Acute cholecystitis management in high-risk, critically ill, and unfit-for-surgery patients: the Italian Society of Emergency Surgery and Trauma (SICUT) guidelines.

Dealing with acute cholecystitis in high-risk, critically ill, and unfit-for-surgery patients is frequent during daily practice and requires complex management. Several procedures exist to postpone and/or prevent surgical intervention in those patients who temporarily or definitively cannot undergo surgery. After a systematic review of the literature, an expert panel from the Italian Society of Emergency Surgery and Trauma (SICUT) discussed the different issues and statements in subsequent rounds.

Intestinal Ischemia: Unusual but Fearsome Complication of COVID-19 Infection.

The pathophysiology of gastrointestinal damage in coronavirus disease (COVID-19) is probably multifactorial. It is not clear whether the etiology of intestinal ischemia may be directly related to viral replication or may result from hyper-coagulability following SARS-CoV-2 infection.To confirm a pathogenic role of COVID-19, we retrospectively investigated the presence of SARS-CoV-2 virus in the ischemic bowel of five COVID-19 patients undergoing emergency surgery for intestinal ischemia in the period of March 2020-May 2021.

Indocyanine Green (ICG) for the assessment of splenic perfusion during laparoscopic splenic artery aneurysmectomy. A case report.

Case Report: We describe the case of a 54-year-old man with a 20mm splenic aneurysm, who underwent laparoscopic aneurysmectomy, without splenic removal. The residual splenic blood supply was assessed by using indocyanine green i.v.

A delayed conversion may increase the risk of major complications in acute cholecystitis approached laparoscopically. A retrospective comparative cohort study.

Aim: Aim of this study was to evaluate whether timing of laparoscopy lasting longer than two hours before converting to open surgery can worsen the postoperative course during laparoscopic cholecystectomy (LC) for acute cholecystitis (AC).

Materials And Methods: Medical records of 1,161 patients who underwent urgent laparoscopic cholecystectomy for AC during the period 2001-2017 were retrospectively analyzed. A conversion to open surgery was performed in 70 (6%) patients.

Damage control surgery for perforated diverticulitis with diffuse peritonitis: saves lives and reduces ostomy.

Introduction: Over the last decade, damage control surgery (DCS) has been emerging as a feasible alternative for the management of patients with abdominal infection and sepsis. So far, there is no consensus about the role of DCS for acute perforated diverticulitis. In this study, we present the outcome of a multi-institutional series of patients presenting with Hinchey's grade III and IV diverticulitis managed by DCS.

Open abdomen and entero-atmospheric fistulae: An interim analysis from the International Register of Open Abdomen (IROA).

Introduction: No definitive data describing associations between cases of Open Abdomen (OA) and Entero-atmospheric fistulae (EAF) exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) thus analyzed the International Register of Open Abdomen (IROA) to assess this question.

Material And Methods: A prospective analysis of adult patients enrolled in the IROA.

Laparoscopic resection of multiple aneurysms of the gastroepiploic arterial arcade.

Background: Gastroepiploic arterial aneurysms (GEAA) represent a very rare disorder [1, 2]. The risk of GEAA rupture is high, and it is associated with a high mortality rate [3]. GEAAs are usually identified following rupture or are incidentally diagnosed.

Less is more: an outcome assessment of patients operated for gallstone ileus without fistula treatment.

Background: The treatment of gallstone ileus (GI) consists of surgical removal of the impacted bilestone with or without cholecystectomy and repair of the biliodigestive fistula. The objective of this study was to assess whether sparing patients a definitive biliary procedure adversely influenced the outcome.

Materials And Methods: Patients with a diagnosis of GI were reviewed.

Acute appendicitis complicating De Garengeot's hernia treated with combined laparoscopic-open technique: a case series and literature review.

Unlabelled: An acute appendicitis in the context of a De Garengeot's hernia is a very rare event and represents a hard challenge for surgeons. As only few cases have been reported in literature, there is no consensus about its optimal surgical strategy of treatment. Here we present two consecutive cases of female patients presenting an uncommon acute appendicitis in a femoral hernia treated with a combined laparoscopic/open technique.

Erratum to: IROA: International Register of Open Abdomen, preliminary results.

[This corrects the article DOI: 10.1186/s13017-017-0123-8.].

IROA: International Register of Open Abdomen, preliminary results.

Background: No definitive data about open abdomen (OA) epidemiology and outcomes exist. The World Society of Emergency Surgery (WSES) and the Panamerican Trauma Society (PTS) promoted the International Register of Open Abdomen (IROA).

Methods: A prospective observational cohort study including patients with an OA treatment.

Hemoptysis caused by pulmonary sequestration in perforated appendicitis: A rare case report.

Pulmonary sequestration is a rare and usually asymptomatic congenital anomaly. Optimal management of this condition is still a subject of debate, including superiority of surgical resection or angiographic embolization of the aberrant arterial vessel. Presently described is rare case of a 51-year-old male who presented with hemoptysis related to pulmonary sequestration associated with acute right lower quadrant abdominal pain caused by perforated appendicitis.

Early cholecystectomy for non-severe acute gallstone pancreatitis: easier said than done.

Background: Laparoscopic cholecystectomy (LC) carried out within 3 days after an attack of non-severe acute gallstone pancreatitis (NSAGP) is recommended to reduce hospital stay and overall costs. Aim of the study was to evaluate factors that may delay a timely surgical management of NSAGP and the consequences of this deviation.

Methods: We reviewed the charts of patients admitted for NSAGP and managed by LC during the last 14 years.

An unusual case of repeated splenectomy: traumatic rupture of an accessory spleen in a previously splenectomized patient.

Unlabelled: The traumatic rupture of an accessory spleen is a very rare condition and only few cases have been reported in the literature. We describe the case of a 51-year-old man undergone splenectomy for trauma several years before, who developed hemoperitoneum due to a laceration of a voluminous accessory spleen, following an accidental two-meter fall. As a conservative management of the injury was not possible, an accessory splenectomy was then required.

Pancreatoduodenectomy for groove pancreatitis Report of two cases.

Unlabelled: Groove pancreatitis is a rare condition with patients having clinical characteristics similar to those of chronic pancreatitis. Differentiating on clinical and radiological basis between groove pancreatitis and paraduodenal head cancer can be extremely challenging. Due to diagnostic uncertainty and to poor response to medical treatment surgery may offer these patients the best chance of cure.

Acute abdomen caused by greater omentum torsion: A case report and review of the literature.

Torsion of the greater omentum is a rare cause of acute abdomen. Based on etiopathogenesis, it can be classified as primary or secondary. However, regardless of the cause, segmentary or diffuse omental necrosis will follow.

Incidental appendectomy? Microscopy tells another story: A retrospective cohort study in patients presenting acute right lower quadrant abdominal pain.

Background: Optimal management of macroscopically normal appendix encountered during laparoscopy for acute abdominal pain is still unclear.

Methods: 164 acute abdominal pain cases in which laparoscopy showed a normal appendix were reviewed. No other intra-peritoneal acute disease was present in 50 patients (Group 1) whereas a miscellanea of intra-peritoneal conditions was identified in the other 114 (Group 2).

Splenic abscess after splenic blunt injury angioembolization.

Introduction: Splenic Angioembolization (SAE), during Nonoperative Management (NOM) of Blunt Splenic Injury (BSI), is an effective therapy for hemodynamically stable patients with grade III, IV, and V OIS splenic injuries. We report a case of a patient with a blunt abdominal trauma due to an accidental fall, who presented splenic abscess a week after SAE and a review of the literature.

Case Report: A 38-year-old male arrived at Emergency after an accidental fall with contusion of the left upper quadrant of the abdomen.

The role of laparoscopy in adult bowel obstruction caused by intussusception.

Aim: The intestinal intussusception in the adult represent 1% of all occlusions. Organic causes are detectable in 90% of cases. Aim of this study is to discuss the diagnostic and therapeutic iter of adult intestinal intussusception with particular emphasis on role of laparoscopy.

Laparoscopic repair of perforated peptic ulcer: single-center results.

Background: Perforated peptic ulcer (PPU), the most common indication for emergency gastric surgery, is associated with high morbidity and mortality rates. Outcomes might be improved by performing this procedure laparoscopically, but no consensus exists on whether the benefits of laparoscopic repair (LR) of PPU outweigh the disadvantages.

Methods: From January 2002 to December 2012, 111 patients underwent surgery for perforated ulcer.

Mesoappendix and appendix stump treatment in laparoscopic appendectomy: a retrospective study in 1084 patients.

Background: Laparoscopic appendicectomy (LA) rapresents a standard but questionable approach in the treatment of acute appendicitis. The scope of this study is to show our experience using different methods in the mesoappendix and appendix stump treatment.

Materials And Methods: A retrospective analysis of all patient with acute appendicitis that underwent to LA was obtained.

[Outcome of laparotomy for severe secondary peritonitis].

Background: Temporary abdominal closure with planned re-operations is a treatment method for several critical abdominal conditions. Aim of the study was to evaluate the effectiveness of laparostomy and the risk factors for survival in patients presenting with severe secondary peritonitis (SSP).

Methods: 52 patients (mean age 66.

Laparoscopic transcystic exploration for single-stage management of common duct stones and acute cholecystitis.

Background: Common bile duct (CBD) stones are found in 10% of patients who undergo elective laparoscopic surgery for gallstone disease and in 10-20% of patients who present with acute cholecystitis (AC). For the latter, the role of laparoscopic transcystic exploration of the common duct (LTCE) as part of a single-stage procedure is still unknown.

Methods: This study, based on a "laparoscopy first" policy, included 201 subjects with cholecystocholedocholithiasis: 104 underwent a scheduled laparoscopic surgery (group A), and 97 where admitted for AC and had urgent laparoscopy (group B).