Iatrogenic enterocutaneous fistula following an incarcerated Richter's femoral hernia misdiagnosed for an inguinal abscess: A case report.

INTRODUCTION AND IMPORTANCE: As the Richter's hernia contains anti-mesenteric intestinal wall, patients usually do not present with obstructive symptoms. Consequently, this leads to delays in diagnosis and increased morbidity and mortality. Early detection and surgical treatment are therefore paramount to improving outcomes. CASE PRESENTATION: A 51-year-old female presented with an incarcerated Richter's femoral hernia misdiagnosed as inguinal abscess that underwent incision and drainage. This developed into an enterocutaneous fistula (EC Fistula) and was eventually complicated by peritonitis, requiring laparotomy and herniorrhaphy. Post-operative recovery was uneventful. CLINICAL DISCUSSION: In advanced stages, Richter's femoral hernia may present with obstructive symptoms as in other incarcerated hernias. Richter's hernias may eventually present with obstructive symptoms in their advanced stages. Their relatively asymptomatic nature increases the risk of complications, such as enterocutaneous fistula. CONCLUSION: This case highlights how an incarcerated Richter's femoral hernia in a female misdiagnosed as an abscess delayed treatment, increased patient morbidity with development of an enterocutaneous fistula and peritonitis, and mandated surgical exploration to control sepsis and repair the hernia.

Exceptional Survival of a Buried Alive Newborn: A Case Report.

Introduction: This report details the exceptional survival of a female newborn buried alive by her own mother after a clandestine and unassisted birth. Despite spending over six hours underground, the newborn remarkably survived without exhibiting signs of perinatal asphyxia or major complications, and did not require advanced resuscitation measures. Case Presentation: Rescued following a shocking discovery in a garden and rushed to the hospital, this newborn experienced transient hypothermia, mild to moderate respiratory distress, and scattered skin bruises. After five days of hospital care, she was discharged in clinically stable condition with no infectious complications, displaying age-appropriate normal neurological examination findings and excellent feeding. Conclusion: This case not only defies established expectations but also illuminates perinatal physiological adaptation complexities. It highlights a fortunate and exceptional outcome in dire circumstances, presenting a captivating enigma within scientific realms. This report sheds light on the critical importance of early intervention and timely rescue efforts in cases of neonaticide, emphasizing the significance of raising awareness and implementing prompt measures to safeguard newborns in vulnerable situations and collectively contribute to our understanding of handling similar distressing cases.

A rare case of Demons-Meigs' syndrome with a 7.5 kg giant ovarian fibroma associated with severe dyspnea: case report.

Introduction and importance: Demons-Meigs syndrome is a rare condition characterized by the presence of a benign fibroma of the ovary, ascites, and pleural effusion. It is very uncommon, and the diagnosis is made with difficulty based on symptoms that usually mimic disseminated malignancy or tuberculosis, but imaging may confirm the diagnosis. The definitive treatment is laparotomy, after which the symptoms resolve. Case presentation: We present a 36-year-old female with Demons-Meigs' syndrome with severe dyspnea who underwent an abdominal surgical exploration, which revealed ascites of 1500 ml and an ovarian fibroma weighing 7.5 kg and measuring 12 cm in length. There were no postoperative complications. CA-125 was undetectable at 3 months post-procedure. Clinical discussion: The most common symptoms are dyspnea, fever, fatigue, and weight loss. In low- and middle-income countries, patients usually present with late-stage disease. The treatment of choice for Demons-Meigs' syndrome is exploratory laparotomy. Conclusion: This tumor is often misdiagnosed as a uterine myoma on sonography. The symptoms resolved, and the patient became asymptomatic after laparotomy and thoracocentesis. For this reason, when patients present with effusion and an abdominal mass, a thorough assessment should be done to confirm if it is Demons-Meigs' syndrome, which can be completely cured by the removal of the tumor.

Congenital infantile hypertrophic pyloric stenosis in preterm dizygotic twins infants diagnosed early: A case report.

INTRODUCTION AND IMPORTANCE: The association in the occurrence of hypertrophic pyloric stenosis (HPS) is 0.25 % to 0.44 % between monozygotic twins and 0.05 % to 0.10 % in dizygotic twins. A combination of genetic and environmental factors may have contributed to the occurrence of HPS. In view of the few related cases reported recently, we present two dizygotic twins who were diagnosed with HPS. CASE PRESENTATION: This report describes a rare case of congenital infantile hypertrophic pyloric stenosis in preterm dizygotic twins diagnosed early, in which the first case presented with severe clinical features and managed surgically while the second presented with moderate features and hence managed non-operatively with atropine for 14 days. At 6 months of age, both twins continued to tolerate feeds, demonstrated satisfactory weight gain and had achieved appropriate developmental milestones. The postoperative course was uneventful in the twin A. CLINICAL DISCUSSION: Congenital HPS in premature twins remains an underdiagnosed pathology due to its clinical picture mimicking digestive intolerance to feeds. The mean age at diagnosis is about 38 days, and only 0.4 % of all children suffering from HPS show symptoms in the first 3 days of life. Symptom relief is achieved after a classic pyloromyotomy is performed by a more preferable laparoscopic technique or using the open surgical technique. CONCLUSION: If one of the dizygotic twins has HPS, the other baby should be evaluated for the same diagnosis as early as possible, to ensure timely management. HPS with moderate clinical features can be treated with atropine for 14 days while severe HPS should be treated by pyloromyotomy.

Urethral calculus with a recurrent acute urinary retention in a male child aged 11 years: A case report.

Urolithiasis is the presence of a stone anywhere in the urinary tract, it is commonly seen in adult patients and rare in children, especially when it is associated with acute urinary retention. In children, history is not suggestive and not specific; diagnosis is made by exclusion, and imaging studies often get the findings as incidental. In this case, the clinical presentation made early diagnosis quite difficult. The management of urethral calculi varies according to the site, size, associated urethral pathology, and available resources. It becomes an emergency when it causes acute urinary obstruction, urethral bleeding, or pain. We present a case report of an 11-year-old male with a history of 3 episodes of acute urinary retention secondary to urethral obstruction by calculi. The period between 1 episode and the next was observed to be approximately 1 year, with no logical explanation. Urethral calculus in children is less frequent than in adults worldwide. Urethral calculi are either formed in the native urethra or migrate from the upper urinary tract. Urgent urinary diversion and removal of the calculus with minimal urethral trauma is the recommended treatment.