Introduction: Non traumatic acute abdominal pain is a very common reason for patients’ visit to the Emergency Department and remains a challenging task for general surgeons in terms of appropriate diagnosis as well as management in a timely manner. Aim: To evaluate the clinical presentations, the operative management and the post-operative outcome of patients presented with non-traumatic acute pain abdomen. Materials and Methods: A hospital-based prospective interventional study was done in 250 patients presenting with non-traumatic acute pain abdomen to the Emergency Department of General Surgery, Jorhat Medical College and Hospital, Jorhat, Assam, India, from June 2021 to May 2022. Demographic profile, detailed history physical examination, operative managements and the outcome were noted. Results: Out of 250 patients with non-traumatic acute pain abdomen who underwent operative intervention, most affected age group was 2nd-4th decade of life, comprising 165 (66%) patients. A total of 167 (66.80%) were males. Most common presenting symptom besides pain abdomen was nausea, seen in 172 (68.80%) cases. Most common clinical sign besides tenderness was abdominal muscle guarding, seen in 220 (88%) cases. Acute appendicitis was the most common aetiology with 129 (51.60%) patients and emergency open appendicectomy was the most common surgical procedure performed. Most common post-operative complication was surgical site infection, seen in 57 (22.80%) cases. Mortality rate was 3.60% (9 deaths). Conclusion: As most acute pain abdomen invariably present with surgical emergency and varied aetiology, the complexity for imparting the most appropriate treatment is increased. Hence, surgeons in the emergency department need to be wellversed in assessing the patients right from taking of proper history, clinical correlation of symptoms to elicitation of signs, assisted with most readily available investigations, to arrive at a prompt diagnosis to provide appropriate surgical intervention at the earliest.

Background: Most of the emergency abdominal surgeries are either contaminated or dirty, they carry a higher rate of complications, aided by lack of optimization of the patient before surgery as opposed to elective surgeries. Complications related to surgical site encompasses a majority and may be aggravated by pre-existing co-morbid conditions. Seroma, hematoma, wound dehiscence, surgical site infection (SSI) are some of the major complications of surgical wounds. A prospective study was carried out in Department of General Surgery, Assam Medical College and Hospital (AMCH), Dibrugarh, Assam to find out the incidence of surgical site infection (SSI), clinical presentations and causative organisms including their antibiogram.Methods: Total 280 patients undergoing emergency abdominal surgeries in Department of General Surgery, AMCH from June 2017 to May 2018 were included in the study. Preoperative, intraoperative and post-operative details were collected, recorded and analysed. In case of SSI, wound swab was taken for culture and sensitivity and antibiotics tailored accordingly. Regular follow-up for at least 30 days post-operatively was maintained.Results: The incidence of SSI was 21.43%, with male: female ratio being 1.22:1. SSI was highest in the age group above 50 years; 33.33%, and with co-morbidities. SSI seen highest in class 4 wounds (55%). Commonest clinical features were erythema, tenderness, edema around the wound in superficial SSI and deep SSI. Organ space SSI was associated with fever, trachycardia and leucocytosis. The most common isolates were Staphylococcus aereus (55%), Escherichia coli (21.67%), Pseudomonas aeruginosa (11.67%), Klebsiella species (3.3%).  Conclusions: To reduce the incidence of SSI, strict adherence to antisepsis protocol specially during intraoperative and postoperative is of paramount importance in emergency surgeries.

Background: Small bowel obstruction (SBO) is a common surgical emergency, associated with significant morbidity and mortality specially if strangulated. There was not much used of scoring system for SBO. The aim of the study was to determine the usefulness of acute general emergency surgical severity (AGESS)-SBO score developed by Patrice Wendlling at Mayo Clinic in 2015 to evaluate the prognosis and outcomes of SBO.Methods: 80 patients age ≥13 years who fulfill the study criteria and admitted in surgery ward, Jorhat Medical College and Hospital, Jorhat between May 2020 to October 2021 were identified. The American association for the surgery of trauma (AAST) anatomic score, physiological score and comorbidity score are added to get AGESS-SBO score.Results: The mean age was 41.2 years and males (77.5%) were more affected. Obstructed external hernia (40%) was the most common cause of SBO. 64 patients (80%) were operated and 16 patients were treated conservatively. Complications were seen in 30 patients and 8 patients (10%) died during hospital stay. The median AGESS-SBO score is 5 (IQR 5-6) for complications and 2 (IQR 1.0-2.5) for no complications (p value of 0.0001).Conclusions: Incidence is more in males and obstructed hernia was the commonest cause. Higher the AGESS-SBO score more the complications and so was morbidity and mortality. A score more than 2 has unfavorable outcome.