Gallstones are very common. However, giant gallstones are extremely rare and only few cases are reported in literature. Giant gallstones oppose the patient to a high risk of complications. We hereby report a case of a giant gallstone measuring 6 cm. A 63-years-old obese female, known to have hypertension and diabetes, was admitted electively for laparoscopic cholecystectomy and laparoscopic incisional hernia repair with mesh. The patient was set for surgery and the gallstone (measuring 6 cm) was successfully managed by laparoscopic cholecystectomy. Giant gallstones measuring ˃5 cm in diameter, although rare, can oppose the patient to high risk of complications. We hereby report a case of a giant gallstone measuring 6 cm that was managed successfully by laparoscopic cholecystectomy.

Background: The acute care surgery (ACS) model employs a 24/7 multidisciplinary team—surgeons, nurses, and residents—supported by an electronic consultation system to optimize emergency The acute care surgery (ACS) model provides 24/7 multidisciplinary management of emergency surgical patients. This study aimed to describe the demographic and clinical characteristics of patients admitted from the emergency department (ED) under general surgery, identify the most common presenting complaints and operative procedures, and determine which general surgery subspecialties were most frequently consulted at King Abdulaziz Medical City (KAMC). Methods: We conducted a retrospective study at KAMC, Riyadh (MNGHA), from September 2022 to November 2023. A total of 384 ED patients admitted under general surgery were included. Data were extracted from the BestCare electronic medical record and analyzed for demographics, presenting complaints, operative procedures, and subspecialty consultations. Results: Of 384 patients, 204 (53.1%) were male and 180 (46.9%) were female. The largest age group was 30–45 years (n = 112, 29.2%), followed by <30 years (n = 98, 25.5%). Leading presenting complaints were abdominal pain (n = 243, 63.3%), fever with nausea/vomiting (n = 68, 17.7%), and rectal pain/bleeding (n = 44, 11.5%). Laparoscopic cholecystectomy was the most common procedure (n = 123, 32.0%), followed by laparoscopic appendectomy (n = 57, 14.8%). ACS received most consultations (n = 231, 61.8%), with additional referrals to colorectal surgery (n = 86, 23.0%) and upper gastrointestinal surgery (n = 40, 10.7%). Nearly all consult requests originated in the ED (n = 355, 98.9%). Conclusions: Abdominal pain was the predominant ED complaint prompting surgical referral, and laparoscopic cholecystectomy and appendectomy were the most frequently performed procedures. ACS was the primary subspecialty consulted, underscoring its central role in emergency surgical care at KAMC.

Background/Objectives: Mesh repair reduces hernia recurrence compared with suture repair, but permanent synthetic meshes are associated with chronic foreign-body complications. Biosynthetic poly-4-hydroxybutyrate mesh (Phasix™) provides temporary reinforcement with gradual resorption; however, short-term real-world outcomes across different hernia types remain limited. This study evaluated short-term outcomes after Phasix™ hernia repair and identified factors associated with baseline recurrent hernia at presentation. Methods: This retrospective cohort included patients ≥ 16 years who underwent open or laparoscopic hernia repair with Phasix™ at King Abdulaziz Medical City (2020–2023). Patients receiving other mesh types were excluded. Demographic, operative, and postoperative data were analyzed. Multivariable logistic regression identified factors associated with baseline recurrent hernia. Results: Among the 228 patients (51.8% female; mean age 55 years), hernia types were incisional (36.0%), paraumbilical (26.3%), and inguinal (24.6%). Early complications were uncommon: seroma in 2.2% and surgical site infection in 1.8% at 1 month. One-year recurrence occurred in 1.3% (3/228). Female sex, prior incisional hernia repair, previous mesh removal, and open repair independently predicted baseline recurrent hernia, while laparoscopic repair was protective. Conclusions: Phasix™ repair demonstrated low short-term complication rates and rare 1-year recurrence across ventral and inguinal hernias. Short-term outcomes were driven mainly by patient and procedural factors rather than mesh-specific effects.