Epiploic Appendagitis: An uncommon surgical diagnosis

Epiploic appendagitis or appendices epiploicae, is a rare cause of abdominal pain in patients with mild signs of abdominal pathology. It mimics diverticulitis or appendicitis clinically as there are no pathognomonic features. It is a surgical diagnosis presenting with localised, sharp, acute abdominal pain, not associated with symptoms like nausea, vomiting, fever or suggestive laboratory values. With the availability of abdominal CT scans and ultrasound, it will frequently be a differential diagnosis preventing unnecessary surgery for patients. However, it may be erroneous and therefore clinical judgement is of paramount importance. This report highlights this rare presentation and identifies management guidelines. KEY WORDS: Epiploic appendagitis; Appendices epiploicae; Appendicitis; Diverticulitis

Computed tomography of the thorax with 3D reconstruction in penetrating chest injury

Penetrating chest wounds is less common but more deadly then blunt trauma. Majority of penetrating chest trauma can be managed conservatively with observation and simple thoracotomy. This case report highlights a bizarre occupational hazard causing a penetrating chest injury and the option of non-invasive management with the aid of computed tomography with 3D reconstruction.

A curious case of Meckel’s diverticulum

Meckel’s diverticulitis or Meckel’s associated pathology frequently presents in childhood with gastrointestinal bleeding. It is rarely seen in adults. It is a congenital abnormality that commonly goes undetected. We present a case of a perforated Meckel’s diverticulum due to fishbone ingestion in an elderly gentleman. The aim of this case report is to highlight the rare presentation of a perforation in a Meckel’s diverticulum due to an extrinsic pathology and to outline diagnostic and management options in cases of Meckel’s diverticulum.

Fulminant necrotising amoebic colitis: A diagnostic conundrum

Fulminant necrotising amoebic colitis is a complication of untreated amoebiasis. This is seen in mainly low-income countries. It has a high mortality rate and is difficult to diagnose. We present an extremely rare case of fulminant necrotising amoebic colitis that caused diagnostic confusion in mimicking an acute abdomen, presumably caused by a perforated duodenal ulcer.