A 39-year-old woman underwent preoperative chemotherapy and laparoscopic low-anterior resection for rectal cancer (Rab, ypT3, ypN1b, ypStageIIIb). Preoperative examinations and intraoperative macroscopic findings showed no significant abnormality in the ovaries. Two months postoperatively, however, she complained of abdominal distention, and work-up examinations revealed massive ascites and pleural effusion with bilateral nodular-cystic enlargement of the ovaries. She underwent bilateral salpingo-oophorectomy, and histopathological findings revealed bilateral ovarian metastasis of the rectal cancer. The ascites and pleural effusion disappeared soon after the surgery and have not recurred. The pathology was considered to be pseudo-Meigs syndrome. Postoperative chemotherapy was administered for 12 months, and there has been no evidence of no recurrence as of this writing 18 months postoperatively.

A 48-year-old woman with a history of recurrent alcoholic pancreatitis was found to have a pancreatic pseudocyst. In November 20XX, she visited the emergency department due to sudden abdominal pain. Contrast-enhanced computed tomography showed a pancreatic pseudocyst with a maximum diameter of 67 mm and ascites. A ruptured pancreatic pseudocyst was suspected and abdominal paracentesis was performed. The amylase level in the ascitic fluid was high (3444 IU/L), leading to a diagnosis of acute generalized peritonitis due to rupture of a pancreatic pseudocyst. Intraoperative findings revealed 500 mL of ascites mixed with pancreatic juice and turbid cyst contents, and distal pancreatectomy was performed. The postoperative course was favorable, and the patient was discharged on hospital day 14. Rupture of pancreatic pseudocyst is rare. In this case, it was promptly diagnosed and successfully treated with emergency surgery.