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.

HighlightsHIV and TB, are a lethal combination in resource-limited countries without adequate follow up.Intestinal perforation due to TB in an HIV patient is a rare complication and depends on the immune status of the host.If non-compliance is anticipated when treating TB and HIV, fully supervised therapy should be initiated.

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.

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