Surgical emphysema, also widely known as subcutaneous emphysema, is defined as a clinical state in which air gets trapped subcutaneously. The etiology may be traumatic or atraumatic, and multiple causes in each are present. Case report. A 63-year-old female patient presented to the emergency room with a facial soft tissue injury following road traffic accident and developed surgical emphysema later on with no evidence of rib fractures or pneumothorax. Infectious etiology was ruled out. Due to the respiratory embarrassment, the patient was electively intubated. Conservative management was provided. Emphysema resolved within 24 hours after the accident. Discussion. Various theories have been outlined in literature, like Mackler effect, Crampton theory and ballvalve mechanism. In our case, it was difficult to apply any of these theories to confirm the diagnosis. Conservative management is still used in the treatment of surgical emphysema. Conclusion. Surgical emphysema is a common encounter in trauma practice, and its identification is essential to rule out any emergency causes which may lead to respiratory distress.

Amyand’s hernia is a rare finding of the appendix inside an inguinal hernia sac. Most cases are found intra-operatively during inguinal hernia repair. It is extremely rare and occurs in 1 percent of all inguinal hernias with an estimated rate of 0.07-0.13 percent having associated acute appendicitis. A 60 year old male presented to the hospital with chief complaint of swelling in bilateral inguinal region more on the right side since 6 months associated with chronic cough since 1 month and difficulty in passing urine since 6 months. Patient was taken up for elective right side hernioplasty after taking physicians and pulmonologist opinion for fitness for surgery and urologist opinion for grade II prostatomegaly. Intra operatively indirect hernia sac medial to inferior epigastric artery with appendix as content and hydrocele around 15 ml. The contents were reduced back inside the peritoneal cavity and Lichenstein tension free hernioplasty was performed. Amyand’s hernia widely varies in its presentation, can occur at any age and typically presents in men. The surgical management of Amyand’s hernia includes appendectomy with repair of inguinal hernia through inguinal incision. Amyand’s hernia being an unusual presentation, helps the surgeons to be prepared for such circumstances and do appropriate management.