Introduction: Outcomes of combined liver kidney transplantation in children remains a largely unquantified yet potentially life transforming procedure for those with heritable disease. No case series assessing the impact of the CLK on patient outcome for children solely with heritable disease is available. We therefore sought to retrospectively analyse the practice in a large London quaternary centre. Methods: Children undergoing liver kidney transplantation from 2003 onwards were analysed. Indication for transplant graft types, graft survival and patient survival were recorded. Disease specific metabolic parameters were also recorded. Results: 9 children underwent liver kidney transplanation of which 7/9 were combined. All grafts in CLK group were deceased donor (1 whole liver, 1right lobe, 5 left lateral segments). The mean age was 6.8 yrs. The indication was primary type 1 hyperoxaluria (n=1), Allagile (n=1) and autosomal recessive polycystic kidney disease (n=5). The median follow up was 5213 days. 1 year and 5 year liver and kidney graft survival was 100%. Mean GFR at one year was 66.6 mls/min and last follow up was 64.4mls/min. Mean AST level at last follow up was 44. One child required re transplant at five years due to chronic liver graft rejection. All current transplant grafts were functional at last follow up. Conclusions: CLK is a safe practice in children with heritable and metabolic conditions. Excellent graft outcomes are possible. In countries where deceased donor organ pools are readily available this practice should be adopted as the mainstream of treatment.

matter of equipment availability and personal preference. This video shows how transection can be performed with the use of a single disposable device, the ultrasonic scalpel. Dissection can be performed opening the jaw, exposing the active blade and moving the tip sideways, without pressure on vessels and without blind insertion inside the parenchyma. Vessel sealing is applied with the common use of the equipment, closing the tip around the dissected vessel (after hemostatic clips when needed). Three short videos are shown:

Background: Abdominal tuberculosis encompasses gastrointestinal, visceral and peritoneal forms of tuberculosis in different proportions. Their clinical presentation and radiological findings are varied and non-specific often warranting surgical intervention either for confirmation of diagnosis or for definitive management.  It is not very clear as of now as to which type of patients would require surgical intervention for diagnosis or treatment of abdominal tuberculosis. This study aims to profile such patients accurately to revalidate the need for surgical intervention in cases of abdominal tuberculosis.Methods: This study is a retrospective descriptive observational study wherein the documents of patients whose final diagnosis was confirmed as ‘Abdominal Tuberculosis’ from January 2011 to December 2013 were analysed. Their demographic and clinical profile, hematological, biochemical and radiological investigations including barium meal follow-through, ultrasonography, CT scan abdomen, colonoscopy and biopsy, HIV status and ascitic fluid analysis were analysed. Patients in whom diagnosis was not confirmed by these investigations, and therefore underwent diagnostic laparoscopy or exploratory laparotomy were studied. Simultaneously, patients in whom, the diagnosis was confirmed, but still underwent surgical intervention for therapeutic purposes were also analysed.Results: It was found that 44 out of 54 patients (81.4%) underwent surgical procedure.  28 (52%) required surgical intervention for confirmation of diagnosis (diagnostic procedures: diagnostic laparoscopy- 21 and exploratory laparotomy- 07) while 16 (29.4%) required therapeutic procedures (emergency- 08; elective- 08).Conclusions: In spite of extensive investigations, many patients of abdominal tuberculosis require surgical management either minimally invasive or otherwise, both for confirmation of diagnosis and for definitive management.

Schwannomas are neurogenic, benign, well circumscribed tumors arising from schwann cells. Schwann cells are neural originating cell. These are either sporadic or inherited with sporadic being most common. In about 3% of patients, association with neuro-fibromatosis 2 gene is documented. Primary mesenteric schwannoma is extremely rare with establishing a pre-operative diagnosis almost impossible. Imaging modalities including computed tomography as well as MRI fails to make a diagnosis due to the non-specific characteristics. Surgery is curative with histopathological examination and immunostaining establishing the final diagnosis post-operatively. Immunostaining helps in differentiating it from other conditions such as gastro-intestinal stromal tumors as well as malignancies. Rarity of this condition make this case report of a 32-year-old male unique.

In this COVID – 19 pandemic, there's an urgent need for a sensitive and specic test which provides results in a short span of time. Rapid Antigen Tests, have the potential to replace RT-PCR tests as a conrmatory test. A comparative study of Point-of-Care test vis-à-vis gold standard test was carried out by the Surgical Department of a secondary level care hospital. A total of 112 patients, with various surgical emergencies were tested, by RADT and by RT-PCR for conrmation. Patients were managed based on RADT results as per the institutional algorithm. 107 RADTs tested negative while ve tested positive. 105 RT-PCR tested negative while seven tested positive. Two patients reported negative by RADT were reported as RT-PCR positive. Although RADTs have the potential, their sensitivity is highly variable. To establish them as diagnostic tests of choice, RADTs need to be developed further so as to ensure that their sensitivity is high and results are reproducible across multiple centers.