No abstract

Amyand's hernia is an extremely rare condition in which the appendix is positioned in the inguinal hernia sac. Acute appendicitis is much less common in this situation, especially in the elderly population, and few reports are found in the literature. Whether the presence of the appendix within the inguinal sac increases the chance of developing appendicitis or the relationship is coincidental is unclear. Majority of cases reported are in the male pediatric population. The varying surgical approaches are entirely case-specific without much standardization. Perioperative planning remains difficult in all cases as this condition is exceedingly rare, especially outside of the pediatric population. We present such a case with the hope that we increase awareness about this uncommon condition, in which preoperative diagnosis and planning remains difficult.

Intestinal fibrosis is a rare complication of chronic inflammation resulting from various etiologies, including surgery, abdominal radiation, and inflammatory bowel disease. Consequences of intestinal fibrosis include intestinal dysmotility, malabsorption, and obstruction. Patients with Lynch syndrome are predisposed to developing intestinal adenocarcinoma including in the small intestines which typically require intraabdominal procedures that expose them to fibrogenic triggers. Here, we present a rare case of duodenal fibrosis involving the sphincter of Oddi leading to malabsorption and gastrointestinal symptoms in a patient with Lynch syndrome requiring advanced endoscopy interventions.

Ovarian hyperstimulation syndrome (OHSS) is one of the complications of pharmacological ovarian stimulation used in fertility treatments. This syndrome is characterized by increased vascular permeability secondary to stimulation, resulting in a fluid shift from the intravascular space to the third-space compartments. Patients developing OHSS can experience severe complications, including ascites, pleural effusions, and shock. Here, we present a case of OHSS in the setting of recent transvaginal oocyte retrieval, leading to severe ascites, pleural effusion, and hypotension requiring urgent intervention.

Capsule endoscopy (CE) is a convenient and minimally invasive form of gastrointestinal visualization that has found increased favor as technology has allowed for greater quality imaging. This case addresses some of the issues with this modality emphasizing the need to assess for the contraindication of dysphagia. In this case, we describe a frail patient who aspirated a capsule endoscopy while being evaluated for positive fecal occult blood with concomitant anemia after admission for a stroke alert.