Greater Omental Torsion

Primary or idiopathic greater omental torsion is an uncommon cause of an acute surgical abdomen. The etiology of omental torsion is as yet unknown. The preoperative diagnosis is usually hard, and generally made at laparotomy, due to the objective rareness and absence of typical symptoms. Resection of the infarcted segment is the treatment of choice, offering rapid recovery, and reducing the possibility of adhesion formation. A case of primary omental torsion is reported, with a review of the literature.

Small Cell Cancer of the Duodenum

Primary small cell cancer of the duodenum is very rare. Only six cases have been reported previously. The patient of this case report was a twenty-year-old male who suffered from frequent nausea and vomiting being accompanied by weight loss. The poorly differentiated neuroendocrine cancer was initially diagnosed by endoscopic biopsy and the patient underwent pancreaticoduodenectomy. The diagnosis was refined as primary small-cell neuroendocrine cancer of which the histological appearance was identical to pulmonary and extrapulmonary small-cell carcinoma. The neuroendocrine differentiation was demonstrated by the positive immunoreactions for neuron-specific enolase. This case emphasizes the need to include the duodenum as a possible primary site when metastatic small cell neuroendocrine carcinoma is seen in the absence of apparent pulmonary disease.