No abstract

The zoonotic infection hydatidosis is caused by the tapeworm cestode, Echinococcus granulosus. Though considered endemic in India where association of humans with sheep and dogs form part of the livelihood, primary skeletal muscle involvement of the disease is an extremely rare event. We report a case of primary paraspinal hydatidosis with extradural extension causing acute paraplegia. Excision of the cyst and decompression of the cord was done along with albendazole therapy. Paraspinal hydatid disease is a rare entity, and in regions where hydatid disease is endemic, it can be involved in the differential diagnosis of acute compressive myelopathy. Although antihelminthic chemotherapy forms the mainstay of the treatment, surgical intervention forms a major part of the management.

Lipoma is a rare mesenchymal tumour of stomach (less than 1% of gastric tumours) to present as gastrointestinal bleed. We report a case of upper gastrointestinal bleed from a gastric lipoma in a 42 year male patient who underwent distal gastrectomy for resection of the large submucosal tumour situated in antropyloric region. Most common age of presentation of gastric lipoma is fifth or sixth decade of life and most of these are located in submucosal plane (90% cases) and in antropyloric region (75% cases). Gastric lipomas can be diagnosed by endoscopic means but most often with CT scan which shows characteristic fat attenuation. Small asymptomatic incidentally diagnosed can be safely observed while larger symptomatic tumours are treated by endoscopic or surgical resection which offers cure from this benign lesion.

Background: Radical gastrectomy with D2 lymphadenectomy is a surgery with significant post-operative morbidity. Pre-operative malnutrition portends a poor post-operative outcome following any gastrointestinal surgery in general. This study aims at finding out whether it is feasible to perform D2 lymphadenectomy in patients presenting with significant malnutrition.Methods: In this single centre study, we retrospectively analysed the post-operative morbidity and mortality data of 46 patients who underwent D2 gastrectomy for operable gastric cancer between October 2016 to April 2019. Almost all the patients who were analysed fulfilled at least one criterion for malnutrition.Results: The morbidity rate was 39.1% and the mortality rate was 6.5% which were a little high when compared to results from other Indian centres but not prohibitive, considering the nutritional status of these patients. Almost 50% of these patients were able to complete adjuvant chemotherapy.Conclusions: D2 gastrectomy can be performed in patients with poor pre-operative nutritional status. If perioperative nutritional requirements are taken care of promptly, the post-operative outcomes can be better.