Highlights Pneumoperitoneum secondary to ruptured gas containing pyogenic liver abscess is rare. Klebsiella is frequently associated with gas-forming abscesses. Ultrasound and CT are the mainstays of diagnostic modalities for hepatic abscess. Surgery is essential to drain the abscess and to clean the contaminated abdominal cavity for a ruptured abscess.

Highlights The primary treatment for stage III achalasia is esophagectomy which is an invasive procedure. Here a patient with stage III achalasia in whom a laparoscopic esophago-gastrostomy was successfully performed. Laparoscopic esophagogastrostomy is less invasive, less morbid and has less complications than esophagectomy. The evaluation of long term results of laparoscopic esophagogastrostomy helps to consider it as an effective minimally invasive procedure alternative to esophagectomy.

Cat scratch disease (CSD) is an infectious disease caused by infected cat when it scratches a person hard enough to break the surface of skin. Although it’s a rare disease, the frequency of disease is 1 in 10,000 people. Here we are presenting a case of CSD which was diagnosed with the help of HPE and confirmed by history of scratch from patient’s pet cat. The patient was successfully treated with antibiotic therapy without any complications. However, prognosis is generally good, negligence of disease may lead to serious complications. A correlation of detailed history with clinical presentation as well as high index of suspicion will aid in accurate diagnosis of CSD.

Incisional hernia is the second most common type of hernia. Incisional hernia occurs in 10-20% of patients who were subjected to abdominal surgery in India. Here we are presenting a case series of 20 patients with incisional hernia and obesity. Body mass index (BMI) ranges from 28 to 35 in all cases. Females outnumbered the male in the ratio of 4:1 and 40% of cases had a previous history of caesarean section. All cases were operated by combining open polypropylene meshplasty and abdominoplasty techniques and follow up consultations were done for 1 year. 10% of cases had post-op wound infections, who were known to be diabetic. They were managed with appropriate antibiotics and maintained strict glycemic control. 90% of patients were satisfied from the procedure performed which improved their quality of life, significant cosmetic outcome and no recurrence. 10% of cases had recurrence after heavy weight lifting following surgery (BMI was 36). By incorporating the above mentioned techniques in hernia repair, recurrence rate and complications were reduced, quality of life and aesthetic outcome are enhanced.