Urinary bladder-containing incarcerated inguinoscrotal hernia: a case report.

Inguinoscrotal hernia containing the urinary bladder is a rare entity found in 1-4% of inguinal hernias, while patients rarely present symptoms of urinary dysfunction. We present the case of a 79-year-old Caucasian male with acute renal dysfunction and incarcerated inguinoscrotal hernia containing the entire urinary bladder. The patient presented in the surgical emergency department due to an incarcerated right inguinoscrotal hernia and deteriorated renal function. Preoperatively, ultrasound imaging was performed, which showed the presence of the whole bladder in the hernia sac. The bladder was repositioned to its anatomic position and hernia was repaired through a modified Lichtenstein technique. In patients with inguinoscrotal hernia and acute urinary tract symptoms, surgeons should be aware of the possibility of inguinal bladder hernia. Preoperative imaging can help in preventing intraoperative bladder damage.

Spontaneous massive duodenal perforation after ovarian cancer treatment with bevacizumab.

Bevacizumab has been used as an effective drug for ovarian cancer. However, serious adverse effects, such as gastrointestinal perforation, can occur. Spontaneous gastrointestinal perforation is an uncommon, yet life-threatening complication related to bevacizumab administration. We present the case of a 65-year-old Caucasian female who presented with acute abdomen 10 days after the first administration of bevacizumab for ovarian cancer treatment, and she was diagnosed intraoperatively with a massive duodenal perforation. Bowel perforation after bevacizumab administration is a serious and potentially lethal complication. Careful follow-up of the patients is necessary in order to detect any signs of this condition in time.

Spontaneous rupture of a splenic artery aneurysm treated with a spleen-preserving procedure: a case report.

Splenic artery aneurysm is a rare and life-threatening condition, in case of spontaneous rupture. A rare case of such a rupture, treated successfully with an endovascular procedure, is presented. A 21-year-old man presented to the emergency department after an episode of loss of consciousness. After initial conservative treatment, he developed hemodynamic instability 12 hours later, with concurrent diffuse abdominal pain. Abdominal CT revealed a ruptured splenic artery aneurysm, which was immediately treated with coil embolization. The patient had an uneventful recovery and was discharged on the 12th day after the procedure. Although open surgery is the choice of treatment in cases of ruptured splenic artery aneurysms, endovascular embolization can also be considered a safe procedure with low complication and mortality rates.

Primary greater omental torsion as a cause of acute abdomen-a rare case report.

Greater omental torsion is a rare entity that can cause acute abdominal pain, may mimick other abdominal pathologies, and is difficult to be diagnosed preoperatively. We present a case of a male patient with greater omental torsion mimicking the symptoms of acute appendicitis. A 31-year-old male patient presented with right scrotal pain, initially treated by the urologists, however, 24 h later, he presented right lower quadrant pain, with characteristics of acute appendicitis. After finding in ischemic inflammatory mass on McBurney incision, an exploratory laparotomy was performed, revealing torsion of the greater omentum. Torsion of the greater omentum can be a cause of acute abdomen and could be misdiagnosed with acute appendicitis. Preoperative diagnosis is not easy and resection of the affected tissue is the preferred treatment of choice.

Acute appendicitis as the first presentation of appendiceal metastasis of gastric cancer-report of a rare case.

Metastatic tumors of the appendix is a rare entity, whereas only limited data involving metastasis arising from gastric cancer has been reported. Herein, the case of gastric adenocarcinoma metastasis presenting as acute appendicitis is reported. A 53-year-old male, with a history of subtotal gastrectomy due to gastric adenocarcinoma 3 years before, was referred to the Emergency Department with symptoms of acute appendicitis. While this condition was confirmed intraoperatively, histology examination and comparison with the previously excised gastric specimen indicated that metastasis of gastric adenocarcinoma to the appendix was present. Metastatic appendiceal carcinoma arising from the stomach is an extremely rare condition, associated with poor prognosis. Aggressive treatment of the solitary lesion may present favorable results.