Background: Liver is a common site for Space occupying lesions. It is difficult to distinguish these entities with imaging criteria alone. Development in liver surgery and liver pathology have led to many new types of primary hepatic space-occupying lesions (PHSOLS) being surgically resected and pathologically diagnosed, which has greatly increased the surgicopathological spectrum of PHSOLS.Methods: A 2-year tertiary care teaching hospital based longitudinal study with 77 participants was done. Selection criteria was defined and a prestructured proforma was made to assess and note the findings.Results: The mean age of occurrence of space occupying lesions of liver was 45.49±13.45 years with a range of 24 to 70 years. Space occupying lesions of liver was commonly observed in 4th Decade of life. 64.93% pathology of Space Occupying Lesions of Liver occur in males. 76.62% patients of space occupying lesions of liver present with pain in right upper quadrant.Conclusions: Majority of space occupying lesions were surgically managed with a short-term follow-up of 1 month in which no complications were noted.

BACKGROUND AND AIMS: Many surgeons worldwide had challenging experience of facing an unexplainable and uncertain diagnosis or staging of abdominal malignancies. Laparoscopic visualisation techniques have improved dramatically and had led to reassessment of the laparoscope for use in the staging of intraabdominal malignancies. To evaluate place of preoperative laparoscopy as an additional tool to diagnose, assess staging and operability of intraabdominal tumors. SETTINGS AND DESIGN: A prospective observational case series. MATERIALS AND METHODS: Thirty five consecutive cases undergoing preoperative staging laparoscopy from December 2008 to September 2010 were reviewed in order to determine the value of laparoscopy as a staging tool. Indications for staging laparoscopy were predominantly hepatopancreaticobiliary (45%); however, other primaries such as stomach and colon were included. RESULTS: Unnecessary laparotomies prevented in 57.14% of cases. Metastatic spread detected by laparoscopy was in 40% of cases. The sensitivity and specificity of laparoscopy in Abdominal malignancies to detect resectable disease is 65.3% and 100% respectively. CONCLUSIONS: laparoscopy is a useful preoperative staging tool and can help avoid unnecessary laparotomy for abdominal malignancy in one-half of cases.

Perforative peritonitis is the most common surgical emergency in general surgical practice[2]. The Indian aetiological spectrum of perforation continues to differ from that of the Western world and there is the paucity of data regarding its aetiology, prognostic indicators, morbidity and mortality pattern. In the majority of cases, delayed presentation to the hospital occurs with well-established generalized peritonitis and varying degree of septicaemia. This descriptive cross-sectional study was conducted at Dr D. Y. Patil Medical College from 2017 to 2019 with a sample size of 30 patients. All details of the patients including clinical history, examination findings, laboratory and radiological investigations, intra-operative findings, and post-operative complications were studied. Perforation peritonitis had a male: female ratio of 3.29:1; and was more commonly seen between the age group of 21-30 years, whereas peptic ulcer perforation had a bimodal distribution (21-30 years and 51-60 years). Appendicular perforation was seen in the younger age group. Small bowel rd perforation commonly occured after 3 decade of life. Descending order of perforation sites: duodenum and stomach, appendix, ileum, jejunum, colon and gall bladder. Commonest aetiology was peptic ulcer perforation, followed by appendicitis and enteric fever. Majority of patients presented after 48 hours, in the stage of established generalised peritonitis. The diagnosis was possible by pneumoperitoneum on X-ray abdomen standing in 70% and only a few needed CT for diagnosis. Laparotomy followed by primary closure of perforation with or without live omental patch was the commonest procedure. Appendicectomy was done in appendicular perforation whereas occasionally, resection anastomosis of involved small bowel segment was required. Proximal diversion was not routinely necessary; only if there are severe contraindications to a primary RA. E. coli was the most common peritoneal contaminating organism followed by Klebsiella and Proteus mirabilis. The post-operative complication rate was 53.3% (wound infection 30%) and the mortality rate was 3.3%.

Background: The upper gastrointestinal tract is affected by a spectrum of conditions which span from infectious, idiopathic, inflammatory diseases, polyps, motility disorders and malignancy. Upper gastrointestinal scopy is believed to be the most effective screening modality as it not only allows direct visualization of oesophagus, gastric and duodenal mucosa but to perform biopsies in suspected malignancies. Aim: To evaluate persistent upper abdominal pain by upper gastrointestinal scopy.Methods: A total of 100 patients presented with complains of persistent upper abdominal pain were subjected to upper gastrointestinal scopy. Biopsies in indicated cases were taken from abnormal areas and sent for histopathology.Results: Most common finding in patients according to upper gastrointestinal scopy was gastritis (27%), followed by duodentitis (9%), and gastroduodenitis (7%). Rapid urease test in cases of gastritis and duodenitis to determine H. pylori infection were positive in 53.8% cases.Conclusions: Because of its precision and relatively safe technique upper GI endoscopy can be considered in patients above age of 50 years presenting to surgical OPD with complaints of persistent pain in upper abdomen. Investigating helicobacter pylori should be considered in all patients found to have gastric or duodenal lesions on upper GI endoscopy as its association with these lesions ranges from 50 to 80%.

Background: Liver abscess, a disease troubling mankind from ancient times, has earliest documentation in the Sanskrit document. Where right upper abdominal pain, have potentially lethal consequences, if prompt diagnosis and treatment are not accomplished. However, two major types are known, amoebic and pyogenic, in medical literature. Pyogenic liver abscess constitutes major bulk of hepatic abscess in western countries. The diagnosis is confirmed by ultrasonography, reddish brown (anchovy-paste like material) aspirate from abscess. The diagnosis, treatment and prognosis, of liver abscess have evolved remarkably over past few years. Imaging has improved diagnostic competence and has altered therapeutic strategy. The study aims at early clinical and  diagnosis on imaging of liver abscess, to set up some guide lines in view of conservative or either  intervention.Methods: The present study was hospital based longitudinal study, carried out in tertiary care teaching hospital from November 2013 to November 2015.  A total of 55 patients were enrolled in the study. All patients with suspicion of having liver abscess were confirmed on Imaging and included as present study population. Authors studied mainly presentation, role of conservative treatment, Aspiration, pigtail catheter, Outcome, and post procedural complications.Results: All patients presented with Pain right or left upper abdominal pain in abdomen, any chest complaints , majority of present study group patients had fever with or without rigors, deranged liver function. Imaging is the most diagnostic method, and also helped in therapy and follow up.Conclusions: Males are affected more than females, Imaging is the best modality for diagnosis, therapy and follow up. Aspiration or pigtail drainage is the standard method of drainage. Pigtail drainage is the better method of treatment than aspiration.