HighlightsAcute gastric volvulus is an uncommon surgical emergency requiring timely action.High index of clinical suspicion needed for diagnosis.Early intervention can save lives and lessen the associated high mortality.Primary gastric volvulus may be associated with general laxity of ligaments.Primary gastric volvulus may be linked to fibrosis in active pulmonary tuberculosis.

HighlightsPrimary pelvic hydatid cysts are uncommon, usually presenting with pressure effects on the adjacent organs such as the urinary bladder and rectum.Combination of preoperative albendazole therapy, surgery and postoperative albendazole therapy is a useful regime.Familiarity with atypical manifestations of hydatid disease may be helpful in making a prompt and accurate diagnosis.

Background: Necrotizing fasciitis (NF) is a devastating soft tissue infection associated with potentially poor outcomes. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score has been introduced as a diagnostic tool for NF. We aimed to correlate the clinical features of NSTI with the LRINEC score, its application to distinguish Necrotizing Fasciitis (NF) from other non NSTI and its utility in early surgical management of NSTI.Methods: Patients were evaluated for various symptoms and signs at the time of admission and certain laboratory parameters were assessed. LRINEC score was then calculated. Correlation of the management and severity of infections with respective LRINEC score was then found out.Results: LRINEC score for predicting conservative management of NSTI has a sensitivity of 81.8% and specificity of 98% while for predicting amputation and mortality shows a sensitivity of 100% and specificity of 84.5%.Conclusions: The LRINEC score is a robust score capable of detecting even clinically early cases of necrotizing fasciitis.

Objectives: The liver is a common site for primary as well as secondary malignancies. Ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) is a rapid, accurate, economical, and safe diagnostic procedure for various hepatic lesions. The aims of the study were to categorize and study the cytomorphological features of the hepatic lesions, study the age and sex distribution and analyzing cytological features of the hepatic lesions, and to evaluate the sensitivity, specificity, and diagnostic accuracy of USG-guided FNAC in diagnosing hepatic lesions. Methods: A prospective and observational study of 64 patients with clinically and radiologically diagnosed hepatic lesions and referred for FNAC in department of pathology of a tertiary care hospital. USG-guided FNAC was performed in each patient and cytological features were analyzed. Results: In our study, out of total 64 USG-guided FNAC of liver, metastasis was most common – 33 cases (51.56%), followed by primary hepatocellular carcinoma – 18 cases (28.12%), liver abscess – 6 cases (9.37%), and 7 cases (10.93%) were unsatisfactory smears. Conclusion: USG-guided FNAC, in expert hands being simple, safe, quick, reliable, cost-effective, efficient, and easily available OPD-based procedure and with less number of complications, it has a very important role in accurate diagnosis of primary hepatocellular carcinoma, secondary malignant tumors of liver, and inflammatory lesions of liver.

Cutaneous horn is a conical, circumscribed, dense hyperkeratotic protrusion from skin with epithelial cornification. It is also known by the Latin name ‘Cornu cutaneum’. This rare medical entity resembles animal horn but histological disparity is present between both. They are more commonly present in sun exposed sites or areas that are prone for actinic radiation, burns and hence frequently seen in forearm and upper part of face. Only few cases have been reported with cutaneous horns in unusual sites. Cutaneous horns occurring in oral cavity or perioral regions are extremely rare. The significance of knowing about this dead keratinous cutaneous horn is that it may occur as a part of or in association with a wide range of underlying pathologies, either malignant, premalignant or benign. Majority are due to benign pathologies. We report an unusual presentation of cutaneous horn in left oral commissure of a 45-year-old gentleman which is an extremely rare perioral location for such an ailment.