Background: Achalasia is a medical ailment characterized by irregular contractions of the esophagus and incomplete relaxation of the lower esophageal sphincter. This condition results in difficulty swallowing food and liquids, and often leads to regurgitation and heartburn. Case presentation: This case report describes a 36-year-old female patient who presented with difficulty swallowing, heartburn, chest pain, and coughing while eating or drinking. The patient had lost significant weight despite a good appetite, and a physical examination revealed poor nutrition. Esophageal manometry confirmed the diagnosis of Achalasia Type 1, and endoscopy showed severe Candida esophagitis and a very dilated esophagus with diverticula. Due to the patient's condition and endoscopic finding of diverticula, surgery was considered, as she did not qualify for the Peroral Endoscopic Myomectomy (POEM) procedure. The patient was treated with fluconazole to address the esophageal candidiasis, and NG feeding was initiated to improve weight and nutrition. After recovering, the patient underwent a laparoscopic Heller myotomy with Dor fundoplication using a video laryngoscope to facilitate intubation. Anesthesia was maintained with O2/air with Sevoflurane, and the patient was extubated and transferred to the post-anesthesia care unit. Conclusion: Achalasia is a frequently researched esophageal motility disorder that is distinguished by inadequate relaxation of the LES and absent or irregular peristalsis in the esophagus. Common symptoms in most patients include difficulty swallowing solids and liquids, regurgitation, and varying degrees of weight loss. This case highlights the importance of prompt diagnosis and treatment of Achalasia Type 1, as well as the use of rapid sequence induction and proper anesthesia techniques during surgery.

Laparoscopic surgery has been around in the general surgery world for a long time. It has revolutionized how conventional surgeries used to be carried out. Performing laparoscopic surgery , there is a faster recovery time, complications are less likely, and a significantly lower bleeding and hemorrhage-related risk in these patients. However, some surgeries are still carried out in the traditional ’open ’way. One major reason for this is the lack of skilled professionals available to carry out such complicated cases alone or the fact that some surgeries provide better access to the surgeons when carried out traditionally. This case study revolves around two patients, both of which presented with situs inversus. Situs inversus is a congenital condition where the majority or all of the organs present in the chest and abdomen mirror their normal physiological positions, that is, they are present in the opposite direction of where they normally should be. Since the condition revolves mainly around the ’position ’of the major body organs and does not usually involve any defect or malfunctioning in their ’ function’, it is usually seen that the affected people are capable of living on their own, without any complications affecting their lives. However, this was not the case with both of the patients that are being discussed in this case study. Both of them developed cholelithiasis. Their case was already bound to face complications owing to their condition-situs inversus. But, due to the presence of efficient and skilled surgeons working on the case, it was seen that laparoscopic cholecystectomy was performed on both of these patients. Whether this surgery was carried out successfully or led to further complications is the focus of this paper. Along with that, this study also aims to revolve to look at the diagnostic measures that led to effectively diagnosing the condition in these patients affected by situs inversus. Case Study

Background: The most prevalent gastrointestinal sarcoma is a gastrointestinal stromal tumor.It is frequently misdiagnosed due to its indolent symptoms, which only manifest at an advanced and potentially incurable stage. Case Report: This case report is that ofa recent case of a GIST of gastric origin. Itdiscusses the case of a 56-year-old, non-smoking male with no comorbiditieswho presented to the emergency department with severe colicky intermittent adnominal pain that had occurred over the past three days, approximately three years ago. On September3, 2019, the patient underwent laparotomy in which a mass and related small bowel segment (the part of the omentum) was removed. Later, the pathology profile revealed a neoplasm of the small bowel-Ileum, Gastrointestinal stromal tumor (GIST) with a high-risk tumor of stage 4 with no recorded nodular involvement and no recorded metastasis pT4 pNxpMx but with clear margins. Moreover, the tumor markers KIT (CD117), CD34, and DOG1 (ANO1) were found to be positive. Ki67 was noted up to 35%. However, S-100 and SMA were found to be negative. On gross examination, the lesion's greatest dimension was 11 cm, and other dimensions were 9x6 cm. The tumor had a spindle-shaped morphology. On the basis of these laboratory findings and pathology profile, the patient's diagnosis was a Gastrointestinal Stromal tumor thatwas managed viasurgery. At that time, the patient was also prescribed Imatinib 400 mg. It has been three years since then, our patient is still alive, and no cancer recurrence has been reported yet. Conclusion: This case report revealed that interventional radiology's early engagement with the surgical procedure was the cornerstone of our patient's effective treatment and should be investigated at different stages of the gastrointestinal tumor.

A 53-year-old had complaints of vague abdominal pain for the past few months. The patient had a history of diabetes mellitus, hypertension, and iron deficiency. The pain was aching, mild, intermittent, non-radiating, and generalized. An ultrasound of the abdomen, CT scan and MRI were recommended. After initial examination and reports, the patient was diagnosed with a retroperitoneal tumor. The liposarcoma found was dedifferentiated, high grade, and retroperitoneal. The tumor extended to the inked resection margin, and was large, with 24 cm and 14 cm in greatest dimension measurements.  The liposarcoma was lipomatous and solid, with hot spots of mitosis. In terms of treatment, surgery was recommended to remove the enlarged mass. Two heterologous fragments, which were different in morphology, size, and color, were obtained from the retroperitoneal area during surgery. The mass was a huge grade 3 liposarcoma with a mitotic rate of > 20 mitoses per 10 high-power fields (HPF). The examination and diagnosis included some special studies such as immunohistochemistry assay, which was positive for p16, vimentin, and MDM2. A post-operative scan showed that there was no evidence of recurrence or residual retroperitoneal tumour. Chemotherapy was initiated by the Oncology Department.