Inflammatory pseudotumor or (IPT) is a rare lesion of unclear etiology reported in various organs. Although mostly benign, these tumor may pose a therapeutic challenge in cases of recurrence. We report the case of a 65- years -old male who presented with a mass in the left upper abdomen and upon evaluation was noted to have IPT in the retro-peritoneum involving the duodenum. Complete surgical resection was done with primary repair of the 3rd part of the duodenum with no evidence of tumor recurrence on 6 months follow-up. We review the literature and discern the epidemiological, clinical, pathophysiological and management aspects of IPTs.TAJ 2015; 28(2): 61-63

Laparoscopic Cholecystectomy has become the gold standard for the surgical treatment of gall bladder disease, but conversion to open cholecystectomy and both operative and post operative complications are still inevitable in certain cases. Knowledge of the rate and impact of the underlying reasons for conversion and complications could help surgeons during preoperative assessment and improve the informed consent of patients. In this study we retrospectively evaluated the rate and reasons for conversion and assessed complications of our laparoscopic cholecystectomy series. We included data of 720 consecutive patients who were attempted to laparoscopic cholecystectomy between January 2008 to March 2014 at Islami Bank Medical College Hospital, Rajshahi. The study included 468 (65%) female and 252 (35%) male with mean age of 38 years (range 16-78 years). Conversion to open procedure was carried out in 58 patients with conversion rate of 8.05%. Dense and extensive adhesions were the most common reasons for conversion (21, 36. 2%). The conversion rate due to operative complications was 13.8% of all converted cases. The major operative complications were extrahepatic bile ducts injuries 2(0.3%), duodenal injury 1(0.1%), excessive bleeding 10(1.4%). The incidence of postoperative complications was 2.8%. The most common post-operative complication was wound infection (11, 1. 52%) followed by biliary leakage in 4(0.55%) patients. Delayed complications seen in our series is port site hernia (1,0.13%). Laparoscopic cholecystectomy is the preferred method even in difficult cases. Conversion from laparoscopic to open cholecystectomy should be based on the sound clinical judgment of the surgeon and not be due to a lack of individual expertiseTAJ 2014; 27(2): 58-62

With the advent of industrialization, accelerated social violence, increasing road traffic accident and increasing use of machineries trauma has become the leading cause of mortality and disability. Considering trauma abdominal trauma is one where early diagnosis and accurate assessment and timely intervention can save the life of the victim in most of the instances. This is a prospective observational study that represents the experience of 100 consecutive patients of blunt abdominal trauma with suspected intra-abdominal injuries admitted in surgical words of RMCH, Rajshahi. The most of the patients were male (87%) and in active phase of life. RTA (53%) was the most common cause of blunt abdominal trauma and majority of the patients (38%) arrived in the hospital within 7-24 hours. Major clinical signs of intra-abdominal injuries were signs of peritonitis. The main investigation done was plain X-ray abdomen (71%) in erect posture, of which 55% cases showed free gas under the done of the diaphragm. Out of 100 cases 77 patients were operated upon and 23 patients were managed conservatively. The incidence of hollow viscus injury (57%) was higher than solid organs (36%) injury but only five patients came out to be a negative laparotomy. Of all operated cases fifty one were recovered uneventfully and only twenty three patients developed various postoperative complications. The most of the patients (40%) left the hospital within 11-14 days. Seven patients died on the day of admission but total mortality was nine (9%) in number.TAJ 2015; 28(2): 7-14

Non-Toxic multi-nodular goitre is one of the common presentations of various thyroid diseases. A sizable portion of multi-nodular goitre turns into malignancy over time. This cross-sectional study was conducted in RMCH and different clinics of Rajshahi City to determine the incidence and types of various thyroid malignancies in non-toxic multi-nodular goitres. Among the total cases, 43% of the patients were in the age group of 31-40 years and majority (81%) of whom were female. 52% of the patients had a history of thyroid swelling for 1-5 years and 55% of the patients had goitre size ≤ 15 cm2. Sub-total thyroidectomy was the commonest operation performed and all the resected specimens were sent for histopathological examinations, which demonstrates that 13% of the multi-nodular goitres had malignancies with papillary and follicular carcinoma ratio 5:1. This study did not reveal any significant association of malignancies with age and sex and goitre size also not influence the presence of malignancy. However, it was observed that the mean duration of thyroid swelling in patients who developed malignancy was significantly higher (8.6 years) than that of patients who did not experience any malignant change (5.7 years).TAJ 2016; 29(2): 16-20