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Bleeding in the adrenal glands can be bilateral or unilateral. While it is most common in infants, it can also be observed in young adults and adults and is seven times more common in adolescents than in adults. Idiopathic unilateral hemorrhage is a very rare condition that occurs due to an idiopathic spontaneous rupture or an undetected adrenal mass. The main signs of adrenal bleeding are hemorrhagic shock, flank pain, and fever. Adrenal bleeding is rarely reported, and the ideal treatment is not clear. We present a patient with unilateral idiopathic adrenal bleeding who presented to the hospital with left flank pain and hemorrhagic shock. [ABSTRACT FROM AUTHOR]

The continuous diaphragm sign is a radiological sign seen on either upright or supine views of chest radiographs as reported by Levin (Clin Radiol 24:337–338, 1973). It is indicative of pneumomediastinum or pneumopericardium if radiolucency is present above the diaphragm, or of pneumoperitoneum if radiolucency is present below the diaphragm. Pneumoperitoneum, defined as the presence of free air in the peritoneal cavity, rarely presents with the continuous diaphragm sign on the radiographs as noted by Wu et al. (J Acute Med 3:20–22, 2013). [ABSTRACT FROM AUTHOR]

We report an extremely rare case of spontaneous complete disappearance of a large chronic subdural hematoma in a 78-year aged man with a significant mass effect and a large midline shift which was diagnosed around 6 weeks before admission. Repeat NCCT of the head in our department to everyone's surprise revealed almost complete spontaneous resolution. Spontaneous resolution of a large chronic subdural hematoma is extremely rare, and the scarce literature whatsoever is available is especially in cases of immune thrombocytopenic purpura where steroids may play a role in the stabilization of neomembranes. Our interest is in this case because of the benign clinical course despite a large size causing severe mass effect and large midline shift. Chronic subdural hematoma is a common entity in the elderly generally seen weeks following minor trauma. Surgical evacuation of a chronic subdural hematoma remains the gold standard treatment, but controversy exists regarding the best surgical option. Spontaneous resolution of a chronic subdural hematoma has also been reported rarely, but mainly in patients with immune thrombocytopenic purpura. [ABSTRACT FROM AUTHOR]

Spontaneous perforation of common bile duct (CBD) in an adult is an exceedingly rare phenomenon. It is mostly seen in infants due to congenital anomalies. The diagnosis of biliary tract perforations is often delayed due to their nonspecific symptoms, which results in high morbidity. Early diagnosis and aggressive therapy are mandatory to alleviate this condition. Delayed diagnoses and treatment may have more serious consequences in terms of morbidity as well as mortality. We herein report spontaneous perforation of CBD in a middle-aged male who presented to our accident and emergency department with acute abdominal pain. Exploratory laparotomy revealed a small perforation with necrosed margins in the supraduodenal part of CBD, which was managed by a T-tube drain. However, no apparent cause for the perforation was found. [ABSTRACT FROM AUTHOR]

Spontaneous perforation of the bile duct is a rare disease in children and even rarer in adults. Although diagnostic techniques have advanced over the past years, yet most cases are diagnosed at operation. A 44-year-old woman presented with epigastric pain and vomiting of one-day duration. Abdominal distension with tenderness and guarding was present all over the abdomen. Abdominal ultrasonography showed free fluid in the peritoneal cavity with sluggish peristalsis. Abdominal and chest radiographs were normal. At laparotomy, common bile duct CBD was perforated at the junction of CBD and cystic duct. Cholecystectomy with CBD exploration was done and CBD was closed over a T-tube, and external drainage was carried out. The patient recovered well, and on the 12th postoperative day, a T-tube cholangiogram was performed which was normal. The T-tube was removed on the 14th postoperative day. One month after operation, the patient was well. Examining the patient with a suspicious thinking helps in early diagnosis and management of the patient. [ABSTRACT FROM AUTHOR]

Delayed dehiscence of a previously repaired bladder rupture in a 12-year-old boy is described. There was no obvious cause except that while in bed the boy had withheld his early morning urge to pass urine. He presented with peritonitis and raised urea and creatinine levels. Retrograde cystography was diagnostic after the urinary, catheter had drained 1.2 litres of blood-tinged urine. The rent in the dome of the bladder at the site of previous repair was closed with polyglycolic acid sutures during emergency laparatomy. Though rarely reported, delayed dehiscence is a possibility which can occur in repaired urinary bladder. It emphasizes the need for long-term follow-up. [ABSTRACT FROM AUTHOR]