Introduction:The spleen plays an important role in immune-surveillance and haematopoiesis. Its role in the fight against infection, especially infection of encapsulated organisms, is particularly significant. It also removes intracellular inclusions (pitting) and filters aged blood cellular elements from circulation. Aim: This study aims at the indications for elective splenectomy and the outcomes at a tertiary care centre. Materials and Methods: We conducted a Prospective observational study done for 3 years. Total 42 patients who underwent splenectomy, both emergency and elective were included for data collection. Inclusion criteria for the study were all the patients undergoing splenectomy. The spleen was approached via an upper midline or left subcostal incision. Results: In 42 patients with splenectomy M=mean age of the patients was 37.9 ±15.42 years, of which 23(54.8%) are males and 19(45.2%) were females. A majority of the patients were in the age group of 18-45 years. Most common indication was haematological in 42 patients, of which 20 (47.6%). traumatic Idiopathic Thrombocytopenic Purpura (ITP) cause have 8 patients (19%).Most of the patients 3 (60%) patients have complications after trauma. Conclusions: Most cases of splenectomy in our centre caused by trauma, and among the different types of trauma, blunt trauma is the dominant cause. splenectomy must be undertaken only after anticipating both, short-and long-term risks and potential benefits to the patient.

Background: Perforations of peptic ulcer are third in frequencies, acute appendicitis and acute intestinal obstruction being more common. Prompt recognition of the condition is very important and only by early diagnosis and treatment it is possible to reduce the still relatively    high mortality. The aim of this study was to review and study the factors influencing, the outcome of the duodenal perforations. Subjects and Methods: A clinical study was conducted in 50 cases of diagnosed duodenal ulcer perforation that was established by the admitting surgeon, based on clinical features and supposed by radiological evidence and confined at operation. This study comprises of 50 cases of duodenal ulcer perforation admitted in period from January 2017 to January 2020. Results: In present study, out of total 50 patients with duodenal ulcer 46(92%) males and 5(8%) females, with male predominance. Highest incidence was found between 41-50 years followed by 21-29 years. Most of the patients admitted by 12-24 hours, common site of ulcer is prepyloric in presentation. Duodenal ulcer perforations were single perforation, while two cases of ileal perforations were multiple. Smoking is main predisposing cause of ulcer. ARDS were 14% (7 patients) and it was observed that 32 percent (16 patients) having wound complication, 2 percent (‘1 patient) having mortality and 46% (23 patients) have no complications. In this present study, 60% of patients had h/o Peptic ulcer. On X- ray, 90% of patients had finding of air under diaphragm. Conclusion: The mortality in perforated duodenal ulcer has been reduced owing to early approach to hospital, diagnosis, prompt surgical treatment and appropriate and adequate antibiotics. Smoking and alcohol consumption and life style modification may reduce morbidity and mortality in patients with duodenal perforation.

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Introduction: Peptic ulcer Complications of peptic ulcer disease is a life threatening complication it needs special attention with prompt resuscitation and appropriate surgical management if morbidity and mortality are to be avoided. Aims: Aimed to study surgical management of the various causes of duodenal perforation to try to recognise the predictors of outcome in such patients. Materials and methods: It is a prospective study done in department of general surgery study from April 2018 to September 2019 with 50 patients with diagnosis of perforated peptic ulcer disease, above 20-70 years of age, patients consented for study and patients presenting with complications of PUD like upper GI bleeding, peptic ulcer perforation and features of gastric outlet obstruction were included. Results: In present study the peak incidence was in the 4 th decade (31-40 years). The majority of patients, 23(46%) were younger than 40 years. Post-operative complications were recorded in 14 (28%) patients. Of these, surgical site infection (16%) was the most common post-operative complications. The mean age of patients who developed complications was 53.4±15.1 years. Premorbidiy illness, treatment delay and nature of perforation are significant Predictors of complications. Conclusion: Perforation of peptic ulcer remains a frequent clinical problem in our environment predominantly affecting young males not known to suffer from PUD.