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Introduction: An emergency laparotomy is a life saving procedure undertaken mostly in acute cases without much preparation of the patient. Despite being one of the most common urgent surgical procedures, it still proves to be a challenge for the surgeons of the world. Methods: This prospective study was carried out in 100 patients in Pt. B.D. Sharma PGIMS, Rohtak who underwent emergency laparotomy to evaluate different causes of laparotomy and the morbidity & mortality associated with it. Results: Emergency laparotomy was performed for a variety of conditions; majority were being of perforation peritonitis. Intestinal obstruction (25%), abdominal trauma (19%), burst appendix (5%) etc were others to follow. Post-operative fever (68%) was the most common complication followed by nausea& vomiting(56%),chest infection(38%), wound complications (33%) and paralytic ileus (26%)to name a few. Mortality in this study was 4%. Conclusions: Post-operative complications are more common after emergency laparotomies compared to elective laparotomies. Maximum complications were found in patients of delayed presentation or in patients having any associated co morbidities. Therefore early detection, immediate intervention with better postoperative care can minimise the postoperative complications .The present study suggests that proper awareness among rural populations, adequate health education to seek prompt medical aid, a good referral and effi cient transportation can reduce the delayed presentation which in turn will prevent postoperative complications following emergency laparotomy.

Introduction: Richter's hernia is a rare entity representing a small percentage of all hernia cases. These are small fascial defects that entrap partial circumference of the bowel and vary in presentation with associated increases in morbidity and mortality. Case Report: A 78-year male presented with Richter's hernia of the umbilical region which was diagnosed intra-operatively. The content was the ileal wall with pre-gangrenous changes. Because of doubtful viability resection of the segment and end-to-end anastomosis was done. The postoperative period was uneventful. Discussion: In female and old age patients, Richter's hernia is common with the femoral and inguinal regions being the common sites. The presentation may vary from vague pain abdomen and swelling to gangrene and perforation peritonitis. Some patients present as intestinal obstruction while in some cases the presentation mimics acute gastroenteritis. Radiological investigations like X-ray, ultrasonography (USG), and CT (computed tomography) scan aid in diagnosis but most of the time diagnosis is made intraoperatively. Surgical reduction or resection is often warranted depending on the viability of entrapped segment. Conclusion: To diagnose and manage this deceptive clinical entity experience and expertise is required. Timely taken decision and intervention helps to reduce morbidity and mortality associated with it

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