Background: Trichobezoar is a rare condition resulting from the accumulation of ingested hair within the gastrointestinal tract, most commonly seen in young females with underlying psychiatric disorders. It may lead to serious complications including gastric outlet obstruction and perforation. Case Presentation: A 19‑year‑old female presented with 10 days of intermittent upper abdominal pain with recent worsening, associated with postprandial vomiting and significant weight loss over the preceding months. Examination revealed mild epigastric tenderness, and blood investigations demonstrated microcytic hypochromic anemia. Upper gastrointestinal endoscopy showed an entangled hair mass occupying the body and fundus of the stomach, which could not be retrieved endoscopically. She underwent laparotomy and anterior gastrotomy with removal of an 8 × 5 × 3 cm trichobezoar mixed with digested food particles. Postoperatively she had psychiatric evaluation, was counseled for trichotillomania, advised behavioral therapy, and discharged with iron supplementation, nutritional advice, and scheduled follow‑up. Conclusion: Trichobezoar should be considered in young females presenting with unexplained gastrointestinal symptoms, weight loss, and nutritional anemia. A multidisciplinary approach involving surgical, psychiatric, and nutritional care is vital to ensure complete recovery and prevent recurrence.

Acute acalculous cholecystitis is characterized by inflammation of the gallbladder without the presence of gallstones. It is commonly seen in older and critically ill patients. The etiology of this condition is broad and includes infective, inflammatory, traumatic, and connective tissue disorders. Acute acalculous cholecystitis is associated with a higher risk of complications like gangrene and perforation. Clinical examination and laboratory investigations are not sensitive for the diagnosis of acute acalculous cholecystitis. Ultrasonography is the first-line imaging modality to diagnose acute acalculous cholecystitis, followed by Cholescintigraphy. The management of acute acalculous cholecystitis can be divided into cholecystectomy and percutaneous cholecystostomy. In this review, we will investigate the risk factors, investigations, and treatment of acute acalculous cholecystitis.

Introduction: Benign enlargement of the prostate (BEP) is a major health concern for aging men worldwide. Assessing lower urinary tract symptoms in BEP patients is essential for starting and managing treatment. Both the International Prostate Symptom Score (IPSS) and the new Visual Prostate Score (VPS) are commonly used to evaluate these symptoms. This study was designed to compare the effectiveness of these two scores with urodynamic assessments in patients. Patients and Methods: Following ethical committee approval, a one-year study was conducted that included 100 patients diagnosed with Benign Prostatic Enlargement and lower urinary tract symptoms, all of whom provided written informed consent. After being educated about the study, participants completed the International Prostate Symptom Score and Visual Prostate Score questionnaires, and their uroflowmetry parameters were documented. The scores from the two questionnaires were then compared to each other, as well as to the uroflowmetry results. Result: Among the patients enrolled, 35% were illiterate. Out of 100 patient 61% required assistance to complete IPSS (p = <0.001). VPSS completion time was significantly less (p = <0.001). There was a notable relationship between the total IPSS and the VPSS scores (R = +0.489; p= <0.001), and total IPSS QOL and total VPSS QOL correlated positive (R = 0.349; p = 0.018). Conclusion: There is a significant correlation between the Visual Prostate Score and the IPSS for the quantification of lower urinary tract symptoms resulting from Benign Prostatic Enlargement. Furthermore, the VPSS can be completed without assistance by a greater proportion of patients and in a certain period of time.

Endoscopic gallbladder drainage is performed for high-risk patients with acute calculus cholecystitis who are not fit to undergo a cholecystectomy. Endoscopic transpapillary gallbladder drainage and endoscopic ultrasound-guided gallbladder drainage are the two procedures performed. Both procedures require specialized training and equipment, and the most common complications include perforation, bleeding, and stent migration. In this review, we will investigate the role that endoscopic transpapillary gallbladder drainage and endoscopic ultrasound gallbladder drainage play in the management of acute calculus cholecystitis in high-risk patients who would not undergo a cholecystectomy. We will also review the indications and complications of these procedures and compare them with percutaneous cholecystostomy in the management of acute calculus cholecystitis.

Subtotal cholecystectomy is considered a contingency procedure during cholecystectomy when the critical view of safety cannot be achieved due to inflammation, posing a risk of bile duct injury if the operation proceeds. Laparoscopic subtotal cholecystectomy is the predominant technique employed for this procedure. Subtotal cholecystectomy can be executed using either a fenestrating or reconstituting approach. The most prevalent complications include bile leakage, recurrent stone formation, inflammation of the stump, and a high conversion rate. In this review, we will explore the role of subtotal cholecystectomy in the management of acute calculus cholecystitis, examining the various approaches and the long- and short-term outcomes associated with this procedure.

Acute calculus cholecystitis is the most common complication of gallstone disease, and it is managed with conservative treatment with intravenous antibiotics followed by delayed laparoscopic cholecystectomy, which is performed in 8 to 12 weeks. The Tokyo Guidelines for the management of acute cholecystitis of 2013 and 2018 have recommended delayed laparoscopic cholecystectomy for patients with grade 3 acute cholecystitis, while for patients with grade 1 and 2, an early laparoscopic cholecystectomy is recommended. Patients with severe acute cholecystitis who have undergone percutaneous cholecystostomy will usually undergo a delayed laparoscopic cholecystectomy once their condition has stabilized. In this review, we will investigate the role of delayed laparoscopic cholecystectomy and compare it with early laparoscopic cholecystectomy. We will also look at the role of delayed laparoscopic cholecystectomy following percutaneous cholecystostomy.

Acute calculous cholecystitis (ACC) is a prevalent surgical emergency characterized by inflammation of the gallbladder, typically due to cystic duct obstruction by a gallstone. The diagnostic process relies on a combination of clinical assessment, blood investigations, and imaging modalities. Leukocytosis and elevated inflammatory markers like C.Reactive protein (CRP) are commonly seen in this condition, and ultrasound is the most common imaging modality used to diagnose acute calculus cholecystitis. The Tokyo Guidelines (TG) have served as a critical, internationally recognized framework for standardizing the diagnosis and severity grading of ACC, undergoing revisions in 2013 (TG13) and 2018 (TG18) to enhance specificity and accuracy. This review outlines the key diagnostic methods for acute calculus cholecystitis, focusing on the evolution of the Tokyo Guidelines criteria, the role of specific blood investigations, and the utility of various imaging modalities.