Therefore, it becomes important for the right handed surgeons to modify their techniques and establish a proper hand eye coordination to adapt to the mirror image anatomy of the Calot's triangle in a patient of situs inversus totalis.

Anomalies like midgut malrotation can present as an operative surprise and awareness regarding these anomalies can help surgeons deal with these conditions.

Despite ileostomy patients having highest crude mortality and complication rates, after risk adjustment it was equally safe. Severity of the disease rather than the surgical option had a significant impact on the outcome in patients with ileal perforations.

IntroductionBouveret's Syndrome is a rare cause of Gastric outlet obstruction (GOO) caused by a gall stone which has migrated into the duodenal bulb from a bilioduodenal fistula. It is an uncommon condition and only a few cases have been reported in the medical literature till to date.Presentation of caseWe report a case of a 45 year old woman who presented to us with recurrent pain in the upper abdomen for the last 8 years, and that progressed to develop symptoms of gastric outlet obstruction. An upper gastrointestinal endoscopy revealed duodenal ulceration with a stony hard lesion in the first part of duodenum. An contrast enhanced computed tomography (CECT) scan of the abdomen performed later confirmed the presence of cholecystoduodenal fistula and a gall-stone in proximal jejunum.DiscussionBouveret's syndrome is a case of gastric outlet obstruction caused by the impaction of a large gall stone in the duodenum as a result of a cholecystoduodenal fistula. It constitutes 1–3% of cases of gall stone ileus which in turn complicates only 0.3–4% cases of cholelithisasis. Bouveret's syndrome is managed surgically.ConclusionBouveret's syndrome being an uncommon condition may pose a difficulty in diagnosis and dilemma in managing such patients. An awareness is hence essential.

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This rare malignancy affecting the viscera can be diagnosed only with high index of suspicion and awareness regarding its presentation can help surgeons deal with it.

Aim:To evaluate the outcomes of mandibular angle fractures treated with metal 2.0 mm locking, metal 2.0 mm nonlocking, and 2.5 mm resorbable systems.Study Design:Retrospective cohort study.Materials and Methods:Trauma records were screened for linear angle fractures treated with open-reduction and internal semi-rigid fixation with single metal/bioresorbable plates, and baseline variables were tabulated. The outcome variable was the presence or absence of any complication.Statistical Analysis Used:The Fisher's exact test and analysis of covariance (ANCOVA) using STATA 11.Results:A total of 60 case records of over four years were included. The mean age of the patients was 27.4 (SD 9.7) years. Fifty-five were male and five female. There were 20 nonlocking and 16 locking metal miniplates and 24 bioresorbable plates. In 55 (91.6%) cases there was a third molar in the fracture line. In 51/55 (92.7%) cases the third molar was retained. In seven patients postoperative complications were seen. There was no difference between the complication rates of the three treatment groups. Infection was the most common complication followed by delayed union and hardware failure.Conclusions:This retrospective study found no difference in the complication rate when fractures of the mandibular angle were treated with locking or nonlocking miniplates or bioresorbable plates.

We report herein the rare case of a 40-year-old woman with a 10-year history of dull abdominal pain, in whom a carcinoid tumor of the gallbladder was confirmed by postoperative histological findings. A review of the world literature revealed that only 22 other such cases have been documented, all of which were diagnosed by incidental findings at the time of surgery or at post mortem. Although these patients may present with liver metastasis, rarely do they manifest with features of a carcinoid syndrome. The rarity of this entity prompted us to present our patient's case report, followed by a brief review of the literature on the previous 22 cases.