Ovarian cancer (OC) is one of the most commonly diagnosed cancers among women. Regretfully due to its a broad spectrum of clinical behavior and challenging diagnosis most cases are diagnosed at a late stage. On rare occasions, these tumors can grow to massive sizes if left untreated, worsening the prognosis of the patient. Thanks to the advancement of medicine and diagnostic techniques, these rare cases are less frequent. Timely detection and surgery could avoid all these potentially troublesome scenarios. We report the case of a 64-year-old female with a giant 13 kg high-grade papillary serous ovarian cystadenocarcinoma, the tumor grew during a four year period and was adequately treated with surgery and is under close follow up with the oncologist. To our knowledge, this is the first case of a giant ovarian cystadenocarcinoma ever reported in Ecuador.

Highlights Trauma during pregnancy is an important cause of adverse fetal and maternal outcomes. Gunshot wounds to the gravid uterus are generally lethal for the fetus, and cause significant morbidity to the mother. Gunshot wounds in a pregnant woman must be handled by a multidisciplinary team. Training in maternal and infant resuscitative measures and surgical techniques are vital.

Intestinal duplication is rare congenital pathology generally diagnosed in infancy or early childhood. Presentation in adults is extremely rare. We present a case of a 36-year-old otherwise healthy female patient without any past medical history. She presented with a month of lower abdominal pain, clinical examination revealed pain and a palpable mass in the lower abdomen. CT scan confirmed a cystic mass dependent of the cecum wall and colonoscopy showed an extrinsic compression of the lateral wall of the ascending colon. However, the mucosa and the rest of the colon appeared normal. Since pain became more intense laparoscopy was performed and a cystic mass dependent on the cecum was discovered. Laparoscopic hemicolectomy was performed. Patient underwent full recovery. On follow up controls, pathology described intestinal cystic duplication of the colonic wall.

Amebiasis is still a major healthcare concern, especially in developing countries like Ecuador. The lack of sanitary control and hygiene measures make parasites infections still a burden for patients and physicians. Despite infections due to this parasites are usually mild, severe infections and fatal outcomes although rare still occur. Bowel perforation is a rare complication of amebiasis, and unfortunately, it continues to be almost fatal. We present a case of an Ecuadorian patient who presented to the emergency room with an acute abdomen, despite adequate surgery and critical care, the patient regrettably died. Bowel perforation due to Entamoeba histolytica was the final diagnosis.

Extracorporeal shock wave lithotripsy (ESLW) is a common and relatively safe procedure, with a high success rate and low adverse effects. Complications of this procedure are usually limited to the kidneys and almost always resolve spontaneously. However, on rare occasions, a frightening complication, as a hematoma of a parenchymatous organ, such as the liver can appear. Abdominal pain is usually the only manifestation when a liver hematoma develops, and should always be investigated, as this dreaded complication can put the patient’s life at risk. Conservative treatment is usually the treatment of choice, nevertheless, on severe cases that do not respond to conservative measures, surgery or embolization is necessary. We report the case of a 38-year-old male who underwent ESWL, 12 h after the procedure he presented to the emergency room with severe abdominal pain, after complementary exams a liver hematoma was detected. Following conservative management, the patient fully recovered.