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Introduction The urachal anomaly is a developmental defect, a remnant of fetal life consisting of a patent connection between the dome of the urinary bladder and the umbilicus. It can take various forms. Most commonly it occurs in males, very rarely in adults. The main symptoms associated with this condition are: foul-smelling discharge from the umbilicus, abdominal pain, hematuria, or recurrent urinary tract infections. Imaging plays a crucial role in the diagnosis of the persistent urachus. Aim of the study The aim of the study is to sentize doctors’ attention that patent urachus is the rare but possible diagnosis of acute abdomen pain in adults population and bring the proceedings. Materials and methods: An analysis of papers avaliable on Pubmed and Google Scholar was performed. The following key words: urachal anomalies, adults, abdomen pain, urachal remnants, urachal carcinoma were used. Results: Lately, thanks to modern precise imaging diagnostics, more valuable studies have been conducted, allowing to characterize residual ureteral remnants, which are most often asymptomatic in population of adults. However the manifestation of symptoms is mostly associated with infection of the mentioned area or a tumor transformation. There are at least two case reports which report that infection of urachal remnants could manifestate after intensive physical activity. It is worth in-depth interviewing. Studies indicate the necessity of surgical removal of persistent urachal anomalies, as they carry the risk of rapid growth and unfavorable prognosis of cancerous spread.

Abstract Background Superior mesenteric artery embolism (SMAE) is a rare cause of acute abdomen, and the fatality rate is extremely high if it is not diagnosed and treated in time. Due to the lack of knowledge and experience of nonspecialist physicians, it is easy to misdiagnose. Radiofrequency ablation (RFA) has become the first-line treatment strategy for atrial fibrillation (AF). Thromboembolic events are some of the major complications after RFA, whereas SMAE is rarely reported. Case presentation A 70 year-old woman with paroxysmal AF who regularly took anticoagulant drugs for 3 months experienced abdominal pain after RFA. At the outset, she was misdiagnosed as mechanical intestinal obstruction. When the patient presented with blood in the stool, abdominal enhancement computed tomography was conducted and showed a small bowel perforation. Immediate laparotomy was performed, and the final diagnosis was SMAE. Conclusion It is suggested that for unexplained abdominal pain after RFA of AF, the possibility of SMAE should be considered, and a targeted examination should be carried out in time to confirm the diagnosis and give appropriate treatment.

Background: Superior mesenteric artery embolism (SMAE) is a rare cause of acute abdomen, and the fatality rate is extremely high if it is not diagnosed and treated in time. Due to the lack of knowledge and experience of nonspecialist physicians, it is easy to misdiagnose. Radiofrequency ablation (RFA) has become the first-line treatment strategy for atrial fibrillation (AF). Thromboembolic events are some of the major complications after RFA, whereas SMAE is rarely reported. Case presentation: A 70 year-old woman with paroxysmal AF who regularly took anticoagulant drugs for 3 months experienced abdominal pain after RFA. At the outset, she was misdiagnosed as mechanical intestinal obstruction. When the patient presented with blood in the stool, abdominal enhancement computed tomography was conducted and showed a small bowel perforation. Immediate laparotomy was performed, and the final diagnosis was SMAE. Conclusion: It is suggested that for unexplained abdominal pain after RFA of AF, the possibility of SMAE should be considered, and a targeted examination should be carried out in time to confirm the diagnosis and give appropriate treatment. [ABSTRACT FROM AUTHOR]

Background Acute intestinal obstruction is a commonly encountered surgical emergency that is prevalent worldwide and has substantial morbidity and fatality rates. Therefore, swift and precise diagnosis is essential. While mortality rates in urban areas have declined due to timely medical intervention following early detection, the situation contrasts starkly in rural areas. Delays in presentations often lead to complications because of hesitancy toward surgery, economic challenges, and limited access to healthcare information. Therefore, this study aimed to evaluate how well multidetector computed tomography (MDCT) can help determine the site, cause, and level of intestinal obstruction compared to what the surgeons confirmed intraoperatively. Methodology A prospective study involving 101 patients was conducted at a tertiary care center in western Maharashtra from July 2022 to July 2024. The emergency department referred patients with clinical symptoms such as nausea and vomiting, abdominal distension, abdominal pain, inability to pass flatus, constipation, or diarrhea, which are commonly seen with intestinal obstruction. The study involved all patients who underwent a contrast-enhanced MDCT scan using both intravenous and oral contrast agents. We selected patients from both genders, regardless of their age; however, considerations were taken to include characteristics convenient and relevant to the study. Patients with abnormal serum creatinine levels or allergies to contrast were excluded from the study. We conducted CT examinations, noting findings such as the transition point between the dilated and collapsed loops, mesenteric fat stranding, and intestinal dilatation. An experienced radiologist made the final report, and the operating surgeons' notes on laparoscopy or open surgery for the same patient were reviewed to understand the operative findings. Results MDCT scans had high diagnostic accuracy for small and large bowel obstruction. Of the 101 patients, the mean age was 43.7 years. There were 70 (69.30%) males and 31 (30.69%) females. Sensitivity was 100%, specificity was 98.1%, positive predictive value was 83.7%, and negative predictive value was 100%. Conclusions MDCT demonstrated high sensitivity and specificity for diagnosing and determining the underlying cause of intestinal obstruction. It identified the location of the obstruction and discerned whether it originated from intrinsic, extrinsic, or intraluminal factors., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Research and Recognition Committee issued approval IESC/PGS/2022/162. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kelkar et al.)

Background: The Internet is a universal source of information for parents of children with acute complaints.Objectives: We sought to analyze information directed at parents regarding common acute pediatric complaints.Methods: Authors searched three search engines for four complaints (child + fever, vomiting, cough, stomach pain), assessing the first 20 results for each query. Readability was evaluated using: Flesch-Kincaid Grade Level, Gunning Fog, Simple Measure of Gobbledygook, and the Coleman-Liau Index. Two reviewers independently evaluated Journal of the American Medical Association (JAMA) Benchmark Criteria and National Library of Medicine (NLM) Trustworthy scores. Two physicians (emergency medicine/EM, pediatric EM) analyzed text accuracy (number correct divided by total number of facts). Disagreements were settled by a third physician. Accuracy was defined as ≥ 95% correct, readability as an 8th-grade reading level, high quality as at least three JAMA criteria, and trustworthiness as an NLM score ≥ 3. Accurate and inaccurate websites were compared using chi-squared analysis and Mann-Whitney U test.Results: Eighty-seven websites (60%) were accurate (k = 0.94). Sixty (42%) of 144 evaluable websites were readable, 38 (26%) had high-quality JAMA criteria (kappa/k = 0.68), and 44 (31%) had reliable NLM trustworthy scores (k = 0.66). Accurate websites were more frequently published by professional medical organizations (hospitals, academic societies, governments) compared with inaccurate websites (63% vs. 33%, p < 0.01). There was no association between accuracy and physician authorship, search rank, quality, trustworthiness, or readability.Conclusion: Many studied websites had inadequate accuracy, quality, trustworthiness, and readability. Measures should be taken to improve web-based information related to acute pediatric complaints. [ABSTRACT FROM AUTHOR]

Background Irritable bowel syndrome (IBS) is a chronic condition characterized by persistent abdominal pain or discomfort and impaired bowel function. Symptoms often vary in onset and severity, are worse during flare-ups, and affect the patient's quality of life. A positive diagnosis of IBS based on clinical symptoms may lead to a better outcome. There are different diagnostic criteria like Kruis score, Manning criteria, Rome I, II, III, and IV criteria, and each new one addresses the deficiencies of the previous ones. We analyze the effectiveness of the most commonly used diagnostic criteria associated with clinical examinations and laboratory tests in treating IBS in these studies. Methodology This is a retrospective study in which data from IBS subjects were collected by simple random sampling and compared using Manning criteria, Kruis score, and Rome IV criteria. Laboratory tests included complete blood count (CBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP). Results Of the 130 patients, IBS is more prevalent in adults aged 30-50 years, with a male predominance. The Kruis score outperformed the Manning criterion in distinguishing between organic bowel disease and IBS. This, together with the Rome IV criteria, increases the likelihood of identifying IBS. Conclusions Differentiating IBS from functional and organic gastrointestinal problems is critical. Irritable bowel syndrome can be diagnosed using symptom-based diagnostic criteria. Clinical observation and physical examination should be supplemented with laboratory indicators., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Ghosh et al.)

Objective: The aim: Study of somatoform vegetative dysfunction' clinical features at adolescent age with a chronic pain (HA syndrome and AP syndrome), and also socially-psychological factors of its formation too., Patients and Methods: Materials and methods: There are 82 teenagers have been examined in this research: 48 girls (58,5 %) and 34 young men (41,5 %) at the age of 16 - 17 years. Research will be done according to diagnostic criteria of ICD-10., Results: Results: An aetiological basis of HAS and APS are various somatoform disorder mostly at teenage age (70,8 % cases at girls and in 58,8 % - at young men). 32,2 % of the patients had various neurotic disturbances with anxiety-depressive symptoms in a genesis of HAS and APS. Somatoform vegetative dysfunction - the most widespread reason of HAS and APS development among teenagers. Among teenagers HAS cases (68,8 % - at girls, 58,8 % - at young men) essentially prevail over APS (31,2 and 41,2 % cases accordingly). All adolescents had combine negative life events in their life. Girls felt psychotraumatic experience more strongly than young man. The greatest combine negative life experience has been revealed in a subgroup of girls with HAS. The least influence of psychotraumatic factors was observed at young men with APS. Consequently, SVD, accompanied by severe pain in adolescence - is pathogenic complex and combined mental disorders, requiring adequate psychopharmacological and psychotherapeutic intervention., Conclusion: Conclusions: Chronic stressful situations were experienced by each of the examined patients. Each of the teens noted combination of stress problems in their lives. The widespread common problem among the examined adolescents was a sense of being overprotected by parents. Consequently, SVD, accompanied by severe pain in adolescence -is pathogenic complex and combined mental disorders, requiring adequate psychopharmacological and psychotherapeutic intervention.