The diagnostic dilemma: Giant Mucocele of the appendix-challenging conventional thinking.

This article reports on a 76-year-old male patient diagnosed with a mucocele of the appendix. A mucocele of the appendix is a benign fluid-filled swelling caused by the accumulation of mucus in the appendix due to a blockage in its discharge route. The patient presented with symptoms of chronic constipation and rectal tenesmus and was diagnosed through physical examination, imaging studies and laboratory tests. The patient underwent an open ileocolectomy procedure to remove the affected appendix. The results of the histopathological analysis showed a confined low-grade appendiceal mucinous neoplasm. The overall survival rate after surgery for mucocele of the appendix is excellent, with a low recurrence rate.

Perforated mediastinal gastric volvulus: an uncommon complication of hiatal hernia.

A woman in her 50s was admitted to the emergency department with a 3-day history of abdominal pain, mainly in the right hypochondrium, radiating to the back, associated with postprandial vomiting and dysphagia. The abdominal ultrasound study found no abnormalities. Laboratory tests showed increased C-reactive protein levels, creatinine and high white blood cell count without a left shift. Abdominal computed tomography scan exhibited mediastinal herniation, twist and perforation of the gastric fundus associated with air-fluid levels in the lower mediastinum. The patient underwent diagnostic laparoscopy requiring laparotomy conversion due to hemodynamic instability related to the pneumoperitoneum. During the intensive care unit (ICU) stay, thoracoscopy with pulmonary decortication was performed to treat complicated pleural effusion. After ICU and standard infirmary bed recovery, the patient was discharged from the hospital. This report illustrates a case of perforated gastric volvulus as the cause of nonspecific abdominal pain.