An unusual presentation of carcinoma stomach

Symptomatic gastric malignancy usually presents with symptoms which mimic peptic ulcer disease.Usual presenting features include weight loss and abdominal pain. Other symptoms include nausea, vomiting, dysphagia, melena and early satiety. Gastric malignancy presenting with hemetemesis, macular skin lesions of DIC and low backache due to bone metastasis from the primary is rare. Also bone metastasis in gastric cancer in the absence of hepatic metastasis is also rare.Pan African Medical Journal 2013; 14: 8

An uncommon cause of ascites; spontaneous rupture of biliary cystadenoma

Biliary cystadenomas are cystic hepatic tumors of biliary origin. Cystadenomas are often slow growing benign tumors but always harbor the risk of malignant transformation. Cystadenomas are often asymptomatic but may present with abdominal pain and distension. Though suspected with cross sectional abdominal imaging definitive diagnosis almost always requires histology. Spontaneous rupture of cystadenoma had been reported thrice in medical literature till date, all presenting with peritonitis. We here report a case spontaneous intraperitoneal rupture of biliary cystadenoma presenting as ascites without peritonitis

Clinical Outcome of Pneumatic Dilatation in Patients with Achalasia Cardia: A Single-Center Prospective Study

Background and Aim: Pneumatic balloon dilation is one of the most commonly used and effective methods for treating patients with achalasia cardia. This study was performed to assess immediate and long-term response of pneumatic dilatation (PD) in these patients. Materials and Methods: Forty-four achalasia cardia patients, who underwent PD in our center from January 2013 to December 2015, were prospectively studied. Data from these patients were analyzed for clinical improvement in symptoms after dilatation procedure over this period as per Eckardt score. Patients who required repeated procedure and factors influencing remission of symptoms were analyzed. Results: A total of 44 patients underwent PD, among which three lost to follow up. Of the 41 patients, 21 were male (51.22%) and 20 were females (48.78%). Mean age was 38.68 (13–64) years. Median symptom duration before first dilatation was 18 months (2–240). Major symptoms at presentation were dysphagia (n = 41, 100%), regurgitation (n = 38 92.68%), chest pain (n = 31, 75.6%), and weight loss (n = 20, 48.78%). Mean follow-up period was 22.22 months (9–38). Forty (97.56%) patients had immediate clinical improvement after 1 dilatation, of which 38 (92.68%) patients did not require any further treatment. Mean Eckardt score was 6.82 (4–11) at the time of first dilatation which improved to 0.66 during follow-up. Two patients required second dilatation (one 5 months and other 18 months after the first procedure). Conclusion: PD is a safe and effective long-term therapy for achalasia cardia and has a good long-term clinical remission