Retrograde jejuno-gastric intussusception is a rare complication following gastric surgery. We present a case of retrograde jejuno-gastric intussusception in a 42-year-old female who presented with upper abdominal pain, vomiting and swelling in left hypochondruim. Intussusception was suspected on ultrasound of the abdomen and later confirmed with computed tomography scan. At laparotomy, efferent loop was intussuscepting into stomach. This was reduced and fixed to the abdominal wall and transverse mesocolon. It should be suspected in a patient with the previous history of gastric surgery as it is a rare complication. Early diagnosis and management can prevent further complications like bowel gangrene and its associated morbidity and mortality.

OBJECTIVES:To study the role of ultrasonography and computed tomography in the evaluation of abdominal masses, to compare their diagnostic accuracies, to evaluate the imaging features of lesions and to know the exact site of origin and extension into surrounding structures. MATERIALS AND METHODS:A prospective study of 104 patients with abdominal masses. USG was done with Toshiba SSA and Philips Envisor C machine and CT-Scan examination was performed in all patients on Philips brilliance 6-slice whole body CT scanner. RESULTS: There were 35(30.62%) cases of hepatobilliary masses, renal15(14.40%)cases, pancreatic 7(6.72%)cases, 5(4.80%) cases of splenic masses and 30(28.82%) cases of pelvic masses.8 cases with other abdominal masses. Hepatic SOL were detected in 6(5.76%) and 8(7.69%), 5(4.80%)cases of gall bladder masses and 4(3.85%), Omental caking was seen in 2(1.92%) cases and 4(3.85%), calcification was seen in 2(1.92%) cases and 4(3.85%) cases, renal calculi were seen in 4(3.84%) cases and6(5.77%) cases, on sonography and CT examination. Peritoneal deposits were seen in 3(2.88%) cases of ovarian carcinoma and unknown malignancy on US and in 5(4.88%) cases on CT. Ascites and lymphadenopathy was more accurately detected on CT as compared to US.CT detected splenicinfarcts which were missed on ultrasonography. CONCLUSION: CT is more sensitive in evaluation of site and size of lesion, detection of calcification, adjacent organ infiltration and regional lymphadenopathy. The limitations of CT are ionizing radiation, high cost and contrast administration. Hence ultrasound should be the primary screening modality and CT should be used for further characterizing the masses.

Abstract:Sturge-Weber syndrome is characterized by unilateral facial port wine stain, ipsilateral leptomeningeal vascular anomalies, ipsilateral choroidal angiomas which lead to glaucoma and one or more symptoms (epilepsy, hemiparesis, hemiplegia or mental retardation). We hereby, present a case of 5 year old girl with seizure disorder, right sided hemiparesis along with angiomas on both sides of her face, more extensive and prominent on her upper and lower limbs. Ocular examination revealed raised intraocular pressure and choroidal hemangiomas in both eyes. Non contrast enhanced computerized tomography of head showed left sided cortical hemi-atrophy with mild atrophy of the right occipito-parietal cortex. Gyriform calcifications were seen in bilateral temporo-occipitoparietal regions. The case was diagnosed as bilateral Sturge-Weber syndrome with extensive extrafacial distribution of cutaneous lesions.

A large non symptomatic soft swelling in the submental area are usually due to thyroglossal duct cyst, sublingual dermoid cyst, giant ranula and cystic hygroma. Here we present a case of a rare giant submental hemangioma with multiple phleboliths in the floor of the mouth presenting as a submental swelling. We report a case of 14 years old male who presented with the mass in the submental region that had been gradually growing over period of several years.

Abstract:A 46 years old male presented with a history of assault and insertion of a long wooden object through his anus. Examination and radiological investigations of the patient revealed a 34x4.0 cm long wooden object in the rectosigmoid colon. The foreign body was delivered by colotomy under general anesthesia.