HighlightsPancreatic hydatid cysts are very rare entities with an incidence ranging from 0.14% to 2%.They can masquerade as pseudocyst or cystic neoplasm of pancreas.Ultrasonography, Computed tomography and Hydatid serology help in diagnosis.Pericystectomy, Partial cystectomy with omentopexy/external drainage, Marsupialization, Cysto-enterostomy are some of the surgical options.Prophylactic preoperative and postoperative anti-helminthics(Albendazole) are recommended.

HighlightsPresacral tumors are rare variety of space occupying lesions which due to their location, etiological heterogeneity and difficult surgical approach, present a challenge to treating physician.Surgical excision remains the treatment of choice for presacral masses.Posterior surgical approach, if applied judicially, in carefully selected cases, remains an attractive option as it provides better surgical exposure, is more direct approach, commodious to adopt, easy to learn with quicker post-operative recovery.

HighlightsSurgical diagnosis of conditions causing acute abdominal pain in situs inversus is complicated by the mirror image anatomy.Chest X-ray and Ultrasonography abdomen can be helpful in diagnosing this condition.Laparoscopic cholecystectomy in situs inversus is problematic for right handed surgeons.We describe a modified 4 port configuration where right handed surgeons can use the left mid-clavicular port for dissection.

Highlights55 year old male patient presented with features of acute intestinal obstruction.On exploratory laparotomy, malrotation of gut with compression of duodenum and terminal ileum by the superior mesenteric artery pedicle was found along with multiple jejunal diverticula.No ladd's bands or midgut volvulus was noted.Malrotation may present in adult age group as acute or chronic obstruction and surgeons must keep a flexible approach toward management.

Introduction: Anal fissure is a common problem with widespread presence in young adults and middle age group people. After the failure of conservative method there is a need of a good surgical procedure. Aim of this study is to determine the better surgical outcome between LIS and AD. Material and methods: This is a prospective observational hospital based study which included 65 patients of CAF in each LIS and AD group. They were followed for 3 months post-op for recurrence, pain relief and ulcer healing. Study was conducted after approval from ethics committee. Result: By the end of 2nd week, 99% patients of LIS group show pain relief with median VAS score of 1 and IQR of 0-1 while 93.84% patients in AD group with median VAS score was 1 with IQR of 0-2. (p-value=0.013). At one-month post-op 100% patients in LIS group shows healing of ulcer while in 92.3% in AD group. (p-value=0.068). At 3rd month LIS group show 4.6% recurrence while it is 27.7% in AD group, which is significantly higher with p-value>0.001. Conclusion: Both the surgical procedures are good with ulcer healing and pain relief but, LIS shows significantly higher pain relief than AD. In terms of recurrence LIS is a significantly far better procedure than AD. Overall LIS is a superior procedure for CAF than AD.