Background: Acute appendicitis is a common cause of abdominal pain for which a prompt diagnosis is rewarded by a marked decrease in morbidity and mortality. Right Iliac fossa pain is the hallmark of acute appendicitis until proven otherwise. Decision making in a case of acute appendicitis may be difficult, especially for junior surgeons. Hence, we aimed at analysing the Alvarado Score in patients with right iliac fossa pain.Methods: A prospective study involving 120 patients with right iliac fossa pain attending KIMS casualty during May 2015- April 2016 were included in the study. Results: The least was in the age group of 56 to 65 years (2%). Out of 120 patients, 84 were males (70%) and 36 were female (30%). The male to female ratio was 1:0.4. Patients with Alvarado score 7-9 (Group I) includes 60 male and 26 females (71% of total study group). Alvarado score 5-6 (Group II) includes 17 males,19 female (22% of total study group). Alvarado score 1-4 (Group III) includes 7 males, and 1 female (7% of total study group). In patients of Group I, among 60 males, 51 were confirmed with acute appendicitis. Among 26 females, 19 were confirmed with acute appendicitis, with a positive appendicectomy rate of 81.3% and negative appendicectomy rate 19.7%. The numbers of patients were highest in the age group 15 to 25 years (38%) followed by 36 to 45 years (30%).Conclusions: The Modified Alvarado scoring system was found to be highly effective in the diagnosis of the acute appendicitis in men and can be widely used to avoid expensive time consuming and non-readily available additional investigations. However, this system was not very effective in women. Therefore, ultra sound examination of abdomen and pelvis and diagnostic laparoscopy are also advised to minimize the high false negative rate in women which excludes common pelvic pathology that mimic clinically acute appendicitis.

Introduction: The pseudocysts present clinically as epigastric pain, abdominal masses to jaundice. Radiology helps in the diagnosis of the pseudocysts with the help of USG, CT scan, MRI, etc. These investigations govern the therapeutic procedures to be carried out. Aims and objectives: To understand the epidemiology of pancreatic pseudocysts. To analyze the various treatment modalities that can be utilized in the management of the pancreatic pseudocysts. To compare USG guided per-cutaneous aspiration with the other treatment options available in terms of patient and physician factors. Materials and methods: Data was collected from patients who came to Konaseema Institute of Medical Sciences & Research Institute for treatment. Patients diagnosed as pseudopancreatic cyst with help of diagnostic procedure like USG abdomen, Barium meal, if required CT scan Abdomen and admitted patients of both sex and all age groups were included in the study. Results: Commonest treatment was Internal drainage in 50% of the patients followed by conservative management in 36.66% of patients, external catheter drainage was done in 13.33% of the patients. Immediate postoperative pain was present in 16.66% of patients and wound infection in 13.3%. Conclusion: Acute Pancreatic pseudocysts were treated conservatively, infected cysts and ruptured cyst required external drainage.

A 35 years old female presented to casualty with complaints of pain abdomen and vomiting since 3 days. The pain is non radiating type with associated abdominal distension. There is no blood or bike in the vomitus. She has undergone mitral valve replacement 1 month 15 days back and was on prophylactic warfarin medication. On examination vitals were unstable with pallor present and cold extremities. On physical examination. On physical examination: abdominal distension+ guarding+ diffuse tenderness over abdomen+. On USG Abdomen gross collection of blood in the peritoneal cavity. Patient immediately stabilised with 8 units of PRBC. On abdominal laparotomy, active bleeding from right ovarian cyst was observed. Right oophorectomy with peritoneal lavage was done. Hemostasis secured. Postoperative period was uneventful with good post op recovery.

Retroperitoneal sarcoma(RPS) accounts for 15% of all sarcomas commonly presenting as abdominal mass(90%), weightloss (20%),neurologic (20%), urinary (10%),pain &discomfort, bowel obstruction, para neoplastic syndrome(hypoglycemia).70% presents with tumour more than 20cm & 20% present with metastasis. Liposarcoma is the most common retroperitoneal sarcoma. It can be well differentiated, dedifferentiated, myxoid, round cell and pleomorphic type.

Introduction: Surgical infection, particularly surgical site infection (SSI), has always been a major complication of surgery and trauma. For microbial culture and sensitivity of close cavities like blood cultures and sterile body fluids like CSF, peritoneal fluid BACTEC (Becton Dickinson Microbiology system) test is most appropriate for microbial culture and antibiotic sensitivity. Aims and objectives: Culture and sensitivity of intraoperative peritoneal irrigation fluid for prediction of post operative complication in elective and emergency abdominal surgeries. Materials and methods: This observational study was conducted for every elective and emergency abdominal surgeries for the patients attending KIMS and RF, Amalapuram, during the years from December 2016 to October 2018, For the prediction of post operative complications in elective and abdominal surgeries, the patients are divided into cases and controls, cases and controls are taken in the ratio of 1:1. Results: In case group 18 had clean contaminated, 19 had contaminated and 13 had dirty type of surgery. 1 each in clean contaminated and contaminated and 4 had complications in dirty. 33 had emergency and 17 had elective surgical procedures. Conclusion: the conclusion of this study states that there is a significant benefit in terms of prediction, prevention and timely management of post operative complications among those abdominal surgical cases.