Background: Eventration of diaphragm associated with gastric volvulus is an uncommon condition.

The nasogastric tube is used extensively in medical practice. However, this innocent-looking tube can at times cause unexpected complications especially in patients with preexisting risk factors. A 25-year-old male was referred to our hospital with a blocked and impacted nasogastric tube which had been inserted to maintain his nutritional status after he sustained a caustic injury to the esophagus in an attempted suicide. Esophagoscopy was done, the knotted nasogastric tube was retrieved and a tracheoesophageal fistula was detected at the site of impacted knot. However, the patient succumbed to ARDS and sepsis before definitive surgery could be done. Nasogastric intubation is not a simple procedure as is the general concept and it should not be done in cases of caustic injury to the esophagus because of increased risk of complications in the face of preexisting inflammation. To our knowledge, this is the first case report of its kind in the literature review.

A lipoma is a fatty tissue tumor presenting as a painless slowly growing mass that can affect any part of the body rich in adipose tissue. Lipomas can be present in the thigh, shoulder, trunk, etc, although they are usually small. We are reporting a 65-year-old man with a giant lipoma involving his left buttock and lumbar region.

Training in minimal access surgery has always been difficult in developing countries with limited resources, non availability of formal animal labs, inaffordability of conventional endotrainers and lack of trained endosurgeons to help the amateurs. It is always difficult to start a new procedure in such places where not only the patients but the orthodox surgical fraternity are reluctant to accept new ideas and newer trends in surgery. After thorough discussions with senior surgeons, the author (who was the only trained endosurgeon to begin with) developed a training policy to train the surgeons over a period of time through various exercises before allowing them to assist him in the actual surgeries. A homemade, inexpensive endotrainer was designed for these exercises. Audio-visual seminars were held in between the training sessions. This training module can be employed by other rural hospitals to improve the skills of surgeons who are new to the art of endosurgery.