Background: Incidence of perforation on posterior wall of stomach is rare throughout world; its occurrence has not been found till now in literature of central India. diffuse symptoms with delayed presentation to health center and poorly skilled faculty with facilities make a way to raise in total number of deaths associated with posterior gastric perforation. Objective: To report a rare case of posterior gastric perforation at a tertiary health care center in Central India, which would be first to be documented. Case Presentation: A 74-year-old male patient was referred to Department of General Surgery, AVBRH, with chief complaint of acute abdominal pain for two days. He had a history of alcohol consumtion which was stopped 2 years back A moderately distended, distinctly tender abdomen accompanied by guarding, rigidity and excluded bowel sounds was unveiled by abdominal examination. Patient has been resuscitated with intravenous fluids, antibiotics and analgesics. Consequently, an emergency exploratory laparotomy revealed a significant collection of purulent peritoneal fluid, 1x1 cm sized perforation on posterior wall of stomach. Perforation was repaired and thus patient recovered in a satisfactory way. Conclusion: And since posterior gastric perforation is extremely uncommon and expected to worsen, associated with increased morbidity and mortality leading to missed presence, this case report indicates that evaluation of patients with gastric perforation, identify risk factors and ability to repair perforations right away along with resuscitation will greatly enhance clinical outcome.

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Background: Acute appendicitis is amongst the most encountered emergencies seen in casualties requiring intervention. The incidence of negative laparotomy is 15% to 25% and is associated with notable morbidity. Scoring systems are useful and logical for distinguishing acute appendicitis from non-specific abdominal pain. Presently many scoring systems exist that aids in the diagnosis of acute appendicitis but still fail to decrease the rates of wrong diagnosis and the negative appendicectomy rate. This comparative study has been undertaken to evaluate and compare the efficacy of the Tzanakis scoring system with the relatively newer Yash scoring system which has been found more effective for the Indian population in diagnosing acute appendicitis. Aim:To compare the efficacy of the Yash scoring system with the Tzanakis scoring system in diagnosing acute appendicitis. Method and Material:A prospective comparison of the Tzanakis scoring system and Yash scoring system was done on 50 patients. The decision of an appendicectomy was taken by the consultant surgeon. The outcomes of the Tzanakis scoring system and Yash scoring system in terms of sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were calculated and compared.

Meckel's diverticulum (MD) is among the many known congenital malformations of intestine. It is seen in approximately 2% of the population. Desmoid tumors are unusual. They are unique, well-differentiated, and fast-growing musculoaponeurotic fibromatosis tumors, contemplated as Grade 1 fibro sarcoma. They offer exclusive management challenges to surgeons. The most common presentation of desmoid tumors is of painless masses with sluggish growth. Rarely, they may present as intestinal obstruction leading to surgical emergency. We present the only case in history till date along with review of the relevant literature of a 65-year-old gentleman who presented to us with features of intestinal obstruction who successfully underwent elective segmental resection of ileum containing MD with its desmoid tumor. A multimodality approach is needed to tackle such kind of diseases with a team comprising oncosurgeons, oncophysicians, and radiation oncologist to design a standard treatment protocol.