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Echinococcosis, caused by larval stages of taeniid cestodes, primarily affects the liver and is commonly treated surgically. However, a complication post-treatment is biliary fistula, necessitating interventions like biliary stents. While stent complications are recognized, proximal migration leading to pneumonia is exceptionally rare. This case report details an unusual occurrence of biliary stent migration years after hepatic hydatid echinococcosis treatment. A 42-year-old patient underwent 2014 surgery for a large hydatid cyst, resulting in a biliary fistula. Endoscopic sphincterotomy and biliary stent placement led to a successful outcome. Lost to follow-up, the patient reappeared in 2022 with basithoracic pain, fever, and a thoracic CT scan revealing transdiaphragmatic stent migration causing basal pneumonitis. Antibiotic therapy and endoscopic stent removal ensued with an uncomplicated recovery. This report emphasizes a rare complication that is proximal migration of a biliary stent 10 years post-initial placement for biliary fistula management. Despite the absence of typical risk factors. We managed a successful endoscopic retrieval. This highlights the importance of vigilance and follow-up for potential complications associated with biliary stent. Unusual presentations, like pneumonitis, underscore the need for awareness and a cautious approach. The primary complication following surgical intervention for hepatic hydatid cysts is the development of an external biliary fistula, necessitating the use of biliary stents for treatment. Given the rarity of complications observed in our case, the removal of stents post-treatment for biliary fistula becomes crucial, underscoring the significance of vigilant follow-up care. • Biliary stent are a widely used treatment for persistent biliary fistula. • Proximal migration is a rare complication of this procedure. • It usually occurs in patient with cholangiocarcinoma rarely for non-malignant disease such as hydatic echinococcosis. • Proximal migration causing a pneumonia is an extremely unusual complication. • Endoscopic management associated or no with surgery is the main treatment. [ABSTRACT FROM AUTHOR]

The Intrauterine Contraceptive Device (IUD), a widely used contraceptive since 1965, has demonstrated efficacy but is associated with complications such as bleeding, pain, and rare occurrences of perforation. This case report details an IUD migration into the peritoneal cavity, leading to acute appendicitis. A 33-year-old woman, with a history of IUD insertion 16 months prior, presented with pelvic pain. Gynecological examination and computed tomography, revealed the IUD intraperitoneal migration. The patient underwent laparoscopic extraction of the IUD which was embedded in the appendix and appendectomy, with an uneventful recovery. This case emphasizes the complexity of IUD migration and its rare association with acute appendicitis, underscoring the importance of vigilant monitoring and prompt intervention. We also explored factors contributing to IUD perforation risk, imaging modalities for detection, and emphasizes the necessity of surgical removal upon confirmation. We highlight the fact that despite the atypical presentation with minimal symptoms, we should always consider emergency situations. Surgical intervention, particularly laparoscopy, may be the standard approach for managing migrated IUDs. We insist about the critical need for thorough assessment and vigilance in managing IUD-related complications, emphasizing timely intervention to ensure patient safety. This case contributes valuable insights into the complexities surrounding IUD migration, urging healthcare professionals to remain attentive to potential injuries in patients with a history of IUD insertion and abdominal pain. • The Intrauterine Contraceptive Device (IUD) is a widely used contraceptive method, but its popularity is accompanied by potential complications. • Uterine perforation is a rare but serious complication of IUD insertion leading to severe complications that may require intensive treatments, including surgery. • We highlight a novel occurrence of IUD migration into the peritoneal cavity, causing acute appendicitis. We performed a laparoscopic extraction. • This case also highlights the importance risk factor consideration and IUD continuous follow-up to avoid complications, such as acute appendicitis to ensure patient safety. [ABSTRACT FROM AUTHOR]

Splenic artery aneurysms (SAA's) pose a rare yet clinically significant challenge, characterized by the weakening and ballooning of the splenic artery, potentially leading to severe complications such as rupture and hemorrhage. A 52-year-old female presenting with biliary colic. Diagnostic imaging revealed a saccular lesion closely associated with gallstones. A multidisciplinary approach guided the decision for surgery due to the size and location of the aneurysm. A bi sub costal laparotomy was performed, after the resection of the aneurysm, an arterial anastomosis with pds 5/0 suture was performed. SAA's treatment modalities are tailored based on aneurysm localization and size. Imaging modalities such as Doppler ultrasound and CT angiography play a crucial role in accurate diagnosis, providing essential information for treatment planning. Treatment options include endovascular embolization, and surgical intervention. Traditionally open surgical techniques, including ligation of the splenic artery, aneurysmectomy, and splenectomy. Surgical treatment, especially for proximal aneurysms, is highlighted, with the presented alternative approach of resection with end-to-end anastomosis, showcasing an alternative surgical technique aimed at reducing the risk of spleen infarction. SAA's are a rarity that emphasizes the need for early detection and intervention. We are urged to maintain a high index of suspicion, particularly in high-risk individuals. We report an alternative surgical technique that we hope will contributes to the expanding repertoire of approaches, calling for further research to optimize SAA management strategies in the quest for improved patient outcomes. • SAAS ARE RARE BUT SIGNIFICANT CLINICAL CONDITIONS THAT CAN LEAD TO LIFE-THREATENING COMPLICATIONS. • IMAGING MODALITIES SUCH AS DOPPLER ULTRASOUND, CT ANGIOGRAPHY, ARE ESSENTIAL FOR DIAGNOSIS. • DECISION FOR INTERVENTION DEPENDS ON FACTORS SUCH AS SIZE, LOCALIZATION, AND COMPLICATIONS, WITH EARLY INTERVENTION BEING CRUCIAL TO PREVENT CATASTROPHIC HEMORRHAGE. • TREATMENT OPTIONS INCLUDE ENDOVASCULAR EMBOLIZATION, AND SURGICAL INTERVENTION. • WE HIGHLIGHTED SURGICAL TREATMENT, ESPECIALLY FOR PROXIMAL ANEURYSMS, WITH AN ALTERNATIVE APPROACH OF RESECTION WITH END-TO-END ANASTOMOSIS. [ABSTRACT FROM AUTHOR]

Primary hydatid cyst of the retroperitoneum is an exceedingly rare manifestation of hydatid disease. Diagnosis proves challenging due to nonspecific symptoms, and the condition is typically not suspected when facing a retroperitoneal cystic mass, necessitating awareness among clinicians and surgeons, particularly in endemic regions. A 45-year-old male with a three-month history of progressive abdominal enlargement and pain. Living in a rural area, he exhibited a 30 cm, well-defined retroperitoneal cyst, with no guarding confirmed by CT-scan, with characteristic daughter cysts. The diagnosis of primary retroperitoneal hydatid cyst was supported by positive hydatid serology and eosinophilia. Surgical intervention was crucial, and a complete pericystectomy, with 4 cm of pericyst on the aorta due to safety concerns, was performed after three months of preoperative albendazole-based treatment. The postoperative course was uneventful, and a two-year follow-up revealed no recurrence. The prevalence of hydatid disease in North Africa is high, yet retroperitoneal cases are rare. The difficulty to diagnosis retroperitoneal masses, underscores the importance of precise patient evaluation and detailed imaging analysis. Percutaneous puncture is contraindicated due to the risk of dissemination, highlighting even more the significance of accurate preoperative diagnosis. Surgery, coupled with Albendazole treatment, remains the gold-standard, associated with meticulous intraoperative precautions to prevent disease dissemination. Primary retroperitoneal hydatid cyst is rare. Diagnosis is difficult. Precise determination of patient's background and detailed analysis of imaging findings are mandatory. Percutaneous puncture is forbidden as it leads to disease spreading or even anaphylactic shock. Surgical excision is the gold-standard. • Primary retroperitoneal hydatid cyst are rare, emphasizing its infrequent occurrence in the natural course of hydatid disease. • This rarity poses challenges in diagnosis and necessitates awareness among clinicians and surgeons. • Diagnosing primary retroperitoneal hydatid cyst is difficult especially when encountering a retroperitoneal cystic mass, making accurate diagnosis challenging. • The patient's rural residence, contact with animals, and specific imaging findings played crucial roles in indicating the possibility of a hydatid cyst. • Surgery coupled with preoperative Albendazole-based treatment, is the primary treatment with successful outcome along with no recurrence. [ABSTRACT FROM AUTHOR]

Boerhaave's syndrome, recognized as spontaneous esophageal rupture, is an uncommon and perilous medical condition marked by the spontaneous tearing of the esophagus. This paper highlights the importance of an early diagnosis and its correlation to better outcomes for a rare pathology with high mortality. A 67-year-old female presenting with unexplored vomiting and hypertension, presented to the ER with a septic shock. The patient's clinical deterioration prompted emergency exploration, revealing a dilated esophagus with a 3-cm perforation. Despite surgical intervention, including suturing with a T-tube and esophageal exclusion, the patient succumbed to multiorgan failure. Boerhaave's syndrome, triggered by forceful vomiting, presents diverse clinical manifestations, making accurate diagnosis challenging. The characteristic triad of vomiting, pain, and subcutaneous emphysema is observed in a minority of cases, often overshadowed by acute respiratory distress. Diagnostic modalities include chest X-rays, contrast esophagography, and computed tomography, aiding in visualizing contrast leakage and confirming the diagnosis. The choice of surgical technique, ranging from esophageal suturing to esophagectomy, depends on the duration between rupture and surgery initiation. In this case, a bipolar esophageal exclusion was performed due to the patient's critical condition. Boerhaave's syndrome demands consideration in patients presenting with thoracic pain and vomiting, particularly in those with a pathological esophagus. Early diagnosis and surgical intervention remain pivotal in improving outcomes. Identification of hydro-pneumothorax in radiographic studies should prompt consideration of spontaneous esophageal rupture, highlighting the need for heightened clinical suspicion in nonspecific clinical scenarios. • BOERHAAVE'S SYNDROME, A SPONTANEOUS ESOPHAGEAL RUPTURE, IS A RARE AND LIFE-THREATENING CONDITION REQUIRING PROMPT DIAGNOSIS AND INTERVENTION. • CLINICAL MANIFESTATIONS VARY, WITH THE CHARACTERISTIC TRIAD OF VOMITING, PAIN, AND SUBCUTANEOUS EMPHYSEMA OBSERVED IN A MINORITY OF CASES, OFTEN OVERSHADOWED BY ACUTE RESPIRATORY DISTRESS. • EARLY DIAGNOSIS AND SURGICAL INTERVENTION ARE CRUCIAL FOR IMPROVING OUTCOMES, AND THE IDENTIFICATION OF HYDRO-PNEUMOTHORAX IN RADIOGRAPHIC STUDIES SHOULD PROMPT CONSIDERATION OF SPONTANEOUS ESOPHAGEAL RUPTURE. • THE CHOICE OF SURGICAL TECHNIQUE DEPENDS ON THE DURATION BETWEEN RUPTURE AND SURGERY INITIATION, WITH OPTIONS RANGING FROM ESOPHAGEAL SUTURING TO ESOPHAGECTOMY. • BOERHAAVE'S SYNDROME SHOULD BE CONSIDERED IN PATIENTS WITH THORACIC PAIN AND VOMITING, ESPECIALLY IN THOSE WITH A PATHOLOGICAL ESOPHAGUS. [ABSTRACT FROM AUTHOR]

Bouveret Syndrome, a rare form of gallstone ileus, involves the migration and impaction of a gallstone in the duodenum or stomach, causing gastric outlet obstruction. Early intervention and a comprehensive care plan are essential for favorable outcomes. This article presents a case of an 82-year-old female with a history of coronary artery disease and untreated gallstones. The patient experienced nausea, vomiting, and abdominal pain for two weeks. Diagnostic procedures revealed a cholecystoduodenal fistula with a 4 cm stone lodged at the duodenojejunal angle. For our patient the gallstone was moved to the jejunum, followed by enterotomy and a latero_lateral gastroenteroanastomosis. The rarity of Bouveret Syndrome and its nonspecific symptoms make diagnosis challenging, necessitating differentiation from other gastrointestinal disorders. Esophagogastroduodenoscopy (EGD) and imaging, such as computed tomography (CT), play crucial roles in diagnosis. In this case, the EGD did not show gallstones up to the second part of the duodenum. Management involves a multidisciplinary approach, with supportive care for stabilization and the primary goal of removing the impacted stone. Treatment options include endoscopic, surgical, or lithotripsy techniques. Bouveret Syndrome poses challenges due to its rarity, leading to delayed diagnosis. Prognosis varies based on factors such as stone size, location, and overall patient condition. Through this case we emphasizes the importance of awareness, timely diagnosis, and appropriate management, with EGD and CT scan playing key roles in diagnosis. Surgical intervention remains a viable treatment option when endoscopic approaches are unavailable. The article highlights the controversial nature of fistula repair in Bouveret Syndrome. • Bouveret Syndrome, a rare form of gallstone ileus causing gastric outlet obstruction. • Esophagogastroduodenoscopy (EGD) and especially computed tomography (CT) showing Rigler triad, play crucial roles in diagnosis • Bouveret Syndrome poses challenges due to its rarity, leading to delayed diagnosis. • Treatment options include endoscopic, surgical, or lithotripsy techniques. • Prognosis varies based on factors such as stone size, location, and overall patient condition. [ABSTRACT FROM AUTHOR]

Background Adult intussusception is a rare clinical entity. It is an uncommon cause of intestinal obstruction in adult. It often presents with nonspecific symptoms and preoperative diagnosis remains difficult. The purpose of this study was to determine the clinical entity and surgical approach of adult intussusception. Methods We have conducted a retrospective descriptive study starting from 2006 until 2014. We reviewed data for all patients that had been admitted to our department for intestinal intussusception. Results Eight consecutive patients were admitted to our department. The mean age was 48 years old (20–71). The sex ratio was 0,6. The clinical presentation was acute in 5 cases. A computed tomography was performed in 6 cases. The diagnosis of gastrointestinal intussusception was made preoperatively in 100% of patients. All patients underwent surgery. An organic lesion was identified in 100% of the cases. In all cases, resection of the intussuscepted intestinal loop was done without intestinal reduction. All patients were well followed up and recurrences have been documented. Conclusion In adults, intussusception is usually secondary to an organic cause. In the absence of signs of severity, etiologic diagnosis based on CT allows the diagnosis of the intussusception and sometimes can detect the causal lesion. Therapeutic sanction of intussusception is surgery and there is more emphasis towards resection without reduction. [ABSTRACT FROM AUTHOR]

The first case of COVID-19 declared in Tunisia was on March 2nd [1], and as the number of infected people escalates the healthcare system was put under pressure, leading to a total containment by March 22nd and hospitals reorganization and restructuring, to improve the management of infected patients' care. Patients with acute appendicitis in the COVID period there had more peritonitis and gangrenous appendicitis (45.4%) than in the non-COVID period (14.3%) (P<0.002). [Extracted from the article]

This study presents a microscale simulation method that allows one to study the impact of particle loading on the aerosol capture efficiency of an electrostatically charged filter. This was done by considering a bipolarly charged fiber loaded with different amounts of neutral and charged particles with a diameter of 300 nm. The simulations predicted the deposition pattern of the aerosol particles as well as their impact on the electrostatic field of the bipolar fiber. The particle-loaded fiber was then challenged with aerosol particles in the range of 50 nm to 1 μm and with different charge polarities to study how the electrostatic field of the deposited particles interacts with that of the fiber to attract or repel the incoming airborne particles. More specifically, our simulations revealed that particle deposition can enhance the capture efficiency of a bipolar fiber when it is challenged with small particles (smaller than about 400 nm) regardless of the charge polarity of the airborne or deposited particles. The numerical simulations reported in this paper were conducted using the ANSYS CFD code enhanced with in-house subroutines to superimpose the electrostatic field of the deposited particles to that of the bipolar fiber and to include Brownian, polarization, and Coulomb forces in particle trajectory calculations. [Display omitted] • Simulated the electrostatic field around a particle-loaded corona-charged fiber. • Demonstrated the impact of particles' electrostatic field on fiber's capture efficiency. • Discussed the effects of fiber polarity on particle loading. • Demonstrated agreement between simulation results and experimental observations. [ABSTRACT FROM AUTHOR]