The term intussusception refers to invagination of a segment of the gastrointestinal tract into the lumen of an adjacent segment. This is a rare entity and it is more prevalent in children and less common in adults. The diagnosis of intussusception in adults is difficult as a result of the nonspecific signs and symptoms. As there are many common causes of acute abdomen, intussusception should be considered when more frequent etiologies have been ruled out. The laparoscopic approach offers both a diagnostic option and a therapeutic one for intussusception in adults. We report a forty-one year old male patient, who presented to our Emergency Department complaining of peri-umbilical pain associated with nausea and vomiting for 1 day. Diagnosed with transient small bowel intussusception without any obvious underlying pathology. This report is the first to present an intra-operative video showing the small bowel intussuscepting and reducing spontaneously. Furthermore, the authors present a review about this rare condition, including previously reported similar cases in literature. Transient intussusception is extremely rare and is a challenging condition. Imaging techniques, especially CT scan, are helpful in the diagnosis of intussusception. However, laparoscopy offers the advantage of distinguishing transient intussusception from persistent intussusception.

Obesity remains the strongest predictor of knee osteoarthritis (OA). Studies have reported improvement in knee pain and function post-bariatric surgery secondary to weight loss and reduced mechanical loading, yet others found increased rates of total knee arthroplasty (TKA) in that patient population. To address this controversy, our study aimed to further assess the effect of surgically induced, “rapid” weight loss on knee pain and function. Obese patients with chronic knee pain, who were undergoing bariatric surgery, were enrolled and surveyed preoperatively and 3 months postoperatively. Our outcome measures were knee pain and knee function, assessed by a knee injury and osteoarthritis outcome score (KOOS). The paired t test was used to compare pre- and postoperative KOOS scores. Pearson correlation coefficient was used to test the correlation between change in body mass index (BMI) with knee function, pain, and stiffness. A total of 30 patients was included in the study. The mean age was 35 years, with a mean preoperative BMI of 42.8. The mean difference in BMI at 3 months was 8.4 (SD3). There was a significant improvement in KOOS, − 23.2 (± 20) points, p < 0.01, most pronounced in knee function related to sport activities, with a difference of − 22.6 points, p < 0.01. Knee pain scores improved but did not reach statistical significance. Surgically induced rapid weight loss significantly improved knee function, particularly related to sports. However, there was no change in knee pain. This may be related to increased high-impact knee exercises and reduced lean mass. Tailored exercise programs for bariatric surgery patients postoperatively, may improve symptoms and decrease the need for knee replacements in the long term.

Aim: Obesity carries with itself an increased risk of psychological distress, depression and anxiety. Several studies have proven that the best modality of treatment for morbid obesity is bariatric surgery. However, the outcome of bariatric surgery on psychological health varies between individuals. Comprehensive perioperative mental health evaluation for patients seeking bariatric surgery is important, as psychiatric comorbidities could result in poor outcomes, and based on our knowledge, studies on psychiatric outcomes post bariatric surgery are limited in Saudi Arabia. This study is aimed at assessing the impact of bariatric surgery on developing depression and anxiety symptoms. Methods: Data for this cross-sectional study were collected from patients via an electronic self-administered questionnaire of both genders who underwent bariatric surgery during the period between July 2013 and July 2017 at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia. Results: The total number of the participants was 214, wherein 66 (30.8%) were males and 150 (69.2%) were females. Participants who underwent bariatric surgery ranged between 17 and 64 years of age with a median age of 36.69 years. With regards to preoperative assessment, we found that 95.8% of our sample did not visit a psychiatry clinic. The postoperative percentage of depression and anxiety among patients was 67 (31.3%) and 40 (18.7%), respectively. Using multivariate regression analysis, patients’ income was found to be significantly associated with anxiety, those who had higher income had less odds of being anxious compared to the group with low income (<3000 riyals) and this was statistically significant. Conclusion: Compared to general population, the post bariatric surgery prevalence of anxiety and depression is high. We recommend pre- and postoperative psychiatric assessment for all bariatric surgery patients in centers where this has not yet been implemented in the pre- and postoperative protocols.

Meckel's diverticulum is the most common congenital anomaly of the small intestine. Common complications related to Meckel's diverticulum include hemorrhage, intestinal obstruction and inflammation. Acute large bowel obstruction is a rare complication of Meckel's diverticulum and in the presented case it is caused by volvulus. We report a 39 year old female who presented with the diagnosis of a large bowel obstruction occurring as a result of cecal volvulus caused by adhesions of a perforated diverticulum. The reported case presents one of the rare complications of MD, which is volvulus. The case described above presented with signs and symptoms suggestive of acute intestinal obstruction and radiological findings suggestive of cecal volvulus. The patient was taken to the operation room for exploration and we discovered the presence of a perforated MD. The main treatment of such case is to perform diverticulectomy in all symptomatic patients. MD is mostly identified intraoperatively. Knowledge of the pathophysiologies by which MD can cause complications such as volvulus is important in order to plan management.