Introduction: Congenital hernias are rare findings, and their diagnosis is often delayed due to an incorrect interpretation of the clinical symptoms and/or images. We present a rare case of leftsided paraduodenal hernia at the ligament of Treitz, followed by a review of the literature.Case Presentation: We report the case of a 20-year-old patient with unusual, recurring abdominal pain in the past 3 months. There were no previous operations or past illnesses in the patient's history. The computed tomographic scan showed a misplacement of small bowel into the lesser sack. With high suspicion of an internal hernia, we performed a diagnostic laparoscopy, which revealed a Treitz hernia. The reduction and fixation could be carried out fully with minimally invasive surgery with an uneventful postoperative course and complete recovery. Conclusion:A Treitz hernia is a rare cause of unspecific abdominal pain and the clinical signs are difficult to interpret. However, its knowledge may help to avoid emergency procedures and provide quick recovery of the patients. We recommend the laparoscopic approach as the first choice of treatment in all cases of internal hernia in the absence of peritoneal irritation or severe bowel obstruction.

Introduction: Isolated complete transection of the small bowel is extremely rare in blunt abdominal trauma. If it occurs, it is often associated with high-energy impact, as seen in motor vehicle accidents and falls from heights. In this case, a trivial trauma due to a handlebar injury caused a complete transection of the middle jejunum.Case Presentation: A 47-year-old man walked into the emergency department with moderate abdominal pain ∼10 hours after a fall on to a bicycle's handlebar from a standing position. A bedside ultrasound showed minimal amount of free fluid and a following performed computed tomographic scan indicated an edematous loop of small bowel with diminutive amount of extraluminal air, suggesting small bowel perforation. Because of the absence of abdominal peritonism in a hemodynamically stable patient, a conservative treatment and surveillance was established. In the follow-up, the patient suddenly developed severe abdominal pain with now clear signs of peritonism. An emergency laparoscopy showed a complete transection of the middle jejunum. A primary anastomosis was performed. The patient had an uneventful recovery and was discharged after 7 days.Conclusions: Even seemingly trivial blunt abdominal traumas can cause complete transection of the small bowel, as shown in this case. Patients with blunt abdominal trauma need to be reviewed frequently by an experienced clinician. Diagnostic laparoscopy attaches a great importance to early detection and treatment of small bowel injuries. The mechanical pattern of the injury seems to be more important than the energy of the impact itself.

Background: Pressurized intracavitary aerosol chemotherapy is a newly developed therapeutic strategy to treat peritoneal and/or pleural carcinomatosis by directly applying antitumor agents into the peritoneal and/or in thoracic space (PIPAC = pressurized intraperitoneal aerosol chemotherapy, PITAC = pressurized intrathoracic aerosol chemotherapy). According to the current literature these approaches appear to be promising in terms of efficacy and safety as compared to the other standard chemotherapy strategies for advanced stage tumors. Methods:The purpose of our retrospective, monocentric, observational study is to evaluate the postoperative outcomes of PIPAC/PITAC in patients with peritoneal and/or pleural carcinomatosis from several tumor entities; focusing in particular on gastric cancer, ovarian cancer, mesothelioma and colorectal cancer. Other peritoneal/pleural metastatic tumors have also been investigated and are included in the study.