Sreekanthan Gobishangar

University of Jaffna · Department of Surgery

Congenital abnormalities of the spleen are not uncommon. The most typical anomaly is the occurrence of accessory spleens (splenunculi). However, the presence of a second spleen is infrequent. While the size and shape of an accessory spleen can vary markedly, a second spleen is almost identical to the normal spleen morphologically. Torsion in a seco...

Common bile duct (CBD) stones affect around 5-15% of patient with gallbladder stones. Mainly it comes from the gallbladder, but occasionally it can develop in the CBD itself. Patients will develop serious complications like acute pancreatitis, cholangitis, obstructive jaundice and secondary biliary cirrhosis. Therefore, it is essential to exclude o...

Common bile duct (CBD) stones affect around 5-15% of patient with gallbladder stones. Mainly it comes from the gallbladder, but occasionally it can develop in the CBD itself. Patients will develop serious complications like acute pancreatitis, cholangitis, obstructive jaundice and secondary biliary cirrhosis. Therefore, it is essential to exclude o...

This study compares the safety and surgical outcome between conventional suture ligation technique and suture-less vascular sealing technique by using bipolar diathermy in total thyroidectomy. And it has been done in terms of recurrent laryngeal nerve damage, duration of surgery, postoperative bleeding, the incidence of hypoparathyroidism and dur...

Background Timely and safe elective health care facilitates return to normal activities for patients and prevents emergency admissions. Surgery is a cornerstone of elective care and relies on complex pathways. This study aimed to take a whole-system approach to evaluating access to and quality of elective health care globally, using inguinal hernia...

Introduction: Gastrointestinal stromal tumours are rare, but most common mesenchymal tumours originate from the gastrointestinal tract. Though surgery is the primary treatment, advanced tumours require targeted therapy in combination with surgery. Case presentation: A 62-year-old lady who presented with abdominal distention and pain was found to ha...

Introduction and importance Adrenal myelolipomas are uncommon benign tumors of the adrenal gland. It has various other sites of origin. Case presentation A 51-year-old male with elevated serum creatinine and an incidentally discovered adrenal mass underwent right adrenalectomy for an adrenal myelolipoma, a benign tumor with fat and haematopoietic...

A narrative review about the assesment and management of the lower GI bleeding comparing and contrasting the best available guidlines uptonow.

Introduction : Acute appendicitis is one of the common causes of acute abdomen in adults, which is managed widely with appendicectomy. Neuroendocrine tumours are the most common appendiceal tumours diagnosed incidentally on appendicectomy specimens. Methods: Demographic data, presenting complaints, indications for appendicectomy, and the histol...

Introduction Emphysematous pyelonephritis is a severe kidney infection characterized by gas formation, predominantly affecting diabetic women. Symptoms include fever, pain, and nausea, requiring urgent and accurate management due to its potentially fatal nature. Case presentation This article reports a successful management of a case of bilateral...

Introduction: Breast cancer is the commonest cancer among females in Sri Lanka. The markers that define the treatment recommendations are Estrogen receptors (ER) status, Progesterone receptor (PR) status, HER-2 neu and Ki-67 proliferative index. Methodology: This is a retrospective study performed on the pathological specimens of invasive ductal ca...

Objectives Carpal tunnel syndrome (CTS) generally causes functional disabilities and consequently develops socioeconomic burdens for individuals and our community in the long run. The negative consequences are more recorded in developing nations. Therefore, early addressing the disorder is essential to eliminate the negative impacts on any health-c...

Introduction: Total thyroidectomy is a common surgical procedure in endocrine surgery. However, it carries potential complications such as damage to the recurrent laryngeal nerve, permanent hypoparathyroidism, and bleeding. Methods: A prospective study was conducted at the Professorial Surgical Unit, Jaffna Teaching Hospital, involving consecutiv...

Introduction: Omental torsion is due to the twisting of the omentum along its axis and is observed in young male patients. The first description of omental torsion was first made by Eitel in 1899. Case presentation: A 35-year-old male presented with right iliac fossa pain, nausea, occasional vomiting and loss of appetite for four days. His clini...

Introduction: Groove pancreatitis (GP) is a rare pancreatitis variant affecting the pancreaticoduodenal groove. It typically affects middle-aged men with a history of chronic alcoholism. Diagnosis is often challenging due to its resemblance with the head of the pancreatic carcinoma. Presentation of case: We report a unique case of GP in a 55-year-...

This study describes the correlation between Ki67 and ER, PR, and Her 2 neu receptor status in invasive breast cancers at a tertiary care centre in Northern part of Srilanka.

This is a descriptive retrospective analysis of clinical, etiological and demographic features of patients who underwent appendicectomy during a 4 year period at a tertiary care centre in Northern Srilanka.

Introduction: Abdominal hernias, including incisional hernias, can occur due to weakness in the abdominal wall. Incisional hernias commonly occur following surgical incisions, and factors such as poor closure technique and patient-related factors can contribute to their development. Case presentation: In this case, the patient was presented with...

Introduction: Pleomorphic adenoma is the most common benign tumour of the parotid gland. It is commonly observed in middle-aged women. Usually, pleomorphic adenomas are asymptomatic with a slow-progressing tendency. There is a substantial risk of malignant transformation if left untreated. Imaging modalities and fine needle aspiration cytology are...

Type B lactic acidosis is a rare complication of gastric adenocarcinoma and is associated with poor prognosis. Very few cases have been reported in the literature. A 48-year-old female presented with recurrent episodes of vomiting, loss of appetite and loss of weight for 1 month duration. Endoscopy and subsequent biopsy revealed poorly differentiat...

Introduction: Laparoscopic cholecystectomy is a surgical procedure that removes a diseased gallbladder for various indications. It is preferred over open cholecystectomy due to fewer complications and early recovery. However, it carries different operative and postoperative complications. In addition, the availability of resources and skillful surg...

Introduction: Stauffer's syndrome is a rare paraneoplastic non metastatic hepatic dysfunction related to renal cell carcinoma. It is characterized by elevated alkaline phosphatase, erythrocyte sedimentation rate, a-2-globulin, y-glutamyl transferase, thrombocytosis, prolongation of prothrombin time and hepatosplenomegaly, in the absence of hepatic...

Prostatitis is a common and important urological problem which affects men of all ages. It is a challenging condition to be diagnosed and treated. It is classified under four categories according to the National Institute of Health Classification (Category 1 - Acute bacterial prostatitis, Category 2- Chronic bacterial prostatitis, Category 3-Chroni...

Introduction: Aortic dissection occurs following a tear in the tunica intima of the aortic wall resulting in blood entering between the intima and media. Type A aortic dissection can rarely manifest as upper limb malperfusion. Case presentation: This is regarding a patient who presented with intermittent malperfusion of the bilateral upper limbs...

Introduction and importance Generalized peritonitis following proximal ureteral rupture is a very rare complication. This is about a successfully managed case without open surgical intervention. Case presentation A lady in her 70s presented with generalized abdominal pain, high spiking fever and low urine output for 3 days. She was haemodynamicall...

Rectal cancer can present with distant metastasis specially to lungs and liver, which can undergo metasectomy. Distant lung recurrence following curative surgery to rectal cancer after 20 years is a rare presentation.

Laparoscopic cholecystectomy is a minimally invasive surgical procedure that removes a diseased gallbladder. However, it carries different operative and postoperative complications.The objective is to analyze the single unit experience of laparoscopic cholecystectomy, to enhance the training programme and improve the surgical outcome.All the laparo...

A male patient in his 70s, who had undergone an abdominoperineal (A1) resection for rectal cancer 20 years prior, presented with hemoptysis. Imaging studies revealed distant lung recurrence, with no evidence of local recurrence. Biopsy revealed an adenocarcinoma, possibly of rectal origin. Immunohistochemical markers were suggestive of rectal cance...

Introduction: Urolithiasis is the most prevalent surgical disorder of urinary tract in Asia. The prevalence of urolithiasis varies with demographic factors. There are many treatment options feasible. The specific treatment approach depends on composition, location, size of the stones and preferences of the patients and hospital capability. Objectiv...

This case report describes a rare delayed presentation of posttraumatic pseudoaneurysm of superficial femoral artery (SFA). A 22-year-old man presented with a painful expanding mass over the anteromedial aspect of the distal thigh three months after a motor traffic crash. The lump was tender and pulsatile on examination. CT angiogram revealed a pse...

Prostate cancer is one of the most frequent cancers in males and commonly a disease of the older population, but it is increasingly seen among older adolescents and young adults. The common sites of metastasis of prostatic carcinoma are bones and regional lymph nodes. Testicular metastasis from prostatic carcinoma is an infrequent presentation. We...

Varicocele is primarily tortuous dilation of the internal spermatic vein [ISV] and pampiniform plexus in the scrotum. It’s the most common correctable cause of infertility. It has a higher prevalence in primary and secondary infertility in men. In this article, we reviewed the advantages and disadvantages of microscopic intermediate sub inguinal [M...

Biliary endoprosthesis plays a crucial role in the management of patients with obstructive jaundice. However, a biliary leak is a life-threatening complication of this procedure. A 52-year-old otherwise healthy man presented with obstructive jaundice and was found to have a stricture at the confluence of the right and left hepatic ducts, which was...

Introduction and importance Inflammatory myofibroblastic tumour (IMT) is a rare tumour with malignant potential and has been described in many major organs with the most frequent site being the lungs. However, bladder is an extremely rare location. IMT presents a unique diagnostic challenge because of the characteristics it shares with malignant ne...

Chronic pancreatitis (CP) is a progressive inflammatory process that causes irreversible damage to the pancreas due to fibrosis and scarring. The incidence of CP varies among regions. Alcohol consumption and smoking are the main aetiological factors of CP. In addition, autoimmune diseases, hereditary and genetic factors, and tropical CP also contri...

Introduction & importance: Giant hydronephrosis (GH) is defined as a kidney containing greater than 1000 ml of urine in its collecting system. It is a rarely presented condition in an adult. Common aetiology for GH is due to congenital ureteropelvic junction obstruction. We present a case of a late presentation of GH was being managed by a minimal...

This cross-sectional study done on patients who have undergone laparoscopic varicocelectomy during 2019 and 2020 at Teaching Hospital Jaffna to assess the presentation, complication, and outcome of the surgery.

Here we report the case of a 47-year-old male who presented with storage lower urinary tract symptoms associated with non-specific lower abdominal pain for one month duration. Contrast-enhanced computed tomography of abdomen and pelvis revealed a 6 cm tumour at the dome and left side anterior wall of the bladder. He underwent laparotomy and partial...

Hemorrhagic cholecystitis—a rare cause of hemobilia and melena—is an atypical presentation of calculous cholecystitis, associated with significant morbidity and mortality. A 75-year-old woman with multiple comorbidities, who was undergoing dual antiplatelet therapy, presented with symptoms of acute cholecystitis. Two days later, she developed melen...

Introduction Diabetic foot ulcer (DFU) is a common complication of diabetes mellitus, and it develops around 25% of diabetic patients. 60 80 % of DFUs will heal, and approximately 10 15% of the ulcers will remain as an ulcer or progress to end up with amputation of the limb. The DFUs management's primary aim is to achieve complete ulcer healing and...

Introduction Primary pancreatic lymphoma (PPL) is an uncommon condition. Clinical features of PPL are nonspecific & likely to be misrecognized as pancreatic malignancy. Case presentation 71 years old male patient presented with upper abdominal pain with obstructive jaundice. Clinical findings and investigations Examination reveals RHC tenderness...

Oesophageal cancer common in patients over 60 years with male predominance. Squamous cells CA common in mid oesophagus while adeno CA mainly in lower oesophagus. Factors that influence treatment decisions include the stage and histology type of cancer along with the person's general condition and any other diseases that are present.

We present a case of delayed diagnosis of ureteric injury, complicated by a large, life threatening retroperitoneal abscess, that was managed without surgical intervention.

Chronic right iliac fossa (CRIF) pain leads to repeated hospital attendance and missed days of routine life. The growing evidence supports the role of laparoscopy with or without appendectomy as one of the management of CRIF pain.

Introduction: Pancreatitis is one of the common causes of acute abdomen in patients admitted to casualty surgical wards. It is fairly common in Jaffna population as well. Several etiologies have been discovered all over the world but the most common aetiological factor has regional variation. We design this study to evaluate the common aetiological...

Introduction: Haemorrhoids are one of the common surgical problems in Sri Lanka. Haemorrhoids are usually managed by sclerotherapy, rubber band ligation, excision haemorrhoidectomy and stapled haemorrhoidopexy. The recent introduction of Trans-anal Haemorrhoidal De-arterialisation (THD) to the National Hospital (NHSL) leads to research on the above...

Thyroid malignancy is the most common endocrine malignancy, accounting for 1-2% of all new malignant tumours. A retrospective study was conducted using 49 patients who underwent treatment for thyroid malignancy to identify the pattern and distribution of thyroid malignancy among males and females. In our study, females are more affected, and papill...