Author name: Clinical and Medical Images

The patient is a 71-year-old male with multiple co-morbidities including past medical history of acute pancreatitis and metastatic renal cell carcinoma presented with epigastric abdominal pain for 3 days. Physical exam demonstrated mild diffuse abdominal tenderness with more tenderness elicited in right upper quadrant and epigastric region without rebound tenderness or guarding.

Internuclear ophthalmoparesis (INO) is a specific gaze abnormality characterized by impaired adduc- tion of the affected eye with abduction nystagmus of the contralateral eye. It results from a lesion in the medial longitudinal fasciculus (MLF) in the dorsomedial brainstem, tegmentum of either the pons or the midbrain [1]. The INO can be unilateral or bilateral

Staged bilateral traumatic pedicle fractures of lumbar spine (LS) are rare, only two cases have been de- scribed in the literature. This is the first case reported in an adolescent patient. Injuries to this area, therefore, are infrequent and involve the transfer of high amounts of energy responsible most often for spinal instability requiring spinal

A 46-year-old woman, she was operated a year ago, for a normal pressure hydrocephalus with insertion of a Ventriculoperitoneal Shunt (VPS). The evolution was favorable. She was admitted for trans-anal protru- sion of the VPS peritoneal catheter. Furthermore, the patient was asymptomatic with a mobile trans-anal catheter with peristaltic movements of the intestines the culture