Isolated involvement of the lower gastrointestinal tract with relative sparing of the oesophagus and the stomach is extremely rare following corrosive agent ingestion. We report a case of isolated full thickness jejunal necrosis following sulphuric acid cocktail ingestion. A 42 year old man presented with history of consuming 200ml of sulphuric acid mixed with alcohol, with suicidal intent. On exploration there were multiple, full thickness necrotic areas in the proximal jejunum with minimal congestion of the oesophagus, stomach and duodenum. Inversion of the jejunal necrotic areas with feeding jejunostomy was carried out. However postoperatively patient developed progressive pulmonary insufficiency with features of sepsis and expired on the nineteenth day following a bout of massive haematemesis. Corrosive agents when taken in considerable amount mixed with other fluids can lead to full thickness small bowel necrosis with relative sparing of the proximal gastrointestinal tract
IntroductionPyometra can be caused by various etiologies. We present a rare case of diverticular disease of the colon presenting as pyometra. This type of presentation can be challenging even for an astute clinician.Case presentationA 74-year-old Caucasian woman with a history of pyometra was referred to our gynecology clinic as an urgent case. She was obese, diabetic and hypertensive. Due to the patient profile and the clinical presentation, clinicians were misled toward a diagnosis of possible endometrial cancer. After further investigations, she was found to have colouterine fistula secondary to a diverticular abscess of the sigmoid colon.ConclusionsPersistent vaginal discharge due to pyometra can be caused by diverticular disease of the colon. Clinicians should be aware of this important differential diagnosis.
Rupture of intracranial aneurysm in pregnancy is rare and the presentation is easily confused with eclampsia. A high index of suspicion could lead to early diagnosis and prompt management. A multidisciplinary team approach is essential for best outcome.
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