We report a very rare case of HEREDITARY ANGIOEDEMA, presenting as recurrent acute abdomen. A 22 yr old Maharastrian male, law college student, got admitted for about fifteen times in previous three years for severe, acute onset, upper abdominal pain, vomiting, distention and acute exudative inflammatory ascites .The whole episode used to subside spontaneously within 2-3 days with or without conservative general management .He underwent various investigations from far basic type, to advanced and invasive type with each recurrence but without definitive diagnosis. He also underwent unnecessary appendectomy. The authors did a review of his previous records, but didn't find any definite surgical or medical cause for his acute abdomen. Obviously it was something rare. Authors did search for it in various surgical and medical literature and searched extensively on internet for rare causes of abdominal pain which guided them for further appropriate investigations and diagnose him as a case of HEREDITARYANGIOEDEMA ,as his clinical features and C1-INH,C3-C4 levels were strongly in favour of it . It goes without saying that the internet has become a standard accessory to conventional literature for cases with diagnostic dilemmas and for treatment options as well.

Idiopathic scrotal calcinosis (ISC) is a rare benign condition which presents with multiple, asymptomatic, and painless nodules on the scrotal skin wall. The lesions have been attributed as sebaceous cysts, calcified steatocystoma, fibroma, atheroma, and xanthoma. Shapiro et al. reviewed the histologic data and found no evidence of an epithelial lining, residual cysts, and lipid or organisms, and concluded that the calcification was idiopathic introducing the term "idiopathic scrotal calcinosis." We have studied four cases of idiopathic scrotal calcinosis, one of which had scrotal calcinosis involving the whole of the scrotum. He presented with painless multiple nodules over the scrotum. He was subjected for surgery with SOS skin grafting, but as the scrotal skin is so lax, primary closure is easily possible. In all our four cases, primary closure was easily possible. Keywords Calcinosis . Inclusion cyst . Scrotal swellings Case HistoryA 40-year-old male came in surgery OPD for multiple painless nodules involving the whole of the scrotum (Fig. 1). All routine investigations including HIV and VDRL were done which were normal. He was posted for in toto excision with skin grafting, but surprisingly, primary closure was possible and his postoperative recovery was very good (Fig. 2). The specimen was sent for histopathology which was suggestive of calcinosis of the scrotum (Fig. 3).

BACKGROUND: Core factors involved in the treatment of hemorrhoids include the engorgement of hemorrhoids, prolapse, recurrence, and pain. OBJECTIVE:The goal of this study was to assess the safety, pain, and efficacy of the transanal suture mucopexy for the treatment of hemorrhoids. DESIGN:This was a retrospective study over a 13-year period.

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Tailgut cysts (TGC) though relatively common are rarely diagnosed and documented. Most of the times, they are misdiagnosed and mismanaged. When malignancy develops in TGC it is rarely attributed to it as it is undiagnosed earlier and later on there may not be any evidence left behind. We report one such case which was diagnosed though not preoperatively. Review of literature reveals only few such cases after the initial description by Hjermstad and Helwig in 1988. Surprisingly most of the reports especially the larger case series are by radiologists. Surgeons and pathologists have contributed very few cases. This case report is aimed at increasing the awareness about this entity so that it will be suspected, investigated properly and treated before development of complications like recurrent fistulae, ischioanal abscesses which increase the morbidity and life threatening complications like malignant change.

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Isolated cecal necrosis is a rare abdominal condition. Usually presents as acute appendicitis clinically. Mostly occurring in older patients with cardiac and renal comorbidities. Anatomical abnormality of cecal blood supply is usually observed. Diagnosis is difficult preoperatively without high degree of suspicion. Any delay in diagnosis can lead to fatal complication. Key words: isolated cecal necrosis, ischemic colitis, acute appendicitis.