Delayed presentation resulted in morphological changes, increased complications, number of orchidectomy and reduced chance of testicular growth post orchidopexy.

The diagnosis of appendicitis is challenging in neonates and infants due to the unspecific clinical signs and symptoms, presence of many differentials and inability to elicit history from a preverbal child. Gangrenous retrocolic appendix mimicking incarcerated umbilical hernia is rare. Consequently, the correct diagnosis of a gangrenous retrocolic appendix in a 13-month-old boy who presented with features highly suggestive of incarceration of proboscoid congenital umbilical hernia was very challenging. This case is presented to highlight the diagnostic challenge and increase the suspicion of appendicitis in infants with non-classical clinical features.

Internal carotid artery dissection commonly affects younger patients. We present a case of a previously fit and well 43-year-old gentleman who presented with a sudden onset of slurring of speech, with right-sided tongue deviation and fasciculation on examination. Signs and symptoms began following participation in a home workout class. Magnetic resonance angiography revealed right-sided extracrainal internal carotid artery dissection leading to right-sided unilateral twelfth cranial nerve palsy.

Jehovah’s Witness followers pose a clinical dilemma to the medical practitioners due to their religious belief of an absolute prohibition of blood transfusion under any circumstances. We present a case of Jehovah’s Witness follower who underwent an ultra-low anterior resection for rectal cancer after neo-adjuvant chemo-radiotherapy. The challenges in the perioperative management are highlighted and managed accordingly.