Pancreatic Carcinoma Causing Schnitzler's Metastasis.

Schnitzler's metastasis occurs due to the deposition of the tumor cells in the submucosa of the rectum, leading to rectal stenosis. We present a 60-year-old female who presented with abdominal pain, distension, and vomiting. Abdominal examination showed a distended abdomen and palpable bowel loops, and per rectal examination showed rectal stenosis. Imaging studies suggest rectal stenosis with carcinoma of the pancreas head. The patient was diagnosed with Schnitzler's metastasis with carcinoma of the pancreas head, which has not been reported in the literature. The patient underwent a diversion sigmoid colostomy and was planned for palliative chemotherapy after stenting the common bile duct.

Duodeno-duodenal intussusception presenting as upper gastrointestinal bleed.

Duodeno-duodenal intussusception (DDI) is the type of intestinal intussusception in which a segment of the duodenum invaginates into the next part of the duodenum. We present a case of a male patient in his 50s presenting with right upper abdominal pain with multiple episodes of vomiting and a history of melena for 1 month. Imaging studies showed the presence of DDI without apparent growth. The patient underwent upper gastrointestinal endoscopy, which showed a doubtful growth in the duodenum, and the biopsy, was suggestive of adenocarcinoma. The patient underwent Whipple's procedure, and postoperative histology was diagnostic of Brunner's gland adenoma. The patient improved well without any complications.

Cardiac Arrest Due to Anaphylactic Shock Following Vecuronium Injection.

Anaphylaxis under anesthesia is a rare but potentially severe disease. Although anaphylaxis is rare, it can be lethal if not diagnosed and treated appropriately. We present the case of a 43-year-old male with no prior allergy history who experienced a severe anaphylactic reaction that resulted in cardiac arrest after the intravenous injection of vecuronium. His surgery was postponed, and the patient required intensive care with ventilator support and other supportive measures. Post-reaction dermal sensitivity tests revealed a clear allergic reaction to vecuronium which confirmed the diagnosis retrospectively. Eventually, the patient made a full recovery and was rescheduled for surgery at a later date.

Isolated pancreatic tuberculosis masquerading pancreatic malignancy.

Pancreatic tuberculosis is the rarest form of abdominal and extrapulmonary tuberculosis. We present a patient in his 40s who presented with pain abdomen and a fever. On examination, the patient had mild jaundice and right hypochondriac tenderness. Blood investigation was suggestive of obstructive jaundice. Imaging studies were representative of pancreatic head lesion, causing mild intrahepatic biliary radical dilatation. Endoscopic ultrasound-guided fine-needle aspiration done from the pancreatic head lesion was diagnostic of tuberculosis. The patient was started on antitubercular medications and responded well.