Laparoscopic colorectal cancer surgery in obese patients is technically feasible and oncologically safe. Despite greater postoperative morbidity, obese patients benefit from shorter length of stay. However, a higher conversion rate, particularly for rectal cancers, should be anticipated in obese male patients.

Stapled haemorrhoidopexy achieved better disease control at 1 year without any major complication. This was sustained in the long-term. Further studies with greater patient numbers are needed to confirm this study.

E alone is best suited in all elderly gallstone ileus patients with significant comorbidities. A one-stage procedure (EC) should be reserved for young, fit and low risk patients.

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Aim:The aim of this study is to analyse the incidence of carcinoma thyroids in toxic multinodular goiters (MNG) and the pathological pattern of these cancer nodules. Methods: This is a retrospective review of 2344 patients, operated for MNG over a period of 10 years from Results: We operated on 2344 patients for MNG, out of whom 160 patients presented to us in a toxic state and the remaining 2184 in a non-toxic state. Of the patients operated for MNG 4.5% were found to have associated thyroid cancer. The incidence of thyroid cancer in toxic MNG patients was 26.25% whereas in non-toxic MNG patients it was 2.5%. All the malignant nodules detected were papillary cancers of the thyroid and relatively large nodules (range 0.6 cm-4.1 cm) were found in toxic MNG compared to non-toxic MNG. Conclusion: Patients with toxic MNG showed a very high incidence of coexisting thyroid cancer. Thyroid cancers can coexist in toxic MNG despite the suppression of thyroid stimulating hormone (TSH). The coexisting thyroid cancer size is larger in toxic MNG than euthyroid MNG. A total thyroidectomy is the treatment recommended for toxic MNG in an endemic area.

Acute pancreatitis constitutes 3% of all admissions with abdominal pain. There are reports of osteal fat necrosis leading to periosteal reactions and osteolytic lesions following severe pancreatitis, particularly in long bones. A 54-year-old man was admitted to our hospital with acute pancreatitis, who later developed spinal discitis secondary to necrotizing pancreatitis. He was treated conservatively with antibiotics and after a month he recovered completely without any neurological deficit. This case is reported for its unusual and unreported spinal complications after acute pancreatitis.

Background Emergency inguinal and femoral hernia repair can be done by suture or mesh repair, there is still scepticism around using mesh. We aim to evaluate the usage of mesh and the outcome of emergency groin hernia repair after mesh and suture repair. Methods Retrospective cohort study of adult patients who underwent emergency inguinal and femoral hernia repair from 1st January 2018 to 31st July 2020. Electronic data and case notes were reviewed and outcome data were collected. Results Eighty‐nine emergency groin hernia repairs were carried out. Sixty‐two were males, 60 inguinal hernia and 29 femoral hernia. Median age was 72 years (range 20–95). 74 (83.1%) were primary hernia and 15 (16.9%) recurrent hernias. 67 (75.3%) mesh and 22 (24.7%) suture repairs were carried out. Eleven cases required bowel resection and of those 10 had suture repair. Inguinal hernia was more likely to have mesh repair as compared to femoral (P‐value 0.002). Median length of stay was significantly lower in mesh group 2 days (1–5 IQR) versus 7.5 days (5–11 IQR) in suture repair group (P‐value <0.0001). Five cases (6.74%) had wound complications (3 wound infections, 2 haematoma). With median 20 months (range 6–36 months) follow‐up, 1 recurrence each in both mesh and suture repair groups, no mesh infection and 2 (2.2%) 30‐day mortality recorded. Wound infection, recurrence and reoperation were not statistically different in two groups. Conclusion Emergency groin hernia are amenable to mesh repair and in case of bowel resection or gross contamination non‐ mesh repair is recommended.