We report a 31 year old patient, presented with painful erection since 48 hours. There was no known predisposing factor on history and examination. Surgery for priapism is rarely indicated nowadays but conservative management failed to achieve detumescence in our case. So Winter's shunt surgery was done which failed then a formal shunt was created between corpora cavernosa and spongiosum which also failed to achieve detumescence. After 4 days -a formal left side cavernosa saphenous shunt procedure was done and detumescence achieved within 24 hrs .Follow up showed good results.

A forty nine year old male who had sustained acute myocardial infarction two days earlier, experienced respiratory arrest and complete heart block and was admitted with a diagnosis of left cerebellar infarct and obstructive hydrocephalus. On examination he was responding to deep painful stimuli with right hemiparesis. ECG indicated acute inferolateral myocardial infarction. Echocardiogram showed an ejection fraction of 63%. Arterial blood gases revealed severe respiratory alkalosis and arterial desaturation. The lungs were ventilated and inotropic support was started to ensure a stable hemodynamic status. Evacuation of the cerebellar infarct was planned as an emergency procedure. Anesthesia was maintained using N 2 O -O 2 -narcoticneuromuscular blocking drugs sequence. Continuous monitoring of ECG, ST segment, invasive arterial blood pressure, CVP, ETCO 2 , SaO 2 and temperature were instituted. The intraoperative period was uneventful. Elective postoperative ventilation was continued for three days. He was then transferred to the step down intermediate care unit for definitive therapy.

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