Congenital cardiac surgery is one of the most challenging and fascinating branches of modern medicine which continues to advance in areas and improving outcomes, post-operative and pre-operative care. Patent Ductus Arteriosus was the first congenital heart lesion to be successfully corrected surgically. The landmark surgery was performed by Dr. Robert E. Gross in 1938 and opened up the possibility of subsequent surgical correction of various other lesions, which were considered to be untreatable previously. The first successful surgical closure of persistent ductus arteriosus (PDA) was preceded by years of work and contributed by various surgeons, physicians, and anatomists, dating all the way back to the 1^st century. They are all worthy of recognition and praise. This article covers the important events related to PDA lesions including its first identification, followed by its description in various texts and sources over the course of time, failed attempts at surgical correction, and disputes regarding credits. These contributions to the branch cannot be overstated and serves as an inspiration to cardiac surgeons all over the world and to students, interns, and newly graduated doctors as well, who would one day like to be part of this fascinating branch.

Background: Obstructive jaundice is a condition caused by bile flow blockage and has various benign and malignant etiologies. Accurate and timely diagnosis is essential for effective treatment, particularly in cases of possible malignancy. Advances in diagnostic methods have improved our understanding and management of diseases. This study aimed to investigate the causes and clinical presentation of obstructive jaundice in Saudi Arabian population. Methods: This study included 193 patients diagnosed with obstructive jaundice admitted to the surgical wards from January 2019 to December 2022. Methods involved comprehensive clinical evaluations, medical history reviews, physical examinations, laboratory tests, and diagnostic imaging to identify the underlying disease. Data were collected systematically and statistically analyzed. Results: The study included 193 patients with a male-to-female ratio of 1:1.4, and an average age of 54.10 years. Malignant causes, primarily carcinoma of the pancreatic head, accounted for 59.4% of cases, while benign causes, notably choledocholithiasis, accounted for 41.6%. Symptoms included jaundice, abdominal pain, and loss of appetite, with treatment varying according to the identified cause. Conclusions: The study highlights that obstructive jaundice is more commonly found in females and tends to be caused by benign conditions in younger people, while malignant causes are more prevalent in older individuals. The most common malignant cause is carcinoma of the pancreatic head, and leading benign cause is choledocholithiasis. For diagnosing obstructive jaundice, key imaging techniques include magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and computed tomography (CT).

Isolated splenic lymphangiomas are rare benign lesions mostly seen in children are exceptionally rare in adults, often discovered incidentally due to their typically asymptomatic nature. This case report elaborates on the surgical excision of a rare splenic cystic lymphangioma in a 33-year-old woman, underscoring the diagnostic and therapeutic challenges these tumors pose. The patient’s symptoms, abdominal pain and a palpable mass led to imaging through ultrasound and CT, which revealed a cystic splenic lesion. Total splenectomy was performed, revealing a large cystic mass, with pathological examination confirming a cystic lymphangioma. This case emphasizes the necessity of considering splenic lymphangiomas in adult patients presenting with splenic lesions. It also highlights the critical role of surgical interventions for definitive diagnosis and to prevent complications such as rupture and hemorrhage, thereby emphasizing on the complexity of managing rare splenic tumors.

Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease presenting beyond the neonatal period. Since its first comprehensive description by Étienne-Louis Fallot in 1888, the management of TOF has evolved remarkably – from a universally fatal condition to one with high survival and long-term quality of life. The introduction of the Blalock–Taussig shunt in 1944 provided the first effective surgical palliation by increasing pulmonary blood flow. In the 1950s, the development of cardiopulmonary bypass enabled complete intracardiac repair, which soon became the definitive treatment. Subsequent decades saw refinements in surgical technique, including the adoption of the transatrial-transpulmonary approach and pulmonary valve-sparing strategies, aimed at preserving right ventricular (RV) function. Early primary repair, now typically performed in infancy, has become the standard of care in most centers. Despite these advances, late complications such as pulmonary regurgitation, RV dilation, arrhythmias, and reinterventions remain common, necessitating lifelong follow-up. Contemporary management includes the use of multimodality imaging, transcatheter pulmonary valve replacement (TPVR), and tailored surgical planning. Emerging technologies such as artificial intelligence and computational modeling hold promise for further improving individualized care. This review outlines the historical milestones, current best practices, and future directions in the surgical treatment of TOF, highlighting its transformation from a fatal diagnosis to a survivable chronic condition requiring multidisciplinary, lifelong care.

Urachal cysts are rare congenital anomalies arising from incomplete obliteration of the urachus, an embryological connection between the bladder and umbilicus. This report describes a 33-year-old man who presented with acute abdominal pain, constipation, and umbilical discharge. Diagnostic imaging, particularly computed tomography scans, revealed a thick-walled, fluid-filled cystic lesion adjacent to the umbilicus, indicative of an infected urachal cyst without evidence of bowel involvement. Diagnosing urachal anomalies in adults remains challenging due to their rarity and nonspecific clinical presentation, emphasizing the importance of imaging for accurate identification and targeted surgical intervention. The patient underwent successful surgical excision with drainage of the associated umbilical sinus and abscess, achieving satisfactory postoperative recovery. This case highlights the necessity of clinician awareness and prompt management of urachal cysts to prevent serious complications, such as persistent infection, abscess formation, or malignant transformation.

Obesity is a growing global health crisis with wide-ranging effects beyond metabolic and cardiovascular disorders. A substantial body of international evidence has linked excess adiposity to increased risk for various cancers. In Saudi Arabia, where obesity rates are among the highest globally, the relationship between obesity and cancer remains insufficiently characterized. This narrative review synthesizes global and regional literature on obesity-associated cancers, with a specific focus on the epidemiologic and research landscape in Saudi Arabia. A targeted search of PubMed, Google Scholar, and official databases from the World Health Organization, International Agency for Research on Cancer, and GLOBOCAN was conducted for English-language articles published between 1990 and 2023. The review highlights several cancers – postmenopausal breast, colorectal, liver, endometrial, kidney, and pancreatic – with convincing or probable associations with obesity. Alarmingly, many of these cancers also rank among the most common and fatal malignancies in Saudi Arabia, as shown in GLOBOCAN 2022 data. However, local research quantifying this link is limited. National cancer registries lack obesity-related variables, and longitudinal cohort studies are scarce. These gaps hinder the ability to implement evidence-based, obesity-targeted cancer prevention strategies. Given the convergence of high obesity prevalence and rising incidence of obesity-related cancers, urgent attention is needed to integrate obesity metrics into national cancer surveillance. Strategic investments in population-based cohort studies and registry reform are essential to inform tailored public health interventions and reduce the burden of obesity-related cancers in the Kingdom.