Pericecal hernia in the superior ileocecal recess is the least common location for this type of hernia. Previously, laparoscopic management of small bowel obstruction was not recommended. However, recent evidence has shown excellent outcomes of laparoscopic management of pericecal hernia.
 
  In pericecal hernia, having a high index of suspicion may help prevent delayed diagnosis and management. Laparoscopic exploration is a safe and acceptable modality for the diagnosis and treatment of small bowel obstruction due to pericecal hernias.
 In pericecal hernia, having a high index of suspicion may help prevent delayed diagnosis and management. Laparoscopic exploration is a safe and acceptable modality for the diagnosis and treatment of small bowel obstruction due to pericecal hernias.
  The synchronous incidence of multiple myeloma (MM) and other primary malignant solid tumor is rare.  https://www.selleckchem.com/products/d-4476.html  No detailed studies have been published regarding the perioperative management of patients with concurrent MM and malignant solid tumor. We report a patient with concurrent MM and gastric cancer who experienced rapid progression of liver metastasis after lenalidomide was discontinued.
 
  An 82-year-old woman with MM was diagnosed with clinical T3N2M0 gastric cancer, and MM had been maintained in remission with lenalidomide. Preoperatively, pancytopenia was found, and lenalidomide was discontinued and lenograstim was administered. Blood transfusions were also administered preoperatively due to anemia caused by tumor bleeding. Surgery was performed after her pancytopenia improved. Intraoperatively, several nodules were found on the liver, which were diagnosed as adenocarcinoma metastases. On postoperative day 13, a low density mass in the liver that was not observed before surgery was shown. The patient received best supportive care because she did not desire adjuvant chemotherapy for gastric cancer or resumption of treatment for MM. She died of progressive gastric cancer on postoperative day 80.
 
  Discontinuation of lenalidomide in our case may have promoted tumor angiogenesis and lowered antitumor immunity, causing rapid tumor growth and liver metastasis. Continuation of the MM agent may be preferable in patients who do not have marked myelosuppression.
 
  Surgeons should be familiar with the risks associated with discontinuation of MM drugs when operating on patients with MM and concurrent malignant solid tumor.
 Surgeons should be familiar with the risks associated with discontinuation of MM drugs when operating on patients with MM and concurrent malignant solid tumor.We present a patient who was found to have a cholecystocolonic fistula during robotic cholecystectomy. The patient initially presented with Non-ST-elevation myocardial infarction (NSTEMI) and biliary obstruction. A delayed cholecystectomy was performed robotically after managing his Coronary Artery Disease (CAD) and relief of his biliary obstruction with endoscopic retrograde cholangiopancreatography (ERCP). Intraoperatively, a cholecystocolonic fistula, was found. This case report aims to highlight intraoperative management of the fistula and review the existing literature.
  Choledochal cyst is a rare common bile duct malformation that usually presents in the pediatric group with abdominal pain, distension, and jaundice. The pathophysiology remains unclear for the cause, and surgery aims to restore biliary enteric drainage.
 
  We present a six-year-old female who presented with gradual abdominal distention associated with jaundice. Abdominal ultrasound was suggestive of choledochal cyst, and CT-scan confirmed the diagnosis. She was operated on successfully and fared well.
 
  Choledochal cysts are a rare entity of common bile duct malformations and should be considered as a differential diagnosis in the pediatric age group. Diagnosis can be easily made by non-invasive and in-expensive radiologic modalities like ultrasonography in resource-limited settings.
 Choledochal cysts are a rare entity of common bile duct malformations and should be considered as a differential diagnosis in the pediatric age group. Diagnosis can be easily made by non-invasive and in-expensive radiologic modalities like ultrasonography in resource-limited settings.
  Intersigmoid hernia (ISH) is a rare disease that is difficult to diagnose preoperatively and sometimes causes intestinal necrosis that requires emergency surgery.
 
  The patient was an 87-year-old male with no history of abdominal surgery who visited our emergency outpatient service due to left lower quadrant pain and vomiting as chief complaints. Abdominal findings showed tenderness with the severest point in the left lower quadrant of the abdomen. Contrast-enhanced CT showed poor imaging of the dorsal sigmoid colon and an expanded proximal small intestine, with regional ascites around the small intestines. The patient was diagnosed with small bowel obstruction associated with ISH incarceration and underwent emergency surgery. Invagination of the small intestine into the intersigmoid fossa was found by laparoscopy. The incarcerated part was removed and the hernia orifice was sutured and closed. Mild congestion was seen in the incarcerated small intestine, but with no findings of ischemia. Thus, intestinal resection was determined to be unnecessary. The postoperative course was good and the patient was discharged on postoperative day 6.
 
  ISH is often diagnosed as simple ileus at the initial visit, which can result in delayed surgery. There are no case reports of complete remission of ISH with conservative therapy, and treatment with surgery is generally required. Our patient underwent early surgery because of CT findings that were characteristic of ISH and allowed diagnosis before surgery.
 
  Early diagnosis of ISH and performance of laparoscopic surgery can avoid the need for intestinal resection.
 Early diagnosis of ISH and performance of laparoscopic surgery can avoid the need for intestinal resection.
  Facial nerve (the seventh cranial nerve) injury causes functional, aesthetic, and psychological difficulties. The second most common cause of facial nerve palsy is trauma.
 
  A previously healthy 21-year-old worker, was brought to emergency room after car accident, with complete paralysis of all muscles of the left side of his face. He was transferred to operating room. After anatomical determining the nerve, end-to-end manner was done. After nine month of follow up an excellent repair was seen.
 
  Traumatic facial nerve injury is usually accompanied by temporal bone fracture (up to 70 percent) but in some cases facial nerve is damaged without any fractures, and damage of facial nerve branches can happen due to laceration. Management of an injured facial nerve depends on its etiology. There are three main options for facial nerve repair; direct end-to-end coaptation, coaptation with an interposition graft and nerve transfer. Surgery exploration is indicated in patients with complete and immediate facial nerve paralysis and denervation more than 90 % electrophysiological findings.