Background Ileoileal knotting is one of the rarest causes of intestinal obstruction. The pathology involves knotting of the ileum around itself, leading to mechanical intestinal obstruction that can rapidly evolve to gangrene. Case presentation Here we will discuss the case of an 18-year-old Oromo girl who presented with sudden onset of severe abdominal pain and signs of generalized peritonitis.Ultrasound examination showed massive peritoneal and cul-de-sac fluid. Explorative laparotomy was done, with a tentative diagnosis of ruptured ovarian cyst. Intraoperative finding was a gangrenous ileoileal knot. The gangrenous segment was resected and ileotransverse anastomosis done. Postoperative course was uneventful, and the patient was discharged improved on the sixth postoperative day. Conclusion We present this case to highlight the diagnostic difficulty that one can face in females of child-bearing age and to create awareness of this rare cause of intestinal obstruction, as morbidity and mortality are very high because of rapid progression to gangrene.

Introduction Solitary fibrous tumors are tumors of mesenchymal origin that occur in the extremities and occasionally in pleura, meninges, and so on, but are extremely rare in the adrenal gland. Their biological behavior is variable but mostly benign. Case presentation A 13-year-old Oromo girl presented with a progressively increasing right upper abdominal mass of 3 years’ duration. She had dull dragging pain and an occasional low-grade fever. On examination she had 20 × 20 cm mass with well-defined medial and inferior border. Both ultrasound and computed tomography scan showed a highly vascularized mass arising from her right adrenal gland but she had neither the constitutional symptoms of a functional adrenal tumor nor an abnormal biochemical test. Surgical resection showed a vascularized mass with attachments to the right lobe of the liver with a weight of 1900 g. It was found to be a giant solitary fibrous tumor of her right adrenal gland with infrequent mitosis. She stayed for 5 days after surgery and was discharged. She showed remarkable recovery at follow-up at 3 months. Conclusion Although very rare, solitary fibrous tumor of the adrenal gland should be considered in differential diagnosis of adrenal masses.

Gallstone ileus is very rare complication of cholelithiasis. As it is usually a disease of the elderly, the morbidity and mortality associated with it is high due to the presence of co-morbidities. This is additionally made worse by the delay encountered before reaching diagnosis which often demands a high index of suspicion. In Ethiopia, a country where intestinal obstruction is seen to be one of the common presentations in the emergency surgical department, gall stone has never been seen to be reported as a cause. Thus we present this rare case and discuss the mode of presentation, diagnostic difficulties and differing treatment options. We report the case of an 80-year old lady who presented with signs and symptoms of small intestinal obstruction. Upon exploration we were astonished to find the cause of the obstruction to be a gallstone which was removed by simple ileostomy. Postoperative course was uneventful.

Tumors of pineal gland are very rare brain lesion in the rats and other species like humans. Neoplasms of pineal gland should be included in the possible differential diagnosis list for brain tumor, This type happened when the tumor is sited in the pineal body region. Research scientific investigation of pineal glands of rats being of important from the scientific point view, Transmission electron microscopic study of old and young rats was done to study the pineal gland associated with aging, these  changes characterized by presence of fat like droplet in cytoplasm. Furthermore in the terminal end pinealocytes which were synapsis like associated with the presence of core vesicles containing neurotransmitter like in consistency.