Trichobezoar is an underdiagnosed entity that has to be considered in children and adolescents, especially females, suffering from trichotillomania and trichophagia. Late diagnosis of trichobezoars showed that they cause gastrointestinal bleeding or perforation. A 17-year-old girl patient was admitted with abdominal pain and gastrointestinal bleeding. On abdominal examination, a well-defined mass in the epigastrium and the left upper quadrant was identified. Upper gastrointestinal (GI) endoscopy identified an enormous trichobezoar, which was later removed by surgery. Misdiagnosed gastric bezoars may cause life-threatening complications. Early detection for trichobezoar requires effective screening of trichotillomania. Psychiatric counseling is important to prevent bezoar recurrence.

Hydatid disease (HD) is a worldwide parasitic disease. HD is endemic in many sheep- and cattle-raising areas, with a high prevalence of 5% to 10% in the Mediterranean region. Fistulation of liver hydatid cysts (LHC) in the bile ducts is the most common complication, followed by rupture of cysts in the peritoneal and thoracic cavities. Vascular complications are a rare complication of HD. We describe the case of a 70-year-old woman who was admitted with the chief complaint of pain in the abdominal right upper quadrant for 6 months. Abdominal computed tomography revealed a large LHC in the right liver that had ruptured into the right portal vein branch, with venous thrombosis. Intraoperatively, the right portal vein was opened longitudinally, and the hydatid contents were evacuated. Right hepatectomy was performed to completely excise the LHC. The penetration of a cyst into an adjoining vessel is very rare, and portal vein invasion by HD is extremely rare, with only 10 cases published in the literature, to the best of our knowledge.

Choriocarcinoma is a highly aggressive, malignant tumor that arises from trophoblastic cells. Although choriocarcinomas usually arise in the genital organs, they can also originate in extragenital organs, but gastrointestinal tract lesions are rare. Gastrointestinal choriocarcinoma can be primary or metastatic. Most primary gastrointestinal choriocarcinomas are associated with adenocarcinomas. We report a case of jejunal choriocarcinoma presenting with acute abdominal pain and intestinal bleeding. The patient had a very high serum beta-human chorionic gonadotropin (β-HCG) level with an isolated jejunal lesion on contrast-enhanced computed tomography of the abdomen and pelvis. The patient underwent emergency surgical resection of the jejunal lesion with good recovery. The histopathological analysis of the resected specimen confirmed the diagnosis of choriocarcinoma. However, the patient suffered from life-threatening rebleeding one month after surgery and succumbed to her illness.

A choledochal cyst (CC) is a rare congenital anomaly manifested as cystic dilatation of the biliary tree. A giant choledochal cyst is defined as a cyst with a maximum diameter of ≥ 10 cm. It is an unusual entity and rarely revealed in adulthood. We describe the case of a giant, infected CC presenting as acute pancreatitis with results of abdominal ultrasound and computed tomography consistent with a pancreatic pseudocyst. The diagnosis of CC was made on magnetic resonance cholangiopancreatography (MRCP) findings. We proceeded with cholecystectomy and the complete resection of the diverticulum after its dissection. The defect in the common bile duct was closed transversally over a T-tube. At the last follow-up two years after his admission, the patient is symptom-free with normal liver enzymes To the best of our knowledge, this is the first case reported of giant CC complicated with both infection and pancreatitis

The coexistence of lobular panniculitis, polyarthritis, and intraosseous fat necrosis in patients with acute pancreatitis is commonly referred to as pancreatitis, panniculitis, and polyarthritis (PPP) syndrome. It is a rare condition associated with serious complications and high mortality. A 70-year-old female was admitted with severe acute necrotizing pancreatitis due to gallstone disease. Laboratory findings indicated an intense systemic inflammatory response syndrome (SIRS). The patient rapidly progressed toward persistent organ failure. During her hospital stay, she also developed panniculitis and polyarthritis, related to severe acute pancreatitis. Eventually, the patient expired despite medical therapy.