lipoma.pptx surgical condition lipoma ppt

Lipoma

1. SHORT CASE PRESENTATION LIPOMA DR JYOTIRMAYA NAYAK ASSO PROF OF DEPT OF GENERAL SURGERY S.C.B MEDICAL COLLEGE AND HOSPITAL

2. PATIENT PARTICULARS Name – Mr Pabitra sahoo Age - 32 year . Sex – male Religion- Hindu Resident- JAJPUR ROAD, JAJPUR . Occupation- businessman .

3. Chief Complaints Swelling at the back of the neck for last 2 years .

4. History of Present illness Patient was apparently alright 2 years back to start with her family members noticed a swelling in the back of neck . -It was insidious in onset , initially small size that is 2cm to start with and gradually progressive to attain the current size of 5cm. -No history of Pain over the swelling or sudden or rapid increase in size . -No other swelling in the other parts of the body.

5. Past History: - No past history of any surgeries. -Not a known case of Hypertension,DM-2 , CAD , Pulmonary Tuberculosis , Asthma .

6. Family History -He having no family history of any neck swelling .

7. Personal History -He having Mixed Indian Diet . -Not addicted to tobacco smoking or alcohol. -Sleep pattern normal . -Bowel and Bladder habit regular.

8. GENERAL EXAMINATION Pt examined in a well lit room with informed consent with proper exposure . - H e was conscious, well oriented and cooperative. - H e has average body built with BMI 0f 22.2 kg/m2 - H e having Performance score of 90 in Karnowski PS . - H e is Well hydrated.

9. GENERAL EXAMINATION He had no pallor/Icterus/cyanosis/ clubbing / Pedal Edema/ generalized lymphadenopathy Patient is afebrile , PR – 78 B/M in right radial artery with regular Rhythm and normal Volume with no radio- radial or radio-femoral delay . BP – 130/80 mmhg in right arm supine position. RR-18 per minute Thoracoabdominal .

10. LOCAL EXAMINATION I had examined the patient in a well lit room with adequate exposure head to sitting position, from front and back after taking due consent . INSPECTION: A single swelling of size approximately 5*3cm , ovoid in shape present at the back of neck. Edge of the swelling clearly defined. No visible pulsation present. Superficial veins are not engorged.

11. INSPECTION -Swelling moving up with the Deglutition . -No movement seen on tongue protrusion . -It has well defined margin and smooth surface . -Skin over the swelling appears Normal . -Inferior border of the swelling well appreciated. -No other swelling noted in the same region or both side of neck .

12. PALPATION -No local rise of temperature and Tenderness over the swelling . -A single swelling of size 5*3cm present at the back of the neck. -It has smooth surface with regular border , soft-firm consistency , mobile in relation to the deeper structure . slip sign is positive,flactuation test negative. Swelling neither reducible nor compressible,and also nonpulsatile .

13. SYSTEMIC EXAMINATION CVS : First(S1) and second (S2) heart sound heard normal. No murmur associated . RS : B/L normal vesicular breath sounds , no added sounds . PER ABDOMEN : soft , non tender , no organomegaly, bowel sounds normal CNS : no focal neurological deficits , motor and sensory functions intact . MUSCULOSKELETAL: no proximal group of muscle involvement .

14. SUMMERY OF THE CASE 32 yrs hindu male patient presented with a gradually increasing swelling in the back of neck for last 2yrs.the swelling was about 2cm in size at the onset and then gradually increased in size to attain the present size of about 5cm,soft ,globular swelling,slip sign positive,margin well defined,freely mobile,flactuation negative.

15. PROVISONAL DIAGNOSIS MY PROVISIONAL DIAGNOSIS IS subcutaneous lipoma in the nape of neck.

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