Spot the diagnosis 252-256

(252) A patient was operated for appendicectomy and was released from the hospital after some days . After a month he came again with a hard lump in right iliac fossa with multiple discharging sinuses .
(253) A lady of thirty has come with severe lower pain abdomen with tachycardia and shock . She gives the history of two missed periods . She was also operated for  tubectomy two years back . Spot the diagnosis?
(254) A lady of forty has come with globular swelling in the midline of lower abdomen just at the suprapubic region . It is tender and dull at percussion . Pressure induces a desire to micturate .
(255) A patient has fever ,rigor tachycardia and pain lower abdomen . On per rectum examination there is bulging on the anterior rectal wall .
Spot the diagnosis?
(256) A patient of sixty has multiple swellings in the abdomen . He was admitted twice for chronic bronchitis in the TATA main hospital . He has a family history of tuberculosis .

Answers.
(252) Actinomycosis.
(253) Ruptured tubal pregnancy .
(254) Distended urinary bladder .
(255) Pelvic abscess.
(256) Retroperitoneal tuberculous lymphadenitis .