Dr- SAAD KHAN

04/07/2026

🔥Key distinguishing features

🔥Ganglion cyst
Arises from a joint or tendon sheath.
Contains gelatinous fluid.
Most common on the back of the wrist.
No punctum.
🔥Sebaceous (epidermoid) cyst
Has a characteristic central punctum.
Contains cheesy, foul-smelling keratin.
May become red, painful, and infected.
Excision should include the entire cyst wall to reduce recurrence.
🔥Dermoid cyst
Congenital lesion present since birth, though it may enlarge slowly.
Commonly occurs at the lateral eyebrow in children.
Contains skin appendages such as hair follicles and sebaceous glands.
Midline dermoid cysts (especially nasal) require imaging before surgery because of possible intracranial extension.
🔥Quick exam points
Ganglion → Wrist + gelatinous fluid + attached to joint/tendon.
Sebaceous (epidermoid) → Central punctum + cheesy keratin + skin attachment.
Dermoid → Congenital + lateral eyebrow + contains hair and skin appendages.

ڈاکٹر سعد خان ( جنرل سرجن 👨🏻‍⚕️🩸)

03/07/2026

🔥Appendicular Mass –
An appendicular mass is a localized inflammatory swelling that forms when an inflamed or perforated appendix becomes surrounded by the omentum and adjacent bowel loops, effectively containing the infection.
🔥Causes
Delayed presentation of Acute appendicitis (usually after 48–72 hours)
Localized perforation of the appendix
🔥Clinical Features
Pain in the right lower abdomen (right iliac fossa)
Fever
Nausea and vomiting
Tender, firm, palpable mass in the right iliac fossa
Guarding may be present, but generalized peritonitis is usually absent
🔥Investigations
👉CBC: Elevated white blood cell count
👉CRP: Raised
👉Ultrasound abdomen: Confirms appendicular mass and excludes abscess
👉CT abdomen: Most accurate imaging when the diagnosis is uncertain
🔥Management
👉Conservative treatment (Ochsner–Sherren regimen):
Nil by mouth (initially)
IV fluids
Broad-spectrum IV antibiotics
Analgesics
Close clinical observation
👉If an appendicular abscess develops:
Image-guided drainage or surgical drainage
Continue antibiotics
👉Surgery:
🚨Emergency surgery is usually avoided unless there is generalized peritonitis, sepsis, or failure of conservative treatment.
👉An interval appendectomy may be considered 6–8 weeks later in selected patients, although it is not routinely required in all cases.
🔥Complications
Appendicular abscess
Generalized peritonitis
Sepsis
Recurrent appendicitis
🔥Key point: An appendicular mass is a contained complication of acute appendicitis in which the body's defense mechanisms wall off the infection, making initial conservative management the preferred approach in most stable patients.

ڈاکٹر سعد خان ۔ 🩺👨🏻‍⚕️.

03/07/2026

🔥Dermoid cyst –
A dermoid cyst is a benign (non-cancerous), slow-growing cyst that develops from embryonic cells trapped during fetal development. It contains tissues that normally occur in the skin, such as hair follicles, sebaceous glands, sweat glands, fat, and sometimes teeth or bone.
🔥Common sites
Face (especially around the eyebrow and nose)
Scalp
Neck
O***y (mature cystic teratoma)
Floor of the mouth
Sacrococcygeal region
🔥Clinical features
Painless, slowly enlarging swelling
Smooth, soft to firm, well-defined, and mobile
Usually present since birth but may become noticeable later in life
Becomes painful if infected
🔥Investigations
Clinical examination
👉Ultrasound (first-line for many superficial lesions)
👉CT scan or MRI if deep extension is suspected (especially in head and neck lesions)
🔥Treatment
👉Complete surgical excision is the treatment of choice.
Avoid rupture during surgery, as the cyst contents can cause inflammation.
Send the specimen for histopathological examination.
🔥Complications
Infection
Rupture causing inflammatory reaction
Recurrence if excision is incomplete
Malignant transformation is very rare
🔥Histology
The cyst is lined by keratinized stratified squamous epithelium and contains skin appendages (hair follicles, sebaceous glands, and sweat glands), with keratinous material inside.
🔥Key point for exams: A dermoid cyst is a congenital, benign cyst containing skin appendages, and complete surgical excision is the definitive treatment.

👉Dr Saad Khan.🩺

04/05/2026

18/04/2026

👉New TB Guidelines 🩻🩺

24/02/2026

the profound responsibility, privilege, and dedication required to save lives.

18/02/2026

TMO General Surgery performed Appendectomy 🩺🔥