Objective: The aim of this study was to perform retrospective analysis of data collected from patients of gallbladder perforations for diagnosis, management and outcome. Material and Methods: A retrospective analysis of data was carried out for 40 patients of gallbladder perforations from the hospital record of patients who were diagnosed preoperatively and intraoperatively as a case of gallbladder perforation over a period of 10 years and were managed in our surgery unit of a tertiary health care centre. Patients were included irrespective of sex except cases of trauma and patients of the paediatric age group. Results: Among 40 patients, 26 were females and 14 were males. As per Anderson modification of Neimeier classification, 13 (32.5%) had type 1, 23 (57.5%) had type 2, and four (10%) patients had type 3 perforations and none of the patients had type 4 perforation. Twenty-three patients (57.5%) were found to have fundal perforation, followed by body in 11 patients (27.5%), three (7.5%) in Hartman’s pouch while in three patients (7.5%), there were multiple perforations. All patients of type 1 Neimer classification were diagnosed clinically as cases of biliary peritonitis, whereas most cases of type 2 Neimer classification were diagnosed preoperatively by CECT abdomen 12/23 patients (52%) and ultrasound abdomen 10/23 (43.47%). All patients underwent surgery, and there were three mortalities. Conclusion: In our study, there was female predominance in patients having gallbladder perforation. Of the patients, 52.5% were diabetic and mean age was 55.9 years. CECT abdomen was the most useful modality for diagnosis of type 2 gallbladder perforations. Timely surgical intervention is mandatory for a better outcome of these cases.

Background: Acute pancreatitis is an acute abdominal emergency that need protracted hospital stay and intensive care. In 80% of cases it runs a mild course and rest of the patients have severe pancreatitis. It's severity is assessed by using Ranson's scoring system and Modified CT severity index. Aim:-1. To evaluate role of Ranson's scoring system and modified CT severity index in assessing severity of acute pancreatitis. 2. To correlate above scoring systems with outcome. Design and Place:-This is a prospective observational study which is conducted on patients with acute pancreatitis admitted in PG Department of Surgery, GMC, Jammu w.e.f. 1st November 2016 to 30th April 2017. Methods: 50 patients of acute pancreatitis enrolled. Ranson's criteria and modified CT severity index apply to all of them. Ranson's and modified CT severity index calculated and complications and outcome related to both scoring systems noted. Results: Out of 50 patients, 34(68%) patients have mild pancreatitis. 6(12%) patients have moderate pancreatitis. 10(20%) patients have severe pancreatitis. Conclusion: We conclude that Ranson's criteria and modified CT severity index have significant role in predicting the severity of acute pancreatitis and the chances of developing complications as regards morbidity and mortality.

Gallstone ileus is a rare complication of cholelithiasis that occurs as a result of occlusion of the intestinal lumen by a large sized gallstone accounting for 1-4% cases of small bowel obstruction. The aim of this work is to introduce a case report that emphasize the diagnostic and therapeutic management of gallstone ileus with an enterolith impacted in jejunum (an uncommon site).

Background: To compare the efficacy of percutaneous catheter drainage (PCD) and percutaneous needle aspiration (PNA) in the management of liver abscess > 6 cm in diameter. Methods: Fifty patients were included in this comparative study. Computer generated randomization was done by double blind trial and the patients were divided into two groups, 25 patients in each PCD and PNA group respectively. Comparison of effectiveness was done between the two groups in terms of duration of hospital stay, time to achieve clinical improvement, duration of intravenous antibiotics needed, reduction in the size of abscess cavity and total /near total resolution of abscess cavity. Results: Percutaneous catheter drainage (PCD) was found to be superior then percutaneous needle aspiration in terms of duration of hospital stay, clinical recovery, reduction in abscess cavity size/ volume and duration for intravenous antibiotics. Conclusion: Percutaneous catheter drainage is better option as compared to percutaneous needle aspiration especially for large abscesses which are partially liquefied or with thick pus.