Among angle closure in young individuals, PIS is not uncommon. The causative mechanism of PIS in young individuals is peripheral iris block, rather than pupillary block which is more often prevalent in older patients. For proper diagnosis and therapy, ultrasound biomicroscopy and gonioscopy should be performed on every young individual with angle closure symptoms.

Stapled hemorrhoidectomy (circumferential mucosectomy) is a technique for the surgical management of third- to fourth-degree hemorrhoids. It is a quick, simple, and painless technique. Complications are endoluminal bleeding, anal stenoses, fistulas, and incontinence. This case report deals with a severe complication which has not been described yet. Our patient had anemic, retroperitoneal bleeding with consecutive evacuation of the hematoma through the stapler anastomosis and following several operations. Nevertheless, a temporary colostomy was not necessary. As mentioned in other publications describing complications after stapled hemorrhoidectomy, this new technique should be used carefully and by surgeons with experience.

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Zusammenfassung. Ein Schweizer Internist und angehender Angiologe ist in Kenia mit einer mobilen Ultraschallklinik unterwegs. Weiter engagiert er sich in der Ausbildung von medizinischem Personal im Bereich Ultraschall. Dies sowie die Zugänglichkeit zu Ultraschall im Kontext limitierter Ressourcen sind das Ziel dieser Initiative.

We report a case of an 88-year old male patient with known chronic lower back pain who presented in late August with progressive pain in his right knee and lower leg as well as paraesthesias. Diagnostic work-up revealed an acute Lyme-Borreliosis.