Compared to colonic diverticula, the jejunum has signicantly less of a tendency to develop diverticulitis because to the diverticulum's bigger size, better intraluminal ow, and relatively sterile jejunal content . Acute intestinal obstruction, diverticular bleeding , and most commonly perforation with mesenteric abscess, localized or global peritonitis are complications of jejunal diverticulitis. Multidectector row computed tomography is now the best diagnostic imaging for small bowel diverticulitis as well as its complications [1]. Treatment depends on the symptomatology of patients, can be non surgical or surgical. Advanced age, concomitant comorbidities , delayed diagnosis , and primarily the gap between perforation and surgery are poor prognostic factors[1]. We present an elderly gentleman whose diagnosis was not made till he had his laparotomy

Diabetic myonecrosis , is a serious complication of long standing suboptimal glycemic control observed in both type 1 and type 2 diabetes. It presents with abrupt pain and swelling of the involved extremity. Diagnosis is often delayed because it mimics several other conditions such as cellulitis, deep vein thrombosis(DVT). We present a 41 year old male with type 2 diabetes mellitus with localized , sudden onset left sided thigh pain. The left thigh pain progressively worsened with decreasing range of motion of left hip and knee joint .Diagnostic evaluation was done for this patient which included blood work up and imaging , pointing towards diabetic myonecrosis. Patient underwent fasciotomy for pain control and muscle biopsy for accurate diagnosis . Patient made an uneventful recovery and is under follow up. Myonecrosis is less known microvascular complication of diabetes and should always be kept in mind when evaluating a diabetic patient with muscle pain. The clinical course is self limiting and patients respond well to supportive medical therapy that involves bed rest , glycemic control along with analgesics .

Surgical materials are sometimes inadvertently left in the body after surgeries,Cotton materials are the commonest objects forgotten[1]. The implications for the patient and the surgeon are serious . A signicant complication of surgical practice is gossypiboma [2]. Despite signicant interest and numerous guidelines, there are few known incidents because of a multitude of variables , including possible legal repercussions .[2] Gossypiboma, also called textiloma or cottonoid , refers to a foreign object , such as cotton matrix or a sponge , inadvertently left in the body cavity at the end of a surgical operation[3]. Here we describe a rare instance of transluminal surgical sponge migration in a 30 year old female who underwent low transverse cesarean section 3 months ago and presents with abdominal distention, anorexia , constipation and weight loss. She was thoroughly evaluated with imaging and suspected features of subacute small bowel obstruction . Patient underwent diagnostic laparoscopy with bowel resection and anastomoses , Patient eventually got better and was discharged .

Growth of dermoid cyst on parietal peritoneum without any prior history of ovarian dermoid cyst is considered a rare condition. The presentation of peritoneal dermoid cyst is vague and depends on the location of the cyst. We report a case of a 28-year-old young female who presented at our outpatient department with vague right upper quadrant pain and no other complaints, but upon examination a swelling was felt on the right upper quadrant, she was investigated radiologically, which reported as a peritoneal cyst, she was taken up for surgery. The cyst was excised and confirmed histopathologically as a dermoid cyst. Clinical progress was uneventful and postoperative recovery was excellent.

Background: To determine if fluorodeoxyglucose-positron emission tomography/ computed tomography (FDG PET/CT) scan identifies axillary nodal disease in conjunction with ultrasound (US) guided fine needle aspiration cytology (FNAC) of suspicious axillary nodes in breast cancer. To determine if this will enable axillary node dissection upfront, avoiding sentinel lymph node biopsy (SLNB). Methods: Study was performed in Apollo main hospital, Off Greams-lane, Greams road, Chennai IRB approval was obtained from institutional ethical committee-bio medical research-Apollo hospitals, (IEC application number: AMH-C-S-029/04-23). Informed consent was obtained from all the patients who met the exclusion criteria. The 61 patients with cT1-T3, N0-N1, and M0 disease underwent 18F-FDG-PET/CT scans after mammographic evaluation and an US guided FNAC of nodes which were seen to be suspicious in the mammogram and correlated US of the Axilla. All patients underwent axillary lymph node dissection (ALND levels 1 and 2) without a SLNB. Results: Out of 61 patients, 40 (65.6%) had axillary node uptake on PET/CT scan. But, after ALND, only 32 patients were found to have metastatic nodes on the histopathological examination (HPE) of the operative specimen. Out of these 32 patients, results for axillary metastasis had been noted on PET/CT, US, and guided FNAC in 18 patients (56.3%). Discordant results were noted in 14 (43.8%) patients, 29 patients had no metastasis on HPE. Negative results for axillary metastasis were noted on PET/CT, US and guided FNAC in 26 patients (89.7%). The results were discordant in 3 (10.3%) patients. Conclusions: An expanded preoperative axillary assessment does not have sufficient reliability to serve as a reliable triaging technique in axillary management. Concordant positive results may permit directly proceeding to ALND without resorting to SLNB. Concordant negative results may similarly permit avoiding axillary surgery. But discordant results warrant SLNB for assessment of axilla.