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Idiopathic retroperitoneal fibrosis is a rare fibro-inflammatory disease of varied etiology which usually originates around aorta and spreads caudally along Iliac vessels into adjacent retroperitoneum causing ureteral obstruction as the most frequent complication. A 53-year-old male patient presented with complaint of mild pain in both the legs off and on. On investigating further, we found that he had been struggling with intermittent relapses every 3-4 years for last 20 years since he was first diagnosed with Idiopathic Retroperitoneal Fibrosis. He was 33-year-old when he first developed the symptoms of anuria for 48 hours and was diagnosed with Idiopathic retroperitoneal fibrosis. This was followed by atrophy of left kidney and hypertension 6 years later, then hypothyroidism after another 3years and finally involvement of Inferior Vena Cava and acute Deep Vein Thrombosis of lower limbs after another 3-4 years. His deep vein thrombosis was well managed in time. He was put on glucocorticoids everytime he had a relapse and a complication. We did a review of literature to understand recent advances about its pathogenesis, diagnosis, investigations and management. We searched in PubMed using terms like retroperitoneal fibrosis alone and in combination with related terms such as Inferior Vena Cava thrombosis, Deep Vein Thrombosis, Tamoxifen, Methotrexate. This case is unique as it is very rare to find acute Deep Vein Thrombosis in Idiopathic retroperitoneal fibrosis without development of any collaterals when Inferior Vena Cava lumen is compromised to almost complete obstruction. After a follow up of 20 years patient is doing well in terms of physical activity and psychological wellbeing with anti-hypertensives, thyroxine and anti-coagulants. Is the disease-free interval actually free of the disease or it just subsided with immunosuppressants to become active after some time?

Background: Purpose of this study was to investigate whether the use of abdominal drainage after laparotomy for peritonitis can prevent or significantly reduce post-operative complications such as intra-peritoneal abscess formation or wound infection.Methods: A prospective randomized study was done of one hundred and one (101) cases who underwent emergency laparotomy at General Hospital Palanpur and Sushrut Surgical Hospital, Palanpur. After completion of operation for peritonitis peritoneal cavity was either drained or not drained. Drained group of cases was termed as group A and non-drained group of cases was termed as group B. Parameters noted in group A were daily drain output, character and culture sensitivity of the fluid. Surgical outcomes in form of hospital stay and postoperative complications like wound infection, wound dehiscence, residual abscess within month of operation were compared between two groups.Results: Significant difference was observed between drained group and non-drained groups in terms of length of hospital stay, wound infection, wound dehiscence, residual abscess and overall postoperative complicationConclusions: From the present study we deduce that prophylactic abdominal drain in each case is unnecessary, as it stops functioning latest by 72 hours if not draining. On the contrary it invites infection from outside. This may delay convalescence. Drain should be kept when leak from suture line is anticipated or when there is lot of necrotic tissue within peritoneal cavity, and kept till it functions; otherwise it should be removed earliest.