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Spontaneous renal hemorrhage, also known as Wünderlich syndrome, is a rare condition that can be life-threatening and consists of the onset of sudden hemorrhage into the subcapsular and perirenal spaces. It can be lethal as it goes unnoticed and requires aggressive treatment. The entity lies mainly in neoplasms, the malignant ones being the most common. We present the case of a 63-year-old female patient with acute abdomen clinic, a diagnostic laparoscopy was performed and renal hematoma was evidenced as the cause of the symptoms. It was managed conservatively without any complications. We emphasize the importance of keeping in mind Wünderlich syndrome as a differential diagnosis to instigate early treatment for a better outcome.

Background: COVID-19 represents the major pandemic seen the last years generating morbidity and mortality around the world. It is well known the propagation of the virus occurs by air mostly, so it is needed a barrier when the medic personal is treating suspect or confirm patients. Personal protective equipment represents a barrier between the health personnel and the patient during the COVID-19 pandemic. The surgical team during a COVID-19 confirmed o suspicious case procedure requires using PPE to be protected and keep the sterility for the patient safety.Methods: A team of surgeons from a 100% COVID-19 hospital of the Mexican institute of social security developed an inner protocol of safe use PPE maintaining sterility for the surgery.Conclusions: The protocol described provides safety to surgical team and the patient minimizing risk of surgical infections.

Gallstone ileum represents an unusual cause of intestinal obstruction as a result of the presence of stones that cause mechanical obstruction. It has an incidence of less than 4%. Reaching mortality up to 25% of cases. It is a difficult suspicion, with characteristic signs that guide its presence such as pneumobilia, occlusion, and the presence of stone in radiological studies. Management should include surgical extraction as well as revision of the entire intestine with a suitable subsequent repair. Authors present the case of a 70-year-old patient with the presence of surgically resolved biliary ileum.

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