Conference Papers

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This collection contains abstracts of conference papers, presented at local and international conferences by the staff of the Faculty of Medicine

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    Case report: Giantadenomatoidtumour of uterus mimicking like large leiomyoma
    (Sri Lanka College of Obstetricians & Gynaecologists, 2016) Kajendran, J.; Gunarathna, S.M.S.G.; Wijesinghe, P.S.; Hewavisenthi, S.J.
    INTRODUCTION: Adenomatoidtumours of uterus are rare benign neoplastic disorder of the female genital tract. Even though reported incidence is around 1-2% true incidence is probably more than that as they are not usually symptomatic. Most cases are under 3 cm in diameter, but giant variants up to 15 cm in diameter are also described. Here, we describe a case of giant adenomatoid tumor of the uterus that was managed surgically. CASE HISTORY: A 24-year-old nulliparous woman presented with abdominal distension, regurgitation and early satiety of five months duration. She did not have any menstrual disorders. Abdominal examination revealed a large pelvic tumourcorresponding to 20 weeks gravid uterus. Ultrasonography revealed a large uterus with multiple fibroid. She underwent a laparotomy,a subserosal mass arising from the posterior uterine wall near the fundus and extending to the left uterine cornuwas found. It was not a welldefined mass and consistency was firm in nature. Tumour was easily enucleated and sent for histology. Uterus was repaired into two layers.Post-operative recovery was uneventful.The histology report revealed as adenomatoid tumor of the uterus. DISCUSSION: Adenomatoidtumour arises from the germinal epithelium of abdomen and thorax. It is a variant of mesothelioma. They can beassociated with fibroids and tend to mimic them clinically, making pre-operative diagnosis difficult. Macroscopically, most appear as nodular formations with ill- defined margins and can occur in ovary, mesentery, adrenal glands, and omentum. Rarely do they recur even after conservative surgery and so far no malignant transformation has been reported. Therefore, the recommended treatment is simple excision of the tumor, if possible
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    Case report: Giant adenomatoid tumour of uterus mimicking like large leiomyoma
    (Sri Lanka College of Obstetricians & Gynaecologists, 2016) Kajendran, J.; Gunarathna, S.M.S.G.; Wijesinghe, P.S.; Hewavisenthi, S.J.
    INTRODUCTION: Adenomatoid tumours of uterus are rare benign neoplastic disorder of the female genital tract. Even though reported incidence is around 1-2% true incidence is probably more than that as they are not usually symptomatic. Most cases are under 3 cm in diameter, but giant variants up to 15 cm in diameter are also described. Here, we describe a case of giant adenomatoid tumor of the uterus that was managed surgically. CASE HISTORY: A 24-year-old nulliparous woman presented with abdominal distension, regurgitation and early satiety of five months duration. She did not have any menstrual disorders. Abdominal examination revealed a large pelvic tumour corresponding to 20 weeks gravid uterus. Ultrasonography revealed a large uterus with multiple fibroid. She underwent a laparotomy, a subserosal mass arising from the posterior uterine wall near the fundus and extending to the left uterine cornu was found. It was not a well-defined mass and consistency was firm in nature. Tumour was easily enucleated and sent for histology. Uterus was repaired into two layers. Post-operative recovery was uneventful. The histology report revealed as adenomatoid tumor of the uterus. DISCUSSION: Adenomatoid tumour arises from the germinal epithelium of abdomen and thorax. It is a variant of mesothelioma. They can be associated with fibroids and tend to mimic them clinically, making pre-operative diagnosis difficult. Macroscopically, most appear as nodular formations with ill- defined margins and can occur in ovary, mesentery, adrenal glands, and omentum. Rarely do they recur even after conservative surgery and so far no malignant transformation has been reported. Therefore, the recommended treatment is simple excision of the tumor, if possible.
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    Prevalence of eosinophilic oesophagitis among adult Sri Lankan patients with refractory upper gastrointestinal symptoms - a prospective study
    (Sri Lanka Medical Association, 2012) Ranawaka, C.K.; de Silva, A.P.; Hewavisenthi, S.J.; Jayathilake, T.M.A.H.; de Alwis, W.R.S.
    INTRODUCTION: Eosinophilic oesophagitis (EoE) is increasing in the West (community prevalence 0.02-1%), and is especially prevalent among patients with refractory upper gastrointestinal (UGI) symptoms (about 6.5-40%). Diagnosis is important as the treatment is with corticosteroids and other immunomodulators rather than acid suppression and prokinetics. EOE has been poorly studied in Asian populations. AIMS: To study the prevalence of EoE among adult Sri Lankan patients with refractory UGI symptoms. Methods: The study was carried out in the University Medical Unit of the Colombo North Teaching Hospital, Ragama. Over a period of one year from March 2011, consecutive, consenting patients (aged 18-70) referred for gastroduodenoscopy (OGD), with persistent UGI symptoms despite standard therapy for at least two months, were included. All patients underwent OGD with two biopsies each from the distal and mid oesophagus. A diagnosis of EoE was made when there were 15 or more intra-epithelial eosinophils per high-power field, according to international guidelines. RESULTS: 106 patients (M: F= 42:64 mean age 48 yrs (SD 13.3) were recruited. Common symptoms were refractory dyspepsia, gastro-oesophageal reflux and dysphagia in74, 64, 27 patients respectively. Endoscopy was macroscopically normal in 97 patients, and suggestive of EoE in 7; concentric mucosal rings in 3 and white exudates in 4 patients. Only 2 (1.9%) patients had histological evidence of EoE, one of whom had compatible macroscopic endoscopic features. CONCLUSIONS: The prevalence of EoE in this Sri Lankan cohort of adult patients with refractory UGI symptoms was much lower than reported in western series.