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Rhomboencephalitis—inflammation of the brainstem and cerebellum—has myriad clinical presentations including encephalopathy, cranial neuropathies, long tract signs and cerebellar dysfunction and is associated with significant morbidity and mortality. There are a variety of potential underlying causes that respond variably to treatment, including infections, parainfective syndromes, inflammatory disorders including autoimmune encephalitis and paraneoplastic syndromes. Here, we review its clinical presentation and outline a practical approach to its investigation, aiming to facilitate prompt diagnosis and confirmation of the underlying cause, to start appropriate management early and optimise the clinical outcome.

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Gallstone ileus and small bowel diverticulosis are uncommon pathologies. However, the simultaneous presentation of both in this patient provided a diagnostic puzzle for the surgical and radiological teams at our institution. The imaging also demonstrated several typical features for the pathologies in question. Ultimately the management of the patient was not compromised by the diagnostic dilemma, but the imaging findings represent a useful learning opportunity for all radiologists and general surgeons.

To present an unusual case of 6 bilateral submandibular sialoliths and a review of the management of submandibular sialothiasis. METHODOLOGY: Presentation of a case report of a 27-year-old gentleman with a 10-year history of bilateral recurrent submandibular sialolithiasis. A literature review of to assess the occurrence and management of submandibular sialolithiasis. RESULTS: The observance of a rare phenomenon of bilateral submandibular sialolithisasis, which only occurs in 3-5 % of cases. CONCLUSION: The vast majority submandibular sialolithiasis occurs as single entities, multiple stones occur in only 3-5% of cases. Newer techniques have emerged for the management of this condition; however traditional methods are still being employed successfully.