Background: COVID-19 infection was linked to an increased risk of thromboembolism in high-risk individuals, so different anticoagulants were employed at varying doses. Anticoagulant-induced spontaneous retroperitoneal bleeding (SRB) is a rare condition. Objective: To analyze spontaneous retroperitoneal bleeding (SRB) associated with COVID-19 infection owing to anticoagulation on a larger scale in terms of comorbidities and factors related with SRB, as well as discuss existing therapeutics modalities, factors influencing decision, prognosis, and associated mortality. Patients and Methods: Twenty COVID-19 patients presented with SRB; 12 were treated surgically, and 8 were treated conservatively. Patients' demographic information, comorbidity evaluation, type of intervention, results, and prognostic factors were all evaluated. Results: Eight patients were treated conservatively; three died as a result of refractory shock. Twelve patients were operated on; eight of them died as a result of myocardial infarction, pulmonary problems, and multiple organ failure. The date of the surgical consultation influenced care and outcome significantly. Increased blood component requirements were found to be substantially associated to mortality. Conclusion:Management should be wise, yet not hesitate to intervene if necessary. In a progressive hematoma, this produces better results than conservation. Independent variables that necessitate intervention include vital instability, increasing hemoglobin decline, and transfusion requirements.

Aim: To evaluate the safety and efficacy of stapled transanal rectal resection (STARR), and its short -term outcomes (12-month) in patients with obstructive defectaion caused by rectal intussception.Patients and methods: A prospective observational study was performed including 25 women with rectal intussusception who underwent STARR in the period from April 2017 to March 2018. Data were collected prospectively from standardized questionnaires for the assessment of constipation [constipation scoring system, Longo's obstructed defecation syndrome (ODS) score system, symptom severity score], patient satisfaction and quality of life (Patient Assessment of Constipation-Quality of Life Questionnaire). Results:The preoperative status, perioperative and postoperative complications at baseline 3, 6 and 12 months were assessed. At a 12-months follow-up, a significant improvement in the constipation scoring system, ODS score system, symptom severity score, and quality of life was observed. The self-reported definitive outcome was excellent in 8 (30%) patients, fairly good in 4 (16%), good in 11 (44%), and poor in 2 (10%). Conclusion:STARR can be performed safely without major morbidity and with very good short-term results in treating patients with obstructed defecation from rectal intussusception.

Background: Recto-sigmoid and rectal tumors are now treated with anterior resection as the gold standard. However, anastomotic leakage and the temporary use of a covering stoma after resection provide a significant problem for colorectal surgeons. The technique of anastomosis is critical in preventing anastomotic leakage. Some surgeons believe that side-to-end anastomosis is superior to end-to-end anastomosis, whereas others do not. Objective: The current study was aimed to compare the surgical outcome, particularly the incidence of anastomosis leakage, between two groups using various surgical techniques. Patients and Methods: This is a prospective randomized clinical trial (RCT) that included 107 patients with rectosigmoid and rectal malignancies. Between March 2018 and March 2022, patients were treated at Ain-Shams University Hospitals with elective laparoscopic anterior resection. Patients were divided into two groups using sealed envelope method. Following anterior resection, Group A had side-to-end anastomosis (SEA) using a double stapling technique, while Group B had end-to-end anastomosis (EEA) utilizing a trans-anal circular stapler. Results: After anterior resection, Group A (35 men and 20 women) received side-to-end anastomosis, while Group B (31 men and 21 women) underwent end-to-end anastomosis. There were no statistically significant differences between the two groups as regard body mass index (BMI), smoking and tumor location. The end-to-end anastomosis group had a statistically significantly longer mean operative time than the side-to-end anastomosis group (251.71 vs. 227.15 minutes, respectively) (P value 0.001). There was no statistically significant difference in anastomotic leakage between the two groups, with a P value of 0.262 (2 instances, 3.6% in SEA Group vs. 5 cases, 9.6% in EEA Group). Conclusion: It could be concluded that side to end colorectal anastomosis could be an alternative to end to end with shorter operative time.