Rates of significant post-operative bleeding are consistent with recent literature. Post-operative hypertension, diabetes and high post-operative drain output were identified as independent risk factors on multivariate analysis; when identified, these may be caveats to same-day discharge of thyroidectomy patients.

Abdominal wall hernias are a common pathology and source of morbidity including chronic pain. They occur in various anatomical areas; amongst the rarest locations is the Spigelian hernia accounting for <2% of all abdominal hernias. We present a case report of a patient with chronic right iliac fossa pain caused by an incarcerated Spigelian hernia containing her appendix within the hernial defect. Rarer still is that her hernial defect penetrated all three layers of anterior abdominal wall, typically a Spigelian hernia would only pass through transversus abdominis and internal oblique layers.

Emphysematous pancreatitis (EP) is a rare and severe complication of acute pancreatitis carrying a high mortality with only a handful of case reports and small studies reporting these cases and their management. The presence of emphysematous pancreatitis is often indicative of infected pancreatic necrosis with the mainstay of treatment being pancreatic necrosectomy; however there are cases where it may be appropriate to have a trial of conservative management, and there is a small body of evidence to support this. This paper describes a case of an 87-year-old male with acute emphysematous pancreatitis successfully managed with conservative cares.

weighed seventeen ounces. Their capsules were loose, the exposed surfaces smooth, and the lobular markings distinct. On section, the cancs were found congested, the cortex presenting a course red-and-white mixture.

Small bowel obstructions are common acute surgical presentations often as a result of intraabdominal adhesions or herniations; rarer causes include malignancies, strictures, foreign bodies and bezoars. Phytobezoars (bezoars composed of undigested plant material) account for<4% of small bowel obstructions. Here we report an unusual case of a 56-year-old male with a virgin abdomen presenting with a small bowel obstruction, a CT scan of his abdomen and pelvis was suggestive of a closed loop small bowel obstruction. The patient progressed to have an emergency laparotomy and was found to have multiple intraluminal obstructing foreign bodies within the distal ileum. On making an enterotomy to remove and examine these, they were found to be rehydrated apple segments that the patient had ingested in the dehydrated form several hours earlier. This is an example of a phytobezoar causing bowel obstruction, contributing factors to the occurrence of these include poor gastrointestinal motility and problems of mastication; in this instance the patient had poor dentition that likely pre-disposed him to this problem.

Background: Australia has the highest incidence of non-melanoma skin cancers (NMSC) in the world estimated to be 2448/100,000 population with the state of Queensland carrying the highest burden of disease. Surgical excision is the primary treatment and makes up a large proportion of general surgical lists in regional Queensland where they are typically removed using either local anaesthetic (LA) alone, local anaesthetic and sedation (LAS), or general anaesthesia (GA). There is little in the literature to suggest if anaesthetic type effects the rate of incomplete excision. The purpose of this study is to establish if anaesthetic type impacts the rate of incomplete excision of NMSC.Methods: A retrospective audit was performed, incorporating a total of 194 squamous and basal cell carcinoma lesions excised between October 2019 and October 2020 at two hospitals in regional Queensland, Australia.  Data was recorded for the type of anaesthetic used and the histopathology of the lesions including type of lesion and clearance of microscopic margins.Results: Of the 194 excised lesions 39 of them had involved margins (20.1%). The rate of involved margins under LA, GA and LAS were found to be 19.79, 18.52 and 22.73% respectively. When comparing these modalities with each other:  LA vs. GA, LAS vs. GA and LA vs. LAS no significant difference was found in the rate of incomplete excision of NMSC with p values (<0.05) of 1, 0.62 and 0.82 respectively.Conclusions: Modality of anaesthetic used for excision of NMSC does not affect the outcome of incomplete excision of NMSC.

Pancreatic pseudocysts are a common complication of pancreatitis affecting up to 40% of chronic cases. Typically, they are located within or abutting the pancreas and are self-limiting with the majority been smaller than 6cm, asymptomatic and resolving with conservative management. Here we present an unusual multiloculated giant pancreatic pseudocyst that originated at the pancreatic tail and extended through the lateral thoracoabdominal walls into the subcutaneous plane in a male with chronic alcohol pancreatitis. A literature search revealed no previous documented cases of this specific complication.