Browsing by Author "Dhungel, K"
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Publication Endoscopic Excision of A Fibroadenoma Breast: Trans Axillary Approach(Kathmandu University, 2012) Adhikary, S; Sood, S; Dhungel, K; Rajbanshi, S; Shakya, V; Khaniya, SABSTRACT Benign breast lumps affect 10% of females in their lifetime. Surveillance, assurance, medications and surgical excision are options available to surgeons. Avoiding scars on the breast is an inherent feminine desire. Numerous minimal invasive approaches have evolved due to this concern. The time honoured circumareolar incisions camouflages the scar to a large extent, yet the incision still remains on the breast tissue and unfortunately the scar undergoes the same old sequelae as with any other scars both aesthetically or psychosocially. The close by anatomical space; axilla provides an easy access for endoscopic breast surgery. We utilized this area and applied our expertise to remove a fibroadenoma in a teenager which spared her breast from the scar. The technique was safe and effective. It conserved aesthetics and led to a better compliance. KEY WORDS breast lump, endoscopic breast surgeryPublication Laryngocele masquerading as a soft tissue neck mass(Kathmandu University, 2009) Dhungel, K; Gupta, MK; Ahmad, K; Sah, PL; Rauniyar, RKAbstract Laryngocele is a rare entity which can clinically present as a neck mass and requires Computed Tomography (CT) and laryngoscopy for diagnosis. We present an interesting case of bilateral laryngocele in a 45 -year-old male presented clinically as hoarseness and left sided neck mass without any history of predisposing factors. Ultrasonography (USG) and CT features of laryngocele is also presented here. Key words: Laryngocele; Cervical mass; Ultrasonography; Computed TomographyPublication Magnetic Resonance Imaging Evaluation of Musculoskeletal Diseases of Ankle and Foot(Kathmandu University, 2018) Sharma, UK; Dhungel, K; Pokhrel, Dinesh; Tamang, S; Parajuli, NPABSTRACT Background Ankle and foot pain is a common clinical problem, that may be due to a variety of soft tissue and osseus abnormalities. Magnetic resonance imaging plays vital role for diagnosing internal derangement of the ankle joint, assessing soft tissue structures around the ankle such as tendons, ligaments, nerves and osseus structures. Method Retrospective magnetic resonance imaging evaluation of the ankle and foot was done in 100 patients using 0.3T and 1.5T magnetic resonance imaging. Clinical history included pain, swelling of the ankle and foot, trauma, twisting injury, palpable mass and difficulty in walking. Result Fifty two patients were male and 48 patients female aged 6 months to 70 years. Ligaments tear were the commonest and seen in 22% patients. Tenosynovitis found in 17%, Pigmented villonodular synovitis (PVNS) in 3%, Achilles tendon abnormality in 8%, stress fracture-9%, osteomyelitis-8%, soft tissue vascular malformation in 5%, soft tissue and bone tumor-4%, marrow edema-20%, osteoarthritis-10%, Osteochondral lesion of talus-8%, sinus tarsi syndrome-3%, posterior impingement-5%, plantar fasciitis-2%, Sever disease-2%, peroneus tendon split-2%. The commonest clinical presentation was pain and swelling of the ankle in 42 patients, twisting/inversion injury of the ankle in 23 patients followed by traumatic injury with difficulty in walking in 20 patients and palpable mass in 8 patients. Ligaments injury were mostly associated with inversion/twisting injury. Conclusion Magnetic resonance imaging is advantageous for assessing soft tissue structures around the ankle and foot, such as tendons, ligaments, nerves, masses and occult osseus lesions. It provides a quick, non-invasive tool for the diagnosis of related injuries and guide for the further treatment planning. KEY WORDS Ankle, Foot, Magnetic resonance imaging, Musculoskeletal