The management of acute calculus cholecystitis has seen a change in management with the introduction of early laparoscopic cholecystectomy. The management of high-risk patients or Tokyo Guideline grade 3, however, is an area of concern. Drainage of the gallbladder is a bridging procedure that is performed to stabilize patients to perform an interval cholecystectomy later. Percutaneous cholecystostomy is the most common drainage procedure, with endoscopic procedures like Endoscopic trans papillary gallbladder drainage and Endoscopic Ultrasound Gallbladder drainage being reserved for patients who will not undergo surgery. In this review, we will investigate the role of early laparoscopic cholecystectomy, subtotal cholecystectomy, and drainage of the gallbladder in the management of acute cholecystitis.

Perforated colon cancer is considered as disseminated cancer. Though colon cancers are common, their presentation with perforated peritonitis is uncommon. Traditionally, disseminated cancers have been managed by conventional open surgery. We, herein, report the case of a 41 years old male patient who presented to the hospital with perforated transverse colonic malignancy and was managed by laparoscopy. The rationale for reporting this case is to underscore the fact that with appropriate case selection, even perforated colon cancers can be managed by minimal invasive surgery, in advanced setups by an experienced team.

Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney, with a rising global incidence. The epidemiology, clinical presentation, and management outcomes of RCC vary across different regions, especially in low-resource settings. This study aims to analyze the demographic patterns, clinical characteristics, treatment modalities, and outcomes of RCC patients at East Oncology Center (EOC) in Sudan. A retrospective study was conducted at East Oncology Center, Sudan, including all patients diagnosed with RCC between 2013 and 2024. Data were collected from hospital records, covering demographic characteristics, clinical presentation, risk factors, diagnostic workup, treatment modalities, and outcomes. A total of 71 patients were included, with a mean age of 57 years (range: 18–100 years). Males constituted 54.9%. The most common presenting symptoms were flank pain (93%), hematuria (33%). Clear cell carcinoma was the predominant histological subtype (52.1%), with more than 70% of patients diagnosed at a locally advanced or metastatic stage. Surgical treatment was performed in 70.4% of cases. The median follow-up period was 23.3 months, with an overall survival rate of 33.8%. This study provides insights into the epidemiology and management of RCC in a low-resource setting. A high proportion of patients presented with advanced-stage disease, highlighting the need for early detection strategies. Further research and resource optimization are required to improve RCC outcomes in Sudan.

Approximately 20 million hernia surgeries are performed worldwide each year. The majority of groin hernia repairs are conducted electively and are regarded as low-risk procedures [1, 2]. In our Center, a developing country with government hospitals, laparoscopic available resources are sometimes insufficient to meet the demand for patients with inguinal hernias. As a result, open repair remains widely performed procedure. Based on this, we made a modification to the Rutkow-Robbins technique by applying its two fundamental physical principles—a plug and a mesh patch— reducing the prosthetic mesh used, and for the first time, shifting the paradigm regarding the effect of polypropylene mesh when in contact with the spermatic cord. This modification has shown favourable outcomes in a two-year follow-up. The aim of this paper is to describe our technique and present the outcomes achieved.

Abstract: Clinical scoring systems have been developed to risk-stratify patients who are presented to the emergency department with symptoms of acute appendicitis. They are used to rule out patients with acute appendicitis and those who may require imaging in the form of ultrasound or computerized tomography. The common scoring systems are the Alvarado score, RIPASA score, AIR, and AAS. In this chapter, we will look at the common clinical scoring systems that are used for adults and children. We will also look at the role of these scoring systems in diagnosing acute appendicitis and reducing the negative appendectomy rate.

Liver abscess is a rare condition that can be divided into amoebic liver abscess and pyogenic liver abscess. The diagnosis is confirmed by performing an ultrasound or computerized tomography. The management of liver abscesses has seen a trend toward minimally invasive procedures like percutaneous drainage and intravenous antibiotics. Percutaneous drainage can be divided into percutaneous catheter drainage and percutaneous aspiration. Surgical drainage can be divided into open and laparoscopic drainage. In this chapter, we will look at the management of liver abscesses, especially the role of percutaneous drainage, which includes percutaneous catheter drainage, percutaneous aspiration, and surgical drainage.

The definition of complicated appendicitis has been an area of concern due to the absence of any universal consensus. Complicated appendicitis often means perforation of the appendix with either peritonitis, abscess, or mass formation. The diagnosis of complicated appendicitis is another area where there is no consensus and there is no one investigation that can diagnose this condition. Diagnosis often involves the use of clinical examinations, blood investigations, and imaging modalities. In this chapter, we will look at the definition and diagnosis of complicated appendicitis.