No abstract

Small bowel adenocarcinoma(SBA)is a rare neoplasm presenting usually in elderly patients as a single tumour. Multiple synchronous SBA is unique and difficult to diagnose due to non-specific presentations.Faecalomas have been described in association with Hirschsprungs disease, psychiatric patients, Chagas disease, both inflammatory and neoplastic conditions, and in patients suffering with chronic constipation.We herein report a case of multiple faecalomas secondary to multiple small bowel strictures leading to small bowel obstruction in a patient with previous history of pulmonary tuberculosis.Thepatient was successfully treated surgically. The strictures on histopathology turned out to be low grade adenocarcinoma. Multiple synchronous SBA as well as multiple fecalomas are individually rare entities, and their combined occurrence is even rarer.

Background: The incidence of gall stones is in increasing trend. The old axiom that a typical gall stone sufferer is a fat, fertile, female of fifty, is only partially true, as the disease is found in women soon after their first delivery, in underweight and thin people. So, while searching for other parameters, iron deficiency was found to be a new parameter of interest in the aetiology of gall stones.7Methods: 50 cases of cholelithiasis and 40 cases of anaemia with low serum ferritin levels from September 2017 to August 2019 was studied. Serum iron was estimated by carbonyl metallo-immunoassay method. Serum cholesterol was estimated by the CHOD-POD Enzymatic method. Biliary cholesterol was estimated after extraction of biliary lipids from bile from the gallbladder specimen of the patients by the method of Folch et al which was followed by the procedure similar to the analysis of serum cholesterol by CHOD-POD enzymatic method. Fischer’s chi square exact test was used as statistical method.Results: It was observed that 70% of the group A study group with cholelithiasis had normal serum ferritin levels and 30% had low serum ferritin levels. It was observed that 95% had normal sonographic findings and 5% had cholelithiasis with normal ferritin levels in group B.Conclusions: In our study low serum ferritin levels with cholelithiasis was associated with raised bile cholesterol levels and so it can be concluded that low serum ferritin level is causing biliary stasis and hence leading to increase in the incidence of cholelithiasis.