Mesenteric lymphadenitis (ML) is an inflammatory response to viral infections, bacterial infections, inflammatory bowel disease, or lymphoma in the ileocecal regions.  It is a common diagnostic mimic to acute appendicitis.  It is a self-limited inflammatory process that affects mesenteric lymph nodes in the right lower quadrant (RLQ).   We present a 15 year-old-girl with low grade fever and RLQ pain.  Initial physical examination and laboratory investigations suggested acute appendicitis.  However, diagnosis of ML was established by the finding abnormal lymph nodes that are usually: (a) clusters of > 3 tender ones anterior to right psoas muscle or in the small bowel mesentery, (b) > 5 mm in diameter of short axis, and (b) rounded in shape.  In addition; the ileal or ileocecal wall is thickened (> 3 mm) over at least 5 cm of the bowel and the appendicular wall is normal and its lumen is patent.  In conclusion; this case reports indicates tha with radiology; ML can be differentiated from acute appendicitis and limits the role of invasive laparoscopy or surgery in exclusion of the latter. Keywords: appendicitis, CT, mesenteric lymphadenitis, radiology, US.

Acute pancreatitis (AP) is a common emergency resulting from inflammation of the pancreas. The mechanism involves premature activation of enzyme precursors in the acinar cells triggering a self-digestive inflammatory cascade.  Hypertriglyceridemia is the most common etiology of pancreatitis after gall stones and alcohol.  It usually follows a sudden surge such as diabetic ketoacidosis on top of hereditary hyperlipidemia.  In the present case report; we describe a patient with type-I diabetes mellitus who had developed recurrent attacks of hypertriglyceridemia AP (HTG-AP) despite Fenfibrate-therapy and report on our experience with Evolocumab in his treatment and prophylaxis.  Keywords: diabetes mellitus, hypertriglyceridemia, pancreatitis, prophylaxis, treatment.

True splenic artery aneurysms (SAA) are rare, but potentially fatal, lesions. They account for 60% to 70% of patients diagnosed with visceral artery aneurysms.  They should be differentiated from pseudo ones since the etiology is different.  They risk of rupture is high if diameter is > 2 cm and in child-bearing years.  In this case report; we describe an encounter of SAA in a patient presenting with severe left loin pain and shock due to acute pyelonephritis.  The aneurysm was 1.2 cm and was partially thrombosed and calcified indicating its stability and chronicity.  The etiology, types and management of SAAs is discussed.  Keywords: abdominal pain, aneurysm, pseudoaneurysm, rupture, splenic artery.