No abstract

Gastric lipomas are rare benign tumours of the stomach, representing less than 3% of all benign gastric neoplasms. They are usually asymptomatic but larger lesions can present with abdominal pain, gastric outlet obstruction and haematemesis. Malignant transformation is extremely rare. Accurate preoperative diagnosis can be established with computed tomography. Being benign, extensive surgery is not necessary and simple excision of the lesion is adequate. Small asymptomatic lesions can be followed up. We present a case of 80-year-old woman with gastric submucosal lipoma who presented with haematemesis.

Laparoscopy-assisted TAP block is faster and equally efficacious when compared with USG-guided block and has a definite role in centers where ultrasound is not available in operating rooms.

Introduction: Incisional hernia is one of the common complications following abdominal surgery in patients undergoing laparotomy. Various surgical procedures are performed by creating a potential space and placing a foreign body (mesh), which may render the wound susceptible for many postoperative complications. It is clinically important to evaluate the efficacy of Incisional Negative Pressure Wound Therapy (INPWT) in reducing wound complications. Aim: To compare the efficacy of INPWT dressing with traditional gauze dressing in reducing postoperative complications following meshplasty in incisional hernia repair. Materials and Methods: This was a hospital-based randomised controlled trial, conducted in the Department of General Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, India, from October 2013 to July 2015. 64 consenting patients with incisional hernias undergoing meshplasty were included in this study. After being randomised into the two study groups, they had their postoperative wounds dressed with either INPWT (Group A) for five days, or traditional gauze (Group B) based dressings. Operative parameters like duration of surgery, type of dissection and type of skin sutures used were studied and analysed. Also, postoperative outcomes like Surgical Site Infection (SSI), seroma, duration of drain, hospital stay were analysed using Chi-square or Fisher’s-exact test. Results: Out of total 64 patients, there was a statistically significant reduction in the volume of drain (p=0.004) and duration of wound drainage (p=0.029) with the use of INPWT. There was also a reduction in the incidence of SSI (6.7% vs 17.6%) and seroma (6.7% vs 11.8%) and the duration of postoperative hospital stay (6.03±1.99 days vs 7.09±2.31 days) in the INPWT group, which were however not statistically significant. Age, comorbidities, Body Mass Index (BMI), duration of surgery, type of dissection and type of skin sutures were not found to have any effect on the parameters assessed. Conclusion: Incisional negative pressure wound therapy in postoperative wounds, following meshplasty for incisional hernia significantly reduces the volume and duration of wound drainage. It also reduces the incidence of SSI, seroma and the duration of hospital stay

Spindle cell lipomas (SCL) are slow-growing benign adipocyte tumours that are most commonly seen in (1) the upper back, posterior aspect of the neck, and shoulders . Both genders are affected, but it is more (1) prevalent in males between the ages of 40 and 70 . Spindle cell lipoma is a benign tumour that is frequently confused with (1) liposarcoma. SCLs account for approximately 1.5 percent of all lipomatous tumours reported, making them uncommon . They (2) have a morphology similar to other benign and malignant fatty/spindle cell or myxoid lesions . Microscopically, it is a complex mixture of lipocytes and uniform spindle cells embedded in a mucinous matrix and traversed by (2) a variable number of birefringent collagen bres . Due to the unusual presentation and similar morphology of tumours, early diagnosis is critical; thus, diagnosis is based on clinical examination and conrmed by histopathological ndings. Because SCL has a favourable prognosis, wide local (1) excision is the treatment of choice . This is a case report of a 52-year-old male with a similar presentation in the right upper limb.