Acute epiploic appendagitis is a benign condition caused by inflammation of the epiploic appendages that are serosal lined outpouchings of the colon lying adjacent to the tenia coli. This rare condition has non-specific clinical findings and is frequently misdiagnosed as either acute diverticulitis or acute appendicitis. However, unlike other surgical causes of acute abdomen, epiploic appendagitis is a self-limited condition and resolves with conservative management. CT of the abdomen plays a vital role in diagnosing this condition and excluding other causes of acute abdomen. This case report highlights the importance of being aware of this rare condition and its consideration in the differential diagnosis of acute lower abdominal pain to avoid unnecessary hospitalization and surgery.

Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology that presents with high-grade fever, arthritis, evanescent rash, and multiorgan involvement. It is a rare disorder and is a diagnosis of exclusion. AOSD is often misdiagnosed initially as viral exanthems or upper respiratory tract infections leading to a delay in diagnosis. Management includes non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, and conventional or biologic disease-modifying antirheumatic drugs (DMARDs). We report a case of a 53-year-old female with prolonged fever, sore throat, arthralgia, and rash. She was initially presumed to have infectious pharyngitis but did not respond to antimicrobial therapy. After extensive evaluation that excluded infectious, malignant, and other rheumatological etiologies, she was noted to satisfy multiple Yamaguchi criteria and was subsequently diagnosed with AOSD. Glucocorticoids and biologic DMARDs were initiated, leading to improved clinical manifestations and a decline in inflammatory markers.

Dulaglutide is being extensively used for non-insulin-dependent diabetes mellitus and congestive heart failure and is also being used as an off-label weight loss aid. Due to its wide use, we had to shed some light on this rare finding of normal lipase level in a patient with signs and symptoms suggestive of acute pancreatitis. A high index of clinical suspicion for acute pancreatitis despite normal lipase should warrant a low threshold for radiological imaging to rule it out.