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Pulmonary hypertension is a known perioperative risk factor that carries a high morbidity and mortality rate. Severe pulmonary hypertension is related to high morbidity after general anaesthesia. We are reporting three patients with underlying severe pulmonary hypertension, who presented with intestinal obstruction managed with different perioperative approaches.

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Introduction: Neurogenic bowel dysfunction is a frequent consequence of spinal cord injury/disease (SCI/D). A colostomy is considered when conservative treatments fail [1, 2]. In the last year we observed several SCI/D persons with colostomy, admitted to our institution with multiple complications.

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Introduction: Few cases of intestinal obstruction after colostomy are caused by internal hernia. Some institutions perform stomas through the extraperitoneal route because some patients experience an internal hernia outside the stoma performed through the intraperitoneal route.

Presentation Of Case: A 72-year-old woman presented with a history of laparoscopic abdominoperineal resection (APR).

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Anastomotic leak is the most dreaded complication after anterior resection (AR). To do prophylactic diversion stoma or not is a matter of constant dilemma that most surgeons face. In such a situation, ghost stoma (GS) technique offers a middle path, wherein unnecessary prophylactic stomas can be avoided and at the same time ensuring that a diversion stoma can be created if need arises without the need of any major surgery or anaesthesia.

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Aim: A significant proportion of stoma patients develop a parastomal hernia (PSH), with reported rates varying widely from 5% to 50% due to heterogeneity in the definition and mode of diagnosis. PSHs are symptomatic in 75% of these patients, causing a significant impact on quality of life due to issues with appliance fitting, leakage, skin excoriation and pain. They can also lead to emergency presentations with strangulation and obstruction.

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