We present a case where the clinical manifestation of a duodenal perforation was masked by preeclampsia during the initial workup. A 22 year G2A1, 32 weeks pregnant female presented with symptoms of impending eclampsia and blood pressure of 190/120 mm Hg. Emergency cesarean section was done for failed induction. Subsequently, she developed subacute bacterial peritonitis leading to acute renal failure and disseminated intravascular coagulation. On post-operative day 4, the abdominal wound dressing was stained with greenish yellow discharge when the possibility of a perforated viscus was made. Laparotomy was done on day 6 and a perforation was seen on the anterior part of duodenum. Being vigilant to make an early diagnosis and intervention can reduce the maternal morbidity and mortality associated with duodenal perforation which is a rare occurrence during pregnancy.

Background: Polycystic ovarian syndrome (PCOS) is associated with dyslipidaemia and may render the affected women "at risk" of developing cardiovascular disease. Lipoprotein(a) [Lp(a)] is an independent risk factor for development of atherosclerosis and along with dyslipidaemia may add to cardiovascular risk. In this background the levels of Lp(a) and lipid profile are assessed in PCOS patients. Material and Methods: The study was carried out on 30 newly diagnosed PCOS subjects aged 18-35 years and 30 age-matched healthy women. Blood samples were collected in a fasting state and serum Lp(a), lipid parameters were estimated. Results: The lipid profile parameters were comparable between patients and control subjects. There was no statistically significant difference in the median [interquartile range (IQR)] Lp(a) levels between patients with PCOS and normal controls. However, the proportion of subjects with elevated (> 30 mg/dL) Lp(a) levels were significantly higher in patients with PCOS compared to control subjects. Conclusion: Elevated Lp(a) levels may contribute for development of atherosclerosis and increased cardiovascular risk in PCOS patients.