Physical health monitoring of patients receiving antipsychotics is vital. Overall it is estimated that individuals suffering with conditions like schizophrenia have a 20% shorter life expectancy than the average population, moreover antipsychotic use has been linked to a number of conditions including diabetes, obesity, and cardiovascular disease. [1][2][3][4]

Obturator hernias are classically difficult to diagnose, have a high mortality and are an uncommon cause of intestinal obstruction. They are usually found in thin, elderly female patients. We present a case of a misdiagnosed 89-year-old female who presented to accident and emergency with a short history of abdominal pain. The diagnosis of an incarcerated obturator hernia was confirmed after re-discussion of computed tomography scan with the consultant radiologist in the morning. The patient underwent emergency laparotomy and the defect reduced. The patient recovered well post-operation; however; on the fourth day post-operation, the patient suffered a cardiac arrest. We report this case as a reminder to our health care colleagues to be mindful of elderly female patients who present with small bowel obstruction due to the high risk of mortality of this type of hernia.

A 7-year-old girl presented with a 2-day history of right iliac fossa pain, fever and elevated inflammatory markers. Clinical examination supported a diagnosis of appendicitis. The patient was taken to theatre for an open appendicectomy the following morning. Intraoperatively, a right-sided ovarian haemorrhagic cyst with 360 degrees torsion was discovered. The ovary was torted along with the cyst. Both were detorted and the abdomen was closed. The patient was discharged 48 hours later, with gynaecology outpatient follow-up 6–8 weeks later. Paediatric ovarian torsions caused by a haemorrhagic cyst greater than 2 cm are rare. Here, we discuss an atypical presentation of ovarian torsion and how the clinical presentation can mimic appendicitis.

Introduction A 90 year old lady presented with history of sudden onset abdominal pain. The pain was continuous, severe with a tender abdomen. Methods Blood investigations were not conclusive. A CT of the abdomen revealed a possible torsion of the gall bladder around its axis with impending gangrene. She went on to have a successful emergency laparoscopic cholecystectomy. Results A work up and successful surgical intervention with an extremely unusual gall bladder presentation of torsion.

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