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Ectopic spleen is a rare clinical entity characterized by splenic hypermobility which may be congenital or acquired. The spleen may be migrated to different positions in the peritoneum. The main complication is pedicular torsion with splenic volvulus, presenting as an emergency abdominal surgery. We present and discuss a case of ectopic and twisted spleen resulting in complete splenic infarction, diagnosed by ultrasound, confirmed by CT scan and treated by splenectomy., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

The anterior liver hernia is a very rare entity that mainly occurs within an incisional hernia. Primary anterior liver hernia, in the absence of a previous abdominal incision, is extremely rare. The diagnosis is suspected in patients with epigastric bulging. The confirmation requires imaging studies such as computed tomography scan (CT scan). We report the case of an incarcerated primary ventral liver hernia, in an 83-year-old man who presented with a sudden epigastric swelling. A contrast-enhanced CT scan confirmed the diagnosis of incarcerated epigastric hernia with liver and epiploic content. Risk factors were thought to be the increased intra-abdominal pressure related to benign prostate hyperplasia, as well as the old age of the patient. The surgical conservative management was successful., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Splenic rupture is most commonly encountered after blunt abdominal trauma. Spontaneous atraumatic splenic rupture is a rare but dramatic occurrence that is most commonly attributed to infection or neoplasia. We report the case of a 27-year-old female patient without pathological history. Admitted to the emergency department for the sudden onset of left hypochondrial pain associated with vomiting, rapidly progressing to hypovolemic shock. She had reported an influenza-like illness a week earlier for which her COVID-19 PCR was negative. Emergency abdominal ultrasound and CT-scan revealed a ruptured spleen and widespread hemorrhagic fluid in the abdomen. Exploration revealed multiple ruptures in the spleen capsule. The patient underwent splenectomy with good clinical evolution. Despite the rarity of this condition, physicians should consider the diagnosis of spontaneous non traumatic splenic rupture when encountering healthy patients presenting with nonspecific left hypochondrial abdominal pain and hypovolemia. Mortality is essentially related to the delay in diagnosis and treatment and to the severity of the underlying pathology. Treatment often consists of splenectomy., (© 2022 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Enterolithiasis is an uncommon medical condition. It's defined by the formation of gastrointestinal concretion in the setting of intestinal stasis. Enteroliths are typically incidentally discovered during imaging and are a rare cause of acute small bowel obstruction. We report the case of acute small bowel obstruction, secondary to primary true enterolithiasis, in a 73-year-old male, with unremarkable medical history. He presented with clinical features in keeping with acute small bowel obstruction, for 2 days. An abdominal contrast-enhanced CT scan suggested a small bowel obstruction caused by a 32mm diameter enterolith located in the terminal ileum. The surgical management was successful and consisted of the removal of the enterolith after enterotomy., (© 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Utero-cutaneous fistula is a rare pathology. It mostly occurs consecutively to surgical intervention such as Cesarean section. Blood discharge from the cesarean scar during menstruation is a quasi-pathognomonic feature. Imaging modalities, particularly with the injection of contrast material through the cutaneous fistulous opening, confirm the diagnosis. The management is mainly surgical. We report the case of a utero-cutaneous fistula in a 27-year-old lady, with systemic lupus erythematosus. She presented seven months after her third cesarean section with pain and blood discharge from the cutaneous scar during menstruation for four months. A pelvic CT scan with the injection of the contrast material through the cutaneous fistulous opening confirmed the diagnosis of utero-cutaneous fistula. Surgical management was successful., (© 2021 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)

Lipomatous pseudohypertrophy (LPH) of the pancreas is an uncommon affection of exocrine pancreatic insufficiency. It is defined as substitution of the pancreatic exocrine gland by a large fat component. We report the case of a young patient with malabsorption syndrome (chronic diarrhoea and steatorrhoea), abnormal laboratory results and normal fibroscopy. Computed tomography revealed characteristic diffuse pancreatic abnormalities., Learning Points: Computed tomography is key for identifying lipomatous pseudohypertrophy.Malabsorption syndrome is usually associated with lipomatous pseudohypertrophy.A syndromic aetiology should be considered., Competing Interests: Conflicts of Interests: The authors declare there are no competing interests., (© EFIM 2021.)

Nowadays, the knowledge of vascular abnormalities is essential for all specialists in their clinical practice and may prevent serious complications through early interventions. Nutcraker syndrome is caused by left renal vein (LRV) compression, usually occurring in the fork formed by the abdominal aorta and the superior mesenteric artery (SMA) and leading to the narrowing of the aortomesenteric portion of the left renal vein and to the dilatation of its distal portion. Symptoms are dominated by lumbar, abdominal, pelvic pain and haematuria. Diagnosis is essentially based on modern imaging tests (computed tomography (CT) scan, Doppler-ultrasound, phlebography) and treatment is controversial. We here report the case of a 43-year-old woman, admitted with epigastric pain associated with pelvic heaviness following nutcraker syndrome requiring radiological screening on admission., Competing Interests: Les auteurs ne déclarent aucun conflit d´intérêts., (Copyright: Mohamed Reda Haboussi et al.)

Emphysematous pancreatitis is a rare and fatal complication of acute necrotizing pancreatitis. We report a radioclinical observation of a 61-year-old female patient who consulted for epigastric pain radiating to the back, associated with vomiting and elevated lipasaemia more than 3 times the normal value. The abdominal computerized tomography (CT) scan carried out on the fourth day of hospitalization, based on worsening of the clinical condition, showed pancreatic necrosis associated with the presence of air bubbles. Percutaneous puncture of a peripancreatic collection was positive for Escherichia coli. A diagnosis of emphysematous pancreatitis was established. The clinical and biological evolution of our patient was favourable with antibiotic treatment., Learning Points: Emphysematous pancreatitis is a rare and fatal complication of acute necrotizing pancreatitis.Abdominal CT allows for suspicion of this pathology based on the intra- and/or peripancreatic presence of air.The diagnosis is confirmed by the isolation of the bacterial agent in peripancreatic needle aspiration fluid., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2020.)

Pseudoaneurysm is due to a disruption in the arterial wall, secondary to inflammation, trauma or iatrogenic causes such as surgery, percutaneous biopsy or drainage. We report the case of a 37-year old patient, presenting with cervical swelling that had progressively evolved after penetrating cervical trauma occurred 8 months before. Doppler ultrasound supplemented by CT angiography confirmed the diagnosis of pseudoaneurysm of the left external carotid artery. The considerable development of sectional imaging techniques and of angiography has allowed easier diagnosis.

Aneurysmal bone cyst is a benign tumor that can affect all bones in the body. It rarely affects the base of the skull. It is usually located at the level of the long bones. We report the clinical case of a 44-year old man treated for a mass in the basisphenoid wrongly diagnosed as invasive prolactin-producing macroadenoma for which he was put under dopamine agonists over a period of 9 months. We adjusted the diagnosis by suggesting aneurysmal bone cyst in the sphenoid bone on the basis of its almost pathognomonic radiological aspect on MRI.

Osteoid osteoma is a benign primary bone tumor. This tumor is relatively frequent, accounting for 12% of all benign bone tumors and about 2-3% of all bone tumors. We report a new case of osteoid osteoma confirmed histologically. A 30-year old patient was referred for evaluation of chronic ankle pain. Front and lateral radiographs of the ankle showed a heterogeneous lesion located in the neck of the talus without soft tissue abnormalities. The CT scan of the ankle showed a nodular, hypodense lesion located in the neck of the talus with a limited osteosclerotic reaction.