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Intra-abdominal displacement of an intrauterine device (IUD) is a rare but serious complication. This is a case report of a 44-year-old woman who was referred to a surgical department with intermittent abdominal pain. Gynaecological examination and ultrasound failed to identify the patient's IUD. An abdominal CT scan confirmed the diagnosis of the intra-abdominally migrated IUD and the device was extracted by laparoscopy. Surgical removal of the migrating IUD is recommended to prevent long-term complications such as intra-abdominal adhesions, organ perforation, and fistula formation.

Acute cholangitis caused by migrating clips is a possible complication following laparoscopic cholecystectomy. In this case report, a 50-year-old woman was admitted to the hospital with fever, icterus, and epigastric pain. Blood samples and blood cultures showed cholestasis, signs of infection and three different types of bacteria in the blood stream. Magnetic resonance cholangiopancreatography showed a migrating clip in the common bile duct and was extracted using endoscopic retrograde cholangiopancreatography. Migrating clip following laparoscopic cholecystectomy is a cause of cholangitis and should be considered in patients presenting with relevant symptoms.

Small bowel obstruction (SBO) due to clip adhaesions from the line of staples is a rare complication and is scarcely reported in the literature. In this case report, a ten-year-old boy underwent laparoscopic appendectomy and five days later developed early postoperative SBO. Diagnostic laparoscopy revealed internal herniation of bowel through a defect created by clip adhesion from the staple line to the adjacent mesentery. The clip was removed, the internal hernia resolved, and the patient discharged the same day. We recommend reviewing the line of staples after surgery.

Acute abdomen is a common cause of admission to hospital. Emergency laparotomy is associated with a significant morbidity and mortality due to deranged physiology and surgery-induced stress. Damage control laparotomy is on the rise as an operative strategy for the septic abdomen as well as for trauma laparotomy but lacks definition in the non-trauma setting. Principles of perioperative care in elective surgery are currently applied to the emergency abdominal surgery patients and should be further studied in the future to reduce morbidity and mortality.

Introduction: Necrotizing fasciitis (NF) is an acute soft-tissue infection, associated with a high mortality and morbidity. To reduce the mortality, an early diagnosis and treatment is essential. Our study aims to identify the number of patients, the microorganisms involved, and NF treatment outcomes among patients admitted to our unit., Material and Methods: This retrospective cohort study enrolled 85 patients admitted to the multidisciplinary, tertiary Intensive Care Unit, Abdominal Center, Rigshospitalet, Denmark in 2005-2007. All received the same protocolled treatment of intensive care, extensive surgical débridements, broad-spectrum antibiotics, intravenous immunoglobulin and hyperbaric oxygen., Results: The microbiological analyses of specimens demonstrated that 51% were positive for polymicrobial infection, 40% for a single pathogen, 74% of these caused by beta-hemolytic streptococci, and 9% of the analyses were inconclusive. Of the patients, 91% required treatment in a respirator, 67.5% presented with septic shock and 25.3% developed acute renal failure needing dialysis. Intensive care unit mortality was 6% and 30-day mortality was 9.5%. Expected mortality based on SAPS II and APACHE II scoring was 38%. Our patients had a significantly higher body mass index than other patients admitted to the unit., Conclusion: NF is a complex disease, often associated with multi-organ failure. A protocolled treatment plan with close cooperation between the intensive care, clinical microbiology, medical and surgical specialties seems to reduce mortality considerably in this vulnerable group of patients.