Intestinal angiodysplasia is one of the main etiologies of bleeding within elderly patients. This entity can present in any portion of the intestinal tract, however, when it affects the small intestine it appears as obscure gastrointestinal bleeding up to 30 to 40% of the cases and it represents a diagnosis and management challenge. Early diagnosis is important to establish the most adequate treatment. We present the case of a 69 years old male patient with obscure gastrointestinal bleeding due to a jejunal angiodysplasia, requiring endoscopic location of varicose vessels and dye instillation followed by surgical management with a video-assisted intestinal resection. Conclusions:Intestinal angiodysplasia is an important etiology of bleeding and should be considered when treating an obscure gastrointestinal bleeding case. The combination of endoscopic procedures to precise diagnosis and surgical management is possible and has low rates of complications, morbidity or mortality.

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.