Specialist surgery of the gallbladder. bile duct. liver. pancreas.

Gestational gigantomastia (GG) is an extremely rare condition characterized by excessive breast enlargement during pregnancy and may lead to serious maternal morbidity. Due to its rarity, standardized management guidelines are lacking, particularly in resource-limited settings. To the best of our knowledge, this is the first reported case of gestational gigantomastia from Bangladesh and contributes valuable regional evidence to guide clinical and surgical decision-making. A 37-year-old woman at 33+ weeks of gestation presented with massive bilateral breast enlargement over seven months, complicated by respiratory distress and an infected ulcer wound. Right and left breasts were weighed approximately 15kg and 13 kg respectively, with associated skin ulceration and accessory breast tissue. Imaging revealed diffuse edematous breast parenchyma without malignancy, and core biopsy for histopathology confirmed a benign proliferative lesion. After multidisciplinary consultation, pregnancy was terminated via lower-segment cesarean section. Following delivery and clinical stabilization, the patient was treated conservatively with the dopamine agonist cabergoline. Post-treatment, the patient demonstrated a significant reduction in breast size with resolution of respiratory distress. She was discharged in stable condition with a plan for delayed reduction mammoplasty, which she later declined. At follow-up, breast volume had decreased, although residual skin laxity remained. Early recognition of gestational gigantomastia is essential, particularly when rapid breast enlargement leads to systemic complications.

Lymphangioma is a benign cystic neoplasm that results from congenital malformation of the lymphatic system. Among them, splenic lymphangioma is a rare entity accounting for only <0.007% of all tumors. This case highlights the importance of considering splenic lymphangioma in the differential diagnosis of cystic splenic lesions. Most of the patients are symptomless and detected incidentally. A 35-year-old lady presented to a tertiary care hospital of Dhaka, Bangladesh with abdominal pain and fatty food intolerance. On abdominal examination, splenomegaly was noted incidentally. Ultrasonography of whole abdomen showed features of chronic calculus cholecystitis with multiple hypoechoic area in spleen indicating multiple cystic lesion of spleen. Her echinococcal antibody tests were negative. Contrast CT scan of abdomen showed enlarged spleen with multiple cystic lesions indicating polycystic splenic disease associated with gall stones. After proper counseling, she underwent laparoscopic cholecystectomy with open splenectomy. Though she was planned for laparoscopic splenectomy, open conversion was required for huge size of spleen. Her post-operative period was uneventful. She was advised for post splenectomy vaccination and prophylactic antibiotics. Follow up after 1 and 3 months showed no abnormality.

Background: Gallbladder carcinoma (GBC) is the most frequent cancer of the biliary tract. When caught at an advanced stage, the outlook is poor, with patients typically surviving for less than six months. Reports of survival beyond one year are uncommon and may offer insights into prognostic factors and management strategies.

Case Presentation: A 60-year-old female patient presented with right upper quadrant pain, worsening jaundice, loss of appetite, and weight loss, along with pale stools. Diagnostic imaging confirmed advanced gallbladder carcinoma complicated by a blockage in the biliary tract. The patient underwent cholecystectomy with external biliary drainage followed by systemic chemotherapy using a gemcitabine–carboplatin regimen.

Control of pain in patients with chronic pancreatitis is difficult because 30.0% to 50.0% of patients still experience persistence or recurrence of pain even after surgery. So a combined approach of surgery and coeliac plexus neurolysis was carried out in this study to see the relief of pain and reduce the requirement of analgesics in these patients. This prospective observational comparative study was carried out in the Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from November 2017 to October 2018. Forty one (41) study participants with the diagnosis of chronic pancreatitis were included consecutively in this study.

Obstructive jaundice patients need surgical intervention to overcome the biliary obstruction. For planning these complex interventions, the radiologist has to precisely assess the etiology, location, level, and extent of the disease.

To be true, the name of this specific pathological lesion is not widely encountered in our dayto- day surgical practice, but still, pilomatricoma or pilomatrixoma is notifiable skin neoplasm for which diagnosis can be made histopathological and only after an adequate excision. This case report is of a 23-year-old young female medical student who presented with swelling in neck, that histopathologically diagnosed as pilomatricoma. The purpose of reporting this specific case is that this pathology is rare in occurrence, but more rarely diagnosed because of lack of confirmatory pathological analysis and it is immensely essential to be kept in the differentials of all superficial skin tumors in surgical practice.

Periampullary neoplasms are a heterogeneous group of tumors arising within 2 cm of the ampulla of Vater. Neuroendocrine tumors can originate throughout the entire body from neuroendocrine cells. These neoplasms exhibit deep differences, according to their origin and biological behavior. The synchronous presence of a primary tumor in patients affected by a neuroendocrine tumor is reported in the literature; incidence is variable and the most common site is the gastrointestinal tract. Here we report a case of 68 years old female presented with jaundice, anorexia and weight loss. She was mildly anaemic. Gall bladder was palpable. There was no organomegaly. Her CT scan and MRCP revealed a growth in periampullary region. So she underwent Whipple’s procedure. Histopathological report showed synchronous presence of periampullary carcinoma and a carcinoid tumor in stomach. As the carcinoid tumor was nonfunctioning and very small in size, it was not identified in pre-operative work up.