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Papers by Sudeendra Doddi

Research paper thumbnail of Occult small bowel perforation in a patient with Ehlers Danlos syndrome: a case report and review of the literature

Cases Journal, 2010

Patients who present with a co-existing connective tissue disorder add a degree of complexity to ... more Patients who present with a co-existing connective tissue disorder add a degree of complexity to operative intervention. We present an unusual case of a 53-year-old Caucasian female patient with Ehlers Danlos syndrome who presented with an occult perforation of the distal ileum. The patient had known small bowel diverticulae yet the perforation occurred within the normal bowel wall. The pre-operative CT only showed malrotation of the large bowel and did not correlate with the intra-operative findings. Our case has highlighted that although small bowel perforation is a rare occurrence, it may be more common in Ehlers Danlos and may present with atypical features. Perforation may also occur alongside normal bowel as well as diverticulae within the bowel. Where diverticulae exists within a patient with Ehlers Danlos syndrome and there is some diagnostic uncertainty, there should be a lower threshold for operative intervention. We present in the discussion a number of salient features and learning points.

Research paper thumbnail of 406 POSTER Is polypectomy adequate for colonic polyps with Invasive Cancer

406 POSTER Is polypectomy adequate for colonic polyps with Invasive Cancer

Ejso, 2006

Research paper thumbnail of 327 POSTER Mastectomy making decision multidisciplinary meeting (mdm) revisited

327 POSTER Mastectomy making decision multidisciplinary meeting (mdm) revisited

Ejso, 2006

Research paper thumbnail of 328 POSTER Ultrasound tumour measurements: Potential for mismanagement in Primary Breast Cancer

Ejso, 2006

Half of them were younger than 40 years. All presented with cystic masses, one clinically maligna... more Half of them were younger than 40 years. All presented with cystic masses, one clinically malignant, one suspicious, and four indeterminate. Aspirate was once clear, bloody in three and twice normal cyst content with a residual mass in one. Mammography failed to diagnose cancer, was suspicious once but wasindeterminate or benign in others. Ultrasound diagnosed malignancy once, was suspicious twice yet missed two cancers. Cytology diagnosed four cancers, was once indeterminate and once benign. The six were grade-III invasive ductal carcinoma with extensive necrosis, ER and PR negative except one PR positive. Three were Cerb B2 positive. High grade DCIS was present in four and squamous differentiation in three. Three patients received mastectomy, two WLE and one declined treatment. Four received chemotherapy, one of those was neo-adjuvant. All five treated, received adjuvant radiotherapy. Conclusion: Our study suggests that cystic carcinoma is much more common than previously reported. It seems to occur in younger patients. The heterogeneous ethnicity may have contributed to both findings in our patients. Imaging/cytology seems to be less accurate in diagnosing cystic cancer. Vigilance is imperative.

Research paper thumbnail of 16 ORAL Nurse led flexible sigmoidoscopy in a satellite clinic: solution for NHS

16 ORAL Nurse led flexible sigmoidoscopy in a satellite clinic: solution for NHS

Ejso, 2006

Research paper thumbnail of 298 POSTER Upgrading of routine GP referrals to urgent by the breast care nurses avoids delay in diagnosis of breast cancer

298 POSTER Upgrading of routine GP referrals to urgent by the breast care nurses avoids delay in diagnosis of breast cancer

Ejso, 2006

Research paper thumbnail of Upper gastrointestinal bleeding due to gastric stromal tumour: a case report

Cases Journal, 2010

Introduction: Gastro-intestinal stromal tumours are the most common mesenchymal tumours of the ga... more Introduction: Gastro-intestinal stromal tumours are the most common mesenchymal tumours of the gastrointestinal tract. This case report highlights the necessity of early surgical intervention in such cases to avoid mortality due to rebleeding and to raise the awareness of rare causes of upper gastrointestinal bleed and their management.

Research paper thumbnail of Pneumococcal sepsis presenting as acute compartment syndrome of the lower limbs: a case report

Journal of Medical Case Reports, 2009

Introduction: Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. ... more Introduction: Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. Spontaneous onset of acute compartment syndrome of the lower limbs is rare. We present a very rare case of pneumococcal sepsis leading to spontaneous acute compartment syndrome.

Table |: Results of blood investigations at the time of admission  Gamma GT, gamma glutamyl transferase; HB, haemoglobin; HCT, haematocrit; MCV, mean corpuscular volume; MCH, mean corpuscular haemoglobin; RBC, red blood cell count; WBC, white blood cell count

Research paper thumbnail of Every Wheeze Does Not Merit a Puffer! Case of an Overnight Cure of Chronic Asthma

Case Reports in Medicine, 2010

Research paper thumbnail of Management of an incidentally found large adrenal myelolipoma: a case report

Cases Journal, 2009

Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue... more Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue. Most lesions are small, unilateral and asymptomatic, discovered incidentally at autopsy or on imaging studies performed for other reasons. We would like to present a case report of this rare tumour. Cross-sectional imaging is helpful in making a pre-operative diagnosis. The size of the lesion should be a criterion for surgical intervention.

Research paper thumbnail of 297 POSTER Skin sparing mastectomy and immediate breast reconstruction: is it safe

297 POSTER Skin sparing mastectomy and immediate breast reconstruction: is it safe

Ejso, 2006

Research paper thumbnail of Tooth Crown Foreign Body Appendicitis

Tooth Crown Foreign Body Appendicitis

Digestive Surgery, 2009

Research paper thumbnail of Small cell carcinoma of the anus: a case report

Cases Journal, 2009

Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60y... more Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60year old lady with small cell carcinoma of the anus. She had no metastatic disease on presentation. She had chemotherapy and radiotherapy but developed distant metastasis after completion of treatment. Immunohistochemistry is required to make a diagnosis. Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease. Radiotherapy is for local control and relief of symptoms.

Research paper thumbnail of Femoral Hernia with a Twist

Case Reports in Medicine, 2010

Research paper thumbnail of Lymphoscintigram in sentinel node biopsy: Do we need it

Lymphoscintigram in sentinel node biopsy: Do we need it

Ejso, 2011

Research paper thumbnail of A Forgotten Migrated Intrauterine Contraceptive Device Is Not Always Innocent: A Case Report

Case Reports in Medicine, 2010

The incidence of transuterine perforation and migration of intrauterine contraceptive devices (IU... more The incidence of transuterine perforation and migration of intrauterine contraceptive devices (IUCDs) into the abdominal cavity has been estimated at less than 0.1%. It has been suggested that intraperitoneal IUCD have low morbidity and may be left in situ. We report the first case of closed loop small bowel obstruction due to migration of a "Saf-T-Coil" IUCD into the abdominal cavity, where it became embedded in the omentum and ultimately, 31 years after deployment, coiled both arms around a loop of ileum. This late complication underlines the dangers of intra-abdominal foreign bodies, even when chemically and biologically inert.

Research paper thumbnail of Occult small bowel perforation in a patient with Ehlers Danlos syndrome: a case report and review of the literature

Cases Journal, 2010

Patients who present with a co-existing connective tissue disorder add a degree of complexity to ... more Patients who present with a co-existing connective tissue disorder add a degree of complexity to operative intervention. We present an unusual case of a 53-year-old Caucasian female patient with Ehlers Danlos syndrome who presented with an occult perforation of the distal ileum. The patient had known small bowel diverticulae yet the perforation occurred within the normal bowel wall. The pre-operative CT only showed malrotation of the large bowel and did not correlate with the intra-operative findings. Our case has highlighted that although small bowel perforation is a rare occurrence, it may be more common in Ehlers Danlos and may present with atypical features. Perforation may also occur alongside normal bowel as well as diverticulae within the bowel. Where diverticulae exists within a patient with Ehlers Danlos syndrome and there is some diagnostic uncertainty, there should be a lower threshold for operative intervention. We present in the discussion a number of salient features and learning points.

Research paper thumbnail of 406 POSTER Is polypectomy adequate for colonic polyps with Invasive Cancer

406 POSTER Is polypectomy adequate for colonic polyps with Invasive Cancer

Ejso, 2006

Research paper thumbnail of 327 POSTER Mastectomy making decision multidisciplinary meeting (mdm) revisited

327 POSTER Mastectomy making decision multidisciplinary meeting (mdm) revisited

Ejso, 2006

Research paper thumbnail of 328 POSTER Ultrasound tumour measurements: Potential for mismanagement in Primary Breast Cancer

Ejso, 2006

Half of them were younger than 40 years. All presented with cystic masses, one clinically maligna... more Half of them were younger than 40 years. All presented with cystic masses, one clinically malignant, one suspicious, and four indeterminate. Aspirate was once clear, bloody in three and twice normal cyst content with a residual mass in one. Mammography failed to diagnose cancer, was suspicious once but wasindeterminate or benign in others. Ultrasound diagnosed malignancy once, was suspicious twice yet missed two cancers. Cytology diagnosed four cancers, was once indeterminate and once benign. The six were grade-III invasive ductal carcinoma with extensive necrosis, ER and PR negative except one PR positive. Three were Cerb B2 positive. High grade DCIS was present in four and squamous differentiation in three. Three patients received mastectomy, two WLE and one declined treatment. Four received chemotherapy, one of those was neo-adjuvant. All five treated, received adjuvant radiotherapy. Conclusion: Our study suggests that cystic carcinoma is much more common than previously reported. It seems to occur in younger patients. The heterogeneous ethnicity may have contributed to both findings in our patients. Imaging/cytology seems to be less accurate in diagnosing cystic cancer. Vigilance is imperative.

Research paper thumbnail of 16 ORAL Nurse led flexible sigmoidoscopy in a satellite clinic: solution for NHS

16 ORAL Nurse led flexible sigmoidoscopy in a satellite clinic: solution for NHS

Ejso, 2006

Research paper thumbnail of 298 POSTER Upgrading of routine GP referrals to urgent by the breast care nurses avoids delay in diagnosis of breast cancer

298 POSTER Upgrading of routine GP referrals to urgent by the breast care nurses avoids delay in diagnosis of breast cancer

Ejso, 2006

Research paper thumbnail of Upper gastrointestinal bleeding due to gastric stromal tumour: a case report

Cases Journal, 2010

Introduction: Gastro-intestinal stromal tumours are the most common mesenchymal tumours of the ga... more Introduction: Gastro-intestinal stromal tumours are the most common mesenchymal tumours of the gastrointestinal tract. This case report highlights the necessity of early surgical intervention in such cases to avoid mortality due to rebleeding and to raise the awareness of rare causes of upper gastrointestinal bleed and their management.

Research paper thumbnail of Pneumococcal sepsis presenting as acute compartment syndrome of the lower limbs: a case report

Journal of Medical Case Reports, 2009

Introduction: Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. ... more Introduction: Acute compartment syndrome is a surgical emergency requiring immediate fasciotomy. Spontaneous onset of acute compartment syndrome of the lower limbs is rare. We present a very rare case of pneumococcal sepsis leading to spontaneous acute compartment syndrome.

Table |: Results of blood investigations at the time of admission  Gamma GT, gamma glutamyl transferase; HB, haemoglobin; HCT, haematocrit; MCV, mean corpuscular volume; MCH, mean corpuscular haemoglobin; RBC, red blood cell count; WBC, white blood cell count

Research paper thumbnail of Every Wheeze Does Not Merit a Puffer! Case of an Overnight Cure of Chronic Asthma

Case Reports in Medicine, 2010

Research paper thumbnail of Management of an incidentally found large adrenal myelolipoma: a case report

Cases Journal, 2009

Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue... more Adrenal myelolipoma is a rare benign neoplasm composed of mature adipose and hematopoietic tissue. Most lesions are small, unilateral and asymptomatic, discovered incidentally at autopsy or on imaging studies performed for other reasons. We would like to present a case report of this rare tumour. Cross-sectional imaging is helpful in making a pre-operative diagnosis. The size of the lesion should be a criterion for surgical intervention.

Research paper thumbnail of 297 POSTER Skin sparing mastectomy and immediate breast reconstruction: is it safe

297 POSTER Skin sparing mastectomy and immediate breast reconstruction: is it safe

Ejso, 2006

Research paper thumbnail of Tooth Crown Foreign Body Appendicitis

Tooth Crown Foreign Body Appendicitis

Digestive Surgery, 2009

Research paper thumbnail of Small cell carcinoma of the anus: a case report

Cases Journal, 2009

Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60y... more Small cell carcinoma of the anus is a very rare but aggressive tumour. We present a case of a 60year old lady with small cell carcinoma of the anus. She had no metastatic disease on presentation. She had chemotherapy and radiotherapy but developed distant metastasis after completion of treatment. Immunohistochemistry is required to make a diagnosis. Chemotherapy remains the mainstay of treatment for small cell carcinoma of the anus with or without metastatic disease. Radiotherapy is for local control and relief of symptoms.

Research paper thumbnail of Femoral Hernia with a Twist

Case Reports in Medicine, 2010

Research paper thumbnail of Lymphoscintigram in sentinel node biopsy: Do we need it

Lymphoscintigram in sentinel node biopsy: Do we need it

Ejso, 2011

Research paper thumbnail of A Forgotten Migrated Intrauterine Contraceptive Device Is Not Always Innocent: A Case Report

Case Reports in Medicine, 2010

The incidence of transuterine perforation and migration of intrauterine contraceptive devices (IU... more The incidence of transuterine perforation and migration of intrauterine contraceptive devices (IUCDs) into the abdominal cavity has been estimated at less than 0.1%. It has been suggested that intraperitoneal IUCD have low morbidity and may be left in situ. We report the first case of closed loop small bowel obstruction due to migration of a "Saf-T-Coil" IUCD into the abdominal cavity, where it became embedded in the omentum and ultimately, 31 years after deployment, coiled both arms around a loop of ileum. This late complication underlines the dangers of intra-abdominal foreign bodies, even when chemically and biologically inert.