterior chest wall and umbilical region, were presented as primary, metastasis and recurrence.Correlation spectrum of morphology, clinical presentation and radiological examination of squamous cell carcinoma with its cytological and histopathological features are important tools to predict prognosis and to facilitate the diagnosis of squamous cell carcinoma and diagnostic dilemma can be prevented.