Fecalomas represent firm organized form of impacted feces. They are commonly seen in sigmoid colon. We report a case of large fecaloma in young adult female with chronic constipation, which was managed conservatively.Keywords Fecaloma . Sigmoid colon . Constipation Case SummaryA 22-year-old female came with complains of chronic constipation for the last 3 months. On examination, abdomen was distended, more on left side. A vague mass was palpated in the left iliac fossa. Per-rectal examination revealed empty rectum with no palpable mass or stricture. Plain abdominal X-rays showed dilatation of distal transverse colon and entire descending colon that was filled with fecal matter. Small bowel loops were displaced to the right side of the abdomen. Ultrasonography of abdomen revealed no contributory finding due to gaseous abdominal distension. A contrast-enhanced computed tomography (CT) of the abdomen was performed. CT showed markedly dilated descending and sigmoid colon filled with intraluminal fecal residue that appeared organized in distal descending and sigmoid colon forming a well-defined intraluminal fecal mass of approximately 12 × 11× 10 cm in size (Figs. 1 and 2). Transverse colon was also dilated. No obstructing intraluminal mass or stricture was seen in rectosigmoid region. The patient was managed conservatively with enemas and laxatives.

Background: Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist. Thus, thorough understandings of the anatomy and pathological process that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. The objective of this study was to interpret aetiopathology, clinical presentation, differential diagnosis and management of mass in the right iliac fossa.Methods: A total of 60 cases with mass in the right iliac fossa (RIF) were included in the study. Investigations like colonoscopy and CT scan were done. All the cases underwent right hemicolectomy followed by chemotheraphy. Other cases like psoas abscess, non-hodgkins lymphoma, Meckels diverticulum and intussusception were diagnosed and treated.Results: During this study period, a total number of 36 cases of appendicular mass and 10 cases of appendicular abscess were encountered. In this study 10 cases of appendicular abscess were encountered and treated by extraperitoneal drainage, 4 cases of ileocaecal kochs were encountered. Patients presented with constitutional symptoms like pain, fever, weight loss etc. Right hemicolectomy was done, specimens after operative procedures were examined microscopically and histopathological diagnosis. 3 cases of carcinoma caecum and 3 cases of carcinoma ascending colon were seen. Contrast enema was done which showed filling defect and mucosal irregularities.Conclusions: This study showed that appendicular mass is the commonest pathology in right iliac fossa amongst all and conservative treatment followed by interval appendicectomy is the best mode of treatment. Carcinoma of the colon and ileocaecal tuberculosis is the other two common causes for mass in the right iliac fossa. These cases also carry a good prognosis, if properly diagnosed and treated. The other rare causes of mass in the right iliac fossa are intussusception, psoas abscess and Non Hodgkins lymphoma.

Granular cell tumor, also known as Abrikossoff's tumor, is a rare benign tumor of neural origin, which can arise at any part of the body; however the tongue (30%) is the most commonly affected site. Its clinical behavior is usually benign although malignant and multifocal forms are also known to occur. CASE REPORT: A case of granular cell tumor in a 33 year old female who presented with a firm hyperpigmented nodule on the lateral aspect of the left upper arm. CONCLUSION: This case is quite rare: only a few cases were presented in literature with hyperpigmentation.

Dermatofibrosarcoma protuberans is a rare, usually superficial soft tissue sarcoma, which is diagnosed by its typical clinical manifestations. We report a case of histopathologically proved dermatofibrosarcoma protuberans of the left upper posterior trunk in a 35-year-old female for whom complete surgical resection was done.

Background: Gastric cancer is associated with high mortality. The current five-year survival rate is less than 20%. Preventing the development of gastric cancer or finding it at the earliest possible stage is a far more cost-effective way of dealing with this tumour than the treatment of patients with advanced local regional or metastatic disease. The introduction of immunocytological methods that using monoclonal antibodies, sensitive enough to identify even single tumour cells can now be used to detect secondary metastatic sites. The objective of this study was to evaluate the patients with advanced gastric carcinoma using various factors such as presenting symptoms, predisposing risk factors and evidence of micro metastases by analysis of bone marrow and peritoneal cytology and also to identify any specific risk factors in a group of patients and if there were evidence of early micro metastases in these patients.Methods: Around 30 patients with histologically and endoscopically diagnosed gastric carcinoma, admitted in CMCH, surgery unit I was included in the study. All patients with gastric carcinoma had bone marrow smear and biopsy prior to surgery.Results: In all 30 patients, the periperal bone marrow smears and the bone marrow biopsy was negative for malignant cells. Only 1 patient had evidence of atypical cells on examination of the peritoneal fluid for cytology. 14 patients had less than 3 lymph nodes positive. In 7 patients, more than 3 lymph nodes were positive. 23.3% of the patients had H.Pylori associated gastritis.Conclusions: Smoking and alcohol were found to be significant risk factor. There was a significant association of H.pylori infection in the group. There was only one patient detected to have malignant cells in the peritoneal washings analyzed cytologically. In this study, no significant incidence of micro metastases in the bone marrow or elevated CEA levels in the peritoneal fluid were found.