Perforation peritonitis is an important cause of generalized peritonitis and pneumoperitoneum. Large bowel perforation due to swallowed artificial denture is extremely rare. Foreign body can be ingested accidentally or in a suicidal attempt. However, ingested foreign body causing sigmoid colon perforation is extremely rare. Complications caused by ingestion of foreign body in gastrointestinal tract include obstruction, perforation, bleeding, or impaction at the sites of physiological narrowing or acute angulation in gastrointestinal tract. We hereby report a case of sigmoid colon perforation due to swallowed partial denture.

Eumycetoma (“mycotic mycetoma”) is a chronic subcutaneous fungal infection of the skin and soft tissue, most often affecting the lower extremity (typically a single foot). Eumycetomas are usually confined to subcutaneous tissues but can involve fascia, bone, and regional lymph nodes via contiguous dissemination. We hereby report a case mycetoma of gluteal region, an unusual site of presentation.

Background: Chest trauma (or thoracic trauma) is a serious injury of the chest. Thoracic injuries may present extremely dramatic clinical problem that demand rapid diagnosis, decision making and aggressive management. Thoracic injuries can range from simple single rib fracture to major thoracic vessel injury and pulmonary contusion.Objective of this study was to describe the clinical characteristics and risk factors of thoracic trauma patients, and to evaluate their relationship in the development of complications with special emphasis to surgical emphysema.Methods: Descriptive, prospective and analytical study of a cohort of patients with thoracic trauma who were followed up for a period of 30 days. Excluded from the study were those patients with moderate to severe cranio-encephalic trauma, long bone fractures, abdominal trauma, and patients who required mechanical ventilation.Results: A total of 102 patients met the inclusion criteria out of which 90(88.23%)patients were male and 12(11.77%) female with male to female ratio of 7.5:1. Patients having surgical emphysema were all male 21(21.56%). Most common mode of the injury seen was road traffic accidents in 80 (80.95%) patients, followed by assault in 9(9.52%) patients, bull horn injury and fall from height in 4(4.76%) patients. Other chest injury which was most commonly associated with surgical emphysema was haemothorax in 11(52.38%) patients, followed by pneumothorax in 7(33.33%) patients, pulmonary contusion in 6(28.57%) patients and flail chest in 3(14.26%) patients. The risk of complications increases significantly in patients with more than 2 rib fractures, in older patients and in the presence of some comorbidities such as COPD and pathologies that require anticoagulation. The risk of re-admittance is greater in patients older than 60 years.Conclusions: Patients with thoracic trauma who present with co-morbidities, are older than 60 years and have more than 2 ribs fractures may present with more complications. These factors should be contemplated in the evaluation, management and follow-up of these subjects.

Background: Intestinal obstruction is one of the most common diseases in abdominal surgery. It can slowly lead to changes in intestinal structure and function, and in extreme cases it can be life-threatening. CT allows imaging of the abdominal contents outside the lumen, because of this advantage, the nature and site of the obstruction, especially extraluminal or intramural process, can be established.Methods: Prospective Hospital Based study. From January 2016 to November 2016 (11 months). 50 Patients presenting to Department of Surgery, whether in OPD or Emergency, with complaints suggestive of intestinal obstruction with in study duration eligible as per inclusion criteria will be included in the study.Results: In present study Majority (52.0%) of study population belonged to 41-60 years age group. The most common symptom was pain abdomen (94%). Majority (66%) patients showed multiple air fluid level on X-ray. In CT imaging, maximum 36% presented with dilated bowel loops. 86% were diagnosed as sub-acute intestinal obstruction, in USG. In present study, 60% patients were treated by surgery. Majority of patients (86.67%) CT findings matched with perop/ intraoperative findings. Accurate CT findings were helpful in guiding patient management. In our study, CT had the sensitivity of 86.67%, Specificity75%.Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical and imaging factors to help stratify patients into conservative or surgical treatment.

Background: Liver abscess is an uncommon entity and over past 100 years dramatic changes in demographics, etiology, diagnosis and treatment occurred. The purpose of this study was to determine the clinico-etiological demographic profile of liver abscess by using radiological studies and to evaluate the outcome associated with different treatment strategies.Methods: A prospective study was conducted over a cohort of 50 patients presenting with liver abscess. Patients diagnosed with malaria, enteric fever, pyrexia of unknown origin, acute viral hepatitis, chronic liver diseases, or hepatomegaly due to any cause, were excluded from study. Results: The amebic liver abscess was found in 32 patients and pyogenic abscess in 18 patients. The age group ranges from 16 to 78 years with mean age of 38 years and the peak incidence is found in the 31-40 years age group for both types. The M: F ratio is 7:2 in pyogenic liver abscess and 13:3 in amebic. In the present study, the most common symptoms in both types of liver abscess were pain abdomen, loss of weight, anorexia, chills and rigor, vomiting and cough. The most common signs seen in both type liver abscess were tenderness, hepatomegaly and jaundice. In both types liver abscess, right lobe was affected more commonly, and single abscess was more common. Hb <10 gm % is present in more than 50 % cases in both liver abscesses. The right dome of diaphragm elevation present in 75%-89% in both types of liver abscess. In pyogenic liver abscess group, patient had associated intra-abdominal infections. In amebic liver abscess group associated illness was not seen. Antibiotics alone used for small multiple abscesses and antibiotics with needle aspiration done for large abscess, are the main line of treatment in this series. Mortality was nil in present series.Conclusions: Liver abscesses are more common in males, alcoholics and immune-compromised patients. Percutaneous drainage with antibiotics treat majority of cases. The mortality from liver abscess has decreased but incidence appears to be increasing.