Acute Chyloperitoneum with Small Bowel Volvulus: Case Series and Systematic Review of the Literature.

Chyloperitoneum arises from lymph leakage into the abdominal cavity, leading to an accumulation of milky fluid rich in triglycerides. Diagnosis can be challenging, and mortality rates vary depending on the underlying cause, with intestinal volvulus being just one potential acute cause. Despite its rarity, our case series highlights chyloperitoneum associated with non-ischemic small bowel volvulus.

Health economics aspects of kidney transplantation in Sicily: a benchmark analysis on activity and estimated savings.

Background: International and national registries consistently report substantial differences in kidney transplant (KT) activity despite demonstrable clinical and financial benefits. The study aims to estimate the financial resources gained by KT and produce a benchmark analysis that would inform adequate strategies for the growth of the service.

Methods: We analyzed the KT activity in our region between 2017 and 2019.

Relationships between serum levels of vitamins and papillary thyroid cancer: a single center case-control study.

Background: Vitamins are involved in various human physiological and biochemical mechanisms due to their antioxidant properties and their ability to enhance the immune response. Deficiency of some serum vitamins has been reported to be associated with an increased risk of developing cancer, including thyroid cancer. However, medical literature dealing with cholecalciferol supplementation was not able to show the potential of this intervention in cancer prevention.

Management of Cholelithiasis in Cirrhotic Patients.

Gallstone disease (GD) is a common disease worldwide and has a higher incidence in cirrhotic patients than in the general population. The main indications for cholecystectomy surgery in cirrhotic patients remain symptomatic cholelithiasis and its complications. Over the past two decades, numerous published reports have attested to the feasibility and safety of laparoscopic cholecystectomy in cirrhotic patients.

Percutaneous trans-stomal jejunostomy: a new technique.

Aim: We propose a new technique for feeding a malnourished patient with a "high" double-barrel jejunostomy (at about 60 cm from the Treitz Ligament). The procedure aims to restore an adequate nutritional state maintaining a correct diet for 24 h a day, without complications and without interfering with the normal activity of the nurses caring for the stoma.

Method: Using local anesthesia, we introduced a Reverdin needle through the efferent loop of jejunostomy and externalized it through the skin, medially from jejunostomy of about 10 cm.

Development of Histologically Verified Thyroid Diseases in Women Operated for Breast Cancer: A Review of the Literature and a Case Series.

Background: The possible relationships between breast and thyroid diseases have been reported in the literature. The purpose of our study was to evaluate the occurrence of histologically verified thyroid pathologies in women who were diagnosed with breast cancer and, after mastectomy/quadrantectomy complemented by oncological treatment, were thyroidectomized based on their periodic thyroid evaluation.

Patients And Methods: Our series consist of 31 women with a mean age of 62.

Lymph Node Dissection Morbidity in Thyroid Cancer: An Integrative Review.

Cervical lymphadenectomy is a common procedure for thyroid cancer. Some of the complications are congruent with the complications of thyroid surgery, in particular recurrent laryngeal nerve paresis and hypoparathyroidism as well as bleeding and wound infection. Specific complications of lateral cervical lymph node dissection are injuries to the accessory, phrenic and hypoglossal nerves, and the cervical plexus trunk and injuries, the salivary glands, and the lymphatic system, especially the ductus thoracicus.

CO pneumoperitoneum effects on proliferation and apoptosis in two different neuroblastoma cell lines.

Purpose: The proto-oncogene MYCN is considered a transcription factor involved in the regulation of neuroblastoma (NB) cell biology. Since minimally invasive-surgery represents a debated treatment of NB, we investigated CO effects on proliferative activity and apoptotic pathway in two NB cell lines, SH-SY5Y (MYCN-non-amplified) and IMR-32 (MYCN-amplified).

Methods: SH-SY5Y and IMR-32 were exposed to CO (100%) at a pressure of 15 mmHg for 4 h and then moved to normal condition for 24 h.

Status of Alternative Approaches for Thyroidectomy: Is There Any Evidence to Substitute in Place of Conventional Surgery?

Over the past 20 years, various alternative cervical minimally invasive (partly endoscopically assisted) and extracervical endoscopic (partly robot-assisted) approaches have been developed. All of these alternative access methods aim at optimizing the cosmetic results. In principle, the indication for the use of alternative access procedures does not differ from that for conventional surgery.

A critical view of safety in left colectomy surgery: A case of renal artery injury.

Introduction: The standardization of the laparoscopic approach in left hemicolectomy was facilitated by the vascular anatomy of the left colon, which has few anatomical variants. The current technique for left hemicolectomy consists in approaching the inferior mesenteric artery (IMA), after identification of the inferior mesenteric vein (IMV), from above (craniocaudal) or from below (caudocranial). The type of approach is decided on the basis of the vascular window between the IMV and IMA.

Laparoscopic assisted ERCP in patient with Roux-en-Y gastric bypass. A case report.

Introduction: Choledocholithiasis in Roux-en-Y patients is a therapeutic challenge for both surgeons and endoscopists. In fact, typical procedures, such as ERCP, can't be performed due to the altered anatomy of the patient. Nowadays, procedures on this kind of patient are performed not only in specialized bariatric centers, but, due to the increasing number of patients undergoing bariatric surgery, are starting to become more common even in smaller and non-specialized centers that don't possess the same expertise and technology.

Technique of neuromonitoring during pelvic peritonectomy.

Objectives: Pelvic peritonectomy can induce anorectal and urogenital dysfunctions. To reduce this type of complications during the procedure, we propose to use intraoperative neuromonitoring (IONM).

Content: Stimulation with a bipolar probe allows the identification of the obturator and ilioinguinal and pudendal nerves.

Usefulness of PET-CT scan in recurrent thyroid cancer.

The aim of this paper is to discuss the risk of recurrence in patients with differentiated thyroid cancer and emphasize the importance of risk-group stratification, early recurrence identification and application of new imaging modalities, what is the PET-CT. Moreover, follow-up of patients with thyroid carcinoma should be carried out by specialized teams throughout life. Therefore, interdisciplinary case discussions in tumor conferences may improve the use of multimodal therapy especially in patients with poorly differentiated thyroid carcinomas.

An unusual case of gastric volvulus through Bochdalek hernia A case report and review of the recent literature.

Introduction: Bochdalek Hernias are one of the most common types of diaphragmatic hernia, a congenital pathology diagnosed during the neonatal period. In adulthood, diagnosis of a Bochdalek hernia is rare and its complications may be fatal.

Case Report: We report an unusual case of a 60-year-old woman who presented with upper gastrointestinal bleeding due to a Bochdalek hernia with herniation of stomach and spleen into the chest with a gastric volvulus.

Therapeutic strategies for perforated jejunal diverticulitis. A case report.

Aim: The jejuno-ileal diverticulosis is an unusual disease which affects elderly people and its complications can be fatal due to delayed diagnosis. The most frequent complication of jejunal diverticulitis is the perforation.

Case Report: In this report we describe a case of elderly patient presenting with acute abdominal pain and fever.

Metastatic melanoma of the small bowel. Report of a case and review of literature.

Aim: Malignant melanoma incidence is rapidly growing worldwide. The small bowel is well known to be a preferred site for melanoma metastases. In 60% of patients who died of disseminated melanoma, the gastrointestinal (GI) tract was affected, but only 1% to 4% of GI metastases were clinically diagnosed ante mortem.

Cystic lymphangioma of the pancreas: a hard diagnostic challenge between pancreatic cystic lesions-review of recent literature.

Lymphangiomas are rare congenital benign tumors arising from the lymphatic system. The incidence of this disease in the pancreas is extremely rare, accounting for less than 1% of these tumors. Before introducing the review we reported a case of a 67-year-old woman with cystic lymphangioma of the pancreas.

Gastric inflammatory fibroid polyp tumor with acute intestinal obstruction-Vanek's tumor can mimick a giant gastrointestinal stromal tumor or a gastric lymphoma.

An inflammatory fibroid polyp (IFP) is a solitary rare benign neoplasm of the gastrointestinal tract, frequently located in the gastric antrum. IFPs account for about 0.1% of all gastric polyps.

Wernicke encephalopathy as rare complication of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.

Background: Peritoneal carcinomatosis of gastric origin is a frequent event with poor survival. A new promising approach is the association of the Cytoreductive Surgery (CRS) with the Hyperthermic Intraperitoneal Chemotherapy (HIPEC), which yet is characterized by high morbidity and mortality. We report, to our knowledge, the first case of Wernicke Encephalopathy (WE) complicating CRS plus HIPEC.

Giant retroperitoneal liposarcoma: Case report and review of the literature.

Aim: Retroperitoneal soft-tissue sarcomas are relatively uncommon diseases, the most frequent histotype, ranging from 20% to 45% of all cases, is represented by liposarcoma, which is a hard-to treat condition for its local aggressiveness and clinical aspecificity.

Presentation Of Case: We report a case of a 64-years-old woman who underwent surgical resection for a giant pleomorphic retroperitoneal liposarcoma.

Discussion: Currently chemotherapy for retroperitoneal soft-tissue sarcomas is no effective, and radiotherapy has limited efficacy due to the toxicity affecting adjacent intra-abdominal structures, showed validity only in case of high-grade malignancy by reducing local recurrence, but with no advantage in overall survival.

Vulvar endometriosis and Nuck canal.

Aim: Endometriosis is not a well-known disease and sometimes its rare onset is a pathogenetic, diagnostic and therapeutic problem. The Canal of Nuck is an embryonal rest of the parietal peritoneum that accompanies the round ligament through the inguinal canal. The perviousness of the canal of Nuck could explain the pathogenesis of vulvar endometriosis.

The role of prophylactic hyperthermic intraperitoneal chemotherapy in the management of serosal involved gastric cancer.

Background: Peritoneal carcinomatosis of gastric origin is associated with poor survival. The use of cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) did not significantly improve the survival of patients with this disease. A promising approach can be based on the use of HIPEC as prophylaxis of peritoneal dissemination.