Aortic pressures within a giant right coronary artery aneurysm.

Background: Giant coronary artery aneurysms are rare conditions with potentially devastating consequences. We report a case of the largest documented giant right coronary artery (RCA) aneurysm to date.

Case Presentation: A 57-year-old male patient visited our outpatient clinic for abdominal pain and exertional dyspnea.

Metastatic SMARCA4-deficient undifferentiated tumor in the small mesentery: case report.

Background: SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a rare and highly malignant primary tumor characterized by the loss of SMARCA4 expression. Despite advancements in oncology, diagnosing and treating SMARCA4-UT remain significant clinical challenges.

Case Demonstration: A 67-year-old male with a history of smoking presented to the hospital with complaints of abdominal distention and pain lasting for more than four days.

Isolated Langerhans cell histiocytosis of the stomach in adults: An analysis of clinicopathologic characteristics and molecular genetics.

Isolated gastric Langerhans cell histiocytosis (LCH) occurs extremely rarely in adults. We characterized the clinicopathological and molecular genetics of this rare entity. We retrospectively analyzed the clinicopathologic and prognostic features of 3 patients with isolated gastric LCH during the past 10 years, with a review of an additional 20 patients from the literature.

Identification of Gender Differences in Acute Myocardial Infarction Presentation and Management at Aga Khan University Hospital-Pakistan: Natural Language Processing Application in a Dataset of Patients With Cardiovascular Disease.

Background: Ischemic heart disease is a leading cause of death globally with a disproportionate burden in low- and middle-income countries (LMICs). Natural language processing (NLP) allows for data enrichment in large datasets to facilitate key clinical research. We used NLP to assess gender differences in symptoms and management of patients hospitalized with acute myocardial infarction (AMI) at Aga Khan University Hospital-Pakistan.

Role of surgical vaginoscopy through no-touch hysteroscope in the treatment of female reproductive polyps.

Background: The study aims to investigate the application of surgical vaginoscopy via a no-touch hysteroscopic approach for the management of female genital polyps. The primary objective is to assess the feasibility of this technique in treating intrauterine pathologies in both pregnant and non-pregnant women.

Methods: A total of forty-six patients diagnosed with genital polyps underwent operative vaginoscopy at a university-affiliated hospital between April 1, 2017 and May 31, 2023.

Time from drainage to surgery is an independent predictor of morbidity for moderate-to-severe acute cholecystitis: a multivarirble analysis of 259 patients.

Background: Acute cholecystitis (AC) is an acute inflammatory disease of the gallbladder and one of the most frequent causes of acute abdominal pain. Early cholecystectomy is recommended for mild cholecystitis. However, the optimal surgical timing for moderate-to-severe cholecystitis requiring percutaneous transhepatic gallbladder drainage (PTGBD) remains unclear.

Chronic spontaneous non-aneurysmal aortic rupture treated with endovascular surgery.

Spontaneous non-aneurysmal aortic rupture is rare and is usually attributed to penetrating aortic ulcers, infections, tumor infiltrations, or inflammatory and collagen diseases. Chronic rupture is infrequent but extremely rare in non-aneurysmal aortas, which makes diagnosis difficult because the absence of an aneurysm can mislead the physician to rule out rupture. Here, we describe the case of an 85-year-old male, who was undergoing oncological investigation for weight loss, inappetence, and back pain.

APENDIC-RADS: an ultrasound reporting system for the diagnosis of acute appendicitis.

Objective: Abdominal ultrasonography is widely used to evaluate suspected cases of appendicitis. Objective descriptions of the direct and indirect signs of appendicitis result in varied assessments of its likelihood. This study introduces the Appendix Imaging Reporting and Data System (APENDIC-RADS) to standardize the reporting of appendix ultrasound findings.

The effect of dexmedetomidine on acute kidney injury after elective major abdominal surgery : a retrospective single-center propensity score matched study.

Background: Major abdominal surgery is a kind of high-risk surgery type for postoperative acute kidney injury (AKI) among non-cardiac surgeries. Despite dexmedetomidine exerts significant renal protective effects in cardiac surgeries and animal studies, whether it is associated with a lower incidence of AKI in major abdominal surgeries remains unclear.

Methods: From January 2019 to July 2021, patients undergoing elective major abdominal surgery in West China Hospital were enrolled.

Lower limb necrotising fasciitis descending from malignant colonic perforation: a rare pattern.

Necrotising fasciitis (NF) is a rare surgical emergency characterised by soft tissue necrosis and systemic compromise. Typically it originates following adjacent skin and soft tissue insult; however, our unusual case required a high index of clinical suspicion to avert potential mortality. A man in his 60s with diabetes mellitus presented with 2 weeks of knee pain, swelling and necrotic skin on the posterior calf.

Porcelain appendix: a rare mimicker of the acute abdomen.

An appendiceal mucocele is a rare clinical entity often mimicking that of acute appendicitis in a majority of cases leading to incidental intraoperative findings. Nevertheless, appropriate diagnosis is vital prior to surgery to prevent complications such as pseudomyxoma peritonei. This report details a case of a man in his 70s, who was admitted to the emergency department with right iliac fossa pain with imaging showing wall thickening of the caecum and the ascending colon.

Renal artery thrombosis with deterioration of kidney function.

Renal artery thrombosis is an uncommon but serious cause of acute kidney injury that can result in permanent loss of function. It is frequently misdiagnosed due to its non-specific appearance, which can mimic renal colic and other more common causes of abdominal pain. There is no agreement on the first-line treatment and no prospective studies comparing thrombolysis, anticoagulation and embolectomy.

Goal-directed fluid therapy on the postoperative complications of laparoscopic hepatobiliary or pancreatic surgery: An interventional comparative study.

Background: Intraoperative fluid balance significantly affects patients' outcomes. Goal-directed fluid therapy (GDFT) has reduced the incidence of major postoperative complications by 20% for 30 days after open abdominal surgery. Little is known about GDFT during laparoscopic surgery.

Low vs. conventional intra-abdominal pressure in laparoscopic colorectal surgery: a prospective cohort study.

Purpose: Low intraabdominal pressure (IAP) during laparoscopy is associated with improved post-operative outcomes across a variety of surgical specialties. A prospective cohort study was undertaken to assess post-operative outcomes in patients undergoing laparoscopic colorectal surgery (LCRS) with low (8mmHg) versus conventional (15mmHg) IAP.

Methods: A prospective real-world observational study of patients undergoing LCRS in a single-centre, between June 2020 and June 2023 was performed.

Perioperative Opioid Use in Urogynecologic Mesh Removal.

Importance: Forty percent of patients with urogynecologic mesh pain complications are taking narcotics.

Objectives: We aimed to compare comorbidities and pain scores between patients with and without narcotic use and assess postoperative narcotic use rates.

Study Design: This was a secondary analysis of a prospective cohort study of patients undergoing urogynecologic mesh removal.

[Hereditary protein S deficiency in a patient with prominent mesenteric venous thrombosis: A case report].

Hereditary protein S deficiency (PSD) is an autosomal dominant disorder caused by mutations in the 1 gene which can cause venous thrombosis. Individuals with PSD usually present with recurrent deep vein thrombosis and/or pulmonary embolism, but thrombosis may occur at unusual sites, such as the mesenteric and portal veins. Here we report a case of hereditary protein S deficiency patient with predominant mesenteric venous thrombosis.

Percutaneous nephroscopy combined with ultrasound-guided negative-pressure suction for the treatment of perirenal hematoma.

Percutaneous renal puncture drainage is needed in patients with perirenal hematoma (PRH, renal around hematoma) with poor conservative treatment. Early and thorough removal of hematoma is closely related to the recovery of patients, but percutaneous renal drainage is not effective in some patients. The clinical data of 5 patients with PRH treated in the first affiliated Hospital of Chongqing Medical University from June 2020 to June 2024 were analyzed retrospectively.

Low-grade appendiceal mucinous neoplasm: A case report.

Rationale: Low-grade appendiceal mucinous neoplasm (LAMN) is a clinically rare tumor that predominantly occurs in females and presents with nonspecific symptoms, often resulting in misdiagnosis. While postoperative pathology remains the gold standard for diagnosis, accurate preoperative identification through various diagnostic methods is essential for effective treatment planning. To raise awareness of this condition, we present a case of a middle-aged male diagnosed with LAMN.

Retrospective comparative analysis of human fascioliasis versus bacterial liver abscess.

This study aimed to compare the clinical characteristics of human fascioliasis and bacterial liver abscesses to provide a reference for the early and effective differentiation of these 2 diseases to avoid misdiagnosis. We retrospectively compared the epidemiological and clinical characteristics of 95 patients with human fascioliasis and 95 with bacterial liver abscess admitted to the First Affiliated Hospital of Dali University between January 2013 and March 30, 2023. The human fascioliasis group exhibited a higher proportion of female patients and a greater frequency of abdominal pain and lesions affecting both lobes of the liver.

Anogenital distance on MRI does not correlate to surgical diagnosis of endometriosis in patients without prior abdominal surgery.

Anogenital distance (AGD) is regarded as a potential biomarker for endometriosis, and a measurement on MRI images has been found to be promising. This study aimed to evaluate the measurement of AGD on MRI to predict the surgical diagnosis of endometriosis. We included 127 patients who received an MRI for endometriosis between October 2018 and February 2023.

Underappreciated Relationship: A Case of Type A Aortic Dissection Presented With Atrial Flutter.

Aortic dissection (AD) is a life-threatening emergency involving a tear in the aortic intima, leading to a false lumen. Atrial fibrillation (AF) can complicate AD, increasing management challenges and mortality risks. We report a 67-year-old male with no known past medical history who presented with a 1-day history of abdominal pain.

Cervical Inspection With AAVI and Cryotherapy on HPV-Diagnosed Women in Windhoek, Namibia.

In 2018, the Ministry of Health and Social Services (MoHSS) introduced acetic acid visual inspection (AAVI) screening program and treatment of cervical precancers with cryotherapy in replacement of Pap smear intervention in Namibia. The study examines the effective use of AAVI-and-cryotherapy treatment on HPV-diagnosed women. Female patients of the reproductive age (20-49 years) group visiting 2 Namibian healthcare facilities for AAVI and cryotherapy treatment were investigated using a cross-sectional approach.

The Association of Lipid Abnormalities with Complications in Severe Scrub Typhus.

Aim: To study abnormalities of lipids in patients suffering from severe scrub typhus and their relationship with complications.

Methods: This cohort study was conducted in patients of severe scrub typhus [immunoglobulin (IgM) positive by enzyme-linked immunosorbent assay (ELISA)] admitted to our institute from 1 August 2020 through 31 July 2021. The lipid profile was estimated initially at the time of hospitalization.

Laparoscopic excision of a spontaneously infected mesenteric duplication cyst.

Mesenteric cysts are rare intra-abdominal masses which can occur at any point in the gastrointestinal tract from the duodenum to the rectum. These cysts may remain asymptomatic or may present with an abdominal mass, abdominal pain, or fever. Management may be conservative, percutaneous, or surgical excision.

Anaesthetic and surgical management of gastric perforation secondary to a diving incident: a case report.

Gastric perforation secondary to barotrauma is a rare surgical condition which may manifest as an acute abdomen and potentially lead to complications such as pneumoperitoneum. A 50-year-old, healthy, experienced diving instructor was transported to our emergency department for an acute abdomen and severe dyspnoea after a diving incident. Clinical suspicion combined with computed tomography scanning lead to the diagnosis of linear rupture of the stomach.