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Papers by Anthony Rozario

Frontiers in Endocrinology, May 31, 2023

Tropical Doctor, Apr 1, 2003

PubMed, Aug 13, 2002

Recurrent episodes of pain following pancreatic drainage is a perplexing problem often faced by t... more Recurrent episodes of pain following pancreatic drainage is a perplexing problem often faced by the surgeon. The diagnosis and management of this entity is difficult. We report a case of Roux loop obstruction occurring 4 years after a lateral pancreaticojejunostomy (LPJ) for chronic pancreatitis.

International Surgery Journal, Mar 28, 2022

Background: Acute pancreatitis (AP) is associated with increased mortality. Many scoring systems ... more Background: Acute pancreatitis (AP) is associated with increased mortality. Many scoring systems have been used to predict the severity of acute pancreatitis but they are either time consuming or done after 48 hours of admission. The aim of the study was to evaluate the prognostic value of Neutrophil to lymphocyte ratio (NLR) in acute gall stone and alcoholic pancreatitis. Methods: 240 patients with acute pancreatitis were prospectively enrolled from December 2017 to December 2019 from the department of general surgery and gastroenterology at St. John's Medical College, Bangalore. NLR obtained at admission were compared with other known prognostic scoring systems. Results: A total of 240 patients were studied with an etiology of gall stone (N=131) and alcohol (N=109). NLR (17.6±18.3 vs 8.7±8.4, p<0.001) were significantly high in gall stone pancreatitis group whereas high NLR were not related to severe AP in alcoholic AP. For gall stone pancreatitis group NLR demonstrated a predictive value and not in alcoholic AP. Conclusions: NLR can be used as a predictor of severity of acute pancreatitis, at the time of initial diagnosis. Our study demonstrated that NLR can predict the severity in gall stone pancreatitis.

PubMed, Mar 2, 2002

A 20-year-old woman underwent alcohol sclerotherapy for a symptomatic liver cyst, initially diagn... more A 20-year-old woman underwent alcohol sclerotherapy for a symptomatic liver cyst, initially diagnosed as simple liver cyst. Five months later, she presented with expulsion of the cyst from the puncture site. The cyst was proved to be due to hydatid disease. Spontaneous expulsion is a rare complication of sclerotherapy.

International Journal of Case Reports in Surgery

Indian Journal of Surgery, 2020

Trauma-related deaths are one of the top 10 causes of death. The diagnosis of occult hypoperfusio... more Trauma-related deaths are one of the top 10 causes of death. The diagnosis of occult hypoperfusion in patients who have suffered trauma is indeed challenging. The initial surge in lactate values is known to clear over time, and numerous studies have evaluated 6-h and 12-h lactate clearance. However, the trauma surgeon needs an objective indicator of his resuscitation efforts in record time. To find if blood lactate and a 2-h lactate clearance can predict mortality in trauma and to compare these with the available scores in trauma, namely, the revised trauma score (RTS), injury severity score (ISS) and the trauma-related injury severity score (TRISS). This was a prospective, descriptive study with a sample size of 200 patients. Patients with acute trauma presented to the emergency department between October 2016 and December 2018 who fit the inclusion criteria were chosen. Demographics were collected and the variables were compared. Out of the 200 patient studies, 15 expired during the 30-day period post-trauma. Admission serum lactate was found to be a good indicator for mortality (for values > 2.7 mmol/l) (sensitivity of 86.67 and specificity of 72.43). Independently, collected 2-h lactate predicts mortality (values > 2.5 mmol/L) (sensitivity of 60 and specificity of 87.57). Two-hour lactate clearance had no statistical significance in predicting mortality in trauma patients but maybe considered to be an important prognostic aid to predict adequacy of resuscitation efforts. Injury severity score was found to be a comparable triage scoring system. Lactate values at admission is a good indicator for mortality in trauma patients, as also independently measured lactate at 2 h; however, further studies may be required to prove benefit of lactate clearance in trauma patients. Injury severity score is comparable to lactate as a triage score.

International Surgery Journal, 2020

A hemophilic pseudotumor is one of the rare complications of hemophilia that results from repetit... more A hemophilic pseudotumor is one of the rare complications of hemophilia that results from repetitive bleeding, forming an expanding destructive encapsulated hematoma and necrosed tissue. It has a considerable amount of morbidity. These have become rare over the years with better treatment modalities like factor replacement. Presently, excision is the preferred treatment by many authors. There are instances where surgical excision is not feasible. In such situations, radiotherapy and arterial embolization should be considered either alone or as an adjunct to surgery. A 32 years old male patient, with severe hemophilia A diagnosed with an abdominal tumour 7 years ago during routine screening, that progressively grew to encompass the lower abdominal area. A 44 years old male patient with hemophilia A presented with slow growing swelling over the left gluteal region since, 10 years associated with ulceration and bleeding since, 3 days. The management of a patient with a haemophilic pseu...

International Surgery Journal, 2020

Primary omental infarction is a relatively rare and often presents as right sided abdominal pain.... more Primary omental infarction is a relatively rare and often presents as right sided abdominal pain. It is often diagnosed as appendicitis and is usually picked up intra-operatively, or - as often seen nowadays - on imaging. We describe a series of four cases of primary omental infarction that presented to us with varying clinical features. Three of them had a short history of right sided abdominal pain, whereas the fourth patient had a longer history of left sided abdominal pain. All 4 were managed operatively, with the fourth having presented with an intra-abdominal abscess that required laparotomy. Primary omental infarction is a diagnosis which must be considered in any case of acute abdomen. Cases diagnosed with certainty on imaging may be managed conservatively but must be followed up closely. Need for surgical intervention should be considered in select cases.

International Surgery Journal, 2017

Background: Quality of life (QOL) of patients is affected due to procedures done to treat the dis... more Background: Quality of life (QOL) of patients is affected due to procedures done to treat the disease. A good QOL is essential to achieve a holistic approach in treating patients.Methods: We did a cross-sectional study in a tertiary care hospital to describe, identify and compare the factors affecting the QOL of these patients.Results: 42.5% had a permanent stoma and a majority 32.5% were due to a malignancy. Major concerns were skin rash and irritation, depression, loneliness and suicidal thoughts. 62.5% of the total had not gone to work after creation of a stoma. Malignancy was found to be a significant predictor of having a low QOL score.Conclusions: Quality of life of stoma patients in present study was not ideal. There is a definite need to have support groups for these patients in all hospitals.

International Surgery Journal, 2016

Jejunogastric intussusception is a rare complication following gastric surgery and is estimated t... more Jejunogastric intussusception is a rare complication following gastric surgery and is estimated to occur in less than 0.1% of patients. It is a potentially fatal complication, if prompt diagnosis and surgical intervention is not performed immediately. Here, we present a case of retrograde jejunogastric intussusception who presented with haematemesis. Patient was diagnosed by an upper GI endoscopy. The diagnosis, management and the etiological theories of jejunogastric intussusception following gastric surgery are discussed here.

International Surgery Journal, 2017

Primary angiosarcoma of the breast is a rare form of breast cancer, accounting for only 0.04% of ... more Primary angiosarcoma of the breast is a rare form of breast cancer, accounting for only 0.04% of all malignant breast tumours. We report a 35-year-old woman who presented with a recurrent lump in the left breast for four months. Fine needle aspiration cytology (FNAC) was suspicious of angiosarcoma and this diagnosis was confirmed on core needle biopsy. Modified radical mastectomy was performed as sole treatment. No chemo radiotherapy was given as tumor was grade I, margins were negative and there was no lymph node involvement. She is on regular follow up and no recurrence reported since the surgery. The 5-year disease-free survival for grade I tumours can be as high as 76%, and up to 70% for grade II tumours whereas for grade III tumours it is reportedly about 15%. Primary angiosarcoma of the breast is a rare malignancy with a poor prognosis, even after complete resection. Surgery is the mainstay of treatment with a limited role for chemotherapy and radiotherapy.

International Journal of Surgery Case Reports, 2016

INTRODUCTION: Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and manage... more INTRODUCTION: Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and management a challenge to the treating surgeon. Presentation may be misleading and diagnosis often missed. An imaging study forms an indispensable aid in the diagnosis and surgery is the only treatment option. PRESENTATION OF CASE: A 42 year old male presented with history of pain in lower back of 4 years duration and was being treated symptomatically over 4 years with analgesics and physiotherapy. He had noticed a swelling over the left side of his mid-back and consequently on examination was found to have a primary acquired lumbar hernia arising from the deep superior lumbar triangle of Grynfelt. Diagnosis was confirmed by Computed Tomographic imaging. DISCUSSION: A lumbar hernia may be primary or secondary with only about 300 cases of primary lumbar hernia reported in literature. Lumbar hernias manifest through two possible defects in the posterior abdominal wall, the superior being more common. Management remains surgical with various techniques emerging over the years. The patient at our center underwent an open sublay mesh repair with excellent outcome. CONCLUSION: A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.

Tropical gastroenterology: official journal of the Digestive Diseases Foundation

Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular c... more Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.

International journal of surgery case reports, 2015

Splenic rupture in chronic pancreatitis is a life threatening rare complication. The anatomical p... more Splenic rupture in chronic pancreatitis is a life threatening rare complication. The anatomical proximity of the pancreas with the spleen and the pathophysiological process in acute and chronic pancreatitis form the basis of this dreaded complication. We cite the case of a young male previously undiagnosed with chronic pancreatitis presenting with atraumatic splenic rupture. Definitive diagnosis was made by contrast enhanced computed tomography of the abdomen, intra operative findings, and histopathological examination of the splenectomy specimen. The splenorenal ligament forms the main anatomic proximity between the pancreas and the spleen. A few pathophysiological mechanisms though suggested are incompletely understood. splenic vein thrombosis, intrasplenic pseudocysts, splenic rupture, infarction, necrosis, splenic hematoma, and severe bleeding from eroded splenic vessels are the complications noted of which splenic rupture is the second most common following splenic vein thrombo...

ABSTRACT BACKGROUND: Gastrointestinal stromal tumors (GISTs) represent the majority of primary no... more ABSTRACT BACKGROUND: Gastrointestinal stromal tumors (GISTs) represent the majority of primary nonepithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by the immunohistochemical staining for the CD117 antigen. Extra-gastrointestinal stromal tumors (EGISTs) are neoplasms with overlapping immunohistological features, occurring in the abdomen outside the gastrointestinal tract with no connection to the gastric or intestinal wall. CASE PRESENTATION: We here report the clinical, macroscopic and immunohistological features of an EGIST arising in the greater omentum of a 74 year-old man. CONCLUSION: The EGISTs in the greater omentum can grow slowly in the abdomen for a long time without clinical appearance. In most cases a preoperative diagnosis is not possible, and the patient undergoes a surgical operation for the generic diagnosis of "abdominal mass". EGISTs being highly vascular tumours can show enhancement findings mimicking hemang...

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology

Tropical doctor, 2003

Meningiomas have been found to have receptors for progestational hormones and growth may increase... more Meningiomas have been found to have receptors for progestational hormones and growth may increase durinl pregnancy or with the use of hormonal contraceptives)' . Mengiomas may therefore become symptomatic with fits in late pregnancy when the level of these hormones is high. Early diagnosis offers the best prospect for complete excision of an intracranial meningioma and poor outcome is associated with poor preoperative clinical condition/. The diagnosis in our patient was delayed until recurrent fits and hemiparesis occurred. Seizures from eclampsia are usually generalized and rarely focal in onset. Eclampsia persisting up to 48 hours postpartum is unusual and other causes of seizures should be considered. The differential diagnosis of seizures around pregnancy would include intracranial tumours. cerebrovascular accident. amniotic fluid embolism and sagittal sinus thrombosis. In environments such as ours. meningitis may also cause seizures during pregnancy. A high index of suspicion is vital for the diagnosis of a meningioma presenting during pregnancy. Close follow up of eclamptic patients should be undertaken. to identify those with recurrent fits or neurological deficits. Further evaluation. including a brain computerized tomography scan may then be necessary to exclude an intracranial meningioma. Following diagnosis. the meningioma should be promptly treated.

Frontiers in Endocrinology, May 31, 2023

Tropical Doctor, Apr 1, 2003

PubMed, Aug 13, 2002

Recurrent episodes of pain following pancreatic drainage is a perplexing problem often faced by t... more Recurrent episodes of pain following pancreatic drainage is a perplexing problem often faced by the surgeon. The diagnosis and management of this entity is difficult. We report a case of Roux loop obstruction occurring 4 years after a lateral pancreaticojejunostomy (LPJ) for chronic pancreatitis.

International Surgery Journal, Mar 28, 2022

Background: Acute pancreatitis (AP) is associated with increased mortality. Many scoring systems ... more Background: Acute pancreatitis (AP) is associated with increased mortality. Many scoring systems have been used to predict the severity of acute pancreatitis but they are either time consuming or done after 48 hours of admission. The aim of the study was to evaluate the prognostic value of Neutrophil to lymphocyte ratio (NLR) in acute gall stone and alcoholic pancreatitis. Methods: 240 patients with acute pancreatitis were prospectively enrolled from December 2017 to December 2019 from the department of general surgery and gastroenterology at St. John's Medical College, Bangalore. NLR obtained at admission were compared with other known prognostic scoring systems. Results: A total of 240 patients were studied with an etiology of gall stone (N=131) and alcohol (N=109). NLR (17.6±18.3 vs 8.7±8.4, p<0.001) were significantly high in gall stone pancreatitis group whereas high NLR were not related to severe AP in alcoholic AP. For gall stone pancreatitis group NLR demonstrated a predictive value and not in alcoholic AP. Conclusions: NLR can be used as a predictor of severity of acute pancreatitis, at the time of initial diagnosis. Our study demonstrated that NLR can predict the severity in gall stone pancreatitis.

PubMed, Mar 2, 2002

A 20-year-old woman underwent alcohol sclerotherapy for a symptomatic liver cyst, initially diagn... more A 20-year-old woman underwent alcohol sclerotherapy for a symptomatic liver cyst, initially diagnosed as simple liver cyst. Five months later, she presented with expulsion of the cyst from the puncture site. The cyst was proved to be due to hydatid disease. Spontaneous expulsion is a rare complication of sclerotherapy.

International Journal of Case Reports in Surgery

Indian Journal of Surgery, 2020

Trauma-related deaths are one of the top 10 causes of death. The diagnosis of occult hypoperfusio... more Trauma-related deaths are one of the top 10 causes of death. The diagnosis of occult hypoperfusion in patients who have suffered trauma is indeed challenging. The initial surge in lactate values is known to clear over time, and numerous studies have evaluated 6-h and 12-h lactate clearance. However, the trauma surgeon needs an objective indicator of his resuscitation efforts in record time. To find if blood lactate and a 2-h lactate clearance can predict mortality in trauma and to compare these with the available scores in trauma, namely, the revised trauma score (RTS), injury severity score (ISS) and the trauma-related injury severity score (TRISS). This was a prospective, descriptive study with a sample size of 200 patients. Patients with acute trauma presented to the emergency department between October 2016 and December 2018 who fit the inclusion criteria were chosen. Demographics were collected and the variables were compared. Out of the 200 patient studies, 15 expired during the 30-day period post-trauma. Admission serum lactate was found to be a good indicator for mortality (for values > 2.7 mmol/l) (sensitivity of 86.67 and specificity of 72.43). Independently, collected 2-h lactate predicts mortality (values > 2.5 mmol/L) (sensitivity of 60 and specificity of 87.57). Two-hour lactate clearance had no statistical significance in predicting mortality in trauma patients but maybe considered to be an important prognostic aid to predict adequacy of resuscitation efforts. Injury severity score was found to be a comparable triage scoring system. Lactate values at admission is a good indicator for mortality in trauma patients, as also independently measured lactate at 2 h; however, further studies may be required to prove benefit of lactate clearance in trauma patients. Injury severity score is comparable to lactate as a triage score.

International Surgery Journal, 2020

A hemophilic pseudotumor is one of the rare complications of hemophilia that results from repetit... more A hemophilic pseudotumor is one of the rare complications of hemophilia that results from repetitive bleeding, forming an expanding destructive encapsulated hematoma and necrosed tissue. It has a considerable amount of morbidity. These have become rare over the years with better treatment modalities like factor replacement. Presently, excision is the preferred treatment by many authors. There are instances where surgical excision is not feasible. In such situations, radiotherapy and arterial embolization should be considered either alone or as an adjunct to surgery. A 32 years old male patient, with severe hemophilia A diagnosed with an abdominal tumour 7 years ago during routine screening, that progressively grew to encompass the lower abdominal area. A 44 years old male patient with hemophilia A presented with slow growing swelling over the left gluteal region since, 10 years associated with ulceration and bleeding since, 3 days. The management of a patient with a haemophilic pseu...

International Surgery Journal, 2020

Primary omental infarction is a relatively rare and often presents as right sided abdominal pain.... more Primary omental infarction is a relatively rare and often presents as right sided abdominal pain. It is often diagnosed as appendicitis and is usually picked up intra-operatively, or - as often seen nowadays - on imaging. We describe a series of four cases of primary omental infarction that presented to us with varying clinical features. Three of them had a short history of right sided abdominal pain, whereas the fourth patient had a longer history of left sided abdominal pain. All 4 were managed operatively, with the fourth having presented with an intra-abdominal abscess that required laparotomy. Primary omental infarction is a diagnosis which must be considered in any case of acute abdomen. Cases diagnosed with certainty on imaging may be managed conservatively but must be followed up closely. Need for surgical intervention should be considered in select cases.

International Surgery Journal, 2017

Background: Quality of life (QOL) of patients is affected due to procedures done to treat the dis... more Background: Quality of life (QOL) of patients is affected due to procedures done to treat the disease. A good QOL is essential to achieve a holistic approach in treating patients.Methods: We did a cross-sectional study in a tertiary care hospital to describe, identify and compare the factors affecting the QOL of these patients.Results: 42.5% had a permanent stoma and a majority 32.5% were due to a malignancy. Major concerns were skin rash and irritation, depression, loneliness and suicidal thoughts. 62.5% of the total had not gone to work after creation of a stoma. Malignancy was found to be a significant predictor of having a low QOL score.Conclusions: Quality of life of stoma patients in present study was not ideal. There is a definite need to have support groups for these patients in all hospitals.

International Surgery Journal, 2016

Jejunogastric intussusception is a rare complication following gastric surgery and is estimated t... more Jejunogastric intussusception is a rare complication following gastric surgery and is estimated to occur in less than 0.1% of patients. It is a potentially fatal complication, if prompt diagnosis and surgical intervention is not performed immediately. Here, we present a case of retrograde jejunogastric intussusception who presented with haematemesis. Patient was diagnosed by an upper GI endoscopy. The diagnosis, management and the etiological theories of jejunogastric intussusception following gastric surgery are discussed here.

International Surgery Journal, 2017

Primary angiosarcoma of the breast is a rare form of breast cancer, accounting for only 0.04% of ... more Primary angiosarcoma of the breast is a rare form of breast cancer, accounting for only 0.04% of all malignant breast tumours. We report a 35-year-old woman who presented with a recurrent lump in the left breast for four months. Fine needle aspiration cytology (FNAC) was suspicious of angiosarcoma and this diagnosis was confirmed on core needle biopsy. Modified radical mastectomy was performed as sole treatment. No chemo radiotherapy was given as tumor was grade I, margins were negative and there was no lymph node involvement. She is on regular follow up and no recurrence reported since the surgery. The 5-year disease-free survival for grade I tumours can be as high as 76%, and up to 70% for grade II tumours whereas for grade III tumours it is reportedly about 15%. Primary angiosarcoma of the breast is a rare malignancy with a poor prognosis, even after complete resection. Surgery is the mainstay of treatment with a limited role for chemotherapy and radiotherapy.

International Journal of Surgery Case Reports, 2016

INTRODUCTION: Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and manage... more INTRODUCTION: Lumbar hernia is an uncommon abdominal wall hernia, making its diagnosis and management a challenge to the treating surgeon. Presentation may be misleading and diagnosis often missed. An imaging study forms an indispensable aid in the diagnosis and surgery is the only treatment option. PRESENTATION OF CASE: A 42 year old male presented with history of pain in lower back of 4 years duration and was being treated symptomatically over 4 years with analgesics and physiotherapy. He had noticed a swelling over the left side of his mid-back and consequently on examination was found to have a primary acquired lumbar hernia arising from the deep superior lumbar triangle of Grynfelt. Diagnosis was confirmed by Computed Tomographic imaging. DISCUSSION: A lumbar hernia may be primary or secondary with only about 300 cases of primary lumbar hernia reported in literature. Lumbar hernias manifest through two possible defects in the posterior abdominal wall, the superior being more common. Management remains surgical with various techniques emerging over the years. The patient at our center underwent an open sublay mesh repair with excellent outcome. CONCLUSION: A surgeon may encounter a primary lumbar hernia perhaps once in his lifetime making it an interesting surgical challenge. Sound anatomical knowledge and adequate imaging are indispensable. Inspite of advances in minimally invasive surgery, it cannot be universally applied to patients with lumbar hernia and management requires a more tailored approach.

Tropical gastroenterology: official journal of the Digestive Diseases Foundation

Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular c... more Primary cystic lesions of the liver are very rare. Most of the solid tumours are hepatocellular carcinomas (HCC) with a smaller number being cholangiocarcinomas. The association of HCC with other primary liver malignancies is also extremely rare. This case report is about a 27 year old male patient who presented with a giant cystic lesion of the left liver. A CT scan showed a cystic lesion with internal septations and a thrombus in the main portal vein. The patient underwent an extended left hepatectomy and a portal venotomy with removal of the thrombus. Coexistent hepatocellular and cystadenocarcinoma were reported on histopathological examination. The patient was put on 5-FU postoperatively. He is doing well 11 months after surgery.

International journal of surgery case reports, 2015

Splenic rupture in chronic pancreatitis is a life threatening rare complication. The anatomical p... more Splenic rupture in chronic pancreatitis is a life threatening rare complication. The anatomical proximity of the pancreas with the spleen and the pathophysiological process in acute and chronic pancreatitis form the basis of this dreaded complication. We cite the case of a young male previously undiagnosed with chronic pancreatitis presenting with atraumatic splenic rupture. Definitive diagnosis was made by contrast enhanced computed tomography of the abdomen, intra operative findings, and histopathological examination of the splenectomy specimen. The splenorenal ligament forms the main anatomic proximity between the pancreas and the spleen. A few pathophysiological mechanisms though suggested are incompletely understood. splenic vein thrombosis, intrasplenic pseudocysts, splenic rupture, infarction, necrosis, splenic hematoma, and severe bleeding from eroded splenic vessels are the complications noted of which splenic rupture is the second most common following splenic vein thrombo...

ABSTRACT BACKGROUND: Gastrointestinal stromal tumors (GISTs) represent the majority of primary no... more ABSTRACT BACKGROUND: Gastrointestinal stromal tumors (GISTs) represent the majority of primary nonepithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by the immunohistochemical staining for the CD117 antigen. Extra-gastrointestinal stromal tumors (EGISTs) are neoplasms with overlapping immunohistological features, occurring in the abdomen outside the gastrointestinal tract with no connection to the gastric or intestinal wall. CASE PRESENTATION: We here report the clinical, macroscopic and immunohistological features of an EGIST arising in the greater omentum of a 74 year-old man. CONCLUSION: The EGISTs in the greater omentum can grow slowly in the abdomen for a long time without clinical appearance. In most cases a preoperative diagnosis is not possible, and the patient undergoes a surgical operation for the generic diagnosis of "abdominal mass". EGISTs being highly vascular tumours can show enhancement findings mimicking hemang...

Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology

Tropical doctor, 2003

Meningiomas have been found to have receptors for progestational hormones and growth may increase... more Meningiomas have been found to have receptors for progestational hormones and growth may increase durinl pregnancy or with the use of hormonal contraceptives)' . Mengiomas may therefore become symptomatic with fits in late pregnancy when the level of these hormones is high. Early diagnosis offers the best prospect for complete excision of an intracranial meningioma and poor outcome is associated with poor preoperative clinical condition/. The diagnosis in our patient was delayed until recurrent fits and hemiparesis occurred. Seizures from eclampsia are usually generalized and rarely focal in onset. Eclampsia persisting up to 48 hours postpartum is unusual and other causes of seizures should be considered. The differential diagnosis of seizures around pregnancy would include intracranial tumours. cerebrovascular accident. amniotic fluid embolism and sagittal sinus thrombosis. In environments such as ours. meningitis may also cause seizures during pregnancy. A high index of suspicion is vital for the diagnosis of a meningioma presenting during pregnancy. Close follow up of eclamptic patients should be undertaken. to identify those with recurrent fits or neurological deficits. Further evaluation. including a brain computerized tomography scan may then be necessary to exclude an intracranial meningioma. Following diagnosis. the meningioma should be promptly treated.