Deptt of surgery,AMCH DIBRUGARH

HOD:Proff(Dr)R K BHUYAN
UNIT HEAD ,SURGERY IV: DR S BHUYAN MICROBIOLOGY ,AMCH: DR (MRS)RIMA NATH

Case

report

Dr kamendra singh
Pgt 2nd year general surgery

Pt ,s particular Name : pranabjyoti baruah 21yr/male/hindu

s/o-Dibakar baruah ,khoang gaon ,po-khoang ghat Dibrugarh D O E: 27/12/11 CHIEF COMPLAIN: Swelling below umbilicus -4 month :itching-1 month History of present illness: pt complains of a round smooth swelling of pea nut size just below umbilicus for the last 4 month.swelling was very slowly progressive in growth and painless but over the last one month the swelling has become itching in nature,there is no history of associated fever ,weight

loss,decrease in appetite.he seeks medical advise for its itching character and anxiety about the swelling. Pat history:ther e is no history of jaundice ,tb,malaria,diabetes or any medical or surgical illness of significance. Family history :he lives with his parents and has 3 brothers and one sister who is married ,all are enjoying good health. Personal history:he is occasional alcoholic and regular tobacco chewer ,takes typical non veg asamese diet. Socio economic history :he lives in assamese type semi pucca floored house.his father is farmer and his per capita income is rs 2000 per month.he is doing his graduation from local college.family draws from tube well. Drug history: no significant drug history

Examination
General examination :pal absent,ictrus-absent,cyanosis absent, PR-72/min,BP-124/80 mm hg Local examination :INSPECTION Swelling of large pea nut size on anterior abdominal wall,below umbilicus,normal in color with slight excoriation without any sign of congestion and visible pulsation. PALPATION-swelling is non tender normal in temp,color measuring 2.5 *2.5 cm,with smooth surface,round regular margin,movable over the underlying str in all dimension,skin is fixed to swelling PERCUSSION- normal INVESTIGATIONHb 11.1gm/dl ,esr -10 mm AEFH,tc-8500,DLC-N60,L33,E02,M05. B.UREA -18.1,S.CREAT-0.9,RBS-87mg/dl Swelling was provisionally diagnosed to be case of sebaceous cyst Operative findins : Pt was prepared for local anaesthesia,3 cm long transverse incision given over the swelling,on retracting the skin and further deepening the incision a pearly white capsule is seen,on stroking the swelling and making a small nick a coiled spring like str is seen which soon unfolded itself and shows jerky movements when disturbed.the total length of the live worm extracted was 18 cm.ti was collectd in normal saline soln and sent to microbiology amch for species identification and capsule to pathology for histo pathological examination.whole the procedure was uneventfull. Pathology report : capsule was organized cyst

Peripheral blood smear : no microfilaria seen in the blood Microbiology deptt.AMCH (Dr mrs rima nath,assocte proff ,microbiology) Species identified as DINOFILARIA.

OPERATED IN THE GUIDENCE OF DR S BHUYAN BY DR KAMENDRA SINGH PGT 2ND YEAR DR JITEN TERON PGT 2ND YEAR DR ABHIJEET VERMA PGT 1ST YEARS

video-2011-12-27-11-25-13.mp4