Superior mesenteric artery syndrome secondary to an abdominal aortic aneurysm.

Superior mesenteric artery (SMA) syndrome in association with abdominal aortic aneurysm (AAA) is exceedingly rare and has been noted to occur in patients with severe abdominal pain, bilious emesis, and a history of tobacco use. When symptoms of small bowel obstruction occur, it is imperative to investigate further with cross-sectional imaging to determine the etiology. Conservative management is preferred, but in cases of SMA syndrome with concomitant AAA, aneurysm repair should be considered, regardless of size, if initial treatment fails.

Spilled stones following pyelolithotomy: An unusual mimic of peritoneal carcinomatosis.

While spillage of intraperitoneal gallstones has been reported frequently in the literature, spilled renal stones after urologic intervention is rare. The dropped renal stones may mimic peritoneal carcinomatosis (PC) on imaging, causing concern and potentially leading to unnecessary diagnostic workup. Additionally, these dropped stones may cause surrounding inflammation, potentially leading to the formation of adhesions or an intra-abdominal abscess. Calcifications along the peritoneal lining are generally interpreted as peritoneal carcinomatosis until proven otherwise. However, this case highlights the importance of a detailed history and comparison with prior imaging. We describe a rare case of intraperitoneal spilled renal stones after pyelolithotomy initially mistaken for PC, in addition to a review of diagnostic pitfalls and radiologic mimics of PC.

Asymptomatic pneumoperitoneum in the setting of pneumatosis intestinalis: a benign entity or surgical emergency?

Pneumatosis intestinalis is a potential cause of asymptomatic pneumoperitoneum without peritonitis. The disease can be managed conservatively and presents a clinical scenario where pneumoperitoneum does not necessitate surgical management. This case illustrates the importance of acknowledging the condition and its variable presentation, allowing for increased awareness and avoidance of invasive procedures when not indicated.

Complete gastric duplication in an adult with associated anomalies.

Gastric duplication is a rare congenital developmental abnormality usually encountered in children. Nearly all reported cases of this entity describe noncommunicating-type duplication cysts. We present an extremely rare case of complete gastric duplication, involving two separate gastric lumens with proximal and distal communication, incidentally discovered in an elderly male in association with various congenital anomalies not previously reported in literature, as diagnosed with computed tomographic scan and upper gastrointestinal endoscopy.