Day2

  • Department of General Surgery, Brunei
  • Title:Esophago-gastro-duodenoscopy could be an important tool in the diagnostic dilemma inherent in perforated peptic ulcer: A case report
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Abstract
Acute abdomen is a common and sometimes dramatic clinical condition, which can be fatal if diagnosis is not made in time. Perforated peptic ulcer is a cause of an acute abdomen, which can be diagnosed by imaging investigations. However, erect chest X-ray and CT scan may not always establish the diagnosis. Herein we report a case of a patient with acute abdomen, where radiological imaging and CT scan were not able to provide a clear diagnosis. The patient was diagnosed with perforated peptic ulcer by esophago-gastro-duodenoscopy, and underwent laparotomy to repair the anterior wall duodenal perforation with an omental patch. Early endoscopic evaluation seems to be an essential tool for upper gastrointestinal evaluation in acute abdomen cases with inconclusive imaging results.

  • Department of Otorhinolaryngology , Tanzania
  • Title: Follicular Thyroid Carcinoma with an Iliac Wing Metastasis: Rare case report at Bugando Medical Centre in Tanzania
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Abstract
Thyroid carcinoma is uncommon in our settings with the leading variant being papillary thyroid carcinoma followed by follicular thyroid carcinoma. Histopathologically, differentiated thyroid carcinomas have a good prognosis compared to undifferentiated thyroid carcinomas. Differentiated thyroid carcinomas include papillary thyroid cancer,follicular thyroid cancer and the hurthle cell thyroid cancer while undifferentiated type includes anaplastic thyroid carcinoma.
Case presentation: We are presenting a 57 year old female with a history of anterior neck swelling for 5 years and inability to walk using the left lower limb for 2years. She had no history of difficulty in breathing or swallowing though overconcerned with inability to use the left lower limb.
Clinical discussion: Baseline investigations and thyroid hormonal panel were within normal ranges. Fine needle aspiration cytology showed features suggestive of malignancy. X-ray of the pelvic bone showed a large lytic bubbly lesion within the left iliac wing extending to involve the left acetabulum.Total thyroidectomy and modified neck dissection was done and the specimen that was sent for histopathology confirmed follicular thyroid carcinoma.
Conclusion: Metastatic involvement of iliac wing by follicular thyroid cancer remains to be a rare occurence and posses management challenges.