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and importance: Acute appendicitis is one of the most common causes of acute abdomen in surgical patients. The objectives of the study were to evaluate efficacy of Alvarado scoring system in preoperative diagnosis of acute appendicitis and correlating it with postoperative findings.The present study was a prospective study of 208 patients presenting with symptoms and signs of acute appendicitis to the emergency department during a period of 10 months. Patients who met the inclusion criteria were evaluated using Alvarado scoring system. The efficacy of Alvarado scoring system was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value and negative appendectomy rate.Total 208 patients were included in the study, which included 142 males and 66 females, at score of 7 or more, appendicitis was confirmed in 187/190 patients, while at scores7 appendicitis was confirmed in 10/18 patients. The sensitivity was 94.9%, the specificity was 72.7%, the positive predictive value was 98.4% and the negative predictive value was 44.4%. In the present study, negative appendectomy rate was 4.8.Clinical experience remains of major importance in diagnosing acute appendicitis. The Alvarado score is a simple, easy scoring system at both end of scale.

The Video Capsule Diagnostic Imaging is a technique for exploring the digestive tract, particularly the small bowel. It is indicated for any unexplained digestive bleeding or as a means of monitoring intestinal polyposis or inflammatory diseases. This videocapsule is not digestible, and the risk of its retention, symptomatic or not, is not negligible following an inflammatory, anastomatous or tumoral stenosis. This retention or blockage is defined by the presence of the Video Capsule in the digestive tract at least two weeks after ingestion. Surgical approach is considered effective to retrieve the retained capsule, treat the pathology responsible and prevent acute complications. We report the case of retention of a video capsule in a young patient with severe anaemia due to inflammatory polyposis of the small bowl, whose removal required surgery to extract the capsule and resect the segment of the small intestine stenosis by the polyps., Highlights • The video Capsule Endoscopy is the most sensitive examination for the detection of inflammatory lesions of the small bowel. • It does not currently allow a biopsy but it is indicated for unexplained or occult digestive bleeding. • Its main limitation is the risk of blockage in a stenosis with or without occlusion. • Surgical approach is considered effective to retrieve the retained capsule, and treat the pathology responsible.

Introduction and importance Gossypiboma or textiloma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. The body may react to this foreign body through an exudative inflammatory reaction or an aseptic fibrotic reaction in order to encapsulate the cotton material and result into a mass. Case presentation We report a case of 65-year-old female. She was referred to our department due to 2 episodes of nausea and vomiting. She had history of open cholecystetomy 29 years ago, then cure for eventration one year after. On exploratory laparotomy there was a mass measuring 6 cm axis at the expense of segment 3 of the liver coming into intimate contact with the duodenum. Atypical segmental hepatectomy of segment 3 of liver was performed, and the histological report confirmed necrotic textiloma. Clinical discussion Textiloma represents a complication of all forms of surgery. It is a real, serious but preventable surgical complication, and could present with various complaints. Prevention of this condition can be achieved by meticulous count of surgical materials. Conclusion The embarrassment faced by the surgeon and the medico legal implications of this iatrogenic complication are tremendous and all preventive measures should be taken to avoid this as no excuse is justifiable., Highlights • Gossypiboma is a mass comprising of cotton matrix within the body left accidentally during a surgical procedure. • Gossypiboma is a serious but avoidable complication. • It has serious medicolegal implications and negative impact on medical fraternity. • Surgical and nursing team should be careful and ensure counts of surgical items during and at the end of surgery.