Management of Liposarcoma With Posterior Intercostal Artery Propeller Flap Reconstruction: A Case Report.

This case shows the administration of a 57-year-old male with liposarcoma within the right flank region. Surgical treatment of the case included wide local excision (WLE), taken after reconstruction utilizing a posterior intercostal artery propeller flap. Postoperative care included regular checking for signs of repeat. Comparison with similar cases highlights the changeability in clinical introduction and surgical approaches for liposarcomas. This case emphasizes the significance of convenient diagnosis, fastidious surgical procedures, and successful reconstruction in overseeing liposarcomas. This case report points to highlights the clinical administration, surgical intercession, and postoperative care included in treating a giant liposarcoma and compares this case with similar instances to emphasize the challenges and procedures in treating liposarcomas.

Mesh Antibioma: A New Entity in the Presentation of Late-Onset Mesh Infection.

Antibioma is a tough-walled abscess, which usually forms as a sequela of inadequate or lack of pus drainage during infection and inappropriate use of antibiotics by the patient. In this case report, we present a case of the development of antibioma due to infected polypropylene mesh used in umbilical hernia repair 10 years ago in a 59-year-old obese male. He had a history of umbilical and right inguinal hernioplasty 10 years back. Intraoperatively, we found antibioma whose wall was made up of fibrous mesh and the center was filled with pus and nonfibrous mesh remnants. The pus was found to be sterile, and the wall was made up of fibromuscular adipose tissue with chronic inflammatory cells around it. This is a very rare presentation of umbilical site deep mesh infection as it had no signs of acute inflammation, neither pain nor any pus discharge. We conclude that the possible explanation for the formation of antibioma and its very delayed presentation could be due to mesh infolding and seroma/hematoma formation during previous surgery may have led to the formation of abscess and thick fibrous wall without any fistulous tract and other complications of deep mesh infection.

Techniques for Diagnosing Anastomotic Leaks Intraoperatively in Colorectal Surgeries: A Review.

Colorectal cancer is one of the most common surgically curable malignancies worldwide, having a good prognosis even with liver metastasis. This improved patient outcome is marred by anastomotic leaks (AL) in operated patients of colorectal cancer despite a microscopically margin-negative resection (R0). Various risk factors have been attributed to causing this. Preoperative non-modifiable factors are age, male sex, cancer cachexia, and neoadjuvant chemo-radiotherapy, and modifiable factors are comorbidities, peripheral vascular disease, anemia, and malnutrition. Intraoperative risk factors include intraoperative surgical duration, blood loss and transfusions, fluid management, oxygen saturation, surgical technique (stapled, handsewn, or compression devices), and approach (open, laparoscopic, or robotic). Postoperative factors like anemia, infection, fluid management, and blood transfusions also have an effect. With the advent of enhanced recovery after surgery (ERAS) protocols, many modifiable factors can be optimized to reduce the risk. Prevention is better than cure as the morbidity and mortality of AL are very high. There is still a need for an intraoperative technique to detect the viability of anastomotic ends to predict and prevent AL. Prompt diagnosis of an AL is the key. Many surgeons have proposed using methods like air leak tests, intraoperative endoscopy, Doppler ultrasound, and near-infrared fluorescence imaging to decrease the incidence of AL. All these methods can minimize AL, resulting in significant intraoperative alterations to surgical tactics. This narrative review covers the methods of assessing of integrity of anastomosis during the surgery, which can help prevent anastomotic leakage.

A Case of Jejunal Atresia Associated With Heterotrophic Pancreas and Meckel's Diverticulum.

Apart from meconium ileus, amniotic fluid plug syndrome, malrotation of the gut, Hirschprung's disorder, trauma, and other rare causes, bowel atresia is one of the most common causes of bowel obstruction in newborns. Jejunal atresia can affect multiple lengths of the bowel. The higher the level of atresia, the greater the severity. The outcome of bowel atresia related to surgical repair is favorable. In general, both mortality and morbidity are affected by affiliated medical conditions such as preterm birth, cystic fibrosis, and other congenital anomalies; the sophistication of the lesion; and surgical complications. We present the case of a one-day-old baby who had two episodes of bilious vomiting with abdominal distension within 10 minutes of birth. The baby was advised to undergo ultrasonography of the abdomen and pelvis for further evaluation, and the findings were reported.