Foreign body ingestion (FoBI) is an important source of morbidity and mortality in the pediatric population. Patients with intellectual disabilities (ID) are at increased risk of FoBI, likely due to the known association between ID and increased rates of pica. In this report, we present the case of a 15-year-old female patient with autism spectrum disorder (ASD) and ID who presented to the emergency department with fever, drooling, and respiratory failure. She required intubation for airway management. A diagnosis of FoBI was made after striking CT images revealed an entire graphite pencil in her esophagus, causing perforation of the retropharyngeal space. Her recovery course was complicated. Shortly after discharge, the patient was readmitted with repeat FoBI and another significant esophageal injury. Patients with ID who require surgery due to FoBI are at higher risk of complications and often require prolonged hospitalizations compared to their neurotypical peers. Prevention of FoBI in patients with ID constitutes an important aspect of clinical care and requires efforts toward achieving a balance between patient safety and autonomy.An empyema necessitans is a rare complication of a collection of purulent material in the pleural space that spreads outside of the pleural cavity and involves the soft tissues of the chest wall. Due to compression forces created by the size of the collection of empyema in the chest cavity, patients are usually symptomatic and present with severe dyspnea. Chest X-ray or ultrasound of the chest cavity are the ideal screening tools to visualize the empyema and followed by computerized tomography scan of the chest to confirm the presence and extent of the pathology. In rare occasions, the empyema can rupture spontaneously, which may lead to critical situation requiring emergent intervention. We report the case of a 72-year-old male who presented to the emergency department with severe dyspnea and was diagnosed with empyema necesitans. During the initial management of the case, the empyema necessitans ruptured spontaneously and required emergent interventions to stabilize the patient.Background Incisional hernia (IH) is a common, late complication of open repair of an abdominal aortic aneurysm (AAA), with a variable high incidence. A cohort study was conducted to investigate the role of a lightweight titanized mesh placed in the pre-peritoneal space after AAA repair. The primary endpoint was to determine the incidence of IH at eight weeks and 12 months. Methods Consecutive patients who underwent open repair of AAA with the prophylactic implantation of a mesh after abdominal wall closure were recruited. The development of IH was evaluated using clinical examination, ultrasonography scan (USS), and computed tomography (CT) scan during the follow-up period. Results Thirty-nine of 45 patients (34 male, 5 female, mean age 69.6 +/- 6.5 years) undergoing open repair of AAA over a five-year period via a preferred roof-top incision were analyzed for this study. One additional (2.5%) patient had the mesh explanted following a re-laparotomy for colonic ischemia and later developed an incisional hernia. There was no incidence of wound or mesh infection overall. One radiologically detected early IH closed spontaneously. There were five (12.8%) radiologically detected late cases of midline or paramedian defects beyond the one-year follow-up though this was not clinically significant; compared to this, there was no incidence of lateral defects in the wound (p less then 0.01, McNemar's test). Conclusion These preliminary results suggest that a dedicated lightweight titanized mesh is usable for primary reinforcement of rooftop incisions at the time of wound closure. Whilst this study supports the role of a mesh as a useful adjunct, larger studies and long-term follow-up would provide more sensitive assessments of its efficacy.Background Spondylodiscitis is a potentially life-threatening infection that imposes a significant financial burden on healthcare systems. Current reports suggest an increase in the incidence of spondylodiscitis, which could be attributed to the aging population and the growing rates of drug abuse. This study aims to evaluate the safety and effectiveness of surgical treatment of spondylodiscitis. Materials and methods Thirty-two cases diagnosed with spondylodiscitis and treated operatively between 2010 and 2015 were enrolled in this study. Indications for surgery were progressive neurologic involvement, progressive spinal deformity or instability, impending fracture, epidural abscess, and poor response to antibiotics. Patients underwent a single-stage procedure. A combined anterior and posterior approach was used in 28 of the patients. In 20 patients, a titanium mesh cage was used for reconstruction. The mean follow-up was 5.6 years. p97 inhibitor Results There were 18 males and 14 females. The mean age of the patients was 68.4 years (range 56-78). The cervical spine was affected in two cases (6.3%), the thoracic spine in 12 cases (37.5%), and the lumbar spine in 18 cases (56.3%). The most commonly isolated microorganisms were Staphylococcus aureus and Escherichia coli. There was neither mortality nor severe complications. Fusion was achieved in all the patients. There was complete resolution of the neurologic deficits that were recorded preoperatively. No signs of recurrent or residual infection were recorded until the last follow-up. Conclusions Our data suggest that early detection and surgical intervention of spondylodiskitis is associated with favorable outcomes.Isolated unilateral hypoglossal nerve (HN) palsy caused by vascular compression is a rare condition. We report a case of a 42-year-old male, presenting with tongue paresis and unilateral atrophy of the tongue due to an internal carotid artery (ICA) loop. The compression of HN by ICA loop and concomitant wall irregularities of the loop segment were observed in magnetic resonance imaging and digital subtraction angiography (DSA). The patient was managed with antithrombotic without the need of any further intervention. To our best knowledge, this is the first reported case of isolated compressive neuropathy of the HN caused by loop of the ICA. Here, the clinical presentation, etiology, and management of isolated HN palsy caused by vascular lesions are discussed along with the relevant literature.