Introduction Nipple-sparing mastectomy (NSM), a procedure involving careful dissection of the breast tissue whilst keeping the nipple-areola complex (NAC) intact, is now increasingly practiced amongst surgeons in the treatment of certain situations of breast cancer. Given the importance of breasts to the female body image, this type of conservative breast surgery takes into account patient satisfaction and overall cosmesis, whilst ensuring appropriate oncological safety. Methods and results Four nipple-sparing mastectomy procedures were performed in our tertiary care centre, Princess Basma Teaching Hospital, in Jordan between June and September 2019. Indications for these procedures included invasive ductal carcinoma, malignant phyllodes, and high-grade ductal carcinoma in-situ. Patients were carefully assessed prior to surgical intervention using radiological imaging, ensuring a distance from NAC of >2 cm in all cases. Procedures were performed successfully with minimal intraoperative and no post-operative complications. Follow-up was carried out at 24 months, with no cases of local or distant post-operative recurrence, and patient satisfaction was qualitatively measured with the use of a BREAST-Q questionnaire. The questionnaire demonstrated improved overall physical well-being and satisfaction with an average overall post-operative physical well-being of 97%. Conclusion Following nipple-sparing mastectomy and immediate submuscular reconstruction with silicone implants,patients demonstrated high levels of satisfaction and quality of life (QoL) as measured by BREAST-Q survey. Two years of follow-up confirmed high patient satisfaction with increased scores from the preoperative baseline level.

Highlights Diagnosing rectal foreign body can be challenging due to a vague history or a late presentation. Patients should be treated in a supportive nonjudgmental environment. Surgeons should look for signs of perforation on presentation and after extraction. Creativity is needed in case conventional extraction methods fail.

Omental torsion is a rare cause of acute abdominal pain that is not commonly diagnosed pre-operatively. The increased use of imaging such as computerized tomography in evaluating patients presenting with acute abdominal pain allowed the pre-operative diagnosis of omental torsion to be made much more often. Here we present a case of 18-year-old male who visited our emergency department complaining of right lower abdominal pain for several days. After proper evaluation by clinical examination and imaging, namely CT scan, provisional diagnosis was omental torsion. Differential diagnosis was acute appendicitis. The patient was admitted to the surgical ward. Surgery was performed through a Gridiron incision. Omental torsion with necrosis was found. Diseased omentum was excised and appendectomy performed.

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