Traumatic abdominal wall hernia following handlebar injury can be easily missed and is thus underreported. A 12-year-old boy presented with handlebar injury to the left upper quadrant of his abdomen. Except for a localised swelling, thought to be related to a haematoma, he was haemodynamically stable. CT revealed an abdominal wall defect with herniating fat that was not evident clinically and was also missed on immediate ultrasound examination. As there were no associated injuries and the abdominal wall defect was small without any herniating bowel loops, masterly inactivity was observed. After 6 weeks, the swelling has disappeared completely and there is progressive reduction in the size of the defect.

No abstract

Polysplenia with situs inversus along with the torsion of spleen is a rare event. We report a case of a 12 year old child who presented with acute abdominal pain. There was an ill-defined mass in right hypochondrium and lumbar regions. The CT scan of abdomen revealed presence of multiple spleens with infarction of the largest spleen and features of complete dextroversion. Intraoperatively the infarcted spleen was found twisted around its vascular pedicle and removed.

No abstract

Xanthogranulomatous pyelonephritis is a severe, atypical form of chronic renal parenchymal infection, which mimics neoplasia and other inflammatory renal parenchymal diseases. Although xanthogranulomatous pyelonephritis has characteristic findings on sonography and CT scan, a clinical diagnosis is seldom possible. Correct diagnosis is made on exploration, by the presence of dense adhesions to the surrounding tissue and presence of pus in the kidney, which is confirmed histopathologically by the presence of lipid laden foamy macrophages, accompanied by both chronic and acute phase inflammatory cells.