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Multiple primary malignancies are defined as two or more malignancies arising independently to each other in the same or different anatomical sites, while excluding the possibility of metastasis from the primary malignancy. Here, we present three cases, each with dual malignancies involving different anatomical locations.

OBJECTIVE: This study aimed to assess the quality of life using the EuraHS-quality-of-life (QoL) score and postoperative outcome measures in patients undergoing endoscopic component separation technique with laparoscopic intraperitoneal onlay mesh repair in large (>5 cm) midline ventral hernia mesh placement and to compare EuraHS-QoL score with the currently available hernia-related QoL score—Carolina Comfort Scale. MATERIALS AND METHODS: This was a single-center prospective observational study. A total of 60 patients were studied. Component separation index and abdominal wall strength score were calculated. The quality of life was assessed by EuraHS-QoL Score and Carolina Comfort Score. RESULTS: The mean abdominal wall strength score at 3 months postoperatively was 6.83 ± 0.87, and a P value of less than 0.001 was significant. The correlation between EuraHS-QoL score and Carolina Comfort Scale was assessed with respect to the pain domain and movement limitation/restriction domain using Spearman correlation, which showed a positive correlation. CONCLUSIONS: Endoscopic component separation technique with laparoscopic intraperitoneal onlay mesh repair is a safe procedure owing to its better postoperative and functional outcomes. The EuraHS-QoL score is superior to Carolina Comfort Scale as it is more user-friendly, accessible, detailed, and precise.

Diverticulosis is rare in jejunum and its unusual presentation of mechanical obstruction is difficult to diagnose pre-operatively. We report a case of a 54-year old male patient who had symptoms of general abdominal pain and vomiting off and on for three years. He had been assessed elsewhere and had received a course of anti-tubercular treatment empirically based on features of recurrent intestinal obstruction due to prevalence of tuberculosis in this region. The patient had presented himself with signs and symptoms of dynamic intestinal obstruction. On examination, the abdomen was found to be swollen with a central abdominal distension and hyperactive bowel sounds. The erect abdominal radiograph showed multiple air-fluid levels and dilated jejunal loops. Following this, the patient underwent an emergency exploratory laparotomy. This revealed multiple jejunal diverticulae, multiple bands and adhesions involving jejunum and proximal ileum. The bands and adhesions were removed and the jejunum was resected along with the inflamed diverticulae.

Background: Haemobilia usually occurs secondary to accidental or iatrogenic hepatobiliary trauma. It can occasionally present with cataclysmal upper gastrointestinal haemorrhage posing as a life threatening emergency. Haemobilia can very rarely be a complication of acute cholecystitis. Here we report a case of haemobilia manifesting as massive gastrointestinal haemorrhage in a patient without any prior history of biliary surgery or intervention and present a brief review of literature.Case Presentation: A 22 year old male admitted with history suggestive of acute cholecystitis subsequently developed waxing waning jaundice and recurrent episodes of upper gastrointestinal bleed. Endoscopy showed an ulcer in the first part of duodenum with a clot, no active bleed was visible. Angiography was suggestive of a ruptured pseudoaneurysm in the vicinity of the right hepatic artery probably originating from the cystic artery. Coil embolization was tried but the coil dislodged into the right branch of hepatic artery distal to the site of pseudoaneurysm. Review of angiographic video in light of operative findings demonstrated a fistulous communication between cystic artery and gallbladder as the cause, a simultaneous cholecystoduodenal fistula was also noted. Retrograde cholecystectomy, closure of cholecystoduodenal fistula and right hepatic arteriotomy with retrieval of the endo-coil and hepatic arterial repair was performed.Conclusion: Fistula between the cystic artery and gallbladder has been commonly reported to occur after laparoscopic cholecystectomy. Spontaneous fistulous communication, i.e. in the absence of any prior trauma or intervention, between cystic artery and gallbladder is rare with very few reports in literature. Aetiopathogenesis of the disease, in the context of current literature is reviewed. The diagnostic dilemma posed by the confounding finding of an ulcer in the duodenum, the iconic video angiographic depiction as also the therapeutic challenge of a failed embolization with consequent microcoil migration and primary hepatic arterial repair in the emergency situation is discussed. [ABSTRACT FROM AUTHOR]