The diaphragmatic surface of the liver is normally smooth but may be grooved occasionally. Such grooves could be 'cough furrows' or due to a 'corset liver'. Accessory sulci have also been described and may confuse the inexperienced surgeon. We describe one such case of an accessory sulcus found incidentally at laparotomy.

BACKGROUNDGroin hernia is one of the most common surgical problems in male. Its treatment is always surgical if not contraindicated otherwise. For many years, inguinal hernia surgery has been carried out under general or spinal anaesthesia. But in recent years more and more emphasis is given on repair under local anaesthesia even when GA or SA is contraindicated. It is cost effective, only fear of intraoperative pain hinders its widespread use.

BACKGROUNDLaparoscopic cholecystectomy is considered now the gold standard operative procedure for chronic calculous cholecystitis. Acute calculous cholecystitis was considered previously as contraindicated for lap. cholecystectomy. But increasing experience and confidence, laparoscopic cholecystectomy can be extended to acute cholecystitis also with equal efficacy and safety by the experience surgeon.

Background: The objective of our study was to perform retrospective analysis of management of prostatic abscess in a tertiary care hospital in northeast India.Methods: This was a single tertiary care hospital based retrospective analysis of management of 24 patients diagnosed with prostatic abscess, between January 2015 and January 2020. Diagnosis of prostatic abscess was confirmed by trans-rectal ultrasonography (TRUS) and/or computed tomography (CT) scan/magnetic resonance imaging (MRI) prostate. Various treatment modalities used in our study were conservative, transurethral resection of prostatic abscess (TURP), TRUS-guided trans-rectal drainage/aspiration, trans-urethral drainage (TUD) + trans-urethral incision (TUI).Results: On analysing 24 patients diagnosed with prostatic abscess, mean age was 46.12 years (range, 17 to 73 years), the mean prostate-specific antigen (PSA) was 17.3 ng/ml (range, 2 to 40.0 ng/ml), mean prostatic abscess volume was 33 cubic mm (range, 10 to 75 gm). All patients were hospitalised, on admission all patients were started on intravenous antibiotics (3rd-generation cephalosporin along with an amino-glycoside) or antibiotics as per urine culture report. Diabetes mellitus was most common associated co-morbidity present in almost 50% of patients. Patients presented with dysuria (75%), urinary retention (29%) fever (25%) and perineal pain. Cases were managed by surgical approach after failure of conservative management.Conclusions: Early surgical intervention for prostatic abscess reduces morbidity and mortality associated with it. TRUS guided drainage can be performed under local anaesthesia, are better suited for small localised abscess but associated with increase hospital stay. Trans-urethral drainage are better suited for elderly patient with large prostate volume.

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