HighlightsSubcutaneous emphysema usually follows a benign course, in severe cases it can be debilitating and often requires intervention.Subcutaneous emphysema managed with large-bore drain, maintained on low suction.Simple, safe option with sustained decompression of subcutaneous emphysema.

HighlightsMetastatic gastric carcinoma involving the appendix presenting as acute appendicitis is very rare.Gastric cancer with peritoneal dissemination has a very poor prognosis.To date there has been no other reports of metastatic gastric cancer and a synchronous carcinoid tumour co-existing within an inflamed appendix.