10^th International Conference on Clinical and Medical Case Reports September 16-17, 2019 Amsterdam, Netherlands

"Park Plaza Amsterdam Airport"

Andrew Tan has completed his Bachelor of Medicine in 2016 at the University of Newcastle, NSW, Australia. He is currently employed as an Otorhinolaryngology SRMO at John Hunter Hospital in Newcastle. Within this role he is working closely with head and neck cancer specialists for this region.

Large cell neuroendocrine carcinoma (LCNEC) is a rare entity usually arising from a pulmonary origin. Unfortunately, due to a lack of clinical trials, there is no defi ned approach for the treatment of these cancers. To date there have only been two reported cases of LCNEC originating from the base of tongue. In this case report we discuss the presentation, management and disposition of a patient diagnosed with LCNEC originating from the base of tongue, with a review of the current literature

Daniel Phung is a Surgical Registrar from Newcastle. He has completed a Bachelor of Medicine from the University of New England, Australia and is completing Surgical training in New South Wales.

Second branchial cleft cysts are congenital anomalies that occur due to failed obliteration of the second branchial cleft during embryogenesis. Whilst location of these anomalies commonly lies between the palatine tonsil and anterior border of sternocleidomastoid, atypical presentations are described in the literature and may prove to be a diagnostic and management challenge. We present a case of a 38-year-old gentleman who underwent multiple drainages and excisions of a recurrent retropharyngeal collection with a histological diagnosis of second branchial cleft cyst. This report documents the diffi culty in clearance of a recurrent branchial cleft cyst in the retropharyngeal space and highlights the importance of suitable surgical access to prevent recurrence.

Mohamed Javid R has completed his MBBS from TN Dr. MGR Medical University and is currently in his fi nal year of General Surgery Residency in the prestigious Madras Medical College, which is the third oldest medical college in India. He is known to actively participate in local surgical society meetings, clinical audits, poster presentations, and other academic presentations. He is known for his special interest in medical research and is currently the Principal Investigator in three studies which are expected to be completed by this year-end.

Barotrauma was once very rare but recent reports of such incidents across the globe suggest that advances in the usage of high pressure compressed air for various purposes in the industrial environment has led to an increase in pneumatic injuries. Colorectal barotraumas are injuries that happen due to an elevated intraluminal pressure mainly by air and these injuries can vary from simple mucosal traumas to perforation of the bowel. We present a case of a 22-year-old boy, who presented to us with abdomen discomfort with subcutaneous emphysema in the abdomen and lower chest, following a prank played by his friend who had inserted a nozzle through his anal orifi ce and pumped high pressure condensed air through it. Computed tomography (CT) of the abdomen and pelvis showed evidence of air pockets in ischiorectal fossa and pelvis. Intraoperatively, we found rectal tears and large bowel serosal tears with distension of small bowel and large bowel. The tears were primarily sutured and a transverse loop colostomy was fashioned to facilitate healing of rectal wounds and to relieve the distension. Th ecolostomy was closed aft er eight weeks. Not many of such colorectal barotraumas have been reported and many of these injuries presented with bowel perforations and tension pneumoperitoneum. Most of these patients underwent surgery and very few patients were managed conservatively. Such variations in clinical presentations and the interventions which are done in these scenarios imply the need for further reporting of such injuries and its interventions for formulating better management protocols.