Umbolith is a relatively rare entity under normal circumstances, especially in the urban scenario. Usually seen in obese individuals with a deep and retracted umbilicus due to constant accumulation of sebum/keratin leading to stone formation. It’s usually covert until complicated by secondary infection (abscess) or ulceration. Sinus was laid open and healthy granulation was seen within 1st week. Pus culture sensitivity suggestive of heavy staph growth and antibiotics were given accordingly. Appendicitis was treated conservatively.

Spindle cell sarcoma is a rare tumor that arises most commonly from the peripheral and deep soft tissues. It usually occurs in the extremities but rarely present as a large abdominal mass, and in this case it was a recurrent tumor involving whole of rectus muscle on right side. We report the case of a 42 year old male who presented with abdominal swelling and distention. CT scan showed a mass occupying the whole of the abdomen and pelvis. Exploration of abdomen revealed a hard mass about 13×10×11 cm in size. Complete excision was done, the huge defect was closed by transposition of left side rectus abdominus muscle with prolene mesh, which was a challenging task in this case. On histopathology and immunochemistry a high grade spindle cell carcinoma was confirmed.

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A 40 year old female was referred for acute renal failure. Her chief complaints were oliguria and distension of abdomen with lower abdominal pain of three days. In the past, this patient had renal tuberculosis with right sided pyelonephritis (Positive TB polymerase chain reaction qualitative test on urine sample by DNA amplification for Mycobacterium Tuberculosis Complex, MTC ) and right sided hydronephrosis with placement of a double J stent and had taken antituberculosis medication for 6 months. The stent was removed 3 months later. On general examination she was anaemic, her abdomen was distended with flank fullness and there was a fluid thrill. Haematological investigation revealed a haemoglobin of 5.3 g/dl, serum urea-90 mg/dl, and serum creatinine-4.5 mg/dl. She had normal liver biochemistry tests and normal serum electrolytes and carbohydrate antigen (CA-125) was 29.38 U/ml (Normal-0.0-35 U/ml). Urine analysis showed pyuria and bacteriuria and ascitic fluid analysis showed 95% lymphocytosis, however, urine and ascitic fluid were negative for acid fast bacilli. An ultrasound examination showed moderate to gross ascites, gross right hydronephrosis and a thin right renal cortex with mild compensatory hypertrophy of the left kidney, and right adnexal cysts. The urinary bladder was catheterized on admission and treatment commenced for renal tuberculosis with acute renal failure. Gradually her urine output improved to about 2000ml per day. After satisfactory recovery and reduction in her abdominal girth, her urinary catheter was removed. However, in the ensuing days she developed ascitis which required repeated paracentesis. Since no definitive cause of ascitis could be ascertained a