Airway management has made many advances in recent years. However, an unanticipated difficult airway can turn out to be a nightmare for anaesthesiologist. The various predictors include clinical assessment predictors, X-ray neck, conventional helical computed tomographic (CT) scan, indirect laryngoscopy, pulmonary function tests and fiberoptic bronchoscopy had been successfully used for delineation of airway anatomy [1]. The shortcomings of aforementioned techniques except for fiberoptic bronchoscopy are that they tell about static component without giving much information about dynamic component of airway. Fiberoptic bronchoscopy is invasive and could not be performed without prior anaesthetic preparation. However newer modalities like ultrasonography, multidetector CT (MDCT) scan with virtual 3D bronchoscopic image (VB) reconstruction are upcoming imaging modality which provides both static and dynamic or virtual airway information. Precisely they allow non-invasive intraluminal as well as extraluminal evaluation of the airway.

Hepatic hydrothorax (HH), variceal haemorrhage (VH) and portal vein thrombosis (PVT) are complications associated with hepatic cirrhosis (HC) and involve poor prognosis. HH occurs in 4%-17% of cirrhotic patients [1]. Atypical presentations include pleural effusion without ascites and left-sided only effusions. The pathophysiology is believed to involve defects in tendinous diaphragmatic portion. Usual treatment includes diuretics and thoracocentesis, and even transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation [2]. Among patients with cirrhosis, due to portal hypertension (PH), varices form quite frequently (10% a year, approximately), and about a third of patients with varices will develop VH. PVT is commonly developed in cirrhosis (ultrasonography studies have reported prevalence of 5 to 24 per cent), and is related to unbalanced haemostasis and slowing of portal flow.

The squamous papilloma is a common benign oral epithelial neoplasm [1]. Papilloma usually presents as an exophytic, painless papillary mass [2]. Oral Submucous Fibrosis is a premalignant condition [3]. A 45 year old female patient presented with growth in inner side of left cheek region. Patient had history of gutka chewing for past 6 years. On intra oral examination, the growth was pinkish, strawberry like in appearance with a papillary surface in the right buccal mucosa (Figure 1). Generalized blanching of oral mucosa was present (Figure 2). The growth was not tender on palpation and firm in consistency. The growth was pedunculated with no induration or bleeding on palpation. Palpable fibrotic bands were present in the buccal mucosa. The patient was provisionally diagnosed to have papilloma of right buccal mucosa with oral submucous fibrosis. A differential diagnosis of verruca vulgaris, verrucousleukoplakia and condylomaaccuminatum was considered. After investigations, the patient was subjected to excisional biopsy.

A patient of 55 years presented seven days ago a fever. Since 3 days he developed multiple nodular lesions. Dermatological examination revealed pruriginous pinkish and infiltrated plaques, nodules and papules, with firm consistency, disseminated on the trunk .There was no mucosal or nail lesions. The rest of the physical examination was normal. Histology was in favor of leukemia cutis witch correspond to cutaneous localization of acute leukemia. The study of skin lesions allowed a quick diagnosis of the etiology of fever. The care of his leukemia is accompanied by the disappearance of lesions.

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Coloduodenal fistula is a very infrequent complication, which can arise from both benign and malignant diseases. It consists in a pathological communication between the lumen of the colon and duodenum. The onset of signs and symptoms is generally sub-acute, and the majority of the patients will present with a non-specific abdominal pain, diarrhoea, nausea and vomiting [1]. Nevertheless, the clinical presentation may vary significantly - depending on the site of fistulisation - and some cases may never be diagnosed.