Bronchogenic cyst arising from the crus of the left hemidiaphragm.

A 34-year-old man presented with chronic worsening left-sided retrosternal chest pain. Following a negative cardiac work up he was found, on cross-sectional imaging, to have a cystic mass measuring 9.6×11.8×9 cm related to his left diaphragmatic crus. The patient underwent an exploratory laparotomy with complete resection of the cystic mass. Histopathological examination of the mass confirmed it as being a bronchogenic cyst. His pain resolved following excision of the mass and at follow-up he was asymptomatic with no evidence of recurrence on imaging.

Sigmoid volvulus in a patient with mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS): a rare occurrence.

Mitochondrial diseases are rare and devastating, with a wide spectrum of clinical presentations and systemic symptoms. The majority of the published literature focuses on the neuromuscular manifestations and genetic components of this mitochondrial cytopathy, however, cardiac, renal, endocrine and gastrointestinal manifestations may also be present. The authors report a case detailing a 56-year-old woman's final hospitalisation from the gastrointestinal sequelae of mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes (MELAS) (Co Q10 deficiency variant). She presented with abdominal pain and distension associated with lactic acidosis, and was shown on imaging to have a colon perforation. This resulted in emergent surgery at which a necrotic colon secondary to a sigmoid colon was identified. Following four subsequent operations, and the development of multiorgan failure, care was eventually withdrawn. Practitioners of patients with MELAS should be cognisant of the rare but devastating gastrointestinal consequences of mitochondrial diseases.

Intestinal obstruction secondary to infantile polyarteritis nodosa.

Polyarteritis Nodosa (PAN) is a rare systemic necrotising vasculitis of medium and small-sized arteries. Patients typically present with systemic symptoms. Obstructive intestinal symptoms are described but usually resolve with treatment of the underlying vascular disease. We report a case of a one year old boy with multiple ischemic small bowel strictures secondary to infantile PAN, who was treated with resection of the affected segments by single port laparoscopy.