Context: A total lockdown was announced in India from March 25 to May 31 in four phases in response to the COVID-19 pandemic. This study aimed to study the impact of this national lockdown on the volume and the nature of injuries in patients admitted during this period at a major trauma center in central India. Methods: This is a retrospective descriptive study of prospectively collected data which were collected from the hospital records. Patients admitted to the trauma center during lockdown were compared to patients admitted in the prelockdown period for the change in volume and spectrum and severity of injuries across all age groups and both genders. Results: There was a significant fall in the overall number of trauma patients across all age groups and both genders during the lockdown period (66.8%). There was a significant decrease in numbers among males (68.1%). Road traffic accidents decreased by 75.2%. There was a relative increase in trauma due to falls and assault during the lockdown period. The mortality due to trauma decreased significantly by 79.8%. Conclusions: There has been an overall decrease in the number of patients admitted to the trauma center during the lockdown period. However, there is a relative increase in preventable injuries such as falls, assault, and animal-related injuries. Focused strategies to decrease preventable injuries need to be devised to reduce the load on overburdened resources during the COVID-19 crisis.

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Large incisional hernias are difficult to treat surgically because of the post-operative respiratory complications and abdominal compartment syndrome. Pre-operative progressive pneumoperitoneum is a technique which has been used in such cases. We describe a case of a large incisional hernia, where this technique was employed by objectively calculating abdominal and hernial sac volumes on the basis of computerized tomography scan of abdomen with a satisfactory outcome. A review of literature and issues involved in pre-operative progressive pneumoperitoneum have been discussed.

A rare case of a five-year-old boy who sustained closed abdominal trauma with rectal tear and evisceration of ileum and sigmoid colon per anum, is presented. He was managed successfully with resection anastomosis of ileum and sigmoid colostomy, which was closed subsequently. The relevant literature is also reviewed.

Gossypiboma or a retained surgical sponge is a rare but avoidable surgical complication. It leads to considerable morbidity and at times even mortality. We report a case of a 24-year-old lady who presented one month after a Caesarean operation with complaints of fever, pain in abdomen, and vomiting. After the clinical examination a possibility of a retained surgical sponge was entertained. However a CT scan of abdomen revealed the complete diagnosis and helped in treating the patient surgically with a successful outcome. A review of the literature and all the relevant issues in the management of such a case have been discussed.