Jay Lodhia

• Doctor of Medicine
• General surgeon at Kilimanjaro Christian Medical Centre

Background Mucoepidermoid carcinoma of the skin is an exceedingly rare neoplasm, with only a limited number of cases documented in the literature. Typically, mucoepidermoid carcinoma arises in the salivary glands, where it accounts for 30% of all malignant salivary gland tumors and generally presents as a low-grade malignancy with a low probability...

Background Pancreatic cancer is a common and deadly cancer, ranking as the 14th most common cancer worldwide and the 7th leading cause of cancer-related deaths. Advanced pancreatic malignancy frequently presents with biliary and gastric outlet obstruction and palliative open interventions are often required, especially in low-income countries where...

Background Penile Mondor’s disease (PMD) is a rare clinical condition with an estimated incidence of 1.39%, though the true incidence may be higher as it is often self-limiting. Many patients may not seek medical attention due to stigma, potentially leading to untreated psychological distress and sexual dysfunction. Case presentation We report the...

Meningomyelocele and meningocele are types of neural tube defects, which are congenital abnormalities of the spine and spinal cord. These conditions are frequently encountered by pediatric neurosurgeons worldwide and represent a significant public health concern due to their association with a range of collateral conditions, other malformations, an...

Colon lipomas are rare benign, nonepithelial tumors that are often asymptomatic. However, when symptoms do occur, they vary depending on the size and location of the lipoma and are generally nonspecific. Diagnosis is confirmed through histopathological analysis. Lipomas smaller than 2.5 cm can typically be observed without intervention, but larger...

Ovarian yolk sac tumors (OYSTs), also known as endodermal sinus tumors, are rare and highly malignant germ cell tumors, accounting for approximately 1% of all ovarian cancers. They predominantly affect children and young adults, with a rapid growth rate and early metastasis, making early diagnosis and treatment crucial. This report presents the cas...

Colorectal cancer (CRC) is predominantly a disease of older adults, but its incidence among younger populations has been rising significantly. While the overall global incidence and mortality of CRC have declined due to population-based screening programs, the rate of early-onset colorectal cancer (EOCRC) in individuals under 50 has increased sharp...

Plexiform neurofibroma is a benign tumor of peripheral nerves that occurs in up to 30% of patients with neurofibromatosis type-1 (NF-1). We present a case of a 15-year-old male patient without NF-1, with an 11-year history of a slow growing, painless mass on the left side of the back extending to the gluteal region, with no constitutional symptoms...

Lipomas are common benign tumors, typically affecting subcutaneous tissues in the head, neck, trunk, and upper limbs, particularly in individuals over 40 years old. However, visceral involvement, such as mesenteric lipomas, is exceedingly rare, with fewer than 50 pediatric cases reported in the English literature. Mesenteric lipomas are generally a...

Introduction and importance Giant lipomas, particularly in pediatric patients and unusual locations like the gluteal region, are rare. These benign tumors can mimic other conditions, making diagnosis challenging. This case highlights the importance of considering giant lipomas in differential diagnoses and the challenges posed by delayed treatment....

Adnexal masses are uncommon in children but are increasingly recognized due to advancements in diagnostic facilities. Such masses in the pediatric population often raise concerns about malignancy. Typically, these masses are small and can resolve spontaneously; however, larger ones can pose a diagnostic dilemma due to their signs and symptoms, requ...

Despite technological advancements in clinical medicine, the diagnosis of acute appendicitis remains a challenge owing to its divergent presentation. For years, the Alvarado score has been the mainstay for the clinical diagnosis of appendicitis; however, it has led to a high Negative appendectomy rate with post appendectomy consequences. This study...

Extragonadal germ cell tumors (GCTs) are rare, accounting for 1% to 5% of all GCTs, with malignant sacrococcygeal yolk sac tumors (SCYSTs) being part of this uncommon subset. These tumors primarily occur in children and young adults and are known for their aggressive behavior, necessitating early diagnosis and prompt treatment. In this case report,...

Late presentation of congenital diaphragmatic hernia (CDH) presents usually after the neonatal period and often misdiagnosed for other respiratory pathologies. It is crucial to differentiate late presentation of CDH from other potential causes of respiratory distress and gastrointestinal symptoms. Herein, we present 2 cases of delayed presentation...

Introduction and importance Thyroid disorders encompass a diverse range of conditions, including benign adenomas and malignant carcinomas. Atypical follicular adenomas represent a subset that presents diagnostic challenges due to their ambiguous features. Given the thyroid gland’s proximity to critical structures, prompt and accurate diagnosis is i...

Purpose Gastroschisis is associated with over 90% mortality in many sub-Saharan African countries. The introduction of the Gastroschisis Care Bundle at Muhimbili National Hospital (MNH) increased survival up to 60%. We aim to explain the impact of using implementation science methods to decentralize the care of babies with gastroschisis to other pa...

Primary breast lymphoma (PBL) is a rare malignant lymphoid neoplasm limited to the breast, accounting for about 0.15% of all malignant breast tumors and 1.7% to 2.2% of extra-nodal lymphomas. PBL must be distinguished from conventional breast carcinomas due to different therapeutic approaches. A 25-year-old female presented with a left breast mass....

Introduction and importance Chronic subdural hematoma (CSDH) is a common neurosurgical condition, particularly in the elderly. A rare variant, calcified chronic subdural hematoma, occurs more frequently in children and young adults. The calcification mechanism involves poor circulation, absorption issues, intravascular thrombosis, and prolonged hem...

Enterocutaneous fistula is a dreaded complication by most surgeons especially after emergency abdominal surgery. It can also occur spontaneously from an underlying disease. The pathology is demanding both mentally and physically and causes medical and nursing problems for the affected individual. In this case report we present a timeline of a young...

Cystic hygromas are congenital malformations of lymphatic origin, that are mostly diagnosed in the perinatal period. The term “hygroma” comes from Greek meaning tumor filled with water. They are commonly found in children under two years and incidence decreases with age. Due to their diverse presentation, its optimum treatment often poses a potenti...

Intussusception is a common and well-known surgical pathology. Intussusception in adults is rare, accounting for only 5% of all intussusceptions. Gastrointestinal stromal tumors (GIST) are common mesenchymal tumors of the stomach that can act as a pathological lead point for intussusception. Herein, we present an uncommon case of gastroduodenal int...

Key Clinical Message Jejunalileal atresia is a cause of intestinal obstruction in the newborn, hence a surgical emergency. Prenatal diagnosis can be made by simple obstetric ultrasound and postnatal by plain abdominal x‐ray to plan a multidisciplinary approach to reduce morbidity and neonatal mortality. Abstract Atresia can occur anywhere along th...

Introduction and importance Sacrococcygeal teratoma is a rare extragonadal germ cell tumor occurring at the lower end of the back. It is congenital, and can be diagnosed in utero or just after birth. These tumors are sporadic in nature, more common in females than in males. They can be solid, cystic or a mixture of the two in consistency. Authors p...

Introduction: Gallbladder carcinoma is a malignant epithelial neoplasm of the gallbladder. The tumor is clinically aggressive, with an overall 5-year survival rate of < 10%. Cholelithiasis is a known and established risk factor. Up to 50% of gallbladder tumors are detected incidentally in routine cholecystectomy specimens due to the absence of gros...

Liposarcoma is a tumor derived from primitive cells that undergo adipose differentiation. They comprise 10%–35% of all soft tissue sarcomas. We present a 46-year-old female patient with a 4-year history of a giant swelling on the lateral aspect of the left thigh. Wide local excision of the mass was performed and histopathological analysis revealed...

Introduction and importance Cystic echinococcosis (CE) is a chronic illness caused by the tapeworm Echinococcus granulosus. It is classified as a neglected disease and is a priority according to the World Health Organization. CE is prevalent in populations engaged in specific livestock practices and is associated with poor living conditions. Case...

Background Pancreatic cancer is a common and deadly cancer, ranking as the 14th most common cancer worldwide and the 7th leading cause of cancer-related deaths. Advanced pancreatic malignancy frequently presents with biliary and gastric outlet obstruction and palliative open interventions are often required, especially in low-income countries where...

Intussusception is rarely seen in adulthood but is commonly seen in the pediatric age group. Causes of intussusception in adults are commonly due to tumors and inflammatory diseases. Intussusception in adults accounts for less than 5% of intestinal obstruction. Colonic lipomas are usually asymptomatic and are mostly managed surgically with promisin...

Key Clinical Message A rare form of invasive breast carcinoma, NOS, also known as matrix‐producing carcinoma made up of epithelial and mesenchymal components. Usually, they are triple negative and clinically aggressive and respond poorly to neoadjuvant systemic therapy. Abstract Metaplastic breast carcinomas (MBCs) are ductal carcinomas that under...

Introduction and importance Penetrating neck injuries (PNIs) are common and are associated with arterial injuries in 10–25 % of the cases, with carotid artery twice as frequent as to vertebral arteries. Carotid artery injury constitutes about 22 % of all cervical vascular injuries. Case presentation We present a case of a 44-year-old male who sust...

Hydrometrocolpos is a rare congenital anomaly characterized by gross distension of the uterus and vagina with fluid, which may result in obstruction to the urine flow. The insertion of Foley catheter into the uterus can relieve the obstruction to the flow of urine and improve renal function. Herein we present a case of infant who was diagnosed with...

Background Deep vein thrombosis is a rare condition in the paediatric population, and it tends to overlap with musculoskeletal infections such as cellulitis, myositis or osteomyelitis. When associated with Staphylococcal infection, it is linked to poor prognosis. It should be strongly suspected in any child presenting with unilateral lower limb pa...

Key Clinical Message Primary SCC of the breast is a very rare disease. Metastasis from elsewhere should be excluded first. The tumor is a very aggressive with poor prognosis. No standard treatment approaches are available. Managed by surgical excision followed by chemotherapy and radiotherapy. Abstract Primary squamous cell carcinoma of the breast...

Introduction and importance: Chest tube thoracostomy is a simple life-saving procedure with many benefits but comes with significant potential morbidity. Potentially all intra-thoracic organs are at risk of possible injury as well as peritoneal. Case presentation: We present four patients who had chest tube thoracostomy with potential complicati...

Background Blunt trauma to the urinary bladder is common with penetrating injury being a rare occasion. Most common entry pint for penetrating injuries includes buttock, abdomen and perineum with thigh being rare. There are a number of complications that may develop as a result of penetrating injury with vesicocutanous fistula being a rare occurren...

Sclerosing epithelioid fibrosarcoma (SEF) is a rare and distinctive variant of fibrosarcoma. To date, about 100 cases only have been documented. Histopathologically, it resembles a variety of benign, pseudosarcomatous and other malignancies. Early diagnosis and treatment are vital for improving the treatment outcomes.

A 35-year-old man presented with a right lateral neck mass for 6 years. Thyroid function test was within normal limits. Computed tomography scan of the neck was suggestive of branchial cyst, tuberculous lymphadenopathy and normal thyroid gland. Fine needle aspiration cytology of cervical lymph node was suggestive of metastatic carcinoma. Branchial...

Metanephric adenoma is an uncommon renal tumor with almost exclusively benign behavior, which can clinically and radiologically imitate malignancy. The histological examination is therefore crucial in diagnosis. Herein, we report a case of an 18-year-old male with a huge left renal mass. Histopathology and immunohistochemistry of nephrectomy resect...

Introduction and importance In a low-resource setting, the availability of neurosurgeons and neurosurgical equipment for neurosurgery has proved to be a challenge for the management of extra-axial hematomas hence general surgeons perform burr hole surgeries for emergencies. Case presentation We share our experience with three patients who presente...

Introduction and importance Penile fracture is uncommon entity that rarely involves all the three erectile bodies (the two corpora carvenosa and corpus spongiosum). The diagnosis is clinical as most cases presents with typical signs and symptoms. Case presentation We present a case of young man who sustained penile fracture involving the two corpo...

Pedunculated lipofibroma is a rare form of nevus lipomatous cutaneous superficialis. They are usually solitary lesions found around the thighs, buttocks and trunk; thought to have a predilection for pressure areas. There are two types of lipofibromas; sessile or pedunculated. They are mostly asymptomatic but can cause symptoms as they grow larger a...

The pancreatic pseudocyst contains pancreatic enzymes encapsulated by a non-epithelialized wall. They are rare in the pediatric population and are mostly a result of pancreatic trauma: extrinsic, or intrinsic. Management options include conservative or surgical, depending on the clinical signs and symptoms, and the size of the cyst.

Chondromyxoid fibroma is one of the rarest benign cartilaginous tumors accounting for less than 0.5% of bone tumors and mostly found in the metaphysis of long bones. Diagnosis is by histology showing lobular pattern with stellate-shaped cells in a myxoid or chondroid background. Often they can be misdiagnosed as chondrosarcomas. Recommended treatme...

Paget’s disease of the breast is a rare pathology resulting from abnormal proliferation of glandular epithelial cells in the nipple–areolar epidermis. The disease is named after James Paget, a pathologist and surgeon, who reported a relationship between a nipple rash and mammary gland tumors in 1874. Early diagnosis may be quite difficult. Histopat...

Intestinal obstruction is one of the most common surgical emergencies in the neonatal period. Early diagnosis is vital for proper management and good outcome. Intestinal obstruction can be divided into high, for example, duodenal atresia and jejunal atresia, or low, for example, ileal atresia, colonic atresia, and Meckel’s diverticulum. The most co...

Lymphedema in a newborn can be both physically and psychologically demanding to the patient, caretakers, and clinicians. Low-resource settings prove to be even more challenging due to unavailability of diagnostic investigations. Definitive diagnosis could not be made on our client due to unavailability of lymphoscintigraphy and genetic testing in o...

Introduction and importance Chyle is a lipid-rich, milky-appearing fluid originating from lymph tissues. Chylous ascites is the collection of chyle in the peritoneal cavity and is a rare pathology. Case presentation In this case report we share our experience of successfully managing chylous ascites conservatively from a resource-limited setting....

Tailgut cysts are rare tumors of embryonic remnant located in the retrorectal space. They are mostly asymptomatic hence diagnosis is incidental. They at times present with unspecific symptoms therefore are often misdiagnosed. Radiological imaging aids with the diagnosis and plan the surgical management. Surgeons should be well conversant to avoid c...

Midgut malrotation is a congenital anomaly due to partial or complete failure of rotation of the midgut in fetal life. Majority of the cases present in the neonatal period and 90% within the first year. Adult presentation is rare and the true incidence is unknown as some cases pass undiagnosed. Whirlpool sign is pathognomic for midgut malrotation a...

Pediatric stroke is uncommon. A traumatic cause of pediatric ischemic stroke is even rarer. Ischemic stroke due to intraluminal thrombus can be acutely treated with thrombolysis but various factors in sub-Saharan Africa make this unfeasible. We present a case of an eight-year-old Tanzanian boy who sustained penetrating trauma to his palate developi...

Dysphagia is a serious symptom and requires urgent investigations and prompt diagnosis to initiate appropriate therapy. Dysphagia aortica is a rare entity described as difficulty in swallowing due to external compression by the aorta. The incidence of this entity is unknown. Herein we present a 90-year-old woman who presented with a progressive 3-m...

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 has mainly affected the respiratory system but has expanded to other systems, including the gastrointestinal system. We present an 80-year-old man with sharp epigastric pain and vomiting. Laboratory investigations revealed elevated pancreatic enzymes, and contrast-enhanced c...

Lower limb trauma with significant tissue loss poses a great challenge to the surgeons. Cross-leg flaps were first described in 1854 and are still used for limb-salvage surgeries in those not suitable for free tissue transfer or in resource-limited settings. Herein we present a case of a 16-year-old girl, otherwise well, who sustained burn injury t...

Introduction and importance Gallbladder perforations are infrequently encountered in the pediatric group but can be a cause of peritonitis with significant morbidity and mortality if not diagnosed and managed promptly. Case presentation We present a case of a 10-year-old female who presented with peritonitis due to a perforated gallbladder diagnos...

Extra‐uterine leiomyoma (EUL) is extremely rare and due to its unusual location, results into diagnostic dilemma and due to its unusual location may lead to surgical complication as in this case. We present a case of large broad ligament leiomyoma in a 40‐year‐old premenauposal that was excised with challenges. Leiomyomas are common uterine benign...

Introduction and importance Soft tissue sarcoma is an uncommon form of cancer with poor prognosis. Early diagnosis and treatment are vital for improving the treatment outcomes. Case presentation We report a series of high-grade soft tissue sarcomas of the lower extremity with delayed diagnosis to gain insight into the presentation, treatments and...

Rectal prolapse is rare in children but usually occurs before four years of age. There are a few conditions that predispose to rectal prolapse as well as numerous conditions that mimic the condition. We present a case of rectal prolapse that presented as a gluteal mass and diagnosis was confirmed by radiology imaging and was successfully managed su...

Background: Acute gastric volvulus associated with congenital diaphragmatic hernia is an uncommon disorder in infancy and a surgical emergency. Methods: We present a six-month female baby who presented with clinical features of intestinal obstruction. Ultrasonography of the abdomen revealed gastric volvulus. The baby underwent emergency laparoto...

Introduction: Abdominal emergencies during pregnancy (excluding obstetric emergencies) occur on one out of 500-700 pregnancies. Since they are relatively rare patients should be referred and managed in tertiary level centres where surgical, obstetrical and neonatal cares are available. To our understanding there are no detailed descriptive series o...

Introduction: Abdominal emergencies during pregnancy (excluding obstetric emergencies) occur on one out of 500-700 pregnancies. Since they are relatively rare patients should be referred and managed in tertiary level centres where surgical, obstetrical and neonatal cares are available. To our understanding there are no detailed descriptive series o...

Introduction and importance The superficial circumflex iliac artery perforator flap is a widely used and acceptable option of free tissue transfer for small and large defects due to its ease of dissection and adjustable pedicle length. Case presentation Herein we present our experience with two similar cases of hand ulcers with differing aetiologi...

Midgut malrotation is an anomaly of intestinal rotation that occurs during embryology and usually presents during neonatal period. Symptoms are vague as presentation is delayed whilst some can be identified incidentally during adulthood. Herein we report of a 6-year-old girl who presented with food intolerance, abdominal pain and failure to gain we...

Introduction and importance Congenital stenosis of the esophagus is often overlooked in children with feeding difficulties leading to delayed diagnosis and treatment. This can have detrimental effects on the child's growth and general health, ranging from malnutrition to life-threatening complications such as aspiration pneumonia. Case presentatio...

Jenunoileal atresia is a congenital defect that causes small bowel obstruction in newborns. They are classified into 5 types and simple abdominal x-ray can aid in the diagnosis and with prompt resuscitation and surgery provides positive outcome. We present a 5-day-old newborn male baby was presented with features of intestinal obstruction since bir...

Introduction and importance Ano-genital warts are rare presentation in children. The main route of transmission is by sexual intercourse however horizontal transmission, self-inoculation and vertical transmission are also documented. Establishing the route of transmission when there is no evidence of sexual abuse may be difficult in pediatric and f...

Foreign bodies in the anus and rectum are not uncommon presentations globally. Reasons for foreign bodies in the rectum can be trauma, assault, psychiatric reasons but the most common reason documented is sexual pleasure, and objects range from sex toys to tools to packed drugs. Regardless of the reason, health care providers must maintain nonjudgm...

Introduction Sigmoid volvulus in pregnancy is a rare cause of intestinal obstruction with high maternal and fetal morbidity and mortality if not diagnosed and managed early. Case presentation A 29-year-old female (Chagga by tribe) presented with clinical features of intestinal obstruction 24 weeks into her second pregnancy. She had symptoms for on...

Background Melkersson-Rosenthal syndrome is a rare neurological disorder characterized by a triad of recurrent facial paralysis, fissured tongue, and persistent or recurring orofacial oedema, especially of the lower lip. The etiology is still not well understood, but genetic factors, allergic reactions and some infections have been linked to the di...

In developing countries surgical management can be challenging due to lack of standard resources hence surgeons should adapt to the available resources to serve the purpose in the appropriate management. Herein we share our experience with two children who presented with acute kidney injury to our centre and were managed by peritoneal dialysis usin...

Intussusception is a common pediatric emergency, although a prolapsed intussusception is a rare entity, often misdiagnosed as a rectal prolapse. We report a 10-month-old female baby who presented with a three week history of a mass protruding per anus and vomiting, and a 2 week history of bloody diarrhoea. A clinical diagnosis of a prolapsed intuss...

Ileal Atresia is noted to be the commonest cause of intestinal obstruction in neonates worldwide but still under diagnosed in Sub-Saharan countries with scarce data reported on its occurrence. It is likely under diagnosed due to low index of suspicion. Advancement in foetal ultrasound during prenatal period will increase index of suspicion and henc...

Introduction and importance Duodenal Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the digestive tract. The tumors are derived from interstitial cells of Cajal and usually they present as gastrointestinal bleeding or non-specific abdominal pain, but they can also be asymptomatic even when they have reached considerable size...