Spontaneous gas gangrene of the pancreas: extremely rare condition.

Acute pancreatitis is a common condition, only occasionally leading to necrosis of the pancreas. In instances where abscess formation takes place, the predominant microbial profile involves both aerobic and anaerobic enteric species. We present the case of a patient with clostridial emphysematous pancreatitis who developed pneumoperitoneum without associated visceral perforation.

Vascular complications of tibial exostosis: A case of popliteal vein thrombosis.

Tibial exostosis, also known as osteochondroma, is a common benign bone tumor found predominantly in adolescents and young adults. Vascular complications associated with this tumor, such as arterial occlusion and pseudoaneurysm formation, are rare but can lead to significant morbidity if not promptly diagnosed and managed. We present a case of a 25-year-old patient who presented with thrombosis of the left popliteal vein and a painless swelling in the popliteal fossa. Radiographic and CT angiography revealed an exostosis on the proximal tibia causing arterial occlusion and venous compression. Surgical resection of the exostosis via a posterior knee approach resulted in successful resolution of symptoms and a favorable outcome at a 12-month follow-up. Histopathological examination confirmed the benign nature of the tumor with no evidence of malignant transformation. This case highlights the importance of prompt recognition and surgical intervention in managing vascular complications associated with tibial exostosis. A multidisciplinary approach involving orthopedic and vascular specialists is crucial for achieving optimal outcomes in such cases.

Spontaneous rectus sheath hematoma revealed by abdominal pain during pregnancy: A case report.

INTRODUCTION AND IMPORTANCE: Rectus sheath hematoma (RSH) is an uncommon but significant cause of acute abdominal pain in pregnancy, challenging in both diagnosis and treatment. It often arises from ruptured epigastric vessels and is associated with factors like anticoagulation therapy and previous abdominal surgery. Misdiagnosis, due to nonspecific symptoms, frequently leads to unnecessary surgeries, posing substantial risks to maternal and fetal health. CASE PRESENTATION: We present a case of a 32-year-old multiparous woman at 31 weeks of gestation, experiencing right-sided abdominal pain and irregular contractions. With a history of four full-term deliveries and no recent trauma, her examination showed hemodynamic stability but featured pain upon movement and a notable blue discoloration in the left abdominal area. Moderate anemia was observed in lab tests. The diagnosis of RSH was confirmed via ultrasound and MRI. The treatment approach shifted from conservative to surgical due to deteriorating symptoms and falling hemoglobin levels. CLINICAL DISCUSSION: This case highlights the rarity and seriousness of RSH in pregnancy. Its non-specific symptoms complicate differential diagnosis, underscoring the need for prompt and precise diagnosis to avoid unwarranted surgical interventions. While conservative management is preferred in stable cases, surgical action is required in situations of instability or hematoma growth. CONCLUSION: RSH is a critical consideration in pregnant patients with acute abdominal pain. Early detection and tailored management are essential to mitigate surgical risks and ensure the safety of mother and child. This case reinforces the importance of vigilant and systematic patient evaluation to improve outcomes and minimize unnecessary surgical procedures.

Contraceptive complication: Emergence of a bladder stone - A case report.

INTRODUCTION AND IMPORTANCE: Bladder stones, although rare in a healthy bladder, can emerge due to various factors, including obstructions in urinary flow, recurrent infections, and foreign bodies. Intrauterine contraceptive devices (IUCDs) are known for their potential to migrate from the uterine cavity, leading to unusual complications such as bladder stone formation. CASE PRESENTATION: A 52-year-old woman, previously treated for a complicated urinary tract infection, presented with intermittent lower abdominal pain, dysuria, and hematuria. She had a history of an IUCD insertion 15 years earlier, which was later documented as missing. Diagnostic imaging revealed a large bladder stone, encasing the previously inserted IUCD. An open vesicolithotomy was performed, during which a stone measuring 6 × 5 cm was removed, revealing the IUCD within. The patient had an uncomplicated recovery with no further urinary tract infections at a 6-month follow-up. CLINICAL DISCUSSION: The migration of an IUCD can lead to various complications, depending on its final location. The formation of bladder stones around a migrated IUCD is a rare but significant complication, necessitating a thorough diagnostic approach. Radiography and ultrasonography proved sufficient for diagnosing the intravesical migration in this case. CONCLUSION: This case underscores the importance of considering a migrated IUCD in the differential diagnosis of patients presenting with urinary symptoms, especially those with a history of a missing IUCD. Timely diagnosis and management are crucial in preventing further complications.

Our experience with the surgical management of lower cervical spine fractures: fifty case series.

PURPOSE: Trauma to the lower cervical spine is a serious lesion due to its neurological consequences which jeopardize the vital and functional prognosis. They constitute a public health problem due to their frequency and seriousness requiring rapid and adequate treatment. The aim of our study is to (1) describe the epidemiological, clinical, and radiological characteristics of lower cervical spine trauma patients; (2) support the therapeutic management of these patients and show our experience in surgery for lower cervical spine trauma; and (3) analyze the anatomical and functional results and discuss them with literature data. METHODS: This is a retrospective descriptive study of 50 patients with lower cervical spine trauma treated surgically over a period of five years from January 1, 2016, to December 2020. RESULTS: The average age of our patients was 34.5 years, with a sex ratio of 1.7. The etiologies are dominated by accidents on public roads (58%). They show neurological disorders such as spinal cord damage in 30% of cases and root damage in 20% of cases. The radiological assessment revealed eight tear drops, ten comminuted fractures, 12 severe sprains, 12 biarticular dislocations, six uniarticular dislocations, and two herniated discs. Treatment was surgical in all patients with an anterolateral approach and anterior arthrodesis. The evolution was favourable in 21 patients and stationary in 29 patients. CONCLUSION: Our study concluded that dislocations and fracture dislocations were the predominant type of injury in cases of AVP. Tetraplegia was mainly observed with uni- and biarticular dislocations. The variation in consolidation time was not correlated with trauma-to-surgery time. Better neurological recovery was observed with mild initial neurological damage than with initially severe damage. The appearance of an adjacent syndrome is less frequent with monosegmental arthrodesis than with multisegmental arthrodesis. Cage arthrodesis was an alternative to iliac harvesting with similar results.