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Necrotizing pancreatitis (NP) is a severe complication of acute pancreatitis, characterized by necrosis of pancreatic and peripancreatic tissues, leading to significant morbidity and mortality. The role of necrosectomy, the surgical removal of necrotic tissue, in the management of NP has evolved over the past few decades, moving from early aggressive surgical intervention to a more conservative and stepwise approach. This narrative review explores the historical perspectives, current practices, and future trends in the role of necrosectomy in NP. Early studies favored open surgical debridement; however, high mortality rates associated with early intervention prompted a shift towards minimally invasive techniques, delayed interventions, and the "step-up approach," combining percutaneous drainage with minimally invasive surgery. We also review the indications for surgery, optimal timing, and various techniques, including video-assisted retroperitoneal debridement and endoscopic transluminal necrosectomy. The review highlights the benefits of these strategies in reducing complications, improving patient outcomes, and minimizing hospital stays. Ongoing research into patient selection, timing, and procedural refinement will continue to shape the role of necrosectomy in NP management. Understanding the evolving role of necrosectomy is crucial for optimizing care and reducing the burden of this life-threatening condition., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Vaidya et al.)

Pancreatic pseudocysts, commonly arising as a complication of acute or chronic pancreatitis, present a significant clinical challenge. This narrative review explores the surgical management of pancreatic pseudocysts, emphasizing advancements, techniques, and outcomes. We examine the indications for surgical intervention, including symptomatic pseudocysts, complications such as infection or hemorrhage, and pseudocysts resistant to conservative treatment. Various surgical approaches are discussed, including open surgery, laparoscopic techniques, and endoscopic interventions. The review highlights the evolution of surgical strategies, from traditional cystogastrostomy to minimally invasive methods, and assesses their efficacy and safety. Additionally, we address patient selection criteria, preoperative assessment, and postoperative care. By synthesizing current evidence and clinical experiences, this review aims to provide a comprehensive overview of the best practices in the surgical management of pancreatic pseudocysts, offering valuable insights for clinicians in optimizing patient outcomes., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Jivani et al.)

Kikuchi-Fujimoto disease is a very rare disease, basically involving young adults and ubiquitously distributed. It is characterized by fever and benign lymph node swelling. The distinguishing features of this disease are cervical lymphadenopathy, constitutional symptoms resembling tuberculosis, and its penchant to affect young people of Oriental or Asian descent, especially women. We describe an instance of a 42-year-old female who arrived with multiple neck swellings. On physical examination, there was palpable right-sided cervical lymphadenopathy, while laboratory investigations were essentially within normal limits except for raised erythrocyte sedimentation rate and anemia. After cefepime and nonsteroidal anti-inflammatory medications were administered, symptoms subsided, and lymphadenopathy receded in the patient. This case supports the importance of histological evaluation to reach an exact diagnosis and guide treatment and the need to consider Kikuchi-Fujimoto disease in the differential diagnosis of lymphadenopathy., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Sharma et al.)

In this article, we describe the diagnosis and surgical treatment of synovial sarcoma within the right thigh of a 25-year-old male. Our article aims to demonstrate successful treatment through wide local excision and rotation flap reconstruction, emphasizing the noteworthiness of comprehensive surgical planning and postoperative care. Postoperative care guaranteed satisfactory healing and appendage functionality, with a follow-up plan to monitor for recurrence. This case underscores the need for individualized treatment approaches and highlights the significance of multidisciplinary care for overseeing aggressive tumors like synovial sarcoma. The findings contribute to the ongoing refinement of surgical procedures and postoperative protocols to improve patient results., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)

Superior mesenteric artery (SMA) syndrome, also known as Wilkie's syndrome, poses a diagnostic challenge due to its rarity and varied clinical manifestations. This review explores the syndrome's etiology, symptoms, diagnostic challenges, and management strategies. Symptoms range from early satiety to severe abdominal pain, often leading to malnutrition. Diagnosis involves a thorough gastrointestinal evaluation and various imaging modalities. Management includes medical interventions like nasogastric decompression and nutritional support, along with surgical interventions such as duodenojejunostomy. A thorough understanding of SMA syndrome's complexities is crucial for its timely diagnosis and effective management, especially considering its potential overlap with other gastrointestinal disorders or eating disorders. Further research is needed to enhance understanding and improve patient outcomes., Competing Interests: Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Navandhar et al.)

A 49-year-old woman with a complicated hernia presentation, including direct and indirect inguinal hernias, Spigelian hernias, and Pantaloon hernias, is presented in the case report. The diagnosis was verified by a comprehensive physical examination and imaging, which resulted in a Lichtenstein operation for repair. The surgical procedure for hernia comprised of painstaking dissection, reduction of the hernia sac, and implantation of a prosthetic mesh. The instance emphasizes the value of individualized treatment programs and draws attention to the intricate anatomical details of hernia surgery. Analyzing situations that are similar to one another highlights the necessity of customized strategies to improve patient outcomes., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Navandhar et al.)

Obstructive jaundice, characterised by yellow discolouration of the skin and mucous membranes due to reduced bile flow, often necessitates surgical intervention for resolution. This article provides a comprehensive literature review to contextualise the management of obstructive jaundice, focusing on common treatment modalities such as common bile duct (CBD) stenting and Whipple's procedure for pancreatic head cancer. Additionally, the incidental finding of a Phrygian cap of the gallbladder during surgical intervention for pancreatic head cancer is described in detail. A case presentation of a 48-year-old female with obstructive jaundice and pancreatic head cancer is outlined, detailing the diagnostic process, treatment decisions, and surgical interventions. The patient underwent CBD stenting followed by Whipple's procedure to address the pancreatic head cancer, during which the incidental discovery of a Phrygian cap of the gallbladder was noted. The discussion of the incidental finding highlights the complexity it adds to surgical interventions and emphasises the importance of adaptability and precision in managing anatomical variations. A comparison with similar cases underscores varying approaches to managing incidental findings, ranging from conservative observation to surgical excision based on clinical indications. This case underscores the significance of thorough diagnostic evaluation and surgical intervention in managing incidental findings such as the Phrygian cap, ensuring appropriate patient management and favourable clinical outcomes in complex surgical scenarios., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Navandhar et al.)

Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive narrowing of the brain's arteries, leading to an increased risk of stroke. The primary susceptibility gene, RNF213, has been identified in individuals of East Asian descent, contributing to ongoing research into potential therapeutic targets. The distinction between idiopathic MMD and secondary forms, such as Moyamoya syndrome (MMS), is discussed, focusing on associated conditions and risk factors. Surgical revascularization emerges as the mainstay of treatment, with direct, indirect, and combination bypass procedures explored. The review delves into advancements in imaging technology for diagnosis and treatment planning, emphasizing non-invasive magnetic resonance examination's role in identifying asymptomatic patients. Additionally, insights into anesthetic care and therapeutic approaches underscore the evolving understanding of this complex disease. The presented information aims to contribute to the ongoing dialogue surrounding MMD, providing a valuable resource for clinicians and researchers., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Navandhar et al.)

Introduction The decreased thyroid-stimulating hormone (TSH) levels affect almost every nucleated cell in our body, which directly affects the basal metabolic rate (BMR). It tends to affect multiple organ systems in the human body. In recent times, there have been changes in lifestyle and the consumption of processed foods has increased. Thus, cholelithiasis and hypothyroidism are being encountered frequently, even in rural populations. In recent times, the overt clinical presentation of hypothyroidism is rare due to early diagnosis and treatment of the subclinical hypothyroidism state itself. Aim The aim is to determine the correlation between cholelithiasis and hypothyroidism. Methods This was a cross-sectional study done on the patients presenting to the surgical department at Acharya Vinoba Bhave Rural Hospital affiliated to Jawaharlal Nehru Medical College, Sawangi (Meghe), Wardha, Maharashtra, India between the duration from December 2020 to December 2022, having gallstone disease or with symptoms suggestive of gall bladder stones. The admitted patients were then evaluated for hypothyroidism by thyroid profile tests, and the results were documented. Using the collected data, factors such as clinical spectrum, correlation between cholelithiasis and hypothyroidism, relation with the demographic data, and body mass index (BMI) were studied. Results A total of 52 gallstone patients were included in the study. A greater number of patients were found to be above the age of 40 years (82.7%), with female preponderance (61.5%). More patients with cholelithiasis were from the group with having BMI more than normal (57.6%). More patients having both cholelithiasis and hypothyroidism were also from the group with having BMI more than normal. Most symptomatic patients complained of pain in the right hypochondriac region (88.5%). Of these 52 patients, nine (17.3%) were found to have hypothyroidism (seven were subclinical, two patients had overt clinical symptoms and signs) and the remaining 43 patients were euthyroid. Conclusions Our study supports that there is a correlation between cholelithiasis and hypothyroidism. Out of all the 52 patients, nine had hypothyroidism, seven were subclinical, and two had overt symptoms. Thus, we conclude that there is a correlation between cholelithiasis and hypothyroidism., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Kulkarni et al.)

As long as medicine has subsisted, wound closure has existed. When assessing a surgical wound, physicians are more than ever confronted with various sutures and other closure materials. The surgeon must choose the most appropriate material for that specific closure because not one substance is perfect in all circumstances. The history of suturing wounds is intertwined with the history of surgery. Wound suturing is a critical component of wound therapy, including suturing materials and techniques. Suturing has been practiced for thousands of years. Although suture materials and techniques have changed, the goals like closing dead space, supporting and strengthening wounds until healing increases their tensile strength, approximating skin edges for an aesthetically pleasing and functional result, and reducing the risk of bleeding and infection remain the same. Traditional skin closure with sutures requires time and effort, creates an unsightly scar, and requires infection removal. In this modern era, patients find it appealing when the operated location has a decent cosmetic appearance. The quicker, more comfortable, and most aesthetically pleasing method of skin closure is what surgeons are searching for. Assessing whether newer methods are superior to sutures and staples is necessary. Better cosmesis, flexibility, water resistance, painless sealed skin closure, and ease of application are all advantages of 2-octyl cyanoacrylate. This article aims to provide an overview of the critical characteristics of traditional sutures, common suture materials, sticky glue, and staples, as well as additional closure materials., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Mastud et al.)