Background: One of the most frequent causes of a Massive hemothorax, which refers to a buildup of blood in the pleural area, is either blunt or penetrating injury to the chest wall. In the USA, the majority (70-80%) of cases of hemothorax occur as a result of accidents involving motor vehicles that inflict harm on structures in the mediastinum such as the heart, vessels of major importance, thoracic spine, mammary or intercostal arteries, the diaphragm, or the lung tissue. Case Description: A 16-year-old teenager arrived to the Emergency Room (ER) with stab wound on the left side of the chest caused by a scissor. The patient presented with chest pain, breathlessness and hypoxia. A general surgeon performed emergency management by inserting a chest tube due to the significant left hemothorax. The patient's respiratory problem necessitated the immediate insertion of a chest tube in order to assess future treatment needs. Because the patient was hemodynamically unstable, resuscitation was performed immediately and we then performed a chest X-ray. We did not perform a CT scan of the thorax because the patient's hemodynamics were unstable. The thoracic and vascular surgeon performed an emergency posterolateral thoracotomy to address and stopped the bleeding from the intercostal artery. The patient had been discharged from the hospital seven days after surgery with no complications and stable hemodynamics. A week later, the patient visited the outpatient department for follow-up. Conclusion: The initial step for an emergency physician in treating a hemothorax is to diagnose the condition with imaging techniques like a chest x-ray, ultrasound, or CT scan of the thorax. When dealing with hemothoraces, a chest tube should be inserted to prevent the development of empyemas and fibrothorax. Massive hemothoraces require a thoracotomy, consultation with a trauma surgeon and volume resuscitation. The key to reducing morbidity and mortality from hemothoraces is prompt diagnosis and treatment. Additional testing is required to determine if the aesthetic and motor functions of the left hand joint space are impaired.

Background: Nipple-sparing mastectomies (NSMs) are a relatively new method of conservatism in the treatment of breast cancer. Most of the breast skin is left intact during NSM, creating a pocket that can be filled with an implant or an autologous graft for a rapid reconstruction that yields an excellent cosmetic outcome. Combining prosthetic-based breast restoration with autologous flaps, such the latissimus dorsi (LD) flap, may be necessary to achieve symmetry. Case Description : A 45 year old woman who developed a breast deformity following a mastectomy for breast cancer. The Latissimus dorsi (LD) flap was chosen because it is a thin layer flap with good vascularization. The Latissimus dorsi (LD) flap, on the other hand, necessitates a different skin incision than the mastectomy. An inframammary adipofascial flap has been used as an autologous flap in conjunction with prosthetic-based breast reconstruction subsequent to nipple-sparing mastectomy (NSM). In this instance, the Latissimus dorsi muscle flap was employed in the axillary and breast regions. The Latissimus dorsi (LD) flap was deemed suitable as it can provide extensive coverage without any delay in the transfer procedure. Anatomically, this flap and its vascular supply are quite consistent. The arterial supply is provided by the thoraco-dorsal artery which provides a large branch to the serratus anterior muscle and provides a cutaneous branch. Successful management of the infection, postoperative partial weight bearing, and restricted range of motion in the affected breast was anticipated. Conclusion: The latissimus dorsi flap is a safe choice for skin regeneration after a nipple sparing mastectomy. This procedure has the advantage of minimizing donor site morbidity.

Background: A congenital mesenteric defect is very rare, but can potentially cause internal hernia with consequent incarceration or strangulation of the small intestine. The incidence of mesenteric hernia, as reported by Shaffner and Tennel [1] in a series of autopsies, was found to be 0.2 to 0.9% [2]. Patient's medical examination revealed the presence of internal hernias. Difficulty in reaching a definitive diagnosis due to non-specific clinical and imaging findings often cause life-threatening bowel ischemia.  Case Presentation: A 14-year-old girl, without any remarkable antecedent history, presented to the hospital with progressive abdominal pain in epigastric region, nauseous, and bilious vomiting occurring three days before admission. Clinical examination abdominal findings were distension with decreased bowel sounds and pain in deep palpation in epigastrium region. Discussion: The mesenteric defect is located 22 cm from the ligament of Treitz. Her intestinal obstruction and strangulation were so complex that resection required incision of the mesenterium. Her intestinal obstruction and strangulation were so complex that resection required incision of the mesenterium. Thus we proceeded with reduction of the bowel, small bowel untwisting, and closure of the mesenteric defect followed by primary anastomosis. Conclusion: Internal hernia is one of the rare causes of small bowel obstruction. Treatment involves repositioning of the intestinal loops at all times and prudent closure of the peritoneal orifice in question. Early intervention and surgical correction goes a long way in preventing high morbidity and mortality associated with cases of internal hernia.