Duplication of the Artery to the Cystic Duct: A Case Report of a Rare Anatomical Variation with Surgical Significance.

Anatomical variations of the cystic artery are frequently documented, but variations of the artery to the cystic duct are extremely uncommon. We report a rare duplication of the artery to the cystic duct, revealed during laparoscopic cholecystectomy on an 18-year-old Caucasian female treated for gallstone disease. Both arterial branches were meticulously and carefully retracted and cauterized to avoid bleeding and subsequent postoperative complications.

Preoperative Imaging and Localization of a Mediastinal Parathyroid Adenoma. A Case Report.

Introduction: Primary hyperparathyroidism (PHPT) is a common endocrine entity associated with increased parathyroid hormone (PTH) secretion. A single parathyroid adenoma is the cause of PHPT in the majority of cases. However, due to their embryological origin, discovery of ectopic parathyroid tissue is not extraordinary.

Factors affecting adult intensive care units costs by using the bottom-up and top-down costing methodology in OECD countries: A systematic review.

Objectives: To review the studies, which calculated the total intensive care unit costs and indicated the main cost drivers in the intensive care by using either top-down, bottom-up approach or the combination of them.

Research Methodology/designs: A systematic review of papers published until October 2020 was conducted. Search was performed on PubMed, Medline, Scopus and Science Direct databases.

Anomalous anatomic trajectory of the superior thyroid artery encountered during thyroidectomy. A rare case report.

Superior thyroid artery (STA), which is one of the primary arteries supplying to the thyroid gland, constitutes a severe consideration of both surgeons and interventional radiologists. Knowledge of the origin, the trajectory, the branching patterns and the anatomic aberrations of STA are of paramount clinical significance, due to its proximity to the external branch of the superior laryngeal nerve and the potentiality of accidental hemorrhage. The present manuscript reports for the first time the anomalous trajectory of the left STA, coursing superficially, through the left sternothyroid muscle and underlines the clinical significance of such aberrations.

The Prognostic Value of G1 Cyclins, p21 and Rb Protein in Patients With Colon Cancer.

Background/aim: Cyclins D1 and E play different roles in the cell cycle. Cyclin E promotes chromosome instability, whereas cyclin D1 regulates apoptosis of cells. This study evaluated the prognostic significance of G1 cyclins, p21 and pRb in tumor proliferation.

Metastatic Carcinomas of the Adrenal Glands: From Diagnosis to Treatment.

Background/aim: Adrenal glands are one of the most common sites of cancer metastasis. The treatment options include either surgery or chemotherapy and/or radiotherapy while certain diagnosis is made via percutaneous biopsy or fine needle aspiration (FNA), guided by CT scan. This review aimed to present the current practice regarding the diagnosis and treatment of adrenal cancer metastasis.

An anatomic aberration and a surgical challenge: Mediastinal parathyroid adenoma anterior the pericardium. A case report.

Introduction: Ectopic parathyroid glands occur in 6-16% of cases of PHPT and they constitute a potential cause of failed primary surgical therapy. In particular, aberrant adenomas located deeper in the mediastinum, as in the presented case, remain a severe challenge for the surgeons.

Presentation Of Case: A 54-year-old Caucasian female proceeded to our institution with signs and symptoms of PHPT.

Anatomical variation of the trajectory of the brachiocephalic artery encountered during parathyroid adenoma excision. A rare case report and a surgical challenge.

Introduction: The brachiocephalic trunk (BCT), also known as the "anonymous artery" constitutes the first branch of the aortic arch that bifurcates at the level of the right sternoclavicular joint into the RCCA and the RSA. Anatomical variations of the origin and the trajectory of BCT are of vital clinical significance since they constitute major risk-factors of hemorrhage when performing tracheotomy, surgeries at the anatomic area of the neck as in the presented case.

Presentation Of Case: A 64-year-old Caucasian female proceeded to our institution with signs and symptoms of PHPT.

WITHDRAWN: An anatomic aberration and a surgical challenge: Mediastinal parathyroid adenoma anterior the pericardium. A case report.

The Publisher regrets that this article is an accidental duplication of an article that has already been published in “International Journal of Surgery Case Reports, 57C (2019) 106–109”, https://doi.org/10.1016/j.

Superior mesenteric artery syndrome: a rare case of upper gastrointestinal obstruction.

Superior mesenteric artery (SMA) or Wilkie's syndrome is a rare clinical entity of partial or complete duodenal obstruction. The pathogenic mechanism is an acute angulation of the SMA which leads to compression of the third part of the duodenum between the SMA and the aorta. This is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions.

Histone Deacetylase Inhibitors and Anaplastic Thyroid Carcinoma.

Background/aim: Anaplastic thyroid cancer (ATC) is one of the most aggressive human malignancies, remaining generally incurable. Histone deacetylase (HDAC) seems to play a role in regulating transcription of genes involved in ATC, making HDAC inhibitors (HDACI) promising anticancer drugs for ATC. The purpose of this review was to evaluate the role of HDACIs in ATC treatment and describe the latest trends of current research on this field.

Long-term outcome of myotomy and fundoplication based on intraoperative real-time high-resolution manometry in achalasia patients.

Background: Current treatment options for achalasia of the esophagus predominantly consist of endoscopic myotomy or laparoscopic myotomy combined with a partial fundoplication. The intraoperative use of conventional manometry has previously been proposed with various results. The aim of the present study was to introduce the use of high-resolution manometry (HRM) during surgical treatment for achalasia and to assess the long-term outcome of this technique.

Safe Popliteal Node Dissection and Utility of Key Anatomical Structures: A Rare Case Series.

Metastasis in popliteal nodes is an extremely rare clinical condition that is scarcely reported in the literature, and popliteal node dissection is an infrequently performed surgical procedure. During the two decades of 2000-2020, 26 patients came to our institution for popliteal node dissection due to metastasis from the primary region to popliteal fossa lymph nodes. We report here that with lymphoscintigraphy, popliteal node dissection is an adequate therapeutic procedure in cases of metastasis to popliteal fossa from acral primary tumors.

The Accessory Soleus Muscle: A Narrative Review of the Literature.

Purpose: Although the accessory soleus muscle is a rare supernumerary muscle of the leg, its presence has been well discussed in the literature. This rare anatomic variation has been described mainly in the anatomic, surgical, and radiology literature. Awareness of the muscle's presence and its clinical presentation can help with diagnosis without surgical exploration.

Massive Localized Lymphedema: Two Rare Case Reports of this Peculiar Entity and Anatomic Distortion.

Introduction: Massive localized lymphedema (MLL), also called pseudosarcoma in the literature, constitutes a rare benign clinical disorder presenting in obese patients and characterized by chronic accumulation of lymph and adipose tissue due to lymphatic flow obstruction.

Presentation Of Case: A 43-year-old, morbidly obese white woman proceeded to our institution with extended lymphedema. In addition, a 54-year-old white man sought medical advice for the same clinical issue.

Complete unilateral ureteral duplication encountered during intersphincteric resection for low rectal cancer.

Complete duplication of ureters is a very rare clinical entity that may either be asymptomatic or present with a variety of clinical findings. In the presented case a 51-year-old Caucasian female underwent an intersphincteric resection for low rectal cancer. Intraoperatively, during the standard bilateral recognition and mobilization of the ureters, complete unilateral duplication of the left ureter was incidentally detected, deriving from a single renal parenchyma.

Anatomic variation of the relation between the inferior mesenteric artery and the bifurcation point of abdominal aorta during lower anterior resection: A rare case report.

Introduction: Identification and ligation of the inferior mesenteric artery (IMA) is a crucial surgical step when performing lower anterior resection (LAR) for rectal cancer. Anatomic variations of the relation between the IMA and the bifurcation point of abdominal aorta (AA) encumber surgical maneuvers and are of great clinical importance.

Presentation Of Case: An unusual anatomic variation of the relation between IMA and the bifurcation point of AA was unexpectedly detected during LAR to a 69-year-old Caucasian female patient.

Middle colic vein draining to splenic vein: a rare anatomic variation encountered during a right hemicolectomy.

Right or subtotal colectomy either open or laparoscopic may be a challenging operation owing to technical difficulties. One of these, is to identify a safe and adequate dissection plane, ligating and dissecting lymph nodes around middle colic vessels. The purpose of this study was to depict a rare anatomic variation of middle colic vein (MCV) draining to splenic vein.

Laparoscopic abdominoperineal resection for the treatment of a mucinous adenocarcinoma associated with an anal fistula.

Mucinous adenocarcinoma associated with an anal fistula is a rare oncologic entity which may pose diagnostic and therapeutic challenges for Surgeons and Medical Oncologists. Few reported cases without definite therapeutic guidelines exist. It represents 2-3% of all gastrointestinal malignancies and arises from chronic anal fistulas, ischiorectal or perianal abscesses.

Abnormal distance of the extralaryngeal bifurcation point of the recurrent laryngeal nerve from the cricothyroid joint.

The extralaryngeal bifurcation point of the recurrent laryngeal nerve (RLN) is typically located in a mean distance of 0-2 cm from the cricothyroid joint (CTJ). In the presented case though, the left RLN was unexpectedly identified bifurcating in a mean distance of 7 cm from the left CTJ in a young woman with multinodular goiter during total thyroidectomy. The RLN was carefully exposed throughout its course for the avoidance of iatrogenic injury of the nerval structure.

Anomalous origin of the right colic artery from the right gastroepiploic artery during complete mesocolic excision: a rare case report.

Complete mesocolic excision (CME) is a standardized surgical procedure for colonic cancer that requires ample knowledge of the anatomical patterns of the colic arteries. Variations of the colic vessels encumber both surgical and endovascular techniques. In the presented case below, the right colic artery was incidentally detected emerging from the right gastroepiploic artery, during CME.

Anatomic variation of the relation between the facial nerve and the retromandibular vein during superficial parotidectomy: A rare case report.

Introduction: Identification and preservation of the facial nerve (FN) is a major challenge when performing parotidectomy. Anatomic variations of the relation between the FN and the retromandibular vein (RMV) pose a high risk of nerve injury and bleeding during the operation.

Presentation Of Case: An unusual anatomic variation of the relation between the FN and the RMV was unexpectedly detected during superficial parotidectomy.