In pediatric age group, Intussusception is the most common cause of acute intestinal obstruction. They present with the classic clinical triad of colicky abdominal pain, vomiting and bloody stools. But clinically very few patients (20%) present with this classical symptoms. This article highlights an importance of suspecting intussusception by physician and rare presentations of intussusception lump in abdomen in a child with abdominal pain, gastrointestinal symptoms. Here a case reported of 16-year-old male child who presented with migrating lump in abdomen on and off with varied clinical presentation every time in single admission. Patient underwent laparotomy and manual reduction of intussusception was done. It is advisable to have high suspicion of intussusception while dealing with such cases.

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An anal fissure is a longitudinal ulcerated area in the vertical axis of the squamous lining of the anal canal between the anal verge and the dentate line, noted in 10–15% of proctological patients. Present study was aimed to study, acute fissure-in-ano in relation to clinical diagnosis and management at a tertiary hospital. Present study was hospital based prospective observational study, conducted in patients between 18-70 years of age ( including males & females ), with symptoms of pain on defecation, bright red bleeding, constipation (i.e. suspected cases of acute anal-fissure). Among 100 subjects, 47 % subjects were between aged 31-40 years. mean age of study subjects was 36.44 ± 3.2 years. Out of 100 patients,51% were males and 49% were females. Posterior fissure in ano was present in 90% of males and anterior fissure was present in 20% females. Also concomitant fissures were present in 6% females. 75% Patients (70% male and 80% female) were pain-free after 2 weeks of medical line of management. 84% Patients (84% males and females each) were pain-free after 4 weeks of medical line of management. 91% Patients (92% males and 90% females) were pain-free after 6 weeks of medical line of management. Out of 100 patients, 4% (males and females) undergone surgery (lateral internal sphincterotomy) after 8 weeks of medical line of management and relieved of symptoms. Acute fissure-in-ano, can be treated with medical (conservative) line of management, which is effective, cheaper and feasible way of treatment. Those who are still symptomatic can undergo surgery (lateral internal sphincterotomy).