In recent years, laparoscopic surgery has gained popularity in clinical practice. The key element in laparoscopic surgery is creation of pneumoperitoneum and carbon dioxide is commonly used for insufflation. This pneumoperitoneum perils the normal cardiopulmonary system to a considerable extent. Every laparoscopic surgeon should understand the consequences of pneumoperitoneum; so that its untoward effects can be averted. Pneumoperitoneum increases pressure on diaphragm, leading to its cephalic displacement and thereby decreasing venous return, which can be aggravated by the position of patient during surgery. There is no absolute contraindication of laparoscopic surgery, though we can anticipate some problems in conditions like obesity, pregnancy and previous abdominal surgery. This review discusses some aspects of the pathophysiology of carbon dioxide induced pneumoperitoneum, its consequences as well as strategies to counteract them. Also, we propose certain guidelines for safe laparoscopic surgery.

Background/Aim:Duodenal injury is an uncommon finding, accounting for about about 3 – 5% of abdominal trauma, mainly resulting from both penetrating and blunt trauma, and is associated with significant mortality (6 - 25%) and morbidity (30 - 60%).Patients and Methods:Retrospective analysis was performed in terms of presentation, management, morbidity and mortality on 14 patients of duodenal injuries out of a total of 172 patients of abdominal trauma attending Subharti Medical College.Results:Epigastric pain (100%) along with vomiting (100%) is the usual presentation of duodenal injuries in blunt abdominal trauma, especially to the upper abdomen. Computed tomography (CT) was diagnostic in all cases. Isolated duodenal injury is a rare finding and the second part is mostly affected.Conclusion:Duodenal injury should always be suspected in blunt upper abdominal trauma, especially in those presenting with epigastric pain and vomiting. Investigation by CT and early surgical intervention in these patients are valuable tools to reduce the morbidity and mortality.

Ventricular shunts are commonly employed in the management of hydrocephalus, and numerous complications such as dissection or migration have been reported in the literature besides shunt malfunction. We present a case of the migration of the peritoneal catheter into the scrotum who attended at our institute. He was managed successfully, but subsequently developed intraabdominal cystic swelling for which he was reoperated.

Fibroadenoma, the most common breast tumor in adolescent women, usually arises in the terminal duct lobular unit, but is exceedingly rare in the male breast. The usual presentation is a painless, firm, mobile, and slow-growing lump in the breast of a woman of childbearing age. Its diagnosis is usually made by clinical examination, but ultrasound, mammography, and fine-needle aspiration often help in its confirmation. We are presenting here a rare but interesting case of a large fibroadenoma, which was present in a male breast.

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