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Uterine perforation is an uncommon, perforation due to clostridium perfringens is very rare, but potentially serious complication of uterine gangrene is due to clostridial infection, uterine manipulation, evacuation of retained products, termination of pregnancy, during coil insertion and hysteroscopic procedures. We report a 60 year old female patient presented with abdominal pain, constipation and Fever with features of septic shock. X-ray showed free gas under both domes of diaphragm. CT showed gas under diaphragm and hollow viscus perforation. This report aims to alert surgeons to the possibility that perforation of uterus due to gangrene with clostridium perfringens infection also shows air under diaphragm apart from routine causes. Correct diagnosis and treatment is essential for the survival of the patients with gas under diaphragm due to gas gangrene of uterus.

Background: This study describes the concurrence of ventral hernia, cholelithiasis and uterine fibroid in females and ventral hernia, cholelithiasis and benign prostatic hypertrophy in males.Methods: This is a prospective observational study of 100 patients of ventral hernia, cholelithiasis and uterine fibroid in females and ventral hernia, cholelithiasis and benign prostatic hypertrophy in males.Results: In this study, ventral hernia, cholelithiasis and uterine fibroid in females and ventral hernia, cholelithiasis and benign prostatic hypertrophy in males were observed.Conclusions: This is to specify the presence of more than one symptom in a patient may suggest presence of multiple diseases.

RIF pain is a hall mark of acute appendicitis until proven otherwise decision making in a case of acute appendicitis may be difficult for junior surgeons hence we aimed at analysis in RIF pain. Out of 120 cases we found 3 rare entities they are PMP, CT of appendix and perforated appendix in LIF. Pseudomyxomaperinei and carcinoid tumour are rare presentations. Despite the current standard of treatment modalities as extensive surgical resection combined with chemotherapy, PMP and CT frequently recurs with treatment options being limited at recurrence and with severe impact on quality of life. Perforated appendix in LIF is also a rare presentation which needs appendicectomy, perforation closer with omental patch.

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