De Garengeot hernia, defined as the presence of the vermiform appendix within a femoral hernia sac, is a rare cause of acute groin pathology and often presents atypically. We report the case of a 60-year-old male with diabetes mellitus and chronic corticosteroid use who presented with fever and a painful, erythematous, non-reducible right groin swelling without abdominal symptoms. Laboratory investigations showed marked leukocytosis and elevated C-reactive protein. Computed tomography revealed a right groin abscess with intralesional air. Emergency surgical exploration demonstrated a perforated appendix protruding through the femoral canal, consistent with De Garengeot hernia. Appendectomy with drainage was performed, followed by femoral hernia repair using a McVay technique without mesh due to contamination. The postoperative course was uneventful. Early recognition and prompt surgical management are essential to achieve favorable outcomes in this rare but potentially severe condition.

Intracardiac cement embolism is a rare but potentially life-threatening complication of vertebral augmentation procedures. Management remains controversial, particularly in asymptomatic patients.

Acalculous gangrenous cholecystitis is a rare, life-threatening form of acute cholecystitis associated with significant morbidity and mortality. Neurological deficits may obscure early recognition of severe intra-abdominal pathology, contributing to delayed diagnosis and potentially worse clinical outcomes. We report a case of a 43-year-old male with recent intracerebral hemorrhage and residual right-sided hemiplegia who presented with high-grade fever and progressive clinical deterioration without prominent abdominal findings. Laboratory investigations demonstrated pronounced inflammatory changes accompanied by a predominantly cholestatic pattern of liver enzyme abnormalities. Urine culture was obtained during the diagnostic workup and the culture yielded extensively drug-resistant Klebsiella pneumoniae, likely reflecting healthcare-associated colonization rather than true infection. Abdominal imaging demonstrated findings suspicious for cholecystitis. Due to persistent worsening inflammatory markers despite empirical antimicrobial therapy, urgent laparoscopic intervention was undertaken. Intraoperative findings confirmed acalculous gangrenous cholecystitis complicated by purulent biliary peritonitis. Laparoscopic cholecystectomy with peritoneal lavage and drainage was successfully performed. The patient demonstrated rapid postoperative clinical improvement following definitive surgical source control. This case highlights the diagnostic challenge of clinically occult acalculous gangrenous cholecystitis and emphasizes that severe biliary infection may occur despite minimal abdominal findings. Particular vigilance is warranted in patients with neurological impairment, in whom residual neurological deficits may mask the progression of serious intra-abdominal pathology and contribute to delays in diagnosis and definitive treatment.