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.

Chronic pancreatitis being one of the most distressing medical condition, is often complicated by common bile duct obstruction, fibrosis and acute inflammation of the pancreas. Pain, weight loss and diabetes are common in these patients. Surgery is the ultimate option after medical treatment fails to solve the distress. Longitudinal Pancreatico-jejunostomy is widely practiced all over the world as the option of choice. Pancreatico-gastrostomy is also being practiced by a few surgeons in a few centers. Here we practice Longitudinal Pancreaticogastrostomy (LPG) for chronic pancreatitis patients in our setup. This study was aimed to analyze the outcomes and privileges of LPG.

Post surgical wound infections are still among the most common serious complications of colorectal surgery and have serious consequences for outcomes and costs. Different risk factors may be involved including age, sex, nutrition, diabetes mellitus, type of disease, operation type and some operative factors like spillage of intestinal contents, gangrenous gut etc. This study aimed to determine the risk factors affecting abdominal wound infections in colorectal surgery and their rate at Shaheed Suhrawardy Medical College Hospital, a major referral teaching hospital in Bangladesh

Insulinoma is a rare variety of endocrine neoplasm and is usually benign, solitary, and small in size. The hallmark of this disorder is high endogenous insulin secretion resulting in development of symptoms of hypoglycemia. Insulinomas account for 60% of islet cell tumors (ICT) of the pancreas. Ninety percent (90%) of the insulinomas measure less than 2cm. Early localization of the disease is essential to prevent lethal hypoglycemia. Here we report a case of insulinoma in a 28 year old female who subsequently underwent distal pancreatectomy with splenectomy on February 2017 in Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Background: Conventionally it is assumed that raised level of CA 19-9 (Carbohydrate antigen 19-9) is related to malignancies of liver, pancreas and biliary tract. Through our early experience in Shaheed Suhrawardy Medical College Hospital we found that raised level of CA 19-9 is not associated only with malignancies but also with other benign disorders of HBS. The aim of this study was to explore the relationship of raised CA 19-9 with hepatobiliary disorders other than malignancies. Result: We encountered a total of 57 cases at our department of Hepatobiliary Surgery where patients presented with classical features of obstructive jaundice with pain, anorexia and vomiting.

Hydatid disease is one of the diseases that have been discovered in the ancient times. Liver and lung are the most commonly affected organs, though it can involve any organs. Hydatid disease involving both the liver and the lung is reported about 10% of the cases. Here we report a case of 34 year old male presented with upper abdominal pain and intermittent fever for 3 months admitted in October 2016. His chest radiograph and computed tomography scan revealed large cystic lesion at right lung and another similar large lesion in the right lobe of liver. Echinococcus antibody was found positive. We treated him surgically. Histopathology reports confirmed concomitant hydatid cyst of both the lung and the liver.

Recurrent cholangitis and sepsis are common complications after surgical treatment for hepatolithiasis as total clearance is not always possible. This retrospective study is designed to see the effect of our treatment for hepatolithiasis on stone clearance and post operative complications. We have treated 60 patients with hepatolithiasis surgically from September 2010 to September 2016 in the Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. 

Background: Repair of inguinal hernias in men is a common surgical procedure, but the most effective surgical technique is still in debate.

Methods: We randomly assigned men with inguinal hernias at Mitford Hospital surgery, ward to either open mesh or laparoscopic mesh repair. The primary aim was to detect recurrence of hernias in both groups at 6 month. Secondary aims were to detect complications and patient compliance.

Kaposi’s sarcoma is a vascular tumor usually involves skin, mucous membrane and other organs. HIV associated Kaposi’s sarcoma is very rarely reported in Bangladesh. The reporting case was presented with a recurrent, ulcerated, firm nodule on left groin along with multiple blackish flat or raised lesions on different parts of body. According to previous histopathological report this case was operated as a case of recurrent fibrous histiocytoma and this time the diagnosis was confirmed histologically and by immunohistochemistry as Kaposi’s sarcoma. Later, it was found that the patient is serologically positive for HIV.J Bangladesh Coll Phys Surg 2014; 32: 164-166