The authors conclude that (i) sclerotherapy is the ideal, safe and effective treatment for bleeding esophageal varices, that it prevented bleeding in 88.1% patients after variceal eradication and hence, should be included in primary management strategies; (ii) follow-up endoscopy should be performed on a yearly basis for the first 4 years after variceal eradication; and (iii) surgery is required as a complementary technique for patients with uncontrolled bleeding, painful splenomegaly, growth retardation and symptomatic portal biliopathy.

In patients with bleeding peptic ulcers, the use of high dose pantoprazole infusion following successful endoscopic therapy is effective in reducing rebleeding, transfusion requirements and hospital stay.

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A 15-year-old boy presented with long-standing bleeding of the rectum to the department of gastroenterology. Per rectal digital examination and proctoscopy did not reveal any definite local cause of bleeding. The patient was sent to the department of radiology for computed tomography (CT) scan. CT was done on 64 multislice CT scan, which shows marked rectosigmoid wall thickening as a result of varices and vascular malformations and phleboliths of the rectosigmoid colon. The patient was subjected to abdominal surgery in which a sphincter-saving procedure was done. Postoperative course in the hospital was uneventful.

Obturator hernia is rare, constituting <2% of all abdominal hernias. Clinical diagnosis is rarely made due to vague signs and symptoms. Delayed diagnosis markedly increases postoperative morbidity and mortality especially because the affected patients are often old with other comorbid conditions. Pelvic CT is almost 100% accurate in the diagnosis of obturator hernia and should be the modality of choice in older patients presenting with intestinal obstruction of unknown etiology.

Perinephric lymphangioma is rare disorder that may be confused with various forms of renal cystic diseases and urinomas. In this disorder a developmental malformation results in failure of developing lymphatic tissue to establish normal communication with the rest of lymphatic system. Once there is restricted drainage of lymphatic fluid the lymphatic channels dilate to form cystic masses that may be unilocular or multilocular and may be seen unilaterally or bilaterally .This condition presents with various signs and symptoms or can be just an incidental finding which in presence of misleading clinical history may be confused with other diseases. CT scan with delayed cuts and USG guided aspiration with biochemical analysis of fluid will help us in arriving to final diagnosis.

Post biopsy arterio-venous fistula in renal transplant range in incidence from 15-16%. Spontaneous resolution of 75% A-V fistulas is seen within four weeks. We report a patient with post biopsy arterio-venous fistula who had developed unexplained hypertension with no definite feature of rejection on biopsy. Doppler application revealed an arterio-venous fistula which showed spontaneous resolution in six weeks.

Hydatid disease is a zoonosis caused by Echinococcus granulosus . Infected dogs release eggs through their feces and the eggs infect humans through food and water. The most common locations of hydatid cysts are the liver and lungs, but primary mediastinal involvement, though rare, can be encountered. We report on a 16-year-old female with a primary mediastinal hydatid cyst leading to popliteal arterial embolization. The mediastinal lesion was treated with partial pericystectomy with removal of the germinal membrane and prophylactic albendazole. In endemic areas, it is important to consider hydatid cysts in the differential diagnosis of an acute arterial occlusion.