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Splenosis is the autotransplantation of splenic tissue into abnormal locations due to trauma or iatrogenically. Usually, this causes no symptoms, but in rare cases the mass effect of the transplanted nodules can cause small bowel obstruction. Resection of the culprit splenic tissue is recommended, but not more extensive dissection of non-involved nodules. Our patient presented at 43 years of age with abdominal pain, distention and bilious vomiting. He had undergone a splenectomy at the age of 13 years due to splenic rupture after a motor vehicle collision. Computed tomography demonstrated a small bowel obstruction with multiple nodules suspicious of splenosis. The obstructing mass and compromised bowels. were resected. Final pathology confirmed the diagnosis. Splenosis is an uncommon aetiology of small bowel obstruction and must be considered in patients who had previous splenic trauma or surgery.

Liver haemangiomas are common, but their size very rarely exceeds 40cm. Most people with liver haemangiomas are asymptomatic, and diagnosis is usually made incidentally during imaging for other complaints. When a liver haemangioma is symptomatic or produces complications, surgical intervention may be warranted. Kasabach–Merritt syndrome is an uncommon complication reported in certain rare vascular tumours in children, with only a few cases reported in adults. The syndrome describes a consumptive coagulopathy initiated within a vascular tumour, mainly tufted angiomas and kaposiform haemangioendotheliomas and, less commonly, giant haemangiomas. The process can extend beyond the tumour and become disseminated in certain cases due to trauma or surgery. The definitive treatment for giant liver haemangiomas can include arterial embolisation, surgical excision, hepatectomy or even liver transplantation. We report the case of a 32-year-old woman with a 42 × 32 × 27cm (18,870ml) liver haemangioma associated with Kasabach–Merritt syndrome. The diagnosis was challenging, even with proper imaging, owing to the rarity of the condition. It was achieved with an exploratory laparotomy with biopsy.

Highlights Primary splenic hydatidosis is an uncommon entity. Total splenectomy is considered the standard treatment, but carries multiple risks. Partial splenectomy offers comparable outcomes with reduced morbidity. Partial splenectomy is recommended for simple, single, small, and peripherally located cysts. Laparoscopic cyst unroofing is feasible in treating primary splenic hydatid cysts.

Highlights The spleen is normally located in the left hypochondriac region just underneath the 9th to 11th intercostal spaces. Splenoptosis, wandering spleen or floating spleen, is a rare entity in which the spleen migrates from its normal position. The diagnosis is confirmed by imaging modalities. The only definitive treatment is surgical intervention.

Highlights Liposarcomas are a malignant transformation of fat tissue, found in two major subtypes according to their differentiation. Enhanced CT is essential for diagnosis and confirmed by percutaneous large core needle guided biopsies. Surgery remains the standard practice in treating non-metastatic liposarcomas. No clear definition for giant liposarcoma, Only 52 cases reported between 1998 and July 2020. Our patient has the longest reported follow up in the literature of 10 years, with 3 operations and 3 recurrences.

Highlights CAP can be a challenging diagnosis, with a presentation of acute abdominal pain mimicking a surgical abdomen. In pediatric patients pneumonia is considered as the main extra-abdominal cause of acute abdominal pain. Abdominal Pain mimics is an entity by itself with a vast differential diagnosis. Acute abdomen requires precise and rapid diagnosis and treatment to avoid an increase in mortality. Laparoscopy is safe and effective in setting the diagnosis.