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Background: Ascites is the accumulation of abdominal fluid in the peritoneal cavity. Liver cirrhosis, Alcoholic liver disease, Intra-abdominal malignancy, and tuberculosis are the significant etiologies of ascites. In our context, the etiology behind ascites and its correlation with symptoms and complications have not yet been studied, so the present study is conceptualized to evaluate the clinical profile of ascites. The present study aimed to observe the prevalence, clinical management, and assessment of complications associated with ascites in hospitalized patients, offering insights into contemporary ascites management and outcomes. Materials and Methods: A prospective observational study was conducted at a tertiary care hospital in Hyderabad, and over 6 months of study was conducted on 113 patients admitted with ascites. All patients who fulfilled the inclusion criteria of patients above 18 years and ascites confirmed by clinical and ultrasound examination were thoroughly evaluated with a detailed history, physical examination, and appropriate investigations. Results: The predominantly male (83%) patient population exhibited liver cirrhosis (27%) as the primary cause, followed by alcoholic liver disease (23%) and portal hypertension (17%). Abdominal distension (24%) and hepatic encephalopathy (35%) were prevalent symptoms. Laboratory analysis revealed transudative ascitic fluid in most cases (10% with SAAG values >1.1 mg/dL), prevalent hyponatremia (up to 50% in cirrhosis and ascites patients), hyperkalemia (1.6%) and anaemia (7%). Management primarily involved diuretics (23%) and human albumin transfusions (19%). Conclusion: The study highlights early detection and comprehensive management, including liver transplantation consideration for eligible patients, as pivotal for improved outcomes and reduced morbidity and mortality. Emphasizing a multidisciplinary approach, this study underscores the necessity of vigilant monitoring, appropriate fluid handling, and collaborative efforts among medical specialties in ascites management. [ABSTRACT FROM AUTHOR]

Introduction: Ascites is a condition in which there is accumulation of pathological fluid within the abdominal cavity. It is a challenging problem for healthcare personnel due to different pathological causes. To make a differential diagnosis, many investigations are needed. These investigations mainly depend on the analysis of ascitic fluids. Aim: To determine electrophoresis patterns in ascitic fluid and to relate the findings to each established diagnosis. Materials and Methods: This was a cross-sectional hospital-based study conducted at Khartoum and Alshaab Teaching Hospitals in Khartoum state, Sudan, from May 2018 to August 2018. The study population included all patients who were confirmed to have ascites using ultrasound. Fresh ascitic fluid samples were obtained from a total of 35 patients. All safety and aseptic conditions were applied. Immediately after collection, the samples were brought to the laboratory for electrophoresis of ascitic fluids. Data were analysed using descriptive statistics in terms of frequency and percentage. Results: The study findings revealed that most of the patients were men 26 (74.3%) and were over 50 years old 16 (45.7%). The majority of them were diagnosed with Liver Cirrhosis (LC) (28.6%), while a few (5.7%) suffered from Periportal Fibrosis (PF), Hepatocarcinoma (HC), Ovarian Carcinoma (OC), Heart Failure (HF), or Peritonitis (PT). Different patterns of ascitic electrophoresis were detected in diagnosed patients with ascites. About 29 (82.9%) patients had specific electrophoresis patterns that helped with diagnosis, while only 6 (17.1%) did not. Conclusion: Liver cirrhosis, hepatocellular carcinoma, and hepatitis B bands were specific compared to normal serum patterns, while no changes in ascitic fluid electrophoresis were observed in HF.

Ventriculoperitoneal shunt malfunction is frequently observed, with the ventriculoperitoneal shunt fracture being a prevalent etiology. The occurrence of ventriculoperitoneal shunt malfunction is approximately 40% in the first year after implantation and increases to 50% in the second year. Ventriculoperitoneal shunt fracture accounts for 15% of total ventriculoperitoneal shunt malfunction incidents. Ventriculoperitoneal shunt fractures commonly occur due to calcification, immune reactions, and abrasions. The report describes a 5-year-old child who exhibited ventriculoperitoneal shunt malfunction based on clinical examination and CT scan findings. The patient presented with fever and pain in the postoperative wound located posteriorly to the left ear. Radiographic imaging of the cranium and thoracoabdominal region revealed the presence of a ventriculoperitoneal shunt fracture and a C5 spinal disconnection. Additionally, it was demonstrated that the distal catheter had relocated to the abdominal cavity. The laboratory examination and cerebrospinal fluid analysis yielded normal results. The fractured ventriculoperitoneal shunt was subsequently removed and replaced with a new one. It is important to thoroughly investigate and comprehend ventriculoperitoneal shunt malfunctions, even during routine follow-ups.

Introduction: Ascites is a condition in which there is accumulation of pathological fluid within the abdominal cavity. It is a challenging problem for healthcare personnel due to different pathological causes. To make a differential diagnosis, many investigations are needed. These investigations mainly depend on the analysis of ascitic fluids. Aim: To determine electrophoresis patterns in ascitic fluid and to relate the findings to each established diagnosis. Materials and Methods: This was a cross-sectional hospitalbased study conducted at Khartoum and Alshaab Teaching Hospitals in Khartoum state, Sudan, from May 2018 to August 2018. The study population included all patients who were confirmed to have ascites using ultrasound. Fresh ascitic fluid samples were obtained from a total of 35 patients. All safety and aseptic conditions were applied. Immediately after collection, the samples were brought to the laboratory for electrophoresis of ascitic fluids. Data were analysed using descriptive statistics in terms of frequency and percentage. Results: The study findings revealed that most of the patients were men 26 (74.3%) and were over 50 years old 16 (45.7%). The majority of them were diagnosed with Liver Cirrhosis (LC) (28.6%), while a few (5.7%) suffered from Periportal Fibrosis (PF), Hepatocarcinoma (HC), Ovarian Carcinoma (OC), Heart Failure (HF), or Peritonitis (PT). Different patterns of ascitic electrophoresis were detected in diagnosed patients with ascites. About 29 (82.9%) patients had specific electrophoresis patterns that helped with diagnosis, while only 6 (17.1%) did not. Conclusion: Liver cirrhosis, hepatocellular carcinoma, and hepatitis B bands were specific compared to normal serum patterns, while no changes in ascitic fluid electrophoresis were observed in HF. [ABSTRACT FROM AUTHOR]

BACKGROUND: Numerous measurement techniques for intra-abdominal pressure have been explored, with the Kron Technique established as the gold standard. Despite its prominence, the search for alternative methods persists due to its lengthy application time, the requirement for additional equipment, and overall impracticality. This study investigated a quicker, more accessible method for effective intra-abdominal pressure measurement in the emergency department. It aimed to compare intra-abdominal pressure measurements in patients diagnosed with ileus using a digital manometer and the Kron Technique. METHODS: Conducted from October 2022 to February 2023, this single-center, prospective, single-blind method comparison study involved patients diagnosed with ileus at a tertiary emergency department. Intra-abdominal pressure was measured using both the Kron Technique and a digital manometer by separate practitioners blinded to the study results. RESULTS: The study included 30 patients. No statistically significant difference was observed in the intra-abdominal pressure measurements between the two methods (p<0.237). A very strong correlation existed between the two methods (Spearman’s Rho = 0.998). Bland-Altman analysis showed a bias value of 0.091 mmHg for the digital manometer, with upper and lower agreement limits of -0.825 and 1.007 mmHg, respectively. The measurement time was significantly shorter with the digital manometer than with the Kron Technique (15 vs. 390.5 seconds; p<0.001). CONCLUSION: We believe that the intra-abdominal pressure measurement technique using a digital manometer is a method that can be effectively employed by healthcare professionals in emergency departments. This technique offers ease of use, requires minimal equipment, provides rapid results, and delivers reliable measurement values compared to the Kron Technique. [ABSTRACT FROM AUTHOR]

Simple Summary: Given the important role played by the lymphatic system in tissue drainage, metabolism, water–salt metabolism, and its protective compensatory and immune functions, it is important to further study the role of the lymphatic system in the development of abdominal inflammation. The features of lymph transport through vessels and nodes, the state of formation and biochemical composition of the lymph, the state of innervation of lymph vessels and nodes, and the state of the cellular composition of lymph nodes in the experimental modeling of inflammation in the abdominal cavities of internal organs reveal new insights regarding the mechanisms of this disease. Since, in the literature, only isolated studies regarding the lymphatic system in violation of the abdominal cavity exist, it is clear that the roles and functional states of lymphatic vessels and nodes in inflammation in the abdominal cavity have not yet been studied in a complex and multi-faceted way. This paper provides data regarding the ratios of the functional structures of lymph nodes after inflammation in the abdominal organs. Lymph systems, including lymph nodes, function as filters of tissues and tissue fluids and are places of origin and lymphocyte production for normal physiological functions. They display specific morphological and functional responses in reaction to endogenous and exogenous substances. The morphological pattern of the mesenteric lymph node in experimental rat groups reflects a decrease in its immune function due to the processes of inflammation in the abdominal cavity. These processes work together with the associated organs and their involvement in the abdominal lymph nodes, in which there are discharges of the structure of the paracortical zone under conditions of reduced lymphogenic processes, according to the decrease in the size of the paracortex and the ratios of lymphoid nodes with and without germinal centers. Histological and morphometric analyses show changes in the mesenteric lymph node. These analyses are characterized by changes in the cortical and medullary substances, while the proportion of the cortical structure decreases. We also noted an increase in the number of macrophages in the lymphoid nodes and cerebral sinus, as well as a decrease in the number of mature plasmocytes, the paracortex, and the pulp strands. These changes indicate immunosuppressive effects on the lymph node. Under the conditions of inflammation, the formation of a mixed immune response occurs. [ABSTRACT FROM AUTHOR]

BackgroundFetus-in-fetu (FIF) represents an exceedingly rare disease, characterized as an encapsulated and pedunculated vertebrate neoplasm, typically lacking cerebral tissue. The prevalence shows no gender preference. Notably, FIF can cause compressive damage to adjacent organs and tissues, potentially impeding the host's development and maturation.Case presentationA four-month-old male infant was identified, during pregnancy, to have a left-sided pelvic mass on ultrasound. Subsequent evaluations suggested the mass could be a FIF, exhibiting active movement. Surgical exploration revealed that the mass's left boundary was connected to the left spermatic cord and vas deferens. Pathological analysis post-surgery showed the absence of testicular tissue, but the presence of skin tissue, cartilage-like structures, and gastrointestinal elements. Additionally, localized tissue resembling vertebrae confirmed the diagnosis of testicular FIF.ConclusionAn intraperitoneal testicular FIF is extremely rare, with its cause still unknown. This groundbreaking report details the diagnosis and management of such a case. Following a FIF diagnosis, prompt surgical removal is crucial, along with regular follow-up using ultrasound and tumor markers.

US and MRI-guided therapeutic US (TUS) can aid in the treatment of prostate, liver, and pancreatic cancer, as well as uterine fibroids and osseous metastases, and understanding the selection and optimization of treatment strategies is essential to furthering TUS advances and innovations.

Analysis of the method of using sonography during surgery in animals with polycystic kidney disease is an urgent task since firstly, sonography is a safe and non-invasive method of examination, which allows determining the structural features of the kidneys before, during, and after surgery. Secondly, from the standpoint of improving the results of surgery, sonography helps to clarify the localisation of cysts and determine their size. Thirdly, an important factor in the use of sonography is the reduction of pain and the risk of postoperative complications. In addition, due to this method of kidney examination, it is possible to more accurately determine the optimal route of access to cysts, which helps to reduce tissue injury and ensures rapid recovery of the animal after surgery. The purpose of the study is to analyse in detail and describe the method of using sonography during surgery in animals with polycystic kidney disease. The study focuses on the need to determine how sonography affects reducing the duration of surgery, improving the quality of cyst removal, and reducing the risk of complications during abdominal surgery. The approach in this study is based on the analysis of scientific papers on this subject, in particular on the experience of veterinarians who have already used sonography during abdominal operations in animals with polycystic kidney disease. Thus, special techniques of sonography and surgical treatment of kidney cysts include dopplerography, colour dopplerography, 3D and 4D sonography, elastography, introperative sonography, intraperitoneal sonography, and duplex scanning of renal arteries and veins. Surgical methods of treatment include extraction of individual cysts, drainage of cysts, resection, and nephrectomy. The use of sonography at different stages of surgical intervention helps to optimise the operation process, reduce the risk of complications, and contribute to the introduction of new approaches in the treatment of animals with polycystic kidney disease, which will substantially improve their quality of life

Follicular dendritic cell sarcoma (FDCS) is a rare tumor, which mainly originates from follicular dendritic cells (FDCs) in the lymph nodes. Sometimes FDCS can arise from outside the lymph nodes. FDCS is an extremely rare malignant tumor in intraperitoneal or retroperitoneal tissue. We gathered the detailed clinical data of three patients diagnosed with FDCS in the abdomen. The clinical observations and histopathologic and immunohistochemical features of FDCS were analyzed. The patients included two men and one woman aged 55 ~ 61 years old. The mesentery of the small intestine and colon was involved in case 1, spleen in case 2, and retroperitoneal tissues in case 3. Two patients presented with abdominal masses, and one presented with no obvious symptoms. Histology showed ovoid to spindle neoplastic cells arranged in fascicles and storiforms with inflammatory infiltrate as well as whorled patterns in some areas. Immunohistochemical staining was positive for CD21, CD23, CD35, and SSTR2. FDCS exhibits no characteristic clinical manifestations. Morphologically, FDCS can have overlapping features with many other entities, leading to misdiagnosis. The use of histopathology supplemented with FDC markers, such as CD21, CD23, and CD35, is useful for diagnosis and differential diagnosis.

Distant metastases of well-differentiated thyroid cancers (WDTCs) to bone and lungs are well known, while intra-abdominal, mesenteric metastases are very rare. Herein, we report a case of intra-abdominal, mesenteric metastasis of WDTC. A 62-year-old man underwent thyroid lobectomy for follicular thyroid cancer. One year later, lung metastasis was observed. The patient simultaneously underwent lung wedge resection and complete thyroidectomy. Eleven years later, serum thyroglobulin level was elevated. On the work-up study, a metastatic lesion in the lungs and a mass in the mesentery were identified. Two lesions of the lung and mesentery were surgically resected. The mass in the mesentery was pathologically diagnosed as metastatic WDTC.

Tubal ectopic pregnancy with hydatidiform mole is extremely rare in clinical practice, and preoperative diagnosis is often difficult. The diagnosis is mainly based on the postoperative histopathology results. This article reports a 38 -year -old woman whom underwent laparoscopic right fallopian tube resection in an emergency due to rupture of right fallopian tube pregnancy. The postoperative pathology revealed completeness hydatidiform mole. The patient recovered well after surgery, with a satisfactory decrease in serum human chorionic gonadotropin (hCG) during the follow-up period. There were no symptoms of vaginal bleeding, coughing, hemoptysis, or related lesion metastasis. Tubal pregnancy with hydatidiform mole often manifests as acute abdominal disease. Therefore, for patients with acute abdominal disease, the possibility of hydatidiform mole should be paid to. The treatment is mainly based on surgery, and chemotherapy should be performed if necessary. After surgery, close follow -up is required, and doctors should be noting the possibility of lesion erosion and malignancy too. [ABSTRACT FROM AUTHOR]

The article presents studies of the effect of fecal suspension by introducing into the abdominal cavity at the rate of 0.5 ml of a 10% solution per 100 g of animal body weight. The morpho-functional state and morphometric analyzes of the small intestine were studied in normal conditions and with inflammation of the abdominal organs by introducing fecal suspension. The results showed that inflammation of the abdominal organs led to significant changes in the wall of the small intestine, multiple hemorrhages and fibrin clots were found. In the intestine, there is a change and violation of the structures of the small intestine, the total thickness of the mucous membrane increases. Violation of goblet cells, villus height and crypt depth occur. Analysis of the study showed that the walls of the small intestine, revealed structural changes, mainly in the mucosa, submucosa and muscle membranes. The mean value of the mucosal thickness in the control group was 526.17±17.11 micrometer; submucous layer – 47.21±1.63 micrometer. Phenomena of edema, inflammatory infiltration, and separation of muscle fibers were noted in both layers of the muscular membrane. The average layer of thickness of the muscular membrane was 145.67±6.92 μm. Changes in the mucous membrane of the small intestine, at one time reflected in the structural changes in the villi-crypt of the small intestine. A violation of microcirculation in the tissues of the small intestine after the inflammatory process was revealed, which leads to aggravation of dystrophic and necrobiotic lesions of the overall state of the small intestine and is combined with the severity of the clinical picture in experimental animals. [ABSTRACT FROM AUTHOR]

Atypical teratoid/rhabdoid tumor (ATRT) is a rare but aggressive malignancy of the pediatric central nervous system (CNS), predominantly affecting children under the age of three. Despite its low frequency, ATRT constitutes a notable proportion of embryonal CNS tumors, particularly within the first year of life. The prognosis for ATRT patients is generally poor, with a significant decline in survival rates when metastasis is detected at diagnosis. Treatment typically involves a multimodal approach including surgery, radiation therapy, and chemotherapy, although outcomes remain suboptimal, especially in cases with younger age at diagnosis and metastases. ATRT exhibits distinct radiological and histopathological characteristics, presenting challenges in diagnosis and treatment planning. Additionally, extraneural metastatic spread of ATRT, although rare, can occur, with ventriculoperitoneal (VP) shunts identified as potential routes for dissemination. We present an extremely rare case of extraneural dissemination into the abdominal cavity along ventriculoperitoneal shunt in a 4-year-old boy. This is a type of extraneural dissemination in children that has only been published once and we are the first to present in Croatia. This case report highlights the diagnostic and therapeutic complexities associated with ATRT, emphasizing the importance of comprehensive staging, genetic evaluation, and vigilant surveillance for potential metastatic spreading via VP shunt. Furthermore, it emphasizes the need for further research to improve treatment outcomes and identify prognostic factors for risk stratification in pediatric patients with ATRT. [ABSTRACT FROM AUTHOR]

Analysis of the method of using sonography during surgery in animals with polycystic kidney disease is an urgent task since firstly, sonography is a safe and non-invasive method of examination, which allows determining the structural features of the kidneys before, during, and after surgery. Secondly, from the standpoint of improving the results of surgery, sonography helps to clarify the localisation of cysts and determine their size. Thirdly, an important factor in the use of sonography is the reduction of pain and the risk of postoperative complications. In addition, due to this method of kidney examination, it is possible to more accurately determine the optimal route of access to cysts, which helps to reduce tissue injury and ensures rapid recovery of the animal after surgery. The purpose of the study is to analyse in detail and describe the method of using sonography during surgery in animals with polycystic kidney disease. The study focuses on the need to determine how sonography affects reducing the duration of surgery, improving the quality of cyst removal, and reducing the risk of complications during abdominal surgery. The approach in this study is based on the analysis of scientific papers on this subject, in particular on the experience of veterinarians who have already used sonography during abdominal operations in animals with polycystic kidney disease. Thus, special techniques of sonography and surgical treatment of kidney cysts include dopplerography, colour dopplerography, 3D and 4D sonography, elastography, introperative sonography, intraperitoneal sonography, and duplex scanning of renal arteries and veins. Surgical methods of treatment include extraction of individual cysts, drainage of cysts, resection, and nephrectomy. The use of sonography at different stages of surgical intervention helps to optimise the operation process, reduce the risk of complications, and contribute to the introduction of new approaches in the treatment of animals with polycystic kidney disease, which will substantially improve their quality of life [ABSTRACT FROM AUTHOR]

Cats normally play a role of the definitive host in which the plerocercoid (sparganum), the second larval form of Spirometra spp., develops into an adult in the intestines. However, some cases of cats with visceral or subcutaneous sparganosis were sporadically reported worldwide. We herein documented the discovery of a sparganum in abdominal cavity of a domestic cat during a surgery of dystocia. The larva was molecularly identified as Spirometra mansoni, belonging to Type I, that was recently misidentified to be S. erinaceieuropaei in several Asian countries. This is the first report for sparganum of S. mansoni in the cat. The future study is necessary to provide further insights into the species of Spirometra causing sparganosis and spirometrosis in humans and other animals. [ABSTRACT FROM AUTHOR]

Introduction: The transverse rectus abdominis muscle flap (TRAM) is a method of breast reconstruction with good aesthetic results and does not require the use of silicone implants for better body contouring. It was originally described by Holmstrom in 1979 as an ellipse of skin and fat based on an isolated muscle on its vascular pedicle. The systematic reconstruction of the wall defect installed after flap transposition using polypropylene mesh was described in a previous study by Cunha. The article aims to evaluate changes in the abdominal wall, after the systematization of polypropylene mesh placement during TRAM reconstruction surgery. Method: This is a retrospective cohort study that evaluates possible changes in the abdominal wall of patients undergoing the TRAM flap with preand postoperative abdominal computed tomography. Results: A reduction in the size of the abdominal cavity of, on average, 14.5% and 14.2% in the thickness of the abdominal wall subjected to TRAM was evidenced. The greatest reduction in abdominal wall thickness was in a patient who underwent a bipedicled flap, with 50.7%. The complications presented were umbilical hernia, late seroma, perithellal fibrosis, and thread granuloma. Conclusion: In this study, tomography after surgery demonstrated a reduction in the volume of the abdominal cavity and thickness of the abdominal wall, which did not statistically influence the appearance of abdominal hernia, bulging, mesh extrusion, or other deformities.

Amyand's hernia is a rare condition, in which the appendix is found in the inguinal hernia sac. Many patients remain asymptomatic and this pathological condition is most commonly diagnosed intraoperatively. We report a case of a 66-year-old male who was admitted to the hospital for an inguinal hernia repair and the presence of the appendix in the inguinal hernia sac was discovered intraoperatively. We performed a reduction of the appendix in the abdominal cavity and a hernia repair with a mesh and a plug. There are few studies in literature about the appropriate method of treatment and, because of that, the therapeutic approach remains controversial. Therefore, we also conducted a review of the literature in order to obtain some conclusions regarding the management of Amyand's hernia. [ABSTRACT FROM AUTHOR]

The purpose of this study was to study the blood circulation in large blood vessels and in the abdominal organs during inflammation of the abdominal cavity. Using the method of rheograph and laser ultrasonic dopplerography, the blood flow velocity in the abdominal aorta and inferior vena cava was studied. The circulatory system maintains the stability of the body in violation of internal organs and tissues.In large blood vessels and organs of the abdominal cavity, inflammation leads to disruption of blood supply in the microvasculature of the vessel. The rate of blood flow in the main vessel in acute inflammation of the abdominal cavity decreased compared to the control group. The resistance index in the main vessel RI decreased by 38.3%, which is associated with an increase in the diameter of the main vessel. With inflammation of the abdominal cavity, an increase in the velocity of blood flow in the portal vein and abdominal aorta was recorded.As a result of a decrease in the tone of blood vessels after a violation of liver function, the blood supply to the abdominal cavity decreased. The decrease in the functional properties of arteries and veins led to a decrease in blood flow in the abdominal cavity, which, in turn, manifests itself as a result of the preservation of microcirculatory disorders. [ABSTRACT FROM AUTHOR]

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Suture material used in abdominal surgery must have more or less antigenic properties so that during wound healing it could be destroyed by an immune response to rejection, which is known to involve cytotoxic T-lymphocytes and macrophages. This, in turn, can lead to the development of aseptic peritonitis. Therefore, while planning an experimental simulation of aseptic peritonitis, we decided to use catgut thread as an antigenic stimulation of the local immune system. The aim of our research was to study the morphological criteria of the microscopic structure and tinctorial properties of catgut thread. The material of the research was the sterile catgut thread sized 2/0, 0.3 mm thick, of equal lengths, which we twisted arbitrarily into flat compact globules occupying an area of approximately 1 cm2. In order to carry out a histological examination, some catgut globules were subjected to total staining with a hematoxylineosin solution and subsequent embedding of these globules in a paraffin block and making appropriate sections from it. The other half of the catgut globules were studied using the method of epoxy plastination with the production of grinds with staining by a 1% solution of methylene blue on a 1% borax and without any staining. After the total staining of the catgut globules with a hematoxylin-eosin solution, a clear acidophilic reaction was revealed, which was manifested in the intense pink color. Catgut thread has a non-uniform fibrous structure, in which dark streaks stand out, dividing it into a series of longitudinal, lighter, layered fascicles, which consist of a dense collection of thin fibrillar elements. These fibrillar elements are orderly fascicles of collagen fibers, while the dark streaks are layers of loose fibrous connective tissue. These structures can objectively be indicative of morphological criteria in the microscopic analysis of destructive changes of a catgut implant in the peritoneal cavity in an experimental animal.

This paper provides data regarding the ratios of the functional structures of lymph nodes after inflammation in the abdominal organs. Lymph systems, including lymph nodes, function as filters of tissues and tissue fluids and are places of origin and lymphocyte production for normal physiological functions. They display specific morphological and functional responses in reaction to endogenous and exogenous substances. The morphological pattern of the mesenteric lymph node in experimental rat groups reflects a decrease in its immune function due to the processes of inflammation in the abdominal cavity. These processes work together with the associated organs and their involvement in the abdominal lymph nodes, in which there are discharges of the structure of the paracortical zone under conditions of reduced lymphogenic processes, according to the decrease in the size of the paracortex and the ratios of lymphoid nodes with and without germinal centers. Histological and morphometric analyses show changes in the mesenteric lymph node. These analyses are characterized by changes in the cortical and medullary substances, while the proportion of the cortical structure decreases. We also noted an increase in the number of macrophages in the lymphoid nodes and cerebral sinus, as well as a decrease in the number of mature plasmocytes, the paracortex, and the pulp strands. These changes indicate immunosuppressive effects on the lymph node. Under the conditions of inflammation, the formation of a mixed immune response occurs.

ABSTRACT Objectives: to map the scientific evidence on the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest. Methods: this is a scoping review based on the question: “What is the evidence regarding the use of abdominal compressions during cardiopulmonary resuscitation in patients with cardiac arrest?”. Publications up to August 2022 were collected from eight databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews was used. Results: seventeen publications were included. The identified general population consisted of adults and elderly individuals. The primary outcome revealed significant rates of return of spontaneous circulation. Secondary outcomes indicated a significant improvement in heart rate, blood pressure, oxygen saturation, and other outcomes. Conclusions: abdominal compressions have been shown to be beneficial. However, further clinical studies are needed to identify the best execution method and its impacts.

Calcifying fibrous pseudotumor is a rare clinically benign tumor first reported by Rosenthal and Abdul-Karim in 1988. Although rare, the tumor occurs most commonly in children and adolescents. Here we present a case of a 47-year-old male who reported to our institution with vague complaints of intermittent abdominal discomfort which was of mild to severe intensity, diffuse in presentation for a duration of 6 months. The pain was associated with subjective feeling of a “Wandering Lump” in the lower abdomen. This case report presents how this entity was managed along with review of literature. The novelty in this case report was it was a very peculiar case in the sense of its vague presentation, as the patient complained that he feels a lump and discomfort in right lower quadrant of his abdomen in the morning which moves up in the epigastric region; by evening, it comes to lie in the right lower quadrant of abdomen. So, anybody can discard this vague presentation, but in this case, we showed very high index of suspicion and evaluated him. The laparotomy confirmed its vague but true presentation as the lump was actually a freely lying ball which was wandering freely in the abdomen probably by peristalsis and patient’s routine activities. Surgical specialists are therefore advised never to miss such vague presentations, and index of suspicion has to be kept at all times.

Materials and methods: The authors present seven cases of surgical drapes left in the body cavity after surgery. The most common symptoms reported by those patients were analyzed and the consequences of leaving a foreign body in the abdomen were compared. Results: In most cases, the time between surgery and detection of the foreign body was, on average, 17 months. In one case, the foreign body remained in the abdomen for seven years. The most common symptom reported by the patients was abdominal pain. Some patients also experienced impaired wound healing with purulent discharge, fever, nausea and vomiting, weight loss, or intermittent melena. In most cases, re-operation was required to remove the foreign body. Major surgery with stoma creation or bowel resection was necessary. In one case, leaving the surgical drape ultimately led to the patient's death. In three cases, there was spontaneous expulsion of the surgical drape by the patient by natural means. [ABSTRACT FROM AUTHOR]

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Introduction: Desmoid fibromatosis is a multifactorial disorder classified as a category of intermediate, locally aggressive behaviour, which might be associated with CTNNB1 or APC mutations, trauma, surgery, or pregnancy. Case Reports: We present two cases of postoperative intra-abdominal desmoid fibromatosis. The first case occurred 14 months after the resection of a retroperitoneal gastrointestinal stromal tumour. The second case was located in the mesentery, as evidenced on an 18-month follow-up after a laparoscopy-assisted anterior resection for adenocarcinoma at the rectosigmoid junction. Under the clinical diagnosis of recurrence, tissue excisions were conducted. Microscopically, the tissue was composed of bland spindle cells without cytological atypia, admixed with collagen bundles. Both tumours exhibited nuclear expression of b-catenin on immunohistochemical staining, which is a desirable criterion for desmoid fibromatosis. Discussion: Although positron emission tomography aids the diagnosis of recurrence, the radiological features of desmoid fibromatosis in computed tomography or magnetic resonance images are nonspecific and preoperative diagnosis of desmoid fibromatosis is difficult. The histological diagnosis of desmoid fibromatosis is difficult, especially when the specimen is small. The histological differential diagnosis of desmoid fibromatosis includes other myofibroblastic or fibroblastic tumours or lesions. Additional studies, such as b-catenin immunohistochemistry or CTNNB1 mutation analysis, can enable accurate diagnosis of desmoid fibromatosis. A correct diagnosis is essential, because the current therapeutic strategy is a "waitand- watch" approach, which is significantly different from those of the other locally aggressive, intermediate soft tissue neoplasms. We have summarised the clinicopathological, histological and immunohistochemical features of the post-operative desmoid fibromatosis. [ABSTRACT FROM AUTHOR]

The migration of a prosthetic head during total hip arthroplasty (THA) is a rare complication. Few cases are described in the literature, offering different solutions and surgical approaches for prosthetic head retrievement. Here, we present a case of successful laparoscopic transperitoneal retrieval of a prosthetic head migrated above the right iliac vein after THA with a posterolateral approach.

Abstract Background Malignant melanotic nerve sheath tumor (MMNST), formerly called melanotic schwannoma, is a rare tumor of neural crest derivation which most frequently arises from the region of spinal or autonomic nerves near the midline. Recent studies have reported malignant behavior of MMNST, and there still has no standard management guidelines. Intra-abdominal MMNST, which has never been reviewed as an entity, is even rarer. In this study, we present a rare case of a cystic MMNST arising from the para-aortic region and mimicking an intra-abdominal gastrointestinal stromal tumor (GIST), and review the literature regarding MMNSTs located in the abdominal cavity. Case presentation A 59-year-old female was incidentally found a tumor located in the left para-aortic area by non-contrast computed tomography. A Magnetic Resonance Imaging showed a cystic mass originated from the inferior mesenteric artery (IMA) territory. A GIST was initially diagnosed. The tumor was resected en bloc by laparoscopic surgery and was found between mesocolon and Gerota’s fascia with blood supply of IMA. Grossly, dark brown materials were noted at the inner surface of the cystic wall. Microscopically, the tumor cells were melanin-containing, and no psammomatous bodies were present. Immunohistochemically, the tumor showed positivity for MART1, HMB45, collagen IV, and SOX10, and negativity for AE1/AE3. MMNST was favored over malignant melanoma, since the tumor was located near ganglia and had cells with less atypical cytology and a low mitotic rate, and subsequent adjuvant radiotherapy was performed. The patient was alive with no evidence of recurrent or metastatic disease 11 months after radiotherapy. Conclusions Our review of abdominal MMNST cases showed a female predominance, with an average age of 54.8 years, and a trend toward being a larger tumor showing cystic or necrotic changes. Local recurrence and metastasis rate were reviewed, and both showed a low rate. Diagnosis of MMNST should combine all the available findings, and complete excision of the tumor should be performed, followed by long-term patient monitoring.

Damage control resuscitation may lead to postoperative intra-abdominal hypertension or abdominal compartment syndrome. These conditions may result in a vicious, self-perpetuating cycle leading to severe physiologic derangements and multiorgan failure unless interrupted by abdominal (surgical or other) decompression. Further, in some clinical situations, the abdomen cannot be closed due to the visceral edema, the inability to control the compelling source of infection or the necessity to re-explore (as a "planned second-look" laparotomy) or complete previously initiated damage control procedures or in cases of abdominal wall disruption. The open abdomen in trauma and non-trauma patients has been proposed to be effective in preventing or treating deranged physiology in patients with severe injuries or critical illness when no other perceived options exist. Its use, however, remains controversial as it is resource consuming and represents a non-anatomic situation with the potential for severe adverse effects. Its use, therefore, should only be considered in patients who would most benefit from it. Abdominal fascia-to-fascia closure should be done as soon as the patient can physiologically tolerate it. All precautions to minimize complications should be implemented.

Purpose: We aimed to investigate the effect of spinal anesthesia which will be performed simultaneously with general anesthesia on the site of operation with the same pressure. Material and method: This study was conducted as a randomized, prospective clinical study on 40 patients who were randomly divided into two groups. Twenty women underwent general anesthesia (Group GA) and 20 women underwent spinal anesthesia with general anesthesia (Group SGA). For all cases, preoperative height, weight, waist circumference, body mass index (kg/m2), the distance between both spina iliaca anterior superior, the distance of the intersection of both ribs with an imaginary line drawn over the anterior axillary line, suprapubic bone‐umbilical, umbilical‐xiphoid, and suprapubic bone‐xiphoid distance from the midline of the abdomen were measured. Moreover, while the patient was lying in the neutral position on the operating table, the height of the highest point of the abdomen to the operating table was also measured. These measurements were repeated at intra‐abdominal pressure (IAP) 14 and 25 mmHg. The amount of intra‐abdominal insufflated CO2 was also recorded at IAP 14 and 25 mmHg. Results: When the intra‐abdominal insufflation volumes of both groups were compared at 14 and 25 mmHg, respectively, there was no statistical difference (p: 0.54, p: 0.40). When 14 and 25 mmHg were compared in all cases, a statistically significant difference was observed in other measurements except in xiphoid‐umbilical distance (p < 0.05). Conclusion: We found that spinal anesthesia combined with GA had no effect on the abdominal volume and anthropometric measurements in laparoscopic procedures. [ABSTRACT FROM AUTHOR]

Metacercariae of Tylodelphys sp. were found in the abdominal cavity of the Chinese sleeper (Perccottus glenii) collected in Liaoning Province and Inner Mongolia Autonomous Region of China. The sequences of the mitochondrial cox1 gene and ribosomal ITS1–5.8S rDNA–ITS2 region were obtained and used for molecular identification and phylogenetic assessment of this parasite species. Results of phylogenetic analyses based on ITS and cox1 markers showed that the metacercariae of Tylodelphys sp. ex P. glenii from China were conspecific with specimens of Tylodelphys sp. collected by Sokolov et al. (2013) from the same fish-host species captured earlier in West Siberia, Russia. The examined Tylodelphys sp. ex. P. glenii is the only member of the genus whose metacercariae parasitise the abdominal cavity of fish in northern Eurasia. Tylodelphys sp. ex P. glenii clustered with T. darbyi, T. immer, T. podicipina, and Tylodelphys sp. of Soldánová et al., 2017 based on mitochondrial DNA markers, and with T. darbyi, T. immer, T. kuerepus, and T. schreuringi using nuclear DNA markers. [ABSTRACT FROM AUTHOR]

Abstract Invasive lobular carcinoma (ILC) has a greater tendency to metastasize to the peritoneum, retroperitoneum, and gastrointestinal (GI) tract as compared to invasive carcinoma of no special type (NST). Like primary ILC in the breast, ILC metastases are frequently infiltrative and hypometabolic, rather than mass forming and hypermetabolic in nature. This renders them difficult to detect on conventional and metabolic imaging studies. As a result, intra-abdominal ILC metastases are often detected late, with patients presenting with clinical complications such as liver failure, hydronephrosis, or bowel obstruction. In patients with known history of ILC, certain imaging features are very suggestive of infiltrative metastatic ILC. These include retroperitoneal or peritoneal nodularity and linitis plastica appearance of the bowel. Recognition of linitis plastica on imaging should prompt deep or repeat biopsies. In this pictorial review, the authors aim to familiarize readers with imaging features and pitfalls for evaluation of intra-abdominal metastatic ILC. Awareness of these will allow the radiologist to assess these patients with a high index of suspicion and aid detection of metastatic disease. Also, this can direct histopathology and immunohistochemical staining to obtain the correct diagnosis in suspected metastatic disease.

A two-year-old queen was referred to the surgery section of veterinary hospital with lateral recumbency position and the primary diagnosis of dystocia. The queen was highly lethargic and dehydrated, with a pale mucous membrane, a rectal temperature of 37.3 °C, and no vaginal discharge during first inspection. The primary examination revealed a big mass in the abdominal cavity, which was followed by other diagnostic investigations. Due to a huge and encroaching tumor and the patient's owner's refusal to accept any further therapies, the queen was euthanized during an exploratory celiotomy. This report describes a large Hemangiopericytoma (HPCy) in a domestic short-haired queen diagnosed based on physical examination, radiography, ultrasonography, histomorphology, and immunohistochemical reactivity. The results of pathology revealed a whorls around blood vessels and the "fingerprint" pattern of tumor with negative S-100 immunohistochemistry staining. In dogs, HPCy is a common neoplasm, but it is a seldom finding in cats. There is no previous report of HPCy in the abdominal cavity as observed in the presented case to the authors' knowledge.

Introduction: Isolated iliac wing fracture is a rare pelvic fracture that is considered benign in the literature. As there is a complete lack of information on function and quality of life in patients with this injury, the primary aim of this study was to evaluate the long-term functional results, and secondly to evaluate the patients' clinical function and fracture healing.Patients and Methods: All patients treated in Oslo University Hospital, Ullevaal (OUH-U), the Norwegian National Pelvic Service, in the time period 2006-2016 were included. Nine of 13 eligible patients (69%) were evaluated by the Patient Reported Outcome Measures (PROM); EQ-5D-3L and Majeed Score. For the secondary outcomes, the patients were clinically examined for Range of Motion (ROM) in the hips, pain, muscular function and nerve deficiencies. Finally, the patients underwent X-rays (AP-view and iliac and obturator oblique views).Results: All patients were injured in high-energy trauma with severe associated injuries. Five patients were operated and four received conservative treatment. At the time of follow-up (median seven years after injury), the mean EQ-5D VAS was 84, and the mean Majeed score was 87. Two out of nine reported moderate level of pain, three reported mild pain, and the rest reported no pain. Six patients were still working, two were retired, and the last one was receiving disability benefit of other reasons than the iliac fracture. One patient had difference in range of external rotation of >10° between the hips, while the rest had no differences in ROM. The follow-up X-rays showed healed fractures in all the patients.Conclusion: Patients with isolated iliac wing fractures seem to have a good general state of health, scoring high on the PROMs, with minor and insignificant clinical sequela. This original finding is in accordance with the general assumption amongst pelvic surgeons that the injury is a benign one. [ABSTRACT FROM AUTHOR]

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Background: Malignant melanotic nerve sheath tumor (MMNST), formerly called melanotic schwannoma, is a rare tumor of neural crest derivation which most frequently arises from the region of spinal or autonomic nerves near the midline. Recent studies have reported malignant behavior of MMNST, and there still has no standard management guidelines. Intra-abdominal MMNST, which has never been reviewed as an entity, is even rarer. In this study, we present a rare case of a cystic MMNST arising from the para-aortic region and mimicking an intra-abdominal gastrointestinal stromal tumor (GIST), and review the literature regarding MMNSTs located in the abdominal cavity.Case Presentation: A 59-year-old female was incidentally found a tumor located in the left para-aortic area by non-contrast computed tomography. A Magnetic Resonance Imaging showed a cystic mass originated from the inferior mesenteric artery (IMA) territory. A GIST was initially diagnosed. The tumor was resected en bloc by laparoscopic surgery and was found between mesocolon and Gerota's fascia with blood supply of IMA. Grossly, dark brown materials were noted at the inner surface of the cystic wall. Microscopically, the tumor cells were melanin-containing, and no psammomatous bodies were present. Immunohistochemically, the tumor showed positivity for MART1, HMB45, collagen IV, and SOX10, and negativity for AE1/AE3. MMNST was favored over malignant melanoma, since the tumor was located near ganglia and had cells with less atypical cytology and a low mitotic rate, and subsequent adjuvant radiotherapy was performed. The patient was alive with no evidence of recurrent or metastatic disease 11 months after radiotherapy.Conclusions: Our review of abdominal MMNST cases showed a female predominance, with an average age of 54.8 years, and a trend toward being a larger tumor showing cystic or necrotic changes. Local recurrence and metastasis rate were reviewed, and both showed a low rate. Diagnosis of MMNST should combine all the available findings, and complete excision of the tumor should be performed, followed by long-term patient monitoring. [ABSTRACT FROM AUTHOR]

Pneumoperitoneum normally occurs due to perforation of the hollow organ of the gastrointestinal tract, which is accompanied by the development of peritonitis. Cases of free gas without perforation and peritonitis are rare. Such situations are called “nonsurgical pneumoperitoneum”. This clinical case of a patient with pneumoperitoneum and no clinical picture of acute pathology in the abdominal cavity id reported in this article. Such patients should be carefully monitored by a surgeon to avoid unnecessary laparotomy.

Abdominal hernia mesh is a common product which is used for prevention of abdominal adhesion and repairing abdominal wall defect. Currently, designing and preparing a novel bio-mesh material with prevention of adhesion, promoting repair and good biocompatibility simultaneously remain a great bottleneck. In this study, a novel siloxane-modified bacterial cellulose (BC) was designed and fabricated by chemical vapor deposition silylation, then the effects of different alkyl chains length of siloxane on surface properties and cell behaviors were explored. The effect of preventing of abdominal adhesion and repairing abdominal wall defect in rats with the siloxane-modified BC was evaluated. As the grafted alkyl chains become longer, the surface of the siloxane-modified BC can be transformed from super hydrophilic to hydrophobic. In vivo results showed that BC-C16 had good long-term anti-adhesion effect, good tissue adaptability and histocompatibility, which is expected to be used as a new anti-adhesion hernia repair material in clinic. • Different alkyl chains were grafted on the BC in order to regulate cell adhesion. • The cell adhesion of in different areas is observed by partition observation. • The composites exhibit anti-adhesion and biocompatibility in two animal models. [ABSTRACT FROM AUTHOR]

Contrary to traumatic and iatrogenic intraabdominal hemorrhages, spontaneous intraabdominal hemorrhage is a challenging clinical situation. A variety of neoplastic and non-neoplastic conditions may cause spontaneous intraabdominal bleeding. Imaging findings vary depending on the source of bleeding and the underlying cause. In this article, we aim to increase the awareness of imagers to the most common causes of spontaneous intraabdominal hemorrhage by using representative cases. [ABSTRACT FROM AUTHOR]

Objective: Pelvic floor dysfunctions in women are a challenge for the modern health care system. Presentation of the most popular types of pelvic floor muscle training used successfully in women at different stages of their lives. Mechanism: In the training of the pelvic floor muscles, it is important to have adequate blood supply and flexibility to build the correct muscle tone, which regulates the correct response to pressure changes in the abdominal cavity. Findings in brief: The exercises are designed to strengthen weakened muscles, improve the quality of life and prepare women for possible surgery. Conclusions: The pelvic floor muscle exercises are the primary method of treatment for patients with pelvic floor disorders.

Objectives: To compare the performance of transvaginal and transabdominal ultrasound with that of the first-line staging method (contrast-enhanced computed tomography (CT)) and a novel technique, whole-body magnetic resonance imaging with diffusion-weighted sequence (WB-DWI/MRI), in the assessment of peritoneal involvement (carcinomatosis), lymph-node staging and prediction of non-resectability in patients with suspected ovarian cancer.Methods: Between March 2016 and October 2017, all consecutive patients with suspicion of ovarian cancer and surgery planned at a gynecological oncology center underwent preoperative staging and prediction of non-resectability with ultrasound, CT and WB-DWI/MRI. The evaluation followed a single, predefined protocol, assessing peritoneal spread at 19 sites and lymph-node metastasis at eight sites. The prediction of non-resectability was based on abdominal markers. Findings were compared to the reference standard (surgical findings and outcome and histopathological evaluation).Results: Sixty-seven patients with confirmed ovarian cancer were analyzed. Among them, 51 (76%) had advanced-stage and 16 (24%) had early-stage ovarian cancer. Diagnostic laparoscopy only was performed in 16% (11/67) of the cases and laparotomy in 84% (56/67), with no residual disease at the end of surgery in 68% (38/56), residual disease ≤ 1 cm in 16% (9/56) and residual disease > 1 cm in 16% (9/56). Ultrasound and WB-DWI/MRI performed better than did CT in the assessment of overall peritoneal carcinomatosis (area under the receiver-operating-characteristics curve (AUC), 0.87, 0.86 and 0.77, respectively). Ultrasound was not inferior to CT (P = 0.002). For assessment of retroperitoneal lymph-node staging (AUC, 0.72-0.76) and prediction of non-resectability in the abdomen (AUC, 0.74-0.80), all three methods performed similarly. In general, ultrasound had higher or identical specificity to WB-DWI/MRI and CT at each of the 19 peritoneal sites evaluated, but lower or equal sensitivity in the abdomen. Compared with WB-DWI/MRI and CT, transvaginal ultrasound had higher accuracy (94% vs 91% and 85%, respectively) and sensitivity (94% vs 91% and 89%, respectively) in the detection of carcinomatosis in the pelvis. Better accuracy and sensitivity of ultrasound (93% and 100%) than WB-DWI/MRI (83% and 75%) and CT (84% and 88%) in the evaluation of deep rectosigmoid wall infiltration, in particular, supports the potential role of ultrasound in planning rectosigmoid resection. In contrast, for the bowel serosal and mesenterial assessment, abdominal ultrasound had the lowest accuracy (70%, 78% and 79%, respectively) and sensitivity (42%, 65% and 65%, respectively).Conclusions: This is the first prospective study to document that, in experienced hands, ultrasound may be an alternative to WB-DWI/MRI and CT in ovarian cancer staging, including peritoneal and lymph-node evaluation and prediction of non-resectability based on abdominal markers of non-resectability. © 2021 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Invasive lobular carcinoma (ILC) has a greater tendency to metastasize to the peritoneum, retroperitoneum, and gastrointestinal (GI) tract as compared to invasive carcinoma of no special type (NST). Like primary ILC in the breast, ILC metastases are frequently infiltrative and hypometabolic, rather than mass forming and hypermetabolic in nature. This renders them difficult to detect on conventional and metabolic imaging studies. As a result, intra-abdominal ILC metastases are often detected late, with patients presenting with clinical complications such as liver failure, hydronephrosis, or bowel obstruction. In patients with known history of ILC, certain imaging features are very suggestive of infiltrative metastatic ILC. These include retroperitoneal or peritoneal nodularity and linitis plastica appearance of the bowel. Recognition of linitis plastica on imaging should prompt deep or repeat biopsies. In this pictorial review, the authors aim to familiarize readers with imaging features and pitfalls for evaluation of intra-abdominal metastatic ILC. Awareness of these will allow the radiologist to assess these patients with a high index of suspicion and aid detection of metastatic disease. Also, this can direct histopathology and immunohistochemical staining to obtain the correct diagnosis in suspected metastatic disease. [ABSTRACT FROM AUTHOR]