Branchial cleft cysts (BCCs) are congenital anomalies that can be found in children and young adults. The exact incidence of these anomalies is unknown as the diagnosis may be missed. Branchial cleft cysts can present in a variety of locations depending on the cleft they are derived from. Regardless of location, branchial cleft cysts are rather benign. However, a variety of complications can arise due to infection, and infections are often recurrent. Diagnosis may occur incidentally on imaging studies as such studies are often performed to rule out a variety of complications from infections alone. Treatment includes first treating any infection and any such complications that exist, followed by surgical excision. Surgical excision is performed to prevent the recurrence of infection. A case of a 14-year-old female with a painful swollen throat, trismus, and difficulty swallowing is reported.
Pneumatosis intestinalis (PI), pneumoperitoneum, and ascites are radiographic findings that may be incidental or associated with severe bowel compromise. Asymptomatic patients with benign PI, pneumoperitoneum, or ascites are often observed or treated conservatively. However, these findings are concerning in symptomatic patients and often require surgical consultation and urgent surgical intervention Approximately 15% of PI cases are idiopathic, and 85% are secondary due to an underlying pathology including but not limited to pulmonary disease, autoimmune disease, drug-induced sources, gastrointestinal disease, infectious sources, and iatrogenic sources. A management plan for PI proves challenging to create when the pathogenesis is poorly understood and the presenting clinical picture varies. Reported is a case of a 51-year-old female with severe abdominal pain, PI, pneumoperitoneum, and ascites. Managing a patient presenting this way with surgical intervention is a viable option; however, this patient's management was successful using a conservative approach.
Small bowel obstruction (SBO) has a variety of etiologies, including but not limited to adhesions, malignancy, hernia, and inflammatory bowel diseases. Treatment for SBO may be nonoperative or operative, depending on the underlying condition and clinical symptoms. Clinical judgment and radiological findings cooperate in formulating an appropriate assessment and treatment plan. Mass effect due to malignancy is an indication for surgical intervention, as tumor resection is a mainstay of treatment. However, patient safety and chances of vascular compromise must be considered when determining if the tumor is resectable. Reported is a case of a 65-year-old female with severe abdominal pain, nausea, vomiting, and obstipation due to a malignant neuroendocrine tumor within the mesentery adjacent to the aortic bifurcation. Management included surgical intervention to alleviate bowel obstruction and biopsy of the tumor.
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