An eight-year-old boy presented with a history of intermittent episodes of spastic abdominal pain accompanied by bilious vomiting. Imaging revealed an abnormal position of the large bowel loop, which was associated with an abnormal vascular course. Additionally, a mesenteric cystic lesion was found in relation to the small bowel. A possibility of isolated hindgut malrotation with an enteric duplication cyst was suggested based on these findings. The surgical team confirmed this diagnosis during the procedure. Furthermore, they discovered an internal hernia intraoperatively, with a defect in the colonic mesentery through which the terminal ileum, ileocecal junction, cecum, and appendix herniated.

Keywords:Intestinal Malrotation; Enteric Duplication Cyst; Internal Hernia.

Splenic infarction is an extremely rare complication of Epstein-Barr virus (EBV) infection. We report a case of a healthy young man who presented with fever and pharyngitis and was diagnosed with acute EBV infection. During his hospital stay, he developed sudden left upper quadrant abdominal pain. Computed tomography scan of the abdomen demonstrated hepatosplenomegaly and multiple splenic hypodense lesions suggestive of infarcts. The patient was managed conservatively and discharged on prophylactic anticoagulation therapy. He is currently under close clinical follow up to minimize the risk of splenic rupture. We aim to highlight the importance of suspecting splenic infarction in patients presenting with fever, splenomegaly, and new onset abdominal pain, particularly in the setting of an ongoing or recent EBV infection.

Keywords:Epstein-Barr Virus; Splenic Infarct; Infectious Mononucleosis; Thrombosis; Greece.