Rare Presentation of the Vein of Servelle in a Case of Klippel-Trenaunay Syndrome.

Klippel-Trenaunay syndrome (KTS) is a rare congenital vascular syndrome involving bone and soft tissue hypertrophy of the involved limb and vascular malformations of the lymphatic, capillary, and venous systems. It is often confused with Parkes-Weber syndrome (PWS). KTS is characterized by a triad of capillary malformation in the form of port wine stains, bone or limb hypertrophy, and varicose veins. The vein of Servelle, also known as the lateral marginal vein, is one of the two persisting embryonic veins of the leg, the persistent sciatic vein being the other. Truncal vascular malformation can be a complication of failure of obliteration of these veins. We present a case of a 24-year-old male of KTS who had varicose veins in his right lower limbs since five years of age and macrodactyly with a synchronous presentation of the vein of Servelle.

Gastric Necrosis: A Rare Complication of Gastric Mucormycosis.

Mucormycosis is an invasive fungal infection. The prevalence is low for this disease, and the most common site of its occurrence in the gastrointestinal system is the stomach. The clinical signs and symptoms of gastric mucormycosis are vague such as pain in the abdomen, nausea, vomiting, haematemesis, etc. In the current study, a 42-year-old male patient came with complaints of pain in the abdomen associated with vomiting and mild-grade fever based on vague clinical presentation and imaging like upper gastrointestinal endoscopy and computer tomography angiography of the abdomen. Our preoperative diagnosis was gastrocolic fistula secondary to acute on chronic pancreatitis, which was managed by emergency exploratory laparotomy, resection, and anastomosis. Histopathological examination was successful in confirming the diagnosis of mucormycosis. Through this case report, we intend to draw surgeons' and physicians' attention to gastrointestinal mucormycosis, an emerging cause of gastric necrosis in young patients in the post-coronavirus disease era, and that physicians need to be more aware of the consequent high mortality and morbidity. Early diagnosis followed by aggressive debridement, antifungal therapy, and managing the underlying disease is the most efficient way to reduce mortality associated with the disease.

Urinoma Due to Spontaneous Rupture of the Renal Pelvis Mimicking Appendicitis.

Spontaneous rupture of the renal pelvis (SRRP) with urine extravasation is rare. This condition is primarily associated with an obstructing ureteric calculus. It creates a diagnostic dilemma, especially when the clinical diagnosis can be inconsistent. Herein, we report a 49-year-old male patient who presented with abdominal pain for the past three days and was diagnosed with acute appendicitis. A computed tomography (CT) scan revealed a right renal pelvis rupture and urinoma secondary to an obstructive 4 mm ureterovesical junction calculi. The patient was successfully treated with double-J stent placement. In conclusion, even though SRRP is rare, emergency physicians should have knowledge regarding this condition, which often presents as an abdominal condition and may be misdiagnosed as another condition requiring surgical intervention. Radiologic investigations such as CT scans are useful methods in suspected cases of this condition in order to reduce unnecessary surgical intervention.

Successful non-operative management of multiple intra-abdominal solid organ injury after blunt abdominal trauma: a case report.

Injuries to the solid abdominal viscera are common after blunt trauma. The success of non-operative management of these injuries has led to recent extensions of this approach to managing higher-grade, more complicated injuries that are typically treated operatively. We reported a 19-year-old male who presented with abdominal pain and gross hematuria during the late hours due to a motor vehicle accident. Abdominal computed tomography scan revealed moderate hemoperitoneum, extensively devascularized spleen with laceration extending into the hilum, multiple tears in the left kidney extended to the hilum, and large perinephric hematoma suggestive of Grade V injuries (shattered spleen and left kidney). We managed the patient non-operatively until he improved and became ready for discharge from the hospital in stable good health status. In conclusion, this case brings to light a unique instance where severe grade multiple solid organ injury was successfully managed with a conservative approach.