Acute abdomen is considered as the high level of suspicion and high index of clinical exposure with judicious examination and relevant investigations, none of the one can masters in all. It all requires the judicious use of the all the things together to bring out the best in the provisional diagnosis and best in the interest of the sick presented in emergency room with limited history and blood investigation carried out by practitioner at the different place. Sometimes the things will be made more complicated when the diagnosis and blood investigation doesn’t matches even with the radiological investigations. This text has been designed to explain the importance of each other with each one in the better and contained manner to help the learner and the medical students those who are wish to work in emergency field and the emergency arrives with young gentleman with acute abdomen.The case discussed here is the live example of combination and importance of the altogether