Complete 2nd arch branchial fistulae are very rare congenital anomalies of head and neck. They arise due to the incomplete obliteration of the branchial clefts during embryonic period. In this article we report a case of type IV 2nd branchial cleft anomaly in a 15-year-old female. Explicit knowledge regarding its development, anatomy and accurate diagnosis, skillful complete excision of the tract is paramount in its management and to prevent recurrence.

The incidence of peptic ulcer disease (PUD) has steadily declined with the advent of H2 blockers and proton pump inhibitors (PPIs). The combined use of PPIs and endoscopic treatment has further decreased the need for emergency surgeries. Perforated ulcers are a rare cause of abdominal pain, and may not even be considered when the patient presents with right lower quadrant (RLQ) pain. In this article we report a case of 50-year lady, who presented with symptoms and signs of appendicitis accompanied by elevated inflammatory markers. Proper history taking, explicit knowledge regarding differentials, accurate radiological diagnosis and skilful surgical repair is paramount in its management and to prevent morbidity and mortality.

Background: Umbilical hernias can cause distress to the patients not only because of their complications but also because of the cosmetic angle, therefore this study was undertaken mainly to study the outcomes of preperitoneal mesh repair and on-lay mesh repair in the management of umbilical hernias.Methods: The present study was a prospective, observational and comparative study undertaken in the department of general surgery, who had been operated in Kamineni hospital LB Nagar, Hyderabad, Telangana, during a study period from November-2020 to September-2021.Results: Of 30 patients who underwent on-lay mesh repair, the mean hospital stay was 3.83±1.8 days; wound infection, seroma, hematoma, flap necrosis was seen in 1, 4, 2, 1 respectively and with no recurrence in 6 months follow-up. Of 30 patients who underwent pre-peritoneal mesh repair, the mean hospital stay was 2.13±0.63 days; Wound infection, seroma, hematoma, flap necrosis was seen in 0, 2, 1, 0 respectively and with no recurrence in 6 months follow-up.Conclusions: On-lay mesh repair can be replaced with preperitoneal mesh repair. Overall mesh related complications, including wound infection, seroma, hematoma, flap necrosis is quite rare. Less Hospital stay and low recurrence rate was observed in preperitoneal method. As wound complication increases risk of recurrence, procedures that do not result in formation of de-vascularizing flaps may be recommended.

Neurological deficits with peripheral venous aneurysm are extremely rare. We report this rare event in an elderly female presenting with difficulty in walk for 2 months, a swelling in the right popliteal fossa, and inability to dorsiflex the right foot. She was successfully managed with surgical intervention.