Splenic flexure volvulus: a rare case report.

Colonic volvulus, where the colon twists around its mesentery, commonly occurs in the sigmoid and cecum. However, colonic volvulus of the splenic flexure is quite rare. Reported cases are limited but suggest that prolonged constipation in patients with either congenital anomalies, history of prior abdominal surgery, and or psychiatric history are described as common risk factors for large bowel volvulus. Here, we discuss a case of a 56-year-old man with a history of chronic constipation and no previous abdominal surgeries who presented to the emergency department with abdominal pain and distention. Further workup including a computed tomography imaging and decompressive via limited colonoscopy confirmed diagnosis of colonic volvulus of the splenic flexure. Surgical management of colonic volvulus is patient specific but invariably involves partial colectomy, as was performed in this case.

Necrotizing Soft Tissue Infection of the Breast during COVID-19 Pandemic.

Necrotizing soft tissue infection has been historically recognized as a severe, rapidly spreading soft tissue infection associated with a very high risk of mortality. Cases of primary necrotizing fasciitis of the breast are rarely described but often fatal. We present a case of necrotizing soft tissue infection of the right breast extending to the anterior abdominal wall in a 39-year-old obese female, with a history of tobacco use. The patient presented 10 days after symptom onset due to concerns and anxiety related to COVID-19 exposure. This delay allowed for further extension and smoldering of the breast infection. The treatment of this aggressive disease process begins with early diagnosis, where a high index of suspicion is vital. Once diagnosed, the treatment regimen should be composed of emergent surgical debridement, which can include breast salvage debridement or total mastectomy, in addition to antibiotic therapy.