Primary Malignant Melanoma of the Small Bowel with Hepatic Metastasis: A Case Report

Primary intestinal melanoma is extremely rare, whereas metastatic melanoma of the small bowel is common. In this report, we present a rare case of primary small bowel melanoma with hepatic metastasis. A 51-yearold man presented with constipation and CT identified an ileal mass without bowel obstruction. CT and MRI revealed hepatic metastasis. Ileal mass was confirmed on laparotomy and histologically diagnosed as melanoma.

Perforated Jejunal Adenocarcinoma in a COVID-19-Positive Patient

Jejunal adenocarcinoma is a rare type of primary small bowel malignancy. It is generally diagnosed at late stages and as a surgical finding, with abdominal pain or discomfort being the main associated symptom. Cases presenting with perforation are even rarer, especially without disseminated disease. The relationship between cancer and coronavirus disease 2019 (COVID-19) is still being studied, as well as the postsurgical evolution of COVID-19 patients and its possible causality of intestinal perforation. We present the case of a perforated jejunal adenocarcinoma in a COVID-19-positive patient, in whom the symptomatology secondary to the perforation led to an early diagnosis, treatment and adequate postsurgical evolution, despite the concomitant condition.

Intestinal liposarcoma: an unusual cause for peritonitis

Liposarcoma is the commonest type of soft tissue sarcomas which can occur in any part of the body, most commonly involving the limbs and retroperitoneum but it rarely involves small bowel. Only very few cases had been reported of liposarcoma involving small intestine in the past. The clinical presentations of this type of tumour arising from small bowel are nonspecific mostly during the initial stages of the disease and because of this the disease is often diagnosed at advanced stage. We report a very rare case of primary small bowel liposarcoma of ileum which had spontaneously perforated leading to peritonitis in an elderly female who underwent laparotomy, the tumour mass is resected with adequate margins and primary bowel anastomosis was done. The patient was followed up for a year with no complication. Although the liposarcomas occurring in the gastrointestinal tract leading to intestinal perforation is extremely rare. This unique case represents an important learning point for all clinicians and pathologists.

Non-Operatively Managed Primary Small Bowel Volvulus: A Case Report

Background: Primary small intestinal volvulus is one of the common causes of intestinal obstruction in various localities of the developing world. Although operative intervention has been the usual mode of treatment; this case report depicts with meticulous follow-up & care, there is a possibility for relief of obstruction with non-operative management.Case presentation: This is a case report of a 20-year-old male patient presented with crampy abdominal pain and frequent bilious vomiting. Plain abdominal film showed multiple distended small bowel loops with air fluid level, consistent with small bowel obstruction. Ruling out other etiologies primary small bowel volvulus was entertained and naso-gastric tube inserted, patient catheterized and kept nil per oral. After 48 hours of admission all symptoms resolved the patient resumed feeding and was discharged home. Conclusions: The reported case shows evidence in which the pa­tient’s primary small bowel volvulus was relieved non-operatively with insertion of naso gastric tube keeping nil per oral.

Left bundle branch block revealing a primary small bowel carcinoid metastasizing to the interventricular septum

Carcinoid tumours of the heart occur most commonly as a result of metastatic disease and usually affect the right side of the heart. We report a case of a solitary carcinoid metastasis to the interventricular septum without hepatic involvement in a 74-year-old man.