Total Hip replacement in a Systemic Lupus Erythematosus patient

Patients with systemic lupus erythematosus (SLE) going for surgery have put challenges to the treating surgeon, anaesthetist and physician as the patients can present with various medical complications perioperatively. It can be associated with polyarticular involvement especially avascular necrosis of the head of femur. The patients may present young with severe clinical findings and abnormal radiological features. The surgery in young SLE patients revolves on the longevity of the prosthesis used.We report a case of a 26-year-old lady with SLE going for right total hip replacement for her avascular necrosis of right hip

A Diagnostic Conundrum in a Localized Ascending Aortic Aneurysm

Aortic dissection (AD) is an uncommon life-threatening emergency. Its development is usually subtle and easily missed. On the other hand, an aneurysm nearly always requires immediate surgical intervention. Both interventions are technically different and pose their own challenges. We experienced a distinct case of AD of the ascending aorta in a 65-year-old lady, who presented with a sudden onset of severe chest pain and shortness of breath. Thoracic aortic aneurysm was suspected as computed tomography revealed a saccular aneurysm of the proximal ascending aorta with no involvement of the valve and aortic branches. Surgery was decided after considering the risk of rupture and mortality. However, a diagnosis of localized aortic dissection was discovered and repaired accordingly. We discuss the pitfalls of diagnostic modalities and the techniques of surgical repair

Undifferentiated Embryonal Sarcoma of the Liver: An Enigma of Diagnosis

A 20-year-old man presented with peritonitis requiring emergency laparotomy. He was found to have a huge liver abscess on the right lobe. Open drainage was performed but the abscess was persistently unresolved upon follow up. Computed tomography (CT) revealed a solid liver lesion with raised Ca 19-9. Right hepatectomy was subjected and histology was consistent with a rare and aggressive case of embryonal sarcoma of the liver. Despite oncologic resection, he developed local recurrence and succumbed to death in 6 month postoperatively. We describe a unique aetiology of liver abscess with literature reviews of undifferentiated embryonal sarcoma of the liver

A middle-aged man with a troubled liver: Combination therapy in advanced (BCLC Stage C) hepatocellular carcinoma

Advanced hepatocellular carcinoma carries a bad prognosis with a survival of only few months. Barcelona Clinic Liver Cancer (BCLC) Guidelines recommended sorafenib monotherapy as the treatment modality for advanced BCLC Stage C disease, citing a two-month increase in survival rates. Here, we highlight a case with advanced HCC (BCLC Stage C) treated with combination therapy of liver resection and Sorafenib therapy. The patients current survival rate was beyond 10 months. We also discuss the current evidence on liver resection with Sorafenib therapy in hepatocellular carcinoma. The description of the case may benefit in future diagnosis and treatment. [Arch Clin Exp Surg 2018; 7(1.000): 29-32