A Case of Asymptomatic Perforated Gangrenous Cholecystitis in a Diabetic Patient: A Critical Condition.

Gangrenous cholecystitis (GC) is a severe form of acute cholecystitis (AC) with ischemia and necrosis of the gallbladder (GB) wall. Patients with GC are sicker than the usual AC patients, and their surgical treatment is more complex and linked with a higher risk of morbidity and mortality. Typically, the first imaging modality used to assess patients with clinically suspected AC is ultrasound. However, if the ultrasound results were inconclusive, a CT scan might help evaluate these individuals. Our study presents a 62-year-old male who presented with mild right upper quadrant discomfort. However, an abdominal computed tomography CT scan showed a pericholecystic fluid collection with a sign of GB perforation that was managed with subtotal cholecystectomy. Five days after the operation, the patient was discharged to home in excellent condition.

A rare case of epiploic appendages infarction within an incisional hernia: a usual complain of unusual cause.

Epiploic appendagitis (EA) is an uncommon condition caused by infarction of epiploic appendages "small fat outpouchings present on the outside of the colon wall" because of torsion or thrombosis of the main draining vein. It is sometimes misdiagnosed as diverticulitis or appendicitis. Lab tests usually are normal, and the diagnosis is mainly by computerized tomography (CT) scan. Treatment is conservative as it is a self-limited condition, and the symptoms will resolve spontaneously within 2 weeks. However, surgical appendage removal could be necessary if symptoms increase or continue. Here, we report our experience with a 21-year-old male patient, who presented with a 1-day duration of localized right lower quadrant (RLQ) abdominal pain within 18*10 cm incisional hernia, imaging revealed signs of epiploic appendages infarction within the huge incisional hernia. This case describes an atypical scenario for EA, which was successfully managed with surgery. The final pathology report confirms the diagnosis.

Lower extremity necrotizing fasciitis with iliopsoas abscess secondary to perforated colon cancer: a diagnosis not to miss.

Necrotizing fasciitis (NF) is a life-threatening soft tissue infection, typically caused by preexisting conditions such as trauma, complicated intraabdominal infections, or even small wounds. However, it is very rare for NF to occur as a result of perforated colon cancer (CC). Diagnosis primarily relies on clinical findings, imaging, and laboratory tests. Early diagnosis and treatment are crucial for patient survival. In this study, we present a case of an 82-year-old female a known case of CC diagnosed 1 month ago. She presented with hip pain persisting for 10 days duration, along with skin changes over the proximal anterolateral aspect of the thigh. The patient was diagnosed with NF associated with an iliopsoas abscess caused by perforated CC that was managed with surgical debridement, left hemicolectomy, and end colostomy along with broad-spectrum antibiotics.