The abscess of the spleen is a rare condition with diverse аetiologies and highly polymorphic clinical expression. It is more common in male than female patient, with a wide age range. Regarding varied and often unspecific symptomatology it poses a great problem for diagnostic and overall treatment with a very high mortality rate in untreated patients. Recent diagnosis and treatment are based on modern imaging techniques that enable precise and rapid diagnostics. The following is a presentation of a case that refers to a young male patient with splenic abscess. CASE REPORT. A 37-year-old patient with a history of hypertensive crisis and multiple previous admittances to the emergency room regarding acute attacks of pancreatitis and persistent reduction in body weight was admitted to the emergency room with nonspecific symptoms of abdominal pain, more prominent in the upper left quadrant. Laboratory findings revealed leukocytosis and elevated levels of CRP. Infective panel for hepatitis and HIV was negative. Additional ultrasound investigations were made which revealed hypoechogenic lesion in the spleen, clearly demarcated from the neighboring parenchyma and partially encapsulated, with near proximity to the tail of the pancreas. Hospitalization with additional MRI and surgical treatment was advised, but the patient refused and contrary to the advice of the doctor decided to leave the hospital. After 10 days he was again admitted to the emergency room with persistent leukocytosis and elevated CRP. Because of the worsening condition, he accepted the previously proposed treatment and was hospitalized. The conducted MRI investigation revealed three cystic lesions with dense content in the spleen, measuring from 5x3sm to 2sm in diameter with propagation towards the tail of the pancreas. Surgical splenectomy with partial pancreatectomy was performed, and the surgical specimen was forwarded for histopathological examination. The microscopic examination on the selected specimens revealed severe stasis in the splenic parenchyma with subcapsular abscess formation, and also confirmed the chronic pancreatitis condition. The postoperative course went well without any complications, as well as on the following regular checkups. DISCUSSION. Splenic abscess is very uncommon entity associated with versatile etiologies which covers primary immunocompromised patients, trauma or patients with infective endocarditis. As a potentially life-threatening condition it is essential to emphasize the need for fast detection and splenectomy as a choice of treatment. But also it is very important as a potential aetiology to have in mind other chronic conditions like pancreatitis, especially in young male patients, given that management of the underlying disease is of great importance.

Tumors of the small intestine are extremely rare, and clinical signs and symptoms are nonspecific, resulting in prolongation of the diagnosis process and subsequently worsening the outcome of the treatment. In addition to non-specific symptomatology, additional difficulty in diagnosing is the very inaccessibility of the jejunum through endoscopic techniques. The following is a review of the case of a female patient with jejunum carcinoma. CASE REPORT. A 64-year-old patient with nonspecific symptoms of fatigue, weight loss and sore pain in the stomach initially hospitalized due to anemic syndrome. An endoscopic evaluation was performed, and the fining was chronic gastritis. The patient was prescribed with iron supplementation therapy and was sent home. Within a month, the fore mentioned symptoms started to intensify, and the patient was hospitalized at the General Hospital in Skopje, where extensive investigations were conducted. Upper digestive endoscopy was made, and the finding again only showed chronic gastritis. Due to lack of findings, the doctors performed abdominal ultrasonography that indicated only a bolded intestinal segment with a thick wall of 9mm in the projection of the left flexure to the descending colon. The need for additional investigations grew and computed tomography with contrast of the abdomen and small pelvis was performed. The finding of the computed tomography was in favor of an irregular intestinal segment in the projections of the jejunal convolutions, with a thickened heterogenic wall and pathological post-contrast coloring. Due to the need for correlation with other trials, MRI was performed, and its finding was highly suspected of a tumor change in the jejunum, but an inflammatory disease was not excluded. Because of this finding, the patient was sent to the Department of Digestive Surgery at the same facility. From a surgical point of view, the patient was treated with an upper medial laparotomy, which made it possible for the tumor to be released from its surroundings. The surgery and after surgery course and the patient’s condition were all as expected. The patient was in a stable general condition after the surgery, and she was sent home. The pathophysiological finding resulted in jejunal adenocarcinoma (Latin adenocarcinoma intestinijejuni). After the pathophysiological finding was obtained, the patient was referred to an oncologist for eventual adjuvant therapy. DISCUSSION. Small intestine carcinoma is a specific clinical and surgical entity, which is often diagnosed in an already overdue phase. This is due in part to the non-cohesive symptomatology, but largely due to the still insufficiently sophisticated detection methods. Because of this enigmatic nature of these carcinomas, it may be necessary to think of a special team in the digestive surgery departments, which would solely work on this pathology, in order to speed up diagnosis and improve the outcome of the treatment for the patient.