Fishbone perforation of the stomach into the lesser sac and pancreas with abscess, a fishy business.

Ingestion of foreign bodies is common in critical practice. Thankfully, most of these objects will pass without complications; however, sharp and metallic objects can cause severe complications like ulcers and perforation. Perforation of the gastrointestinal tract is rare; however, once it happens, prompt treatment is needed to prevent dreadful complications.

Progressive dysphagia from an esophageal liposarcoma, a complex problem in a challenging setting.

Esophageal lipomatous tumors are extremely rare, and due to their nonspecific clinical manifestations, distinguishing them is nearly impossible without the aid of histopathology, immunohistochemistry, and molecular analysis. Complete resection with clear margins is the treatment of choice to avert metastasis, improve prognosis, and prevent complex complications due to the polyp growth and location. We present the case of a 70-year-old male who presented in 2023 with dysphagia due to an esophageal polyp; surgery was recommended.

Gallbladder agenesis discovered during surgery, a sum of inadequate decisions.

Background: Gallbladder agenesis is an extremely rare congenital condition in which most patients will remain asymptomatic; nonetheless, a small subset of patients will mimic biliary, urinary, or gastrointestinal disorders. As a result, if these patients are unaware of their condition, an ultrasound may be needed when they present with right upper abdominal pain, which can be misleading or inconclusive, putting the surgeon and the medical team in a diagnostic and intraoperative dilemma.

Case Presentation: We present the case of a 36-year-old woman with a history of ventricular septal defect and cleft palate.

Laparoscopy and intraoperative enteroscopy, a helpful tool in a rare tumor (inflammatory fibroid polyp) of the small bowel. A case report.

Introduction And Importance: Inflammatory fibroid polyps (IFPs) are rare, benign tumors that can arise throughout the gastrointestinal tract, they are usually asymptomatic, and clinical presentation depends on the site of involvement. Gastric and colon IFPs are traditionally identified incidentally, whereas small intestinal lesions are often encountered in the setting of intussusception or during imaging studies. Complete resection via endoscopy or surgery is recommended.

Transvaginal evisceration of the small bowel a rare and potentially lethal event, a case report.

Introduction And Importance: Evisceration of the small bowel through the vagina is an extremely rare condition and a life-threatening surgical emergency. Complications associated with this condition include bowel ischemia, abdominal sepsis, and deep vein thrombosis. Therefore, prompt surgical consultation and treatment are crucial as delay in treatment can lead to a grim outcome.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen: a rare cause of acute abdomen.

Sclerosing angiomatoid nodular transformation (SANT) of the spleen is an extremely rare benign lesion. It originates from the spleen's red pulp; however, its pathogenesis is not clearly defined. These tumors are usually asymptomatic or cause nonspecific abdominal symptoms.

Cycle Threshold Values in the Context of Multiple RT-PCR Testing for SARS-CoV-2.

Purpose: Discharge or follow up of confirmed coronavirus disease 2019 (COVID-19) cases depend on accurate interpretation of RT-PCR. Currently, positive/negative interpretations are based on amplification instead of quantification of cycle threshold (Ct) values, which could be used as proxies of patient infectiousness. Here, we measured Ct values in hospitalized confirmed COVID-19 patients at different times and its implications in diagnosis and follow up.

COVID-19 Infection and Previous BCG Vaccination Coverage in the Ecuadorian Population.

The Bacillus Calmette-Guérin (BCG) is a well-known vaccine with almost a century of use, with the apparent capability to improve cytokine production and epigenetics changes that could develop a better response to pathogens. It has been postulated that BCG protection against SARS-CoV-2 has a potential role in the pandemic, through the presence of homologous amino acid sequences. To identify a possible link between BCG vaccination coverage and COVID-19 cases, we used official epidemic data and Ecuadorian Ministry of Health and Pan American Health Organization vaccination information.

Type III Mirizzi, successfully treated with a free gallbladder flap, a case report.

Background: Mirizzi syndrome is a type of biliary obstruction caused by an impacted stone in the gallbladder neck or cystic duct that causes and extrinsic obstruction of the common bile duct, this condition if left untreated can lead to duct erosion, fistula, and cholangitis. Preoperative diagnosis is difficult since if not diagnosed correctly can elevate the risk of intraoperative bile duct injury.

Case Presentation: We present the case of a 61-year-old patient, she presented to our hospital with obstructive jaundice, and a type III Mirizzi syndrome was identified.

Acute respiratory distress syndrome (ARDS) caused by the novel coronavirus disease (COVID-19): a practical comprehensive literature review.

Introduction: The exponential growth of SARS-CoV-2 virus transmission during the first months of 2020 has placed substantial pressure on most health systems around the world. The complications derived from the novel coronavirus disease (COVID-19) vary due to comorbidities, sex and age, with more than 50% of the patients requiring some level of intensive care developing acute respiratory distress syndrome (ARDS). The authors carried out an extensive and comprehensive literature review on SARS-CoV-2 infection, the clinical, pathological, and radiological presentation as well as the current treatment strategies.

Pneumoperitoneum and Pneumatosis cystoides intestinalis, a dangerous mixture. A case report.

Background: Pneumatosis cystoides intestinalis (PCI) is a rare condition characterized by gas infiltration into the intestine wall. When gas is seen in the intestinal wall, it is usually a sign of bowel wall infarction and a surgical emergency; therefore, an adequate differentiation of benign and urgent conditions of pneumatosis intestinalis is necessary to prevent misdiagnosis and inadequate therapies.

Case Presentation: We present the case of a 79-year-old male with past medical history of Alzheimer's, cholecystectomy, and umbilical hernia.

Duodenal perforation after percutaneous fluid drainage, a rare event: a case report.

Duodenal perforations can be caused by surgical instruments during operations. These injuries can go initially unnoticed and lead to problematic complications. While uncommon, bowel perforation after percutaneous fluid drainage can severely impact the patient's outcome.

Splenic abscess after arterial embolization: a rare cause of acute abdomen.

Splenic abscess is a rare disease and a diagnostic challenge for the medical team. Attributable to its high mortality, prompt diagnosis and treatment are essential. A high degree of clinical awareness is required in conjunction with aggressive treatment, as misleading symptoms may delay treatment and worsen the patient's prognosis.

Ingestion of razor blades, a rare event: a case report in a psychiatric patient.

Foreign body ingestion is a common condition in clinical practice, thankfully most of the cases do not require any surgery as most foreign bodies can pass through the bowel without injuring it. Treatment depends on the size and kind of foreign bodies. When complications arise, patients may require urgent medical attention.

Acute cholecystitis and residual choledocholithiasis in a situs inversus patient, successful laparoscopic approach and ERCP a case report from Ecuador.

Background: Situs inversus totalis is a rare genetic condition characterized by the transposition of organs to the opposite side of the body, consequently, clinical syndromes show an atypical clinical picture creating a challenge for the surgery team and predisposing to delays in treatment and diagnosis. Laparoscopic cholecystectomy is the gold standard for acute cholecystitis, and in patients with situs inversus, the laparoscopic technique must be modified to accommodate the patient's anatomy.

Case Presentation: We present the case of a 55-year-old male patient without any past medical history, he presented to the emergency room with abdominal pain in his upper left quadrant.

Neuroma of the appendix, a rare cause of appendicitis and an important reason for close follow-up.

Acute appendicitis is the most common surgical pathology worldwide, frequently, the patient history and clinical examination are so similar to other appendicular pathologies that preoperative diagnosis is almost impossible for the medical team. Neuroma of the appendix is a rare tumor of neural origin that usually resembles the symptoms of acute appendicitis. Pathology along with close follow-ups are key, as the diagnosis is based on the presence of nerve neuronal cells in the appendicular lumen.