Highlights A Mucocele appendix with wide base communicating with caecum is a rare presentation. Presentation is same as acute appendicitis. Pre-operative diagnosis even with the help of USG & CT is really a challenging issue. Diagnosis of wide base mucocele appendix (preoperatively/intraoperatively) changes whole course of surgical management.

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Ventral hernia is a fascial defect located on the abdominal wall. Primary ventral hernias are named as umbilical, epigastric, spigelian and lumbar hernias. A lumbar hernia is a parietal wall defect that may occur anywhere in the lumbar region between the 12th rib and the iliac crest. A 47-year-old female, came with complaints of mass in left lower abdomen since 2 months. On clinical examination a defect of 8 × 8 cm was felt in the left lumbar region with positive cough impulse. CECT abdomen and pelvis was done to confirm lumbar hernia. Patient underwent mesh repair for the same. Lumbar and flank hernias are uncommon and are a challenge to treat for any general surgeon. Surgery is considered gold standard either an open mesh repair or laparoscopically.

The accessory spleen is a congenital anomaly caused by a failure in embryologic development of spleen tissue with occurring in 10% of general population. In 16% of these cases, this tissue is found in tail of the pancreas. Here we present a case of 55 year old female who presented to our OPD with complaints of recurrent pain abdomen. CT showed a mass in the tail of pancreas with thrombosis of superior mesenteric artery. Patient underwent spleen sparing distal pancreatectomy with celiac axis to hepatic artery bypass and mass was sent for analysis. The pathological examination showed an intrapancreatic splenic tissue. As a rare ectopic location of spleen tissue and it should be considered in the differential diagnosis of pancreatic solid tumors. IPAS should be considered as a differential diagnosis in patients with suspected incidental pancreatic neuroendocrine tumour. Preoperative diagnosis is important as unnecessary surgery can be avoided.