Polyarteritis nodosa (PAN) is a systemic necrotising vasculitis preferentially targeting medium-sized arteries and not related with glomerulonephritis or small vessel involvement. Clinical manifestations of PAN are multisystem. The gastrointestinal, renal, cardiac, musculoskeletal, skin and central nervous systems may be involved. The aetiology remains unknown, and the ensuing vasculitis may lead to aneurysm formation and thrombosis in any organs of the body with resultant ischaemia. PAN of the intestines is a relatively common manifestation of this disease but rarely causes bowel ischaemia resulting in necrosis. Here we report a case of a young Chinese patient who presented with an acute abdomen requiring surgery and made good recovery post operatively. He remains free of symptoms while on steroid therapy.

Spontaneous urinary bladder rupture is a rare condition. Radiotherapy treatment for malignancy of a pelvic organ such as cervix or prostate is one cause of this condition. We report a case of a 71-year-old woman who presented with this illness 30 years after radiotherapy treatment.

Background: Benign Prostatic Hyperplasia (BPH) is common in aging men with worldwide prevalence at 20-62%, while Malaysian prevalence was 39.3% (2001) and increased at 8% per decade. In surgical treatment of BPH, Trans-Urethral Resection of Prostate (TURP) remains the gold standard. Other surgical options would mostly also require general anesthesia (GA). Therefore, more Local-Anaesthesia (LA) based options should be made available for patients who are not fit or unwilling to be under GA. Those currently available LA-based procedure has shown promising results including prostatic stents and trans-urethral lifts, but have drawbacks due to being expensive, not widely available, less suitable in median lobe enlargement or may cause complications including migration, overgrowth of prostatic tissue or foreign-body related complications which may require GA for their treatment. Prostatic Artery Embolization (PAE), initially an LA-based emergency treatment option for persistent life-threatening hematuria from a bleeding BPH, now has been proven to be a safe elective treatment. In Malaysia this novel technique was first reported in 2017 for treatment of post TURP intractable hematuria. Methods and Material: We retrospectively evaluated all 13 catheter-dependent BPH patients in two tertiary urology centres treated with PAE from April 2019 until December 2021 to assess post-treatment efficacy. Results: One patient failed removal of catheter within 3 months post-procedure but 12 out of 13 patients safely got their catheter removed within 1-3 months and resulted in significant IPSS improvement. Conclusion: PAE is a safe and effective treatment option for BPH patients of the Malaysian population but needs prospective evaluation.

Renal artery aneurysms are a rare occurrence, with a prevalence of about <1%. The majority of patients are asymptomatic and are diagnosed through incidental findings on imaging. In very rare occurrences, the aneurysm can rupture and cause significant morbidity and even death.