Penetrating abdominal trauma is mostly caused by gunshots or stab wounds.1 Management of penetrating abdominal trauma is often challenging and time between the injury and surgical intervention play a pivotal role in such cases depending upon the clinical presentation of the patient.The success rate depends so much on early surgical intervention that one cannot wait for pre-operative work up before taking the patient to operation theatre2. We present a case of stab injury presented with eviscerated ischemic bowel and perforation in transverse colon with mesenteric arterial spurter.

Penetration of foreign bodies may present a diagnostic challenge to the surgeon. The foreign body granuloma is a biological response of tissue to any foreign body in the tissue. The pathway of arriving to the diagnosis of foreign body granuloma becomes di?cult when patient presents with non speci?c symptoms such as pain/ swelling, and in history- no recollection of previous trauma. It can be of two types- a) Iatrogenic gossypiboma by retained surgical sponge intra-operatively b) Granulation by a penetrating foreign body such as wooden splinter or other materials. -The most frequent reported injury is to hand, thigh, knee and feet; these may be limited to soft tissue of may be intra articular. The time and type of presentation varies according to the immune status of the individual. In cases, where history of trauma is uncertain, the presentation is very late and the radiographic appearance may be confusing - Median time of presentation: 4 months to 20 years.

Penetrating foreign object rare cause of brain injury, and have high mortality and morbidity rate among traumatic brain injury, surgery and management of this patient challenged and need high experience health care system, we introduced 29 years old man admitted with stab brain injury to emergency department

A Sixteen-year-old male had a road traffic accident resulting in crush and loss of lateral two metatarsals of the left foot. The Lateral plantar arch was reconstructed with a vascularized fibula osteocutaneous flap. Flap survived and partial weight-bearing was started by 3 months and full weight-bearing was started 6-months post-surgery. At a 16-month follow-up patient had a normal gait and integrity of the lateral plantar arch was maintained. Vascularized fibula osteocutaneous flap is an excellent option for one-stage reconstruction of the lateral arch of the foot and gives satisfactory results in terms of functions of foot and in avoiding long-term morbidity.

A 49-year female presented to surgery outpatient clinic with the awareness of a right lower abdomen asymptomatic lump for one week. Contrast enhanced computed tomography of the abdomen demonstrated a 10x11x15cm heterogeneous lesion anterior to the ileocecal junction with the possibility of leiomyosarcoma. Patient was prepared for laparotomy and intraoperative there was a large tumour arising from the medial wall of cecum. Right hemicolectomy was performed, and histopathology came as a desmoid tumour of the cecum. The patient had an uneventful postoperative course and is well on one year follow up.