Intestinal adhesions are fibrotic bands of scar tissue that develop intra-abdominally due to serosal or peritoneal irritation caused during surgery or by severe infections. It may also occur congenitally. It can lead to serious complications such as small bowel obstruction, which is then termed adhesive small bowel obstruction. In this scenario, it can constrict the bowel wall and cause ischemia and necrosis of the affected intestinal segment. Computed tomography imaging may show characteristic signs, such as the "whirl sign" or "fat-bridging sign." Diagnostic laparoscopy or laparotomy can confirm the diagnosis and presence of adhesions. Management of this condition is either conservative or surgical, the latter of which is necessary in the case of intestinal strangulation. While the literature supports the laparoscopic method of adhesiolysis, practically, it may present technical difficulties. Surgeons should employ their clinical judgment in cases where an open procedure may be more beneficial. We present a case of this very occurrence and discuss the risk factors, pathogenesis, diagnostic evaluation, and, finally, the approaches to surgical management of this condition.

Urinary bladder injury is a rare complication of laparoscopic abdominal surgery. The incidence is low and usually goes unidentified with confusing presentation. We report a case of such injury during laparoscopic appendectomy that was identified on 3rd post-operative day and a small 1 cm tear was found at posterior wall of bladder which and was repaired. There was also a collection anterior to bladder which was drained separately under radiological guidance later as on table cystogram did not show any leak anterior to bladder. Patient also had covid pneumonia during stay and patients stay and recovery was prolonged. Attention must be paid to port insertion under vision especially low insertion of supra pubic port should be avoided with pre op catheterization and key to diagnosis of injury is awareness of this rare entity. Keyword: Laparoscopic Appendectomy; Bladder Injury; Uroperitonium