INTRODUCTIONThis study was done as a retrospective analysis of previous data of emergency surgeries; that of gastrointestinal (GI) perforation in a single unit in Bowring and Lady Curzon hospital in Bangalore, India. GI perforation is a complete penetration of the wall of the stomach, small intestine or large bowel, resulting in intestinal contents flowing into the abdominal cavity. 1Perforation of the intestines results in potential bacterial contamination of the abdominal cavity (a condition known as peritonitis). GI perforations include gastroduodenal, small-bowel, appendicular and colorectal perforations. 2Our objectives were to study the incidence of various types of gastrointestinal perforations, complications associated with it, and the management of patients with ABSTRACT Background: Peritonitis secondary to gastrointestinal perforation is still one of the commonest surgical emergencies in India and is associated with high morbidity and mortality. The present study examines the incidence of various types of gastrointestinal perforations, their complications and the management of patients with postoperative leaks in our surgical unit and compares our findings with those of previous studies performed between 1984 and 2014. Methods: Retrospective study analyzing the case files of all the operated cases of gastrointestinal perforations in a single unit over the last 10 years from September 2005 to August 2015 by open procedure. A total number of 381 cases were studied. All cases with perforative peritonitis, whether spontaneous, infective, traumatic or of neoplastic pathology, were included in the study. Results: Gastrointestinal perforations were common between the ages of 30-50 years; 82% were males. From July to October (rainy seasons) every year a higher number of perforations were noticed; 40% of patients had duodenal, 34% had ileal, 11% appendicular, 6% gastric, 6% jejunal and 3% had colonic perforations. Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (50%) and tachypnea (42%) were common signs; 15-20% presented late with features of shock. Conclusions: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever (typhoid) have highest morbidity and mortality. Most of the anastomotic leaks can be treated conservatively. Mortality depends on the general condition of the patient and associated pre-operative comorbidities.

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Background: Cystic swellings of the scrotum are common clinical entities that surgeons encounter in daily practice. Males of all ages are affected. Today, considerable heterogeneity exists in their treatment. This study sought to identify the prevalence and patterns of presentation of these swellings in adults and evaluate the different modalities of surgical management.Methods: A cross-sectional study was undertaken from January 2013 to December 2016. A total of 186 patients fulfilling the inclusion criteria were included. Data was collected using a proforma. All patients were managed surgically.Results: Majority of cases (28%) were observed between 41-50 years (mean age 43.9 years). In 71%, mode of presentation was a painless, gradually progressive swelling. Mean duration of symptoms was 17.3 months. Primary vaginal hydrocele was the commonest swelling encountered (in 73.1%). Jaboulay’s procedure was undertaken in 75.2% of patients. Lord’s plication was associated with a comparatively shorter operative time, lesser postoperative scrotal edema and a shorter hospital stay. Epididymal cysts accounted for 19.4% and were managed by excision. The most common complication observed irrespective of surgery performed was scrotal edema (in 36%). Hematoma and infection were less frequently observed. Patients were followed-up for a mean period of 1.8 months. No recurrences were detected during this period.Conclusions: Cystic swellings of the scrotum are conditions predominantly affecting middle-aged males. Among these, primary hydrocele is the commonest. Although Lord's plication is simpler and gives good results with fewer complications, Jaboulay’s procedure remains the gold standard for surgical management of hydrocele.

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Background: Gastroduodenal perforations constitute one of the commonest surgical emergencies encountered. Helicobacter pylori is a gram negative bacterium that has infected more than half the world’s population. The most commonly recognized manifestation of H. pylori infection in India is peptic ulcer disease. Although the relationship between H. pylori infection and peptic ulcer has been well defined, the relationship of H. pylori infection with gastroduodenal perforation is still controversial. The objective of the study was to determine the presence of H. pylori in gastroduodenal perforations.Methods: We conducted a prospective study, noting the number of cases which turned out to be positive for H. pylori in cases of gastroduodenal perforations intraoperatively, using rapid urease test.Results: Out of 100 cases of gastroduodenal perforations operated, 74% were positive for the test. Gastric perforations positive for the test were 81.4% and duodenal perforations positive for the test were 68.42%.Conclusions: There is a positive attribution between H. pylori infection and gastroduodenal perforations.