Although accounting for 90 % of the intestinal surface area, small bowel adenocarcinomas are not common. The majority of these lesions are incidentally detected during laparotomy for intestinal obstruction or perforation. The symptoms associated with these lesions are not very specific and preoperative diagnosis is rare. We report two cases of jejunal adenocarcinomas detected in patients undergoing laparotomy for acute abdomen and review the literature for small bowel adenocarcinomas.

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Trauma is a major cause of morbidity and mortality in the younger age group. Though diagnostic laparoscopy has been attempted in trauma earlier, with the advance in minimal access techniques, there is an increasing attempt at advancing the indications for laparoscopy in the setting of trauma. Though there are reports and studies on the successful use of laparoscopy in the setting of abdominal trauma, it is essential to remember that laparoscopy in trauma is associated with risks inherent in the procedure itself and also with higher incidence of missed injuries if used as a diagnostic tool.

Mature cystic teratoma is a relatively common tumor of the ovary. It makes up 10-15 % of all ovarian tumours and tends to occur at a relatively early age. Except for functional ovarian tumors, the other lesions from the ovary are usually asymptomatic and usually present with mechanical symptoms from the mass lesion. We present a case of a mature cystic teratoma presenting with small intestinal obstruction with x-ray suggesting a radioopacity in the right iliac fossa.

Diffuse large B-cell lymphoma can present as either primary lymph nodal disease or with involvement of extra-nodal sites. In gastrointestinal involvement, the clinical presentation is often insidious, such as abdominal pain, nausea, vomiting, anemia, weight loss, fever, and occasionally small bowel obstruction or a palpable mass. Small-bowel perforation as the first manifestation of non-Hodgkin’s lymphoma is extremely rare. The case of a 73-year-old woman is reported who presented to the emergency department complaining of a generalized abdominal pain and vomiting. Contrast enhanced computer tomogram (CECT) of the abdomen showed multiple air pockets in left side of abdomen, right hemidiaphragm, edematous small bowel loops with fat stranding with multiple tiny air pockets. Laparotomy was performed that revealed a focally perforated segment of the jejunum. Histological evaluation reported diffuse large B-cell non-Hodgkin’s lymphoma. This case illustrates a rare complication of large B-cell non-Hodgkin’s lymphoma of the jejunum that was responsible for small-bowel perforation and peritonitis. This clinical pattern may appear as a leading presentation of small intestinal neoplastic disease in which surgical resection may have to be considered.

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Background: Urinary tract infection (UTI) is a common reason for accessing health care services in all age groups. Women are more susceptible to UTI across age groups. Among males, the prevalence decreases in adolescence. Socio-economic and behavioural factors may play a significant role in the higher prevalence of UTI among adolescent girls. A study on UTI among children and adolescents will give a better insight in to the gravity of the problem and suggest appropriate interventions. Aim of the current study was to investigate the prevalence of urinary tract infection in males and females in the age group 0 to 20 based on the urine routine examination.Methods: This retrospective study included patients who had urine routine examination (URE) done based on clinical symptoms, during the period from January to December 2018 in a tertiary care teaching hospital. Data was obtained from the laboratory records and medical records department.Results: 1574 (3.43%) out of 45896 patients had a URE. This included 716 males (46%) and 858 females (54%). Among those with positive URE results, females were more affected than their male counterparts and this was statistically significant (male 21.8%, female 78.2%, p< 0.0001). As age advances, the prevalence decreases in males.Conclusions: Urinary tract infection is more prevalent in females across the pre- adolescent and adolescent age group. It decreases with age in males. Understanding the factors responsible for the persistent higher prevalence in females may decrease the prevalence of urinary infection in adolescent females.

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