Epiploic Appendagitis Causing Small Bowel Obstruction: A Pleasant Surprise.

Introduction: Epiploic appendagitis is a rare cause of acute abdominal pain, mimicking acute diverticulitis or appendicitis. Epiploic appendagitis causing small bowel obstruction is highly unusual, and only a handful of such cases have been reported so far. .

Perioperative radiotherapy versus surgery alone for retroperitoneal sarcomas: a systematic review and meta-analysis.

Background There is no clear evidence on whether radiotherapy (RT) improves treatment result in patients with retroperitoneal sarcomas (RPS). Methods A systematic literature search was performed using PubMed, Scopus and CENTRAL databases. Data were retrieved from published comparatives studies in patients with RPS undergoing surgery alone or RT plus surgery.

Solitary Colorectal Cancer Metastasis to the Pancreas.

Introduction: Secondary pancreatic metastasis from other solid organ malignancy is rare and accounts for less than 2% of all pancreatic tumors. The aim of this study is to highlight that colorectal metastatic disease in the pancreas could be in selected cases an indication for surgery rather than for palliative chemotherapy.

Case Presentation: We present a case of a 62-year-old Caucasian female with a history of rectal adenocarcinoma.

ki-67 and Topoisomerase IIa proliferation markers in colon adenocarcinoma.

Aberrant cell proliferation is a major cause in the development and progression of carcinogenic process. Epithelia characterized by increased mitotic rates accumulate easily gross numerical and structural chromosomes (polysomy/aneuploidy) and specific gene (deletions, amplifications, point mutations, translocations) deregulations that lead to their progressive neoplastic and finally malignant transformation. Molecules that are critical for evaluating the proliferation status of the corresponding tissues include mainly ki-67 (cytogenetic band: 10q26.

Immunohistochemical expression patterns of S100, synaptophysin, chromogranin A and neuron specific enolase in predicting malignant behaviour in paragangliomas.

Purpose: The purpose of this study was to evaluate the role of immunohistochemical markers in the prediction of malignancy in paragangliomas.

Methods: Our institute's patient records between 1990-2012 were retrieved in order to identify patients who were treated for paragangliomas. Size and location of the tumour, existence of concurrent metastatic disease, patient demographics and survival were recorded.

Large Enterolith Complicating a Meckel Diverticulum Causing Obstructive Ileus in an Adolescent Male Patient.

We present a unique case of a 16-year-old male patient who was eventually diagnosed with a large enterolith arising from a Meckel's diverticulum. The enterolith had caused intermittent intestinal symptoms for three years before resulting in small bowel obstruction requiring surgical intervention. Meckel's enterolith ileus is very rare with only few cases described in the literature.

Biliary Mucinous Cystic Neoplasm of the Liver with Ovarian Stroma and Elevated Serum and Cystic Fluid Cancer Antigen 19-9 Levels.

Biliary mucinous cystic neoplasms of the liver are rare cystic tumors comprising less than 5% of the liver cystic neoplasms. These tumors demonstrate a female predominance and entail a risk of malignant transformation. We present a 56-year-old female patient with a multiloculated liver cystic lesion measuring 22 cm who underwent a cystectomy with en bloc resection of the liver segments II, III, and cholecystectomy.

The Role of TAMIS (Transanal Minimally Invasive Surgery) in the Management of Advanced Rectal Cancer - One Shared Story of Three Exceptional Cases.

: The current gold standard for contemporary treatment of rectal cancer is total mesorectal excision (TME), achieving excellent local disease control and low recurrence rates. However, TME may be associated with postoperative mortality and quality of life deterioration. Therefore, the need to develop less radical treatment strategies has emerged.

Effect of Increased Intra-abdominal Pressure on Liver Histology and Hemodynamics: An Experimental Study.

Background: While reduction of portal venous (PV) blood flow has been described in animal models of intra-abdominal hypertension, reports on compensatory changes in hepatic arterial (HA) flow, known as the hepatic arterial buffer response are controversial.

Materials And Methods: Pneumoperitoneum with helium was induced in 13 piglets. Hemodynamic measurements and pathological assessment were conducted at baseline and during the three subsequent phases: Phase A: 45 minutes with a stable intra-abdominal pressure of 25 mmHg; phase B: 45 minutes with a stable intra-abdominal pressure of 40 mmHg; and phase C during which the abdomen was re-explored and reperfusion of the liver was allowed to take place.

Collision tumor of the appendix: mucinous cystadenoma and carcinoid. A case report.

Introduction: Mucinous cystadenoma is the most common of benign neoplasms of the appendix and carcinoid is the most common type of primary malignant lesions of the appendix.We report a rare case of a 57-year-old female with combined mucinous cystadenoma and carcinoid tumor of the appendix.Dual carcinoid and epithelial neoplasia is a rare occurrence in the appendix.

Methods of safe laparoscopic cholecystectomy for left-sided (sinistroposition) gallbladder: A report of two cases and a review of safe techniques.

Introduction: Left-sided gallbladder is a rare anatomical variation. Usually it is discovered intra-operatively and is accompanied by anatomic variations that can prove quite challenging during laparoscopy.

Presentation Of Case: From a total of almost 3000 laparoscopic cholecystectomies performed in our institution, two cases of left sided gallbladder were unexpectantly identified intraoperatively.

Complete traumatic main pancreatic duct disruption treated endoscopically: a case report.

Introduction: Pancreatic injury is uncommon and the management remains controversial. The integrity of the main pancreatic duct is considered the most important determinant for prognosis.

Case Presentation: A 19-year-old Greek man was referred to our tertiary referral centre due to blunt abdominal trauma and an associated grade III pancreatic injury.

Bilateral obturator pyomyositis with visceral involvement in an immunocompetent adult patient treated without surgery.

Background: Primary pyomyositis is a rare bacterial infection that affects large muscle groups mainly in immunocompromised patients. Treatment options include antibiotic treatment with surgical or radiologic interventions.

Case: A 22-year-old immunocompetent athlete was diagnosed with bilateral obturator muscle pyomyositis involving pelvic floor muscles and the urinary bladder after muscle injury during training.

Synchronous cytomegalovirus and Clostridium difficile infection of the pouch: a trigger for chronic pouchitis?

Pouchitis occurs in up to one half of patients after restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA). Cytomegalovirus (CMV) and Clostridium difficile are among the commonest secondary identifiable etiologies. A 17-year-old male with ulcerative colitis underwent IPAA due to refractory disease.

Clinicopathological features and management of hepatic vascular tumors. A 20-year experience in a Greek University Hospital.

Purpose: The aim of this study was to review the clinical features, diagnostic modalities, treatment options and pathological characteristics of various types of hepatic vascular tumors treated in our Institution over the last 20 years.

Methods: From 1991 to 2011, 761 cases of various hepatic lesions, benign and malignant, were surgically treated in our hospital. Among these, 56 (7.

Correlation of the ICG test with risk factors and postoperative outcomes following hepatic resection.

Purpose: Liver failure is a major cause of early mortality following hepatectomy. The future-remnant liver function is an important factor when assessing the risk for postoperative liver functional impairment. Several techniques have been established for this evaluation, including the indocyanine green (ICG) test.

Pancreatic Remnant Occlusion after Whipple's Procedure: An Alternative Oncologically Safe Method.

Introduction. To present our experience regarding the use of pancreatic stump occlusion technique as an alternative management of the pancreatic remnant after pancreatoduodenectomy (PD). Methods.

Tacks-free transabdominal preperitoneal (TAPP) inguinal hernioplasty, using an anatomic 3-dimensional lightweight mesh with peritoneal suturing: pain and recurrence outcomes-initial experience.

Background: The emphasis for research in inguinal hernia repair has shifted from hernia recurrence to groin pain, which is considered the most important factor for poor quality of life.

Aim: : To evaluate hernia recurrences and pain at trocar site and at inguinal hernia site, in patients who underwent tacks-free transabdominal preperitoneal inguinal hernia repair, using a lightweight nonfixed 3-dimensional mesh with peritoneal suturing.

Materials And Methods: Between 2009 and 2011, 32 patients (2 female) with mean age 51 years underwent hernia repair.

"Enteroatmospheric fistulae"--gastrointestinal openings in the open abdomen: a review and recent proposal of a surgical technique.

The occurrence of an enteric fistula in the middle of an open abdomen is called an enteroatmospheric fistula, which is the most challenging and feared complication for a surgeon to deal with. It is in fact not a true fistula because it neither has a fistula tract nor is covered by a well-vascularized tissue. The mortality of enteroatmospheric fistulae was as high as 70% in past decades but is currently approximately 40% due to advanced modern intensive care and improved surgical techniques.

Multifocal retroperitoneal sarcoma.

Introduction. Retroperitoneal sarcomas comprise a small proportion of all soft tissue sarcomas, and multiple factors influence their clinical behavior. Histopathological type and grade as well as complete surgical resection especially on the first operative attempt are well recognized as the main prognostic factors.

Atrial and brain natriuretic peptide changes in an experimental model of intra-abdominal hypertension.

Background: Intra-abdominal hypertension (IAH) can have a profound impact on the cardiovascular system. We hypothesized that natriuretic peptides (Nt-pro-ANP and Nt-pro-BNP) are produced in response to the cardiovascular changes observed in an experimental model of IAH.

Materials And Methods: Eleven female pigs were enrolled in this study.

Strangulated femoral hernia turned to be peritoneal cyst.

Introduction. A peritoneal inclusion cyst is a very rare mesenteric cyst of mesothelial origin usually asymptomatic. A rare case of an 82-year-old white Caucasian female with a femoral hernia containing a large peritoneal inclusion cyst, mimicking strangulated hernia, is presented herein.

A multimodal approach to acute biliary pancreatitis during pregnancy: a case series.

The treatment of acute biliary pancreatitis during pregnancy remains controversial. We present our experience of treating 7 pregnant women with acute biliary pancreatitis and verified or suspected choledocholithiasis, by using magnetic resonance cholangiopancreatography (MRCP), endoscopic retrograde cholangiopancreatography (ERCP), and sphincterotomy followed by laparoscopic cholecystectomy. MRCP was performed in all patients to confirm the presence of common bile duct stones, their size and number.

Expression of microRNAs in patients with pancreatic cancer and its prognostic significance.

Objectives: Investigation of expression profile of well-established microRNAs in pancreatic adenocarcinoma, and its correlation with clinicopathological factors.

Methods: Eighty-eight samples of ductal pancreatic adenocarcinoma and 98 control samples were analyzed by real-time polymerase chain reaction for miR-21, miR-31, miR-122, miR-145, miR-146a, miR-155, miR-210, and miR-222 expressions. The results were normalized and then statistically analyzed using nonparametric statistical tests.

Solitary rectal cap polyp: Case report and review of the literature.

Rectal bleeding combined with the presence of a rectal mass has been traditionally associated with the presence of malignant disease. Cap polyposis is a relatively young and still undefined rare entity which mainly involves the rectosigmoid. It is characterized by the presence of inflammatory polyps.