Small bowel intussusception following blunt abdominal trauma in an adult patient.

Blunt abdominal trauma is a rare cause of small bowel intussusception in adults. A patient is described who presented with signs and symptoms of intestinal obstruction following a fall from a ladder. A CT scan revealed evidence of ileo-ileal intussusception. Exploratory laparotomy and resection of a necrotic bowel segment were performed. Rare occurrences like intussusception should be kept in mind in similar presentations with careful examination of the pathognomonic CT findings, as early detection and surgical intervention with manual reduction could preclude the need for small bowel resection and its untoward possible complications.

Acute granulomatous schistosomal cholecystitis.

Schistosomal cholecystitis is a rare entity with less than 10 cases described in the medical literature [1-3]. It is unclear whether schistosomal eggs deposited in the wall of the gallbladder trigger a clinically manifest acute cholecystitis, since most of the cases described were also found to have concomitant gallstones. Herein, we report a patient who developed acute schistosomal granulomatous acalculous cholecystitis. The clinical presentation, chronology of events and pathological findings strongly support the association between cholecystitis and schistosomal infection.

Richter's hernia: an unusual presentation.

Richter's Hernia is an unusual form of herniation. The incarceration accompanying the hernia invariably leads to bowel ischemia. Chronic incarceration of the antimesenteric border of the intestine, presenting with a long-standing history of signs and symptoms with no dire consequences is unusual. We present a case with a typical acute presentation, and the only case we are aware of with a chronic incarceration leading to a true diverticulum of the hepatic flexure.

Penetrating missile embolisation.

The present case report is that of a 13-year-old boy, who was admitted to the Emergency Unit at the American University of Beirut Medical Center (AUBMC), with a bullet injury to the right upper quadrant with no exist. Chest X-ray and KUB failed to reveal the bullet and there was no evidence of haemo- or pneumothorax. X-ray of both thighs showed the bullet at the level of the right groin. The bullet penetrated the liver, diaphragm and pericardium. It entered through the left ventricle and embolised through the arterial circulation to the right superficial femoral artery. Included in this report is a review and analysis of patients with missile embolisation, who were treated at the AUBMC over the last 10 years.