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Management of massive liver trauma (grades IV-VI) is associated with high morbidity and mortality. It can pose serious challenges to treating physician and requires multimodality interventions. For a successful outcome, timing of intervention is crucial. We report a case of grade V hepatic injury treated successfully with angioembolization, laparoscopic lavage, and endoscopic stenting during a time period from admission to discharge on the 24th day. Angioembolization was performed at admission after resuscitation as CT scan showed active extravasation in the arterial phase. Laparoscopic lavage and drainage was performed on the fifth day as abdominal inflammatory response failed to respond to medical management. There was biliary component of abdominal fluid noticed during laparoscopy, which manifested by postoperative localized biliary fistula; hence endoscopic stenting of the bile duct was performed on the seventh day. The patient recovered well with timely minimal invasive approach and was fine at 1 year follow-up.

Scimitar syndrome, a rare anomaly of partial pulmonary venous drainage into the hepatic portion of the inferior vena cava, detected in a ten-day-old neonate who presented clinically with respiratory distress and diagnosed on ultrasound of the thorax is being reported here.

Abdominal cocoon is a rare cause of small intestinal obstruction observed in young females in tropical regions. It manifests by forming a membrane that typically encases the small bowel loops, leading to mechanical obstruction. Preoperative diagnosis is difficult and is usually established during laparotomy. We report a case of abdominal cocoon in a young woman diagnosed on abdominal sonography.

Agenesis of Dorsal Pancreas (ADP) is a rare congenital anomaly characterized by the absence of body and tail of pancreas. We report a case of incidentally detected ADP on Contrast Enhanced Computed Tomography (CECT) component of Fluorodeoxyglucose Positron Emission Tomography (FDG PET/CT) in a treated case of carcinoma (Ca) tongue with suspected local recurrence. Dependent Intestine Sign, hallmark of ADP on CECT imaging was noted in our patient.

Rudimentary gallbladder is a rare congenital anomaly. We present a case of an 18-year-old boy who was referred to us for surgical management of choledochal cyst. Clinical assessment and correlation of various investigations raised the possibility of rudimentary gallbladder rather than choledochal cyst. Laparoscopy evaluation confirmed the same and simple removal of the hypoplastic gallbladder cured him of his symptoms. Awareness of rare anomalies of the gallbladder and correlation of various imaging modalities aids in accurate diagnosis, thus avoiding major exploration.

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