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Surgeons removed bladder stones by perineal lithotomy in ancient times. The first surgeon who dared to invade a body cavity knew human anatomy and was skilled in the use of surgical instruments. The operation probably originated in India since the Sushruta Samhita, a surgical text, antedates Hippocrates by several hundred years. Sushruta's knowledge of bladder of stones, surgical complications and instrumentation identifies him as originator of vesicolithotomy. Why did Hippocrates advise his students to leave operations for bladder stones to practitioners who were skilled in the art? Who were these practitioners and how did knowledge of vesicolithotomy reach Greece from India? Our research suggests that the operation came to Greece from India over ancient trade routes and with surgeons who accompanied Alexander the Great's army. The Sushruta Samhita was translated in Arabic and may have reached Europe during the dark ages by way of Arabian surgeons such as Albucasis. Chelseldon, an eighteenth century English surgeon, brought Sushruta's vesicolithotomy to a peak of perfection.

Patterned bruising of abdominal wall in blunt trauma is called London sign. It indicates that the impacting force is sharp and severe enough to cause visceral injury. Despite its practical significance this sign is seldom described in textbooks and there are no journal articles about it. This communication is intended to draw the attention of pediatric surgeons to this useful clinical sign.

Surnames, although widely used, are not obligatory in many parts of the world. This communication describes the hurdles and humiliations suffered by Oriental and South Indian authors who do not have a surname. A novel solution to the problem of author surnames is also proposed.

Urinary catheters are known to spontaneously knot inside the bladder. Approximately 40 cases of this complication have been recorded in the world literature. Clinical observation in 4 children and simulation experiments done using a balloon model are described herein. Risk factors identified in this study includes catheter size less than 10 Fr, overdistended bladder and insertion of more than 10 cm length of catheter inside the bladder. Water-current generated by the flow of urine appears to play an important role in the pathogenesis of catheter knotting.

Although there is general agreement on the necessity of draining pyopericardium, debate continues as to the safe and effective method of drainage. Studies describing head-to-head comparison of various drainage procedures are very few and are disadvantaged by small numbers of cases. In this observational study, we review our 30-years experience with different techniques of pericardial drainage. Between 1972 and 2003, the authors have personally treated 39 children who suffered from pyopericardium. Among the 22 children who underwent early partial pericardiectomy, 20 were alive. In contrast to this,12 out of 15 children treated with repeated pericardiocentesis or sub-xiphoid tube drainage were dead. The median hospital stay for pericardiectomy group was 18 days (range 11-32) and that for the non-thoracotomy group was 34 days (range 18-55 days). With regard to immediate survival and early convalescence in the pyopericardium, partial pericardiectomy is superior to pericardiocentesis and sub-xiphoid tube drainage. Pericardiocentesis can be used for diagnostic or temporizing purposes, but not as the definitive drainage procedure. Partial pericardiectomy can be done even in small hospitals where heart-lung machines are not available.

Common surgical complications of typhoid fever are ileal perforation and gastrointestinal haemorrhage;1,2 intussusception has been little reported.

The colographic appearance of intussusception is variously described as a claw sign, pincer defect, shouldering effect, and coiled-spring pattern. This report adds a new radiographic sign to the list. An end-on view of an intussusception on barium enema shows a ring of contrast resembling a solar eclipse. Familiarity with this bizarre appearance is desirable, lest it may be mistaken for spillage of barium due to a colonic perforation.

A 75-year-old woman presented with a painful abdominal lump. Clinically and sonographically it was diagnosed as an abscess. Surgical exploration revealed a Spigelian hernia with Richter's type of strangulation. The strangulated portion of the ileum had perforated, leading to abscess formation.