Background: Tuberculosis (TB) is classified according to the site of disease as pulmonary or extrapulmonary. Extrapulmonary TB is less common than its counterpart in which it can be found anywhere in the body including the liver. Similar to ampullary carcinoma, TB liver can manifest with jaundice and deranged liver function tests, particularly in the obstructed biliary systems. Case presentation: A 43-year-old gentleman with locally advanced ampullary carcinoma was noticed to have multiple suspicious liver nodules intraoperatively during curative ampulla resection. The surgery was then abandoned after a biopsy. The histology was consistent with chronic granulomatous inflammation. He was then subjected to a Whipple pancreaticoduodenectomy procedure after initiation of anti-tubercular treatment. He recovered well with no evidence of tumour recurrence and worsening TB. Conclusions: A high index of suspicion and quick decision making can help to diagnose a possible extrapulmonary TB masquerading as a malignant disease in a patient with curative intention of ampullary carcinoma.

HighlightsRuptured hepatocellular carcinoma is associated with a significant morbidity and very high mortality rate.Epigastric pain with hypovolaemic shock in addition to a raised serum alpha-fetoprotein can be suggestive of ruptured hepatocellular carcinoma.One staged laparoscopic surgery can be considered among hemodynamically stable candidates with no ongoing bleeding and good functional liver reserve.

Background Adult intussusception is a relatively rare clinical entity. The majority of cases of intussusception in adults are due to a pathologic condition that serves as a lead point and requires surgery. Small bowel intussusception is usually caused by benign or malignant neoplasms appearing at the head of the invagination. Inflammatory fibroid polyp (IFP) of the small bowel is an unusual benign neoplastic lesion that has been rarely reported to cause intussusception, especially in the jejunum. Case presentation We present a rare case of adult intussusception who presented with a triad of intestinal obstruction. Computed tomography revealed small bowel intussusception with bowel ischemia. Intraoperatively, she required resection of the small bowel and primary anastomosis. Macroscopic examination revealed a single pedunculated polyp, which is the lead point of intestinal obstruction and confirmed histologically. Conclusion Inflammatory fibroid polyp should be considered as a cause of intussusception among adults with small bowel obstruction.