We present the case of an adult woman with a medical history of repetitive episodes of intestinal subocclusion and occlusion that remitted with medical treatment. During hospital admission due to acute abdominal pain and secondary to CT scan results, an urgent surgical approach was decided with findings of a malrotation anomaly consisting in a short, dilated and volvulus cecum behind hepatoduodenal ligament and a collapsed transversal colon, requiring intestinal resection and ileocolic primary intestinal anastomosis. Conclusion:Repetitive intestinal occlusion and subocclusion symptoms also in an adult patient with history of repetitive episodes that were always treated conservatively should be considered as a possible malrotation anomaly. Cecal volvulus is a very rare clinical entity, difficult to early diagnose and can be associated to a malrotation anomaly. Early surgery in this types of patients, that are used to conservative treatment, require a high index of diagnostic suspicion but can be associated with lower mortality and morbidity.

Drug-associated adverse hepatic reactions could be severe, mostly idiosyncratic, that is; they rarely occur, even if administered in the therapeutic dose and are not detected during developmental phase; any substance could be hepatotoxic, however, some drugs could have a higher potential as non-steroidal anti-inflammatory drugs and among them, diclofenac.

Objective: We present a case report of an 89 years old male with a diagnosis of incarcerated left inguinal hernia, with surgical findings of a complicated sigmoid diverticulum and a tubular structure of 0.5 mm attached to the sigmoid colon, fixed to the inguinal ligament with a true lumen that could correspond to a duplicated appendix B4 type. Introduction: Colon diverticular disease is more frequent in western countries, present in 30% of 60 years old patients and in more than 50% in 80 years old patients, with 95% of the times located at sigmoid colon. The most frequent complication is the acute diverticulitis (25%) and in 30% of these patients, surgery is required. Discussion: Acute, complicated, diverticular disease is an infrequent pathology, even more, a colonic diverticulum included within the hernia sac. Of the appendix congenital malformations, a duplicated appendix is the rarest; usually found in asymptomatic adults as an incidental find during abdominal surgery or during contrasted abdominal scans. Conclusion:Awareness must be raised within first-contact health care professionals about diagnosing surgical entities with high mortality rates, in asymptomatic patients with unclear clinical findings, especially with the occurring of a demographic transition in most countries. In this specific patient, Hartman surgical procedure and a second time inguinal plasty were the best surgical options for this patient; even considering the mortality rates (25%) of a perforated diverticulum, considering added surgical site infection.

Objective: To identify the causes related to a rise in morbidity and mortality due to COVID in the most frequent events of acute abdomen and vascular disease.