Pericecal fossa strangulated internal hernia.

Pericecal fossa internal hernias are a rare cause of intestinal obstruction, and high clinical suspicion is required to diagnose them.

Colonic obstruction secondary to incarcerated transiliac bone hernia.

Transiliac bone hernias are a rare cause of intestinal obstruction, and high clinical suspicion is required for their diagnosis.

Early Serratus Plane Block for Rib Fracture Management could Avoid Intensive Care Unit Admission.

How to cite this article: Gorecha M, Menon A, Woodford E, Yahia S, Marimuthu K. Early Serratus Plane Block for Rib Fracture Management could Avoid Intensive Care Unit Admission. Indian J Crit Care Med 2020;24(10):995.

Idiopathic spontaneous lesser sac haematoma: a perplexing case of abdominal apoplexy.

A 37-year-old woman presented with a 3-hour history of back pain, nausea and vomiting and an episode of syncope. A fluid collection in the lesser sac was detected on ultrasound and CT scan. Emergency laparoscopy and subsequent laparotomy were performed and a large blood clot was evacuated from the lesser sac. No identifiable source or predisposition to bleeding was found. She made a full recovery postoperatively. There are few reported cases of spontaneous intraperitoneal haemorrhage. In a third of cases, there is no identifiable source of bleeding. Unfortunately, patients present late with non-specific symptoms and a prompt diagnosis is difficult to make. The case reiterates the importance of awareness of lesser sac haematoma formation; an unusual clinical entity with a high morbidity and mortality rate. A high index of suspicion, radiological adjuncts and appropriate surgical intervention, especially in unstable patients, is essential for a good outcome.