Superior Mesenteric Artery or Wilkie Syndrome is a rare cause of duodenal obstruction and results from compression of the third portion of the duodenum by the superior mesenteric artery and the aortic artery.

Duplication of the inferior vena cava( IVC) is only rarely reported and often detected as an incidental finding(0.5-3%). In our patient, the anomolous vessel is the continuation of left iliac vein crossing anterior to the aorta, joining the right IVC at the level of inferior border of L1 vertebra.The association with a prothrombotic state,was exacerbated after splenectomy for this patient who had sickle cell anemia.

There are cases in which resection of cervico-mediastinal goitres requires additional thoracic access as an adjunct to standard transverse cervicotomy, and typically this takes the form of sternotomy or thoracotomy. The authors propose transclavicular access as an alternative to thoracotomy or sternotomy access for the removal of such goitres. This technical variant is performed by means of resection of the middle third of the clavicle and extraperiosteal disarticulation. They report a case of cervico mediastinal or “plunged” goitre associated with mediastinal metastasis from a follicular thyroid carcinoma in a 77-year-old woman, in whom this technical variant was used. They conclude by stressing the greater effectiveness, ease of execution and relatively limited “aggressiveness” of the technique in comparison with other ways of reaching the mediastinum. The variant proves effective in solving a number of technical, functional and aesthetic problems.

Acute hydrocephalus as a result of unruptured arteriovenous malformation (AVM) is a rare phenomenon in the adult population. Patients with AVMs typically present with hemorrhage, seizures, or focal neurologic deficits. Hydrocephalus may result from obstructing the native cerebrospinal fluid drainage by the malformation’s architecture. We report a previously healthy 32 year-old male who initially presented to an optometrist with blurry vision, visual obscurations, and papilledema. A large right frontal cerebral AVM with hydrocephalus and papilledema was confirmed by MRI. Unfortunately localized lesions may result in hydrocephalus as a rare presentation in unruptured AVMs.

Introduction: Soft tissue tumors are benign or malignant lesions developing from connective tissue and its varieties. Case Report: A 35-year-old patient referred to us for management of a voluminous pelvic-perineal mass. The clinical and para clinical data were in favor of a malignant lesion. The treatment consisted of a wide excision of the tumor. The post-operative period was complicated by an anal incontinence needing a protective left iliac colostomy. A perinioraphy, sphincter refection, and re–establishment of the digestive continuity were performed later on. The cytological examination of the excised mass revealed a conclusive involute hyanilised leiomyoma. Conclusion: This contrast between the clinical, para clinical and histologic data in our patient confirm the diagnostic challenges of soft tissue tumors, hence the need for special technic to assure diagnostic certitude to avoid mutilating surgical approaches for a benign lesion.