Background: Patients with mass in the right iliac fossa may confront the surgeon, pediatrician or gynecologist. Thus, thorough understandings of the anatomy and pathological process that may occur within the abdomen are essential for an accurate diagnosis and plan of treatment. The objective of this study was to interpret aetiopathology, clinical presentation, differential diagnosis and management of mass in the right iliac fossa.Methods: A total of 60 cases with mass in the right iliac fossa (RIF) were included in the study. Investigations like colonoscopy and CT scan were done. All the cases underwent right hemicolectomy followed by chemotheraphy. Other cases like psoas abscess, non-hodgkins lymphoma, Meckels diverticulum and intussusception were diagnosed and treated.Results: During this study period, a total number of 36 cases of appendicular mass and 10 cases of appendicular abscess were encountered. In this study 10 cases of appendicular abscess were encountered and treated by extraperitoneal drainage, 4 cases of ileocaecal kochs were encountered. Patients presented with constitutional symptoms like pain, fever, weight loss etc. Right hemicolectomy was done, specimens after operative procedures were examined microscopically and histopathological diagnosis. 3 cases of carcinoma caecum and 3 cases of carcinoma ascending colon were seen. Contrast enema was done which showed filling defect and mucosal irregularities.Conclusions: This study showed that appendicular mass is the commonest pathology in right iliac fossa amongst all and conservative treatment followed by interval appendicectomy is the best mode of treatment. Carcinoma of the colon and ileocaecal tuberculosis is the other two common causes for mass in the right iliac fossa. These cases also carry a good prognosis, if properly diagnosed and treated. The other rare causes of mass in the right iliac fossa are intussusception, psoas abscess and Non Hodgkins lymphoma.

Background: Inguinal hernias form the commonest subgroup of various hernias; such common condition causes the problem of various complications. A minority of patients with a groin hernia present as an emergency, with a painful and irreducible mass or with intestinal obstruction and delay in presentation is known to result in high morbidity and mortality. Aim was to study about the various acute surgical emergencies in groin hernia with its complications and surgical treatments.Methods: This study was a prospective observational study, conducted in the Department of General Surgery, Saveetha Medical College and Hospital, during March 2015 to February 2017. Thirty-five patients were included in the study. Ethical committee clearance was obtained prior to the commencement of study. All patients were studied from time of admission till discharge and followed up in out-patient department. A detailed history was elicited, and clinical examination was performed, and data recorded. All patients were given pre-and post-operative care.Results: The incidence of hernia was 37.1% for age group of 60 to 69 years whereas it was 28.6% for age group of 50 to 59 years and incidence decreases there by as age decreases. The frequency of hernia in male (94.3%) was more when compared to female (5.7%). The duration of hernia frequency before acute episode was more in first year (54.3%). The right sided hernia was most complicated than left. The common site of constriction was deep inguinal ring than the superficial inguinal ring and femoral ring.Conclusions: Majority of the patients underwent herniorraphy (82.8%). Most common site of constriction was observed to be at the deep ring (71.4%). The most common content was small bowel followed by omentum (74.3% and 25.7% respectively). Most of the patients did not have any post-operative complications (80%). Wound infection was the most common complication (11.5%) and mortality was observed in two patients (5.7%) and the causes of death were sepsis and acute respiratory distress syndrome.

Background: Ileal perforations are a common occurrence in our hospital setup with a majority of cases having an etiology of typhoid. The presentation and management of ileal perforation with special reference to typhoid, nonspecific and traumatic perforations and the outcomes in these patients and the factors affecting prognosis are important. Aims and objectives of the study were to study the management of Ileal perforation. To compare the outcome of two different types of treatment for Ileal perforation i.e. Primary Closure (vs) Resection and Ileostomy.Methods: This is a randomized comparative observational study conducted in general surgery department of Saveetha Medical College and Hospital, Chennai between February 2016 to October 2017. A Minimum of 28 patients was included in the study. Diagnosis was made on the basis of the X-ray erect abdomen, ultrasound abdomen, Widal test and intra-operative findings.Results: The common age groups affected was 41-50 years age group (5 patients) and 61-70 years age groups (5 patients). The least affected were 1-10years age group (one patient). The incidence in males was slightly greater than females. Male to female ratio was 2.5:1. Typhoid perforation is the most common case of ileal perforation followed by non-specific perforation. Post-operative complications are more in the primary closure group with 32.14% (9 patients) which is lower when compared to ileostomy group 17.85% (5 patients). Complications of primary closure were wound infection (2 patients), burst abdomen (3 patients), faecal fistula (1 patient), respiratory complications (3 patients). Complications in ileostomy group were wound infection (4 patients) and respiratory complications (one patient).Conclusions: Mortality was more in primary closure group with 21.42% (6 patients) and mortality was less in ileostomy group with 7.14% (2 patients). This study proposes that ileostomy may be given priority over other surgical options in moribund patients.

Background: Pre-operative nutritional assessment is necessary for all patients undergoing surgery in order to prevent post-operative complications. This is because wound healing is an anabolic process requiring adequate protein stores in our body. Serum albumin levels has been found to be a reliable tool in assessing the nutrition when used along with two other parameters namely, haemoglobin and body mass index. It is necessary to provide adequate nutritional support prior surgery for better clinical outcome post-operatively. Objectives: To assess role of pre-operative serum albumin, haemoglobin and BMI as predictors of post-operative morbidity and mortality in major open surgeries. Materials and Methods:Sixty patients more than 18 years of age posted for elective and emergency laparotomy in the general surgery ward were included in this study based upon the inclusion and exclusion criteria. Detailed history, clinical examination, anthropometry and nutritional assessment with pre-operative serum albumin, haemoglobin and BMI were done. Post-surgery the details of the procedure, anaesthesia, duration of surgery, duration of hospital stay and early post-operative complications were studied. The patients were followed up till they got discharged from the hospital. The data obtained was analysed. Results: Maximum number of post-operative complications were in the age group of 40-59 years (36.66%). Seroma followed by surgical site infections were the two most common complications seen among the study population. Most of the complications were seen among patients with                serum albumin <3.5gm/dl. Patients with hypoalbuminemia and anaemia had a tendency to develop more post-operative complications and this was found to be statistically significant. (p value <0.05) There was no significant relationship between abnormal BMI and complications in the present study. Conclusion: Pre-operative hypoalbuminemia <3.5gm/dl and anaemia were found to be independent risk factors for post-operative morbidity and mortality in major open surgeries. Although the relationship between BMI and complications was not found to be statistically significant, it is also essential to stabilise BMI prior to surgery for better clinical outcome.