Mucormycosis is an opportunistic fungal infection that is associated with high mortality in immunocompromised individuals. While rhinocerebral and pulmonary forms are most common, primary gastrointestinal mucormycosis is very uncommon. The stomach is the most commonly affected organ followed by the colon and ileum in alimentary zygomycosis. We report a rare case of invasive gastric mucormycosis in a 50-year-old diabetic gentleman with a history of chronic alcoholism presenting with complaints of pain and distension of the abdomen for 6 days associated with fever, nausea, vomiting and anorexia. At presentation, he was hemodynamically unstable, febrile with uncontrolled blood sugar level and had negative HIV serology. There was generalized guarding, rigidity and distension of the abdomen and investigations confirmed perforative peritonitis. Upon exploration, there was solitary large 4×4 cm size perforated ulcer in the gastric body with greenish, greyish sloughed out mucosa within. Wedge resection of the ulcer with primary closure was performed. Histopathology revealed aseptate, broad, obtuse angled fungal hyphae, and invasive mucormycosis was confirmed by special stains like Periodic acid-Schiff (PAS) and Gomori′s methenamine silver (GMS). Very few cases of invasive gastric mucormycosis associated with uncontrolled diabetes and alcoholism have been reported in the literature. Delayed presentation of the patient along with rapid progression to fungal septicaemia resulted in the case fatality despite early surgical intervention and critical care management.

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HighlightsThese two forms of a hernia form a very rare association.Laparoscopic management of two different pathologies in one setting.Till now only four cases have been reported in English literature with successful Laparoscopic management of this condition.Patients may present with acute life-threatening complications viz. Incarceration, volvulus, etc.

Schwannomas are slow-growing asymptomatic neoplasms that rarely occur in the gastrointestinal (GI) tract. It is a submucosal tumor arising in the neural plexus of the stomach. We herein describe the case of a 60-year-old male who presented with dull aching abdominal pain associated with nausea. While general examination appeared normal, imaging showed a well-defined isodense lesion in the anterior wall of stomach suggestive of leiomyoma. Upper GI endoscopy revealed a globular mass highly suspicious of gastric malignancy. Laparoscopic wedge resection was carried out. Very frequently misdiagnosed as gastrointestinal stromal tumors; hence, it is essential to differentiate schwannomas from mesenchymal tumors.