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Background Sacrococcygeal teratomas are tumors originating from pluripotent embryonic germ cell layers located in the fetal coccyx. These tumors are highly vascular if they undergo malignant transformation. Typically, they are found in infants and children and occasionally can be diagnosed prenatally. Adult cases are very rare, and represent tumors present since birth with delayed detection. Case presentation We describe a case of a giant sacrococcygeal teratoma in a 25 years old female college student presenting with right gluteal swelling of 4 months’ duration. In addition to the huge disfiguring mass on the perineal area, she also had lower abdominal pain, urinary complaints, and difficulty with ambulation. Discussion Pre-operative impression was of a sacrococcygeal mass and histopathology following complete surgical excision revealed a sacrococcygeal teratoma. She recovered well after surgery with no radiologic evidence of recurrence at six months. Conclusion Although rare, sacrococcygeal teratoma should be considered as a differential diagnosis for female adults presenting with perineal and/or pelvic masses. Complete surgical excision remains the mainstay of treatment.

Coronavirus disease 2019 (COVID-19) is a pandemic affecting over 106 million and killing over 2.3 million people. Inadequate knowledge of the disease coupled with scarce or improper use of infection prevention and control (IPC) measures by healthcare workers (HCWs) and support staff may be contributing to the rapid spread of infection. This survey aims to assess knowledge, risk perception, and precaution practices of HCWs and support staff toward COVID-19 under resource-constrained circumstances at a major referral hospital in Ethiopia. An institution-based survey was conducted in April 2020 using 422 subjects selected by stratified random sampling. A five-section survey instrument was distributed, and the collected responses were cleaned and entered into Epi data (v3.1) and exported to SPSS (v.26) for further statistical analysis. The survey found that about 58% of the HCWs and support staff in the hospital appear to have adequate awareness and perceive COVID-19 to be a high-risk disease. Seven out of 10 subjects practice some form of IPC measures. However, the knowledge among allied HCWs and support staff appears to be inadequate. Gender, occupation, and years in service correlated with the level of awareness. Of those surveyed, 78% were concerned about the lack of personal protective equipment and perceived public transportation to be a high-risk factor for the transmission of infection. Additional campaigns may be necessary to reinforce existing knowledge of HCWs, but more emphasis should be geared toward educating allied HCWs and support staff.

Obturator hernia, protrusion of abdominal content through the obturator foramen, is a rare type of abdominal wall hernia. Late patient presentation is associated with significant morbidity and mortality. We present rare case of obturator hernia causing small bowel obstruction in a 65-year-old-female patient. She presented with crampy abdominal pain, nausea and vomiting of three days duration. She was diagnosed with acute surgical abdomen and managed surgically at Arsi University College of health sciences, Assela, Ethiopia. Intraoperative finding revealed left-side obturator hernia, which is an extremely rare occurrence. Despite delayed presentation, our patient had smooth postoperative recovery. Obturator hernia is exceedingly rare, and it poses a diagnostic challenge as signs and symptoms are often nonspecific, making a preoperative diagnosis difficult. So, it should be considered as differential diagnosis in elderly patients presenting with acute surgical abdomen.

Highlights Iatrogenic pneumopericardium following tube thoracostomy is exceedingly rare. Delayed or missed diagnosis of iatrogenic pneumopericardium can be fatal. Infants tend to develop tension pneumopericardium urging surgical intervention. Iatrogenic pneumopericardium in infants can be managed conservatively with caution.