Remnant cholecystitis is a rare complication following subtotal cholecystectomy (STC), particularly when the reconstituting technique is used, which leaves a portion of the gallbladder behind. This remnant can become inflamed due to recurrent or retained gallstones. We present the case of a 39-year-old female who required a completion cholecystectomy 11 years after her initial STC due to severe recurrent right upper quadrant (RUQ) pain, nausea, and vomiting with an ultrasound that revealed cholelithiasis. This case highlights the need for increased awareness of remnant cholecystitis, better diagnostic approaches, and standardized management guidelines to prevent long-term complications. Further research is necessary to improve the treatment of this rare condition and optimize patient outcomes.

Jejunal diverticulosis is a rare form of diverticulosis characterized by acquired pseudodiverticula in the small bowel. Although most cases are asymptomatic, the condition can present diagnostic challenges due to its atypical presentation. Complications such as perforation can lead to acute abdomen, significantly increasing morbidity and mortality. We report a rare case of perforated jejunal diverticulitis in an 84-year-old female with a known history of diverticular disease. The patient presented to the emergency department with worsening left lower quadrant abdominal pain. A computed tomography (CT) scan revealed a focus of air adjacent to the mesentery, indicative of bowel perforation. An urgent exploratory laparotomy was performed, which identified a 4-cm perforated jejunal diverticulum. The affected segment of the small bowel was resected, followed by primary side-to-side jejunal anastomosis. The patient was discharged home in stable condition following uneventful postoperative recovery. This case highlights the importance of including jejunal diverticulosis in the differential diagnosis of acute abdomen, particularly in elderly patients with a history of diverticular disease. Due to the nonspecific presentation, prompt imaging is crucial for diagnosis. Surgical intervention is often necessary in cases of perforation. Increased clinical awareness of this rare condition may help reduce diagnostic delays and improve patient outcomes.

The prolapse of a pedunculated juvenile rectal polyp is a rare event. It occurs when the polyp protrudes through the anus and appears as a fleshy mass at the anus, leading to an alarming scenario for both the parent and patient and typically prompting a visit to the emergency department (ED). We report a case of a five-year-old male patient who presented to the ED with a prolapsed rectal mass. A careful examination revealed it to be a pedunculated prolapsed polyp through the anus. The polyp was excised in the ED without complication, and the patient was discharged home with follow-up appointments with both pediatric surgery and gastroenterology for colonoscopy. The pathology report later confirmed the diagnosis of the juvenile polyp. We present this case to raise awareness about the various presentations of juvenile polyps and to familiarize clinicians with this diagnosis.

Tuberculosis (TB) remains a significant global health challenge. Miliary TB is a rare manifestation of TB that involves systemic lymphohematogenous dissemination of infection and presents diagnostic challenges due to its often asymptomatic or non-specific nature. This case report documents a rare occurrence of gastrointestinal (GI) bleeding secondary to miliary TB without pulmonary symptoms in an 81-year-old Filipino-American male living in the United States. Extensive imaging studies revealed a mass in the right colon with multiple bleeding vessels draped around it; it was not amendable to treatment with embolization and required right hemicolectomy with end ileostomy. The pathology report of the excised mass demonstrated miliary TB with necrotizing granulomas and granulomatous lymphadenopathy involving 23 lymph nodes. The patient was started on anti-tuberculosis medical management; however, the patient remained clinically unstable and expired on postoperative day 39. This case highlights the importance of the heightened clinical awareness required during times of globalization and in regions with dense immigrant populations. We aim to delineate the clinical understanding of gastrointestinal TB (GITB) and review possible indications for surgical management. We aim to help reduce diagnostic delay, therefore improving patient outcomes and limiting the spread of disease.

Internal hernias (IHs) are a rare but potentially life-threatening cause of bowel obstruction, with a high morbidity and mortality rate if not promptly diagnosed and treated. This case report highlights the clinical course of a 75-year-old female who developed a transverse mesocolic internal hernia, a subtype of transmesenteric hernia (TH), following a Hartmann reversal procedure. The patient presented to the emergency department (ED) with a sudden onset of severe, diffuse abdominal pain. Her medical history was significant for systemic lupus erythematosus, pulmonary fibrosis, multiple pulmonary embolisms, and a recent Hartmann reversal procedure the month prior. Initial imaging suggested postoperative ileus, but the patient's symptoms persisted despite conservative management. Subsequent imaging raised suspicion of an internal hernia, and on hospital day 6, an urgent diagnostic laparoscopy revealed a herniated segment of the small bowel through a defect in the transverse mesocolon with herniation into the lesser sac. The herniated bowel was successfully reduced, and the defect was repaired. The patient had an uneventful recovery and was discharged in stable condition. Transmesenteric hernias, though more common in the pediatric population, can occur in adults, particularly following abdominal surgery. Diagnosis can be challenging due to variable symptoms and imaging findings. However, prompt recognition and surgical intervention are crucial to prevent complications such as bowel ischemia and strangulation. This case underscores the importance of considering internal hernias in the differential diagnosis of small bowel obstruction (SBO), especially in patients with a history of recent abdominal surgery. Early diagnosis and timely surgical management are essential for a favorable outcome.

Methicillin-sensitive Staphylococcus aureus (MSSA) is a gram-positive, coagulase-positive coccus implicated in the pathogenesis of infective endocarditis (IE) due to intravenous drug use (IDU). The tricuspid valve is the most commonly affected valve; however, there is an increased incidence of mitral valve involvement. In this case report, we present a 41-year-old female with no known past medical history but a social history significant for IDU who presented with MSSA bacteremia, sepsis, and IE with vegetations on the mitral valve. This patient had no predisposing immunocompromising conditions; however, her repeated IDU history increased her risks for IE. This patient subsequently developed fatal complications of renal septic emboli. She was treated with broad-spectrum intravenous antibiotics, vancomycin, and ceftriaxone, which was de-escalated to nafcillin following blood culture sensitivity data results. She was ultimately transferred to another facility for surgical management of her condition. We write this case report to bring awareness to this rare but fatal condition and to highlight the presentation of mitral valve vegetations.

Dedifferentiated liposarcoma (DDL) is a rare and aggressive subtype of liposarcoma, arising most commonly in the retroperitoneum but rarely presenting in the mesentery. Due to its rarity, mesenteric DDL poses significant diagnostic and therapeutic challenges, with few cases documented in the literature. Here, we report the case of a 76-year-old female admitted with acute respiratory failure secondary to pneumonia, during which an incidental finding of a large mesenteric mass was noted on computed tomography (CT) imaging. An elective exploratory laparotomy was performed one month later, revealing a large mesenteric tumor adherent to the terminal ileum, cecum, and ascending colon. En bloc resection, including right hemicolectomy and partial small bowel resection, was successfully performed. Pathology confirmed an intermediate-grade DDL. This case underscores the importance of considering mesenteric DDL in the differential diagnosis of large, asymptomatic intra-abdominal masses. Complete surgical resection remains the mainstay of treatment, with a critical focus on achieving negative margins to reduce recurrence risk. Given the aggressive nature of DDL, vigilant long-term follow-up is essential. This report contributes to the limited body of literature on mesenteric DDL and highlights the challenges in its diagnosis and management.