© Department of Continuing Medical Education, Christian Medical College, Vellore
For more information please email: cme@cmcvellore.ac.in

Learning Cases March 2005

STUDY 1: SURGERY - CASE OF THE MONTH

Man with swelling in the mouth and neck

Courtesy: Department of Surgery, CMC, Vellore.

Click on the picture to enlarge.

1. Identify this spotter

   Carcinoma alveolus with secondary neck nodes.
   
   

2. What is the treatment plan?

   Combination therapy with Surgery followed by chemoradiation.
   
   

3. What surgery needs to be done?

   Composite resection with reconstruction.
   
   

4. What is composite resection?

   Removal of the primary tumour along with draining lymph nodes en bloc.
   
   

Defect following the surgery.





5. How do we close the defect?

   Using pectoralis major myocutaneous flap.
   
   

Final result after defect closure.

Acknowledgement: Submitted by Dr. Deepak Thomas Abraham, Department of Surgery, CMC, Vellore.

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STUDY 2: RADIODIAGNOSIS - X-RAY OF THE MONTH

What's the diagnosis?

Courtesy: Department of Radiodiagnosis, CMC, Vellore.

HISTORY

The patient Pachiammal aged 45 years was brought with a history of epigastric burning in nature and gastroesophageal reflex. There was also a history of belching and hicups

FINDINGS





1. What are the findings in these Chest X-rays?

   Image 1: There is a Well defined homogenous retrocardiac opacity.
   
   Image 2: Air-fluid level in the porterior mediastinum (retrocardiac) region.

2. What are the findings in these Chest X-rays?

   Hiatus hernia
   
   

3. What are the findings in these Chest X-rays?

   • Frequent small meals
   • proton pump inhibitors - small hiatus hernia
   • weight reduction
   • Nisson's fundoplication
   
   
   




Acknowledgement: Submitted by Dr. Sudheer, Department of Radiodiagnosis, CMC, Vellore.

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