Modified Alvarado score is useful tool in clinical decision making. When compared with ultrasonography neither one is advantageous. However, additional information provided by ultrasonography improves diagnostic accuracy.

Idiopathic perforation of normal colon in adults is rare. The cause for idiopathic perforation is not known. We report a case of idiopathic colonic perforation in adult who presented with sign and symptoms of perforative peritonitis. On laparotomy patient was diagnosed to have a colonic perforation. There was no causative factor for perforation in the patient. This case is reported because of rarity of this disease

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Genitals and perineal regions are more prone for infection as their tendency to responds to inflammation by causing ABSTRACT Background: Fournier's gangrene is necrotizing fasciitis involving genitals and perineal regions. Fournier's gangrene is a surgical emergency. If not treated immediately it spreads rapidly causing septicemia leading to death. Mainstay of treatment is surgical and regular dressing. Various dressing materials are available like eusol, in our study we use Honey as dressing material. This is a small work to attempt to study incidence, etiology and pathogenesis and use of dressing for the treatment of Fournier's Gangrene. Methods: in our study we study 40 male patients of Fournier's gangrene. We studied clinico-pathology of disease and use of honey dressing for the management of Fournier's gangrene. Out of 40 patients 18 were treated with honey as dressing material and remaining 22 with eusol. Results: 40 patients were admitted, and majority of patients were in age group > 60 years mean age was 54.08_15.47 years. Majority of patients belonged to lower socioeconomic class 82.5%. Most of patients presented in hospital within 7 days of initial symptoms. In this study etiological causes found in 85% of patients and among which most common were urogenital causes 32.5%. Majority of patients had chronic alcoholism and bad hygiene as predisposing factors. 25% were associated with diabetes mellitus. In this study 12% of patients were HIV positive. Most common organism found in pus culture was E. coli (42.5%) followed by Coagulase Negative Staphylococci in 32.5%, Klebsiella in 12.5%, Pseudomonas in 7.5% and no organism were isolated in 5%. Mean days required for healthy granulation by honey dressing was 9.62+-4.5 days and for eusol was 10.5 +-3.79 days. In our study mortality was 22.5%. Conclusions: Diabetes and alcoholism are predisposing factors associated with this disease. HIV is emerging predisposing factor for Fournier's gangrene. Honey is very useful for treatment of Fournier's gangrene it reduces days for clearance of slough and hospital stay.

Background: Blunt trauma abdomen is one of the most common causes of morbidity and mortality among younger age group. Hollow viscus injury is one of the most common cause of mortality following blunt trauma abdomen. The Objective of this research was to study clinical presentation, diagnostic methods, treatment modalities and outcome of hollow viscus injury following blunt trauma abdomen. Methods: All patients with hollow viscus injury were included in this study, All the clinical, operative and postoperative parameters were recorded. It was a retrospective observational study. Results: Total number of patients with hollow viscus injury following blunt trauma abdomen were 15%. Amongst them 88.88% were males and remaining were females. The mean age of patients was 32 years. Road traffic accident was the most common cause of blunt trauma abdomen, seen in 72 % of patients. In 81.25% patients free gas under diaphragm was seen and remaining patients were diagnosed by ultrasonography. Ileum is most commonly site of perforation, and postoperative complications were seen in 66% of patients. Mortality was seen in 22.22% of patients. Conclusions: Hollow viscus injury following blunt trauma abdomen commonly seen in younger age group, and involves small bowel. Repeated clinical examination with appropriate imaging with multidisciplinary teamwork is the key for timely intervention for successful outcomes.