Kikuchi's Disease Diagnosed by an Excisional Biopsy in a Patient With COVID-19.

COVID-19 is an ongoing pandemic caused by the novel coronavirus SARS-CoV-2. The clinical features of COVID-19 are myriad. Though it is a multisystem illness, it predominantly involves the respiratory system. There have been case reports on rare manifestations of COVID-19, of which COVID-19-related Kikuchi's disease is one of them. To our knowledge, this is the third reported case in the world. We report a lady in her late 60s with COVID-19 infection and secondary bacterial pneumonia, which necessitated ICU admission, having ongoing fever spikes with high inflammatory markers and leukopenia. She was also found to have tender cervical lymphadenopathy on the third week of illness, whose biopsy revealed histiocytic necrotizing lymphadenitis in keeping with Kikuchi's disease. The patient had an uneventful recovery in two weeks without any intervention. The pathophysiology of COVID-19-related Kikuchi's disease is unclear. However, COVID-19 is a viral illness that involves changes in interleukins. The latter is postulated in Kikuchi's disease.

Acute Colonic Pseudo-Obstruction Secondary to Renal Calculus: A Case Report and Review of Pathophysiology.

Acute colonic pseudo-obstruction (ACPO) is obstruction of the large bowel without a mechanical cause. The exact mechanism remains incompletely understood but is thought to result from disruption to the autonomic regulation of the colon, typically in the context of hospitalized patients with medical illness, precipitating medications, or recent surgical intervention. This paper presents an unusual case of ACPO in an ambulatory patient with a recently passed renal calculus, explores the anatomy and physiology underlying the autonomic dysfunction theory of ACPO pathogenesis in the context of the case, and provides a 3D reconstruction of the patient's CT to illustrate the abrupt caliber change at the splenic flexure characteristic of ACPO.

An unusual cause for small bowel obstruction as a complication of an ileostomy formation.

Ileostomy formation is a fundamental component in the surgical management of many gastrointestinal diseases and like all intra-abdominal surgeries, small bowel obstruction is a recognized complication. In this paper we discuss a case of a 44-year-old female who previously had a loop ileostomy for slow bowel transit in the presence of spinal bifida. She presented for subsequent total colectomy because of ongoing pain due to chronic colonic dilation. At surgery, the stoma was not revised and the efferent loop was divided at the peritoneal level of the anterior abdominal wall. Six days postoperatively, the patient developed a small bowel obstruction as a result of the remnant efferent loop within the anterior abdominal wall, forming a cystic mass compressing the ileostomy, requiring surgical intervention. As far as we are aware, this is the first case of small bowel obstruction described due to this unusual etiology.