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Congenital agenesis or absence of vermiform appendix is very rare. Herein, author reported a case of a 28 years old Vietnamese lady who presented with a picture of acute appendicitis. During surgery, author failed to find the appendix. Postoperatively, she made uneventful recovery and she was diagnosed as a case of nonspecific abdominal pain (NSAP) with appendicular agenesis.

A carbuncle is a coalescence of several inflamed follicles into a single inflammatory mass with purulent drainage from multiple sinuses. They can develop in healthy individuals with no predisposing conditions or in immune-compromised ones. Author are presenting a case report of 57 years old Saudi presented with neglected huge carbuncle of the neck that was found complicated with intracranial extension in the posterior cranial fossa. He underwent successful simultaneous excision of the carbuncle and debridement of gross necrotic tissues; together with evacuation of the intracranial abscess. Both general and neurosurgical teams were involved. Patient made uneventful recovery and discharged home in good condition.

Despite the major advances in the field of trauma management. High grade Blunt pancreatic injury remains a disease with both high mortality and morbidity specially in cases of delayed diagnosis. Herein we will present a case report of 31 years old Saudi male who was involved in motor vehicle accident with a delayed diagnosis of pancreatic injury associated with other multiple injuries. He was diagnosed late on 12th day of admission during laparotomy where a missed high-grade pancreatic fracture at the neck of pancreas, massive pancreatic ascites and extensive pancreatic necrosis was found. Open abdominal closure technique with mesh mediated fascial closure and Vacuum assisted closure was used to improve both respiratory function and abdominal disease through repeated debridement with peritoneal lavage and sequential approximation of fascia. He responded well gradually and offered definitive closure of fascia and feeding jejunostomy. Unfortunately, he had a sudden stroke followed by rapid deterioration then expired 48 hours later.

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