[Epiploic appendagitis: an often-overlooked diagnosis].

Epiploic appendagitis is an etiology only coming at last of differential diagnoses in the face of acute abdominal pain. The typical patient is often a man between 20 and 50 years old, presenting with non-radiating abdominal pain with nausea, vomiting and inappetence with or without a mild febrile state. Biological assessment most of the time does not show any inflammatory syndrome, although slight elevations in sedimentation rate and CRP are possible.

Ectopic adrenal cortex associated with epididymal malformation in adult: A clinical case report.

To report a case of unusual ectopic adrenal cortex in adult. A 35-year-old male consulted for vasectomy. During the procedure, a small right epididymal cyst was incidentally found.

Abdominal Mondor disease mimicking acute appendicitis.

Introduction: Mondor disease (MD), a superficial thrombophlebitis of the thoraco-epigastric veins and their confluents is rarely reported in the literature. The superior epigastric vein is the most affected vessel but involvement of the inferior epigastric vessels or their branches have also been described. There is no universal consensus on treatment in the literature but most authors suggest symptomatic treatment with non-steroid anti-inflammatory drugs (NSAIDs).

Changes in gene expression profile in human subcutaneous adipose tissue during significant weight loss.

Objective: To analyze the expression of peroxisome proliferator-activated receptor-γ1 and 2 (PPARγ1 and 2), 11β-hydroxysteroid dehydrogenase type 1 (11βHSD1), and leptin in adipose tissue (AT) of obese women during weight loss following Roux-en-Y gastric bypass (RYGB) and to compare these levels with those obtained in AT of nonobese subjects.

Methods: Gene expression was determined by real-time RT-PCR prior to surgery and at 3, 6, and 12 months after RYGB.

Results: All obese patients lost weight, reaching a mean BMI of 29.

The four different types of internal hernia occurring after laparascopic Roux-en-Y gastric bypass performed for morbid obesity: are there any multidetector computed tomography (MDCT) features permitting their distinction?

Background: Four different types of internal hernias (IH) are known to occur after laparoscopic Roux-en-Y gastric bypass (LRYGBP) performed for morbid obesity. We evaluate multidetector row helical computed tomography (MDCT) features for their differentiation.

Methods: From a prospectively collected database including 349 patients with LRYGBP, 34 acutely symptomatic patients (28 women, mean age 32.

Retroperitoneal abscess with concomitant hepatic portal venous gas and rectal perforation: a rare triad of complications of acute appendicitis. A case report.

Background: While retroperitoneal abscess is a known complication, hepatic portal venous gas and rectal perforation have not been reported as a concomitant sequelae of acute appendicitis. Here we report a case of a patient with a perforated appendicitis that was associated with these triad of complications.

Materials And Methods: In addition to report our case, we carefully reviewed the literature in order to detect similar cases and the causes of such rare conditions.

Selective effects of PPARgamma agonists and antagonists on human pre-adipocyte differentiation.

Aim: The insulin sensitizer rosiglitazone (RTZ) acts by activating peroxisome proliferator and activated receptor gamma (PPAR gamma), an effect accompanied in vivo in humans by an increase in fat storage. We hypothesized that this effect concerns PPARgamma(1) and PPARgamma(2) differently and is dependant on the origin of the adipose cells (subcutaneous or visceral). To this aim, the effect of RTZ, the PPARgamma antagonist GW9662 and lentiviral vectors expressing interfering RNA were evaluated on human pre-adipocyte models.

Results of Roux-en-Y gastric bypass in morbidly obese vs superobese patients: similar body weight loss, correction of comorbidities, and improvement of quality of life.

Hypothesis: Gastric bypass corrects comorbidities and quality of life similarly in superobese (SO) and morbidly obese (MO) patients despite higher residual weight in SO patients.

Design: Prospective cohort study comparing results of primary laparoscopic gastric bypass in MO and SO patients.

Setting: University hospital and community hospital with common bariatric programs.

A new type of internal hernia after laparoscopic Roux-en-Y gastric bypass.

Roux-en-Y gastric bypass (RYGBP) is currently the most common bariatric procedure. One of its late complications is the development of internal hernia, which can lead to acute intestinal obstruction or recurrent colicky abdominal pain. The aim of this paper is to present a new, unusual, and so far not reported type of internal hernia.

Preoperative upper gastrointestinal testing can help predicting long-term outcome after gastric banding for morbid obesity.

Background: Gastric banding (GB) is one of the most popular bariatric procedures for morbid obesity. Apart from causing weight loss by alimentary restriction, it can interfere with functions of the esophagus and upper stomach. The aim of this study was to evaluate if the results of extensive preoperative upper GI testing were correlated with long-term outcome and complications after GB.

A new questionnaire for quick assessment of food tolerance after bariatric surgery.

Background: Bariatric surgery is often associated with reduced food tolerance and sometimes frequent vomiting, which influence quality of life, but are not included in the overall evaluation of these procedures, notably the BAROS. Our aim was to develop a simple questionnaire to evaluate food tolerance during follow-up visits.

Methods: A one-page questionnaire including questions about overall satisfaction regarding quality of alimentation, timing of eating over the day, tolerance to several types of food, and frequency of vomiting/regurgitation was developed.

Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity: a continuous challenge in bariatric surgery.

Background: Roux-en-Y gastric bypass (RYGBP) has long been associated with the possible development of internal hernias, with a reported incidence of 1-5%. Because it induces fewer adhesions than laparotomy, the laparoscopic approach to this operation appears to increase the rate of this complication, which can present dramatically.

Methods: Data from all patients undergoing bariatric surgery are introduced prospectively in a data-base.

A 10-year experience with laparoscopic gastric banding for morbid obesity: high long-term complication and failure rates.

Background: Since its introduction about 10 years ago, and because of its encouraging early results regarding weight loss and morbidity, laparoscopic gastric banding (LGB) has been considered by many as the treatment of choice for morbid obesity. Few long-term studies have been published. We present our results after up to 8 years (mean 74 months) of follow-up.

European experience with laparoscopic Roux-en-Y gastric bypass in 466 obese patients.

Background: Roux-en-Y gastric bypass (RYGBP) is usually considered as the procedure of choice for morbid obesity, but its use has been limited in Europe. It is not known whether results with European patients match those from the USA.

Methods: A total of 466 patients were followed prospectively regarding weight loss, co-morbidities, quality of life and morbidity after primary laparoscopic RYGBP.

[Visceral surgery].

Visceral surgery has benefited from several significant therapeutical improvements in 2005. They involve more specifically endocrine surgery, obesity, ovarian cancer, rectocele and cystic pancreatic neoplasia. Minimal invasive surgery is increasingly used, for example in endocrine conditions and obesity treatment.

Comparison of morphological and functional alterations of human saphenous veins after seven and fourteen days of ex vivo perfusion.

Intimal hyperplasia (IH) is a vessel wall remodeling process responsible of early failure after vascular surgery or endovascular interventions. An ex vivo perfusion was used to study human venous segments regarding functional, histomorphological, immunohistochemical and molecular alterations after 7 (group 1, n = 6) and 14 days (group 2, n = 6) of ex vivo perfusion. All vessel segments showed preserved smooth muscle function before and after perfusion.

Idiopathic segmental infarction of the greater omentum: a rare cause of acute abdomen.

Idiopathic segmental infarction of the greater omentum is a rare cause of acute abdomen. Patients, typically children or obese males in their fifties, present with abdominal pain located in the right upper or lower quadrant, mimicking cholecystitis and appendicitis. CT scanning and ultrasound imaging both may show a well-circumscribed soft tissue mass.

Spontaneous hemothorax associated with von Recklinghausen's disease.

Spontaneous hemothorax is a rare and life threatening complication of neurofibromatosis. Two types of vascular involvement have been described: (a) stenotic or aneurysmal alterations in large vessels such as the aorta and its branches; and (b) dysplastic features in smaller vessels. Thoracotomy and surgical ligation of the bleeding vessels is primarily indicated in the presence of active bleeding with associated hemodynamic compromise.