We present a case of Boerhaave’s syndrome managed thoracolaparoscopically. A 45-year- old man presented with hydropneumothorax following severe retching. He was treated with Intercostal drainage insertion as the primary management and referred to a tertiary care centre. There endoscopic stapling was attempted, following which he developed a leak. He presented to us with severe sepsis and mediastinal collection on the ninth day following the perforation. We treated him with thoracoscopic mediastinal toilet, laparoscopic-assisted feeding jejunostomy and cervical oesophagostomy. The patient was managed conservatively. A computed tomography (CT) scan was repeated at intervals of 15 days. He was continued on full jejunostomy feeds. Regular assessment of the oesophagus injury was conducted via the CT scan. The patient had complete healing of the perforation at end of two months. His oesophagostomy was closed and he remained symptom-free at follow-up. We conclude that thoracoscopy has an important role to play in the management of patients with mediastinal sepsis and late presentation of Boerhaave’s perforation.

Retroperitoneal lipomas are known for their rarity and varied presentations. We are reporting a case of giant retroperitoneal lipoma which presented as inguinal hernia.

A 13-year-old girl presented with recurrent colicky abdominal pain and distension. She was treated for abdominal Koch's for 4 months without any relief. She underwent diagnostic laparoscopy which revealed cicatrized cecum and multiple strictures in ileum. Laparoscopyassisted (extracorporeal) resection of affected bowel (terminal ileum and cecum) and ileoascending anastomosis were performed. Histopathological examination of the specimen diagnosed it as enteritis cystica profunda. Laparoscopy can be successfully used as a diagnostic and therapeutic modality in cases with doubtful diagnosis.