A 78-year-old man developed lower abdominal pain during antibiotic treatment for pneumonia and was admitted to the intensive care unit because of hemodynamic instability. Contrast-enhanced computed tomography revealed edematous changes extending from the ascending colon to the rectum, ascites, and increased density of the surrounding mesenteric fat. Blood tests showed a severe inflammatory response, acute renal failure, and metabolic acidosis, and the patient required continuous vasopressor administration for hemodynamic instability. Clostridioides difficile (CD) antigen and toxin were also detected, leading to a diagnosis of fulminant CD enterocolitis. Because colonic necrosis was suspected, exploratory laparotomy was performed. Operative findings showed no ischemic changes or wall thinning. The colon was preserved, and diverting loop ileostomy with colonic lavage was performed. Although total colectomy is the standard surgical treatment for fulminant CD enterocolitis, this case was successfully managed with ileostomy and colonic lavage.

Sigmoid volvulus involves the axial rotation of a distended sigmoid colon around its mesenteric axis, obstructing venous and arterial blood flow. This obstruction leads to progressive bowel ischemia, tissue necrosis, and, if not promptly addressed, an increased risk of perforation. In this case series, involving six patients with sigmoid volvulus, all were managed by exploratory laparotomy, consisting of detorsion, resection of the affected colon segment, and anastomosis. Postoperative recovery was generally uneventful, with normal bowel function restored by day 3 in all cases. Patients were discharged on day 10, and no significant complications occurred. Sigmoid volvulus is a common surgical emergency in older patients and is effectively managed by resection and primary anastomosis using GIA staplers. This surgical approach ensures excellent outcomes, minimal complications, and a low mortality rate.

This case describes a rare but serious complication of endoscopic procedures, highlighting the importance of vigilance in acute care. A 79-year-old man who underwent simultaneous esophagogastroduodenoscopy and colonoscopy developed hemoperitoneum caused by injury to the short gastric artery, a branch of the splenic artery. Emergency angiography demonstrated hypervascularity, and successful hemostasis was achieved using gelfoam embolization. The patient remained stable, with no recurrent bleeding, and was discharged without complications. This case underscores the importance of meticulous procedural technique, comprehensive preprocedural evaluation, and prompt recognition of vascular injury to optimize outcomes in acute care and emergency settings. It also emphasizes the need for continued education and vigilant monitoring to reduce the risk of rare but potentially life-threatening complications in endoscopic practice, in line with the journal’s mission to advance clinical care in trauma and emergency surgery.

Mesenteric injuries from blunt trauma are rare, but can result in life-threatening complications, including massive hemorrhage from mesenteric arterial disruption, bowel ischemia, necrosis, and perforation. Prompt diagnosis and treatment are critical, and surgical intervention is traditionally considered the gold standard intervention. Although transcatheter arterial embolization (TAE) is an established treatment for solid organ injuries following blunt abdominal trauma, its application to mesenteric injuries is less common. A 47-year-old male was admitted to our trauma center, which employes a hybrid emergency room system, after falling from a height of 3 meters. Abdominal computed tomography revealed active contrast extravasation from the middle colic artery which had a large hemoperitoneum, but no evidence of bowel injury. After initial resuscitation and stabilization, TAE was performed to control the hemorrhage. The patient was discharged 42 days after admission without significant complications. As a possible treatment option for mesenteric injuries without intestinal damage, we suggest TAE.

Small intestinal diverticula is a rare occurrence, and their surgical management remains controversial due to the lack of a recognized classification system. Complications such as perforation and obstruction are treated surgically. Their etiology remains nebulous but theories such as damage to the Auerbach’s nerve plexus have been advanced as a possible cause. The concomitant presence of a sigmoid intussusception due to diverticular disease in the same patient is truly a rare occurrence. The vast majority of colonic intussusception is due to malignancy and a benign etiology remains elusive. The reported cases of benign causes include a lipoma and benign lymphadenopathy. We believe this to be the first such case report of a colonic diverticulum causing an intussusception. Despite an exploratory laparotomy of less than sixty minutes, the patient demised in the intensive care unit following an occipital lobe stroke. We believe this case of sigmoid intussusception with concomitant small intestinal diverticula to be the first such case report of its kind in English-language scientific publications.