An Audit of 138 Patients Admitted with Lump in the Neck in Surgical Department of Services Hospital Lahore, (SIMS)

Abstract

Introduction: Neck swellings are very common problem in head and neck region. Causes are highly variable, ranging from simple treatable disease to a metastatic incurable carcinoma. The common causes may differ depending upon the different geographical location, gender and age of the patients. Therefore, the knowledge of local causative factors is important to avoid diagnostic delay. Commonly presenting head and neck masses are due to lymph node, thyroid and salivary gland enlargement. In third world countries, infective causes are most common. Malignant neoplasms were the second most common group. Therefore, frequent audit is necessary for prompt diagnosis and further work up.

Objective: An audit of 138 patients admitted with neck swelling in surgical department of a tertiary care Hospital of Lahore.

Methodology: This cross-sectional study was carried out at Department of Surgery, (unit-1) Services Institute of Medical Sciences Lahore, (SIMS) during January 2014 to July 2015. All patients who presented with neck swelling during study period were included. Diagnosis made after taking clinical history, examination and relevant laboratory work up.

Results: Out of 138 patients with lump in the neck, 93 (67.39%) were female and 45 (32.60%) were male. The commonest swelling is tuberculous lymphadenitis that is 34 (24.63%) and 9 (6.52%) were lymphoma and 4 (3%) with reactive hyperplasia. 49 (35.5%) arose from thyroid (40 benign and 9 malignant). Among the benign swellings, 15 were solitary nodular goiter, 12 were Multinodular goiter and 13 were diffuse thyroid goiter, 11 were Thyroglossal cyst. Other causes included sebaceous cyst 12 (8.69%), lipoma 19 (13.67%), thyroglossal cyst 11 (8%) and carcinoma of thyroid 9 (6.52%)

Conclusion: The most common cause of neck lump is thyroid disease and tuberculous lymphadenitis. Early diagnosis of tuberculosis and goiter is crucial for appropriate management.

Keywords: Head and Neck Swellings, Lymph Nodes, Tuberculous lymphadenitis, Goiter