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We encountered a case of gallbladder volvulus in an 88-year-old thin female in which the initial presentation was more consistent with that of acute appendicitis. After complete work-up, including physical exam, lab work, and computed tomography, the definite diagnosis of gallbladder volvulus was not made until intraoperative visualization was obtained. Gallbladder volvulus is a rare but serious condition, which requires a high clinical suspicion so prompt surgical intervention can be undertaken.

We encountered a case of ruptured splenic abscess presenting as peritonitis and pneumoperitoneum. Our patient did not have an underlying neoplasm nor was she immunosuppressed. In our case, splenectomy was the treatment of choice in combination with antibiotics, which proved to be a good outcome for the patient. Work-up for the cause of the abscess was negative, although bacteria predominately found in the oral flora were isolated from the abscess. We strongly encourage that splenic abscess be considered on the differential diagnosis of patients presenting with pneumoperitoneum and peritonitis, although a clinical rarity.

We describe a case of preseptal cellulitis that presented initially to the ophthalmology department in our hospital. Neisseria gonorrhoeae, a very rare cause of this common condition, was isolated from a swab and the patient successfully treated with appropriate therapy. We review some aspects of non-sexual transmission as the patient denied recent sexual contact and we were unable to isolate the organism from any other site.

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Liposarcoma is one of the most common soft tissue sarcomas and has multiple subtypes, including atypical, well-differentiated, and dedifferentiated liposarcoma1. These tumors most commonly occur in the extremities and the retroperitoneum2, and account for 20% of all retroperitoneal tumors3. Retroperitoneal liposarcoma is very rare overall, occurring in 2.5 per one million people4. Patients will present from symptoms of mass effect due to the uncontrolled growth in the large potential space of the retroperitoneum, with its median size being around 30 cm5. The mainstay of treatment for this type of tumor is resection to a negative margin6. This is a case report describing a retroperitoneal liposarcoma presenting with bilateral inguinal hernias containing intraperitoneal fat from mass effect.