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Papers by Sudeendra Doddi
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.
406 POSTER Is polypectomy adequate for colonic polyps with Invasive Cancer
Ejso, 2006
327 POSTER Mastectomy making decision multidisciplinary meeting (mdm) revisited
Ejso, 2006
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.
16 ORAL Nurse led flexible sigmoidoscopy in a satellite clinic: solution for NHS
Ejso, 2006
298 POSTER Upgrading of routine GP referrals to urgent by the breast care nurses avoids delay in diagnosis of breast cancer
Ejso, 2006
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.
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.
Case Reports in Medicine, 2010
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.
297 POSTER Skin sparing mastectomy and immediate breast reconstruction: is it safe
Ejso, 2006
Tooth Crown Foreign Body Appendicitis
Digestive Surgery, 2009
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.
Case Reports in Medicine, 2010
Lymphoscintigram in sentinel node biopsy: Do we need it
Ejso, 2011
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.
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.
406 POSTER Is polypectomy adequate for colonic polyps with Invasive Cancer
Ejso, 2006
327 POSTER Mastectomy making decision multidisciplinary meeting (mdm) revisited
Ejso, 2006
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.
16 ORAL Nurse led flexible sigmoidoscopy in a satellite clinic: solution for NHS
Ejso, 2006
298 POSTER Upgrading of routine GP referrals to urgent by the breast care nurses avoids delay in diagnosis of breast cancer
Ejso, 2006
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.
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.
Case Reports in Medicine, 2010
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.
297 POSTER Skin sparing mastectomy and immediate breast reconstruction: is it safe
Ejso, 2006
Tooth Crown Foreign Body Appendicitis
Digestive Surgery, 2009
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.
Case Reports in Medicine, 2010
Lymphoscintigram in sentinel node biopsy: Do we need it
Ejso, 2011
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.