Overcoming the Odds: Successful Treatment of Disseminated Mucormycosis with Gastrointestinal and Jaw Involvement in a Patient with Acute Myeloid Leukemia.

Disseminated mucormycosis is a rare life-threatening fungal infection that is uniquely seen in severely immunocompromised patients including those with hematological malignancies. We report a case of disseminated mucormycosis with a biopsy-proven gastrointestinal and oral cavity involvement in a patient with acute myeloid leukemia during induction chemotherapy. The patient had a successful outcome with limited resection of the involvement bowel segment, multiple maxillary dental extractions, debridement of the alveolus and hard palate, and combined antifungal therapy. After clinical improvement, stable infection on serial abdominal imaging, and completion of 6 weeks of combined antifungal therapy, consolidation chemotherapy was given, and molecular remission was achieved. The patient remained clinically well on secondary antifungal prophylaxis.

An Incidental Finding of Suppurative Appendicitis During Colonoscopy.

Colonoscopic diagnosis of acute appendicitis is extremely rare. Although a few appendicitis cases were reported in literature following colonoscopy, we present a case today of a patient who underwent elective colonoscopy for colorectal cancer screening. The presence of an inflamed appendiceal orifice with projecting pus was documented, and the patient was referred to the surgical team for intervention. Endoscopic and intra-operative results are also illustrated.

Mucinous Cystic Neoplasm of the Pancreas in Pregnancy: A Case Report.

Mucinous cystic neoplasms (MCNs) of the pancreas are rare epithelial neoplasms, characterized by an inner epithelial layer and an ovarian-type sub-epithelial stroma. These lesions are typically benign but can pose challenges during pregnancy due to their rapid growth potential, associated risk of malignant transformation, and complications such as pancreatitis. We present a case of a 39-year-old pregnant female with a history of recurrent acute pancreatitis, diagnosed with an MCN during pregnancy. Diagnostic procedures were deferred until after delivery, followed by successful distal pancreatectomy. This case underscores the importance of individualized management strategies in pregnant patients with pancreatic MCNs, balancing the need for timely intervention with maternal and fetal safety. Long-term follow-up is generally unnecessary for MCNs without associated invasive carcinoma, emphasizing the favorable prognosis of these lesions following complete surgical resection.

Hepatic or Cystic Artery Pseudoaneurysms Following a Laparoscopic Cholecystectomy: Literature review of aetiopathogenesis, presentation, diagnosis and management.

Pseudoaneurysms (PSAs) of the hepatic and/or cystic artery are a rare complication following a laparoscopic cholecystectomy (LC). Generally, PSA cases present with haemobilia several weeks following the procedure. Transarterial embolisation (TAE) is considered the optimal management approach. We report a 70-year-old woman who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2016 with massive hemoperitoneum two weeks after undergoing a LC procedure in another hospital. She was successfully managed using coil TAE. An extensive literature review revealed 101 cases of hepatic or cystic artery PSAs following a LC procedure. Haemobilia was the main presentation (85.1%) and the mean time of postoperative presentation was 36 days. The hepatic artery was involved in most cases (88.1%), followed by the cystic artery (7.9%) and a combination of both (4.0%). Most cases were managed with TAE (72.3%), with a 94.5% success rate. The overall mortality rate was 2.0%.

Choledochal Cyst in Adults: Etiopathogenesis, Presentation, Management, and Outcome-Case Series and Review.

Background. Choledochal cyst, a rare congenital cystic dilatation of biliary tree, is uncommon in adults. Their presentations differ from children and surgical management has evolved. Methods. A retrospective review of the records of all the patients above 15 years, who underwent therapeutic intervention in our hospital, was carried out. Results. Ten cases of choledochal cyst were found; 8 female, with mean age 31 years. These included 8 cases of Todani type I and one case each of type II and type III. The predominant symptoms were abdominal pain and jaundice. Abdominal mass and past history of cholangitis and pancreatitis were seen in 2 patients. Investigations included ultrasound in 8 patients, CT in 7, ERCP in 3, and MRCP in 5. Surgical intervention included complete excision of the cyst with hepaticojejunostomy and cholecystectomy (type I), excision of the diverticulum (type II), and ERCP sphincterotomy (type III). Malignancy was not seen in any patients. The long-term postoperative complications included cholangitis in two patients. Conclusion. Choledochal cyst is rare in adults. The typical triad of abdominal pain, jaundice, and mass is uncommon in adults. The surgical strategy aims for single stage complete excision of the cyst with hepaticojejunostomy.