Colonic perforation in a right atraumatic diaphragmatic hernia.

SUMMARY: A 38-year female with no prior medical or surgical history presented with pleuritic pain and respiratory distress. Imaging revealed a right diaphragmatic hernia with colonic content. At right anterolateral thoracotomy, a diaphragmatic hernia containing a perforated right hemi-colon was found. The colon was resected in the chest and continuity restored via a laparotomy. This case illustrates the risk of obstruction, ischaemia and perforation and highlights the importance of early identification and prompt surgical management to reduce morbidity and mortality.

Rectosigmoid screwdriver perforation presenting as a strangulated inguinal hernia.

SUMMARY: We present a case of a young male patient with no previously known medical, surgical or psychiatric history, who was referred to our institution as an irreducible left inguinal hernia with signs of strangulation. Intraoperative findings, however, revealed a retained foreign body at the rectosigmoid junction, which had previously perforated through the floor of the inguinal canal, essentially sealing off the contamination into the inguinal canal and contributing to the clinical presentation of a left inguinal hernia. This is, to our knowledge, the first published case report locally and internationally concerning rectosigmoid-inguinal canal perforation with the working end of a screwdriver.

Giant peritoneal loose body: an instance of incidentaloma or warranted concern?

SUMMARY: In non-specific abdominal pain, cross-sectional imaging, often valued more than clinical examination in today's technologically advanced age, may reveal a large incidentaloma, posing questions regarding its relation to symptoms and the need for surgical removal. This is a situation that highlights the potential for early detection and treatment yet raises the question as to whether surgery is indeed indicated. This report relates the case of a 79-year-old male, with a longstanding history of abdominal pain, who had a giant loose peritoneal body removed. We discuss the reasons for removal and its pathogenesis.