A 40 year old man with acute abdomen.

A 40 years old man with the complaints of abdominal pain and per rectal bleeding for 2 days and abdominal distension for 1 day. There was an ill defined, tender intra abdominal solid mass at the left side of the lower abdomen measuring about 3 x 3cm2 on deep palpation. Direct rectal examination could not be done due to excessive pain at the anal region and non co operation of the patient. Plain X-ray of the abdomen A/P view in erect posture including both domes of the diaphragm shows distended large intestinal gas shadow & bottle like radiopaque shadow at the lower mid abdomen. Ultrasonogram (USG) of the abdomen could not be done due to the restlessness of the patient. With all available aseptic precaution the abdomen was opened by a lower midline incision. After exploration of the sigmoid colon two glass bottles (One measuring 10cm x 5 cm, the other 12cm x 7cm) were removed and the colon was closed primarily. There was also a small piece of stone found in the peritoneal cavity measuring 2 cm in diameter which was sent for histopathology. Post operative period was uneventful. The patient was discharged with advice on the 8th POD.