An unusual presentation of cystic lymphangioma in the mesoappendix: a case report

The spotted scat (Scatophagus argus) is a fish species widely distributed in Indo-Pacific waters. In China, females are preferred for aquaculture due to their faster growth rates. Reproduction in teleost fish requires substantial energy, primarily in the form of lipids and fatty acids, which are closely linked to reproductive success and ovarian development. In this study, female spotted scat broodstock were sampled bi-monthly from May 2019 to March 2020 to examine annual ovarian development, lipid droplet accumulation, and fatty acid composition in the liver and ovaries. Body weight, total length, standard length, and condition factor (CF) increased gradually over the sampling period. In July 2019, the gonadosomatic index (GSI) increased significantly, all ovaries reached stage IV, and lipid droplet accumulation was most pronounced. Ovarian saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), n-3 polyunsaturated fatty acids (n-3 PUFA), and n-6 PUFA reached their highest levels in July, whereas the ovarian n-3 PUFA/n-6 PUFA ratio was highest in May. The hepatosomatic index (HSI) was significantly higher from November to March than from May to September. The viscerosomatic index (VSI) was significantly elevated from November to March and in July. Liver lipid droplet accumulation was lowest from May to July. Absolute contents of liver SFA, MUFA, and n-6 PUFA were significantly higher in January and March than in May and July, while liver n-3 PUFA content and the n-3 PUFA/n-6 PUFA ratio peaked in May. These findings indicate that the peak breeding season of spotted scat occurs around July in southern China. From winter to spring, lipids accumulate in the abdominal cavity and liver, likely serving as energy reserves for subsequent ovarian development. The liver appears to play a key role in the uptake and transfer of n-3 long-chain polyunsaturated fatty acids (n-3 LC-PUFA) to the ovaries prior. This study provides useful insights into the reproductive physiology of spotted scat and supports improved broodstock management in aquaculture.

Background: Focused Assessment using Sonography for Trauma (FAST) is commonly employed to identify visceral organ injuries once traumatic accidents have occurred. Implementation of the FAST scan is used to evaluate the existence of visceral organ injuries, though some clinicians overestimate the real needs of the FAST scan examination when they order it for trauma not involving thoracic and abdominal cavities, and this leads to ineffective implementation of it and leads to delay of patient management and unnecessary costs. Therefore, this study aimed to assess clinicians’ and patients’ factors affecting the implementation of focused assessment with Sonography in trauma (FAST) scan examinations in diagnosing visceral injury among trauma patients at the Emergency Department (EMD) in a tertiary hospital in Northern Tanzania. Methodology: The hospital-based retrospective study was employed at EMD at Kilimanjaro Christian Medical Center (KCMC), covering a period of one year. Data were obtained using a data extraction tool from patients’ medical files who had an accident and attended the emergency department in one year. At a CI of 95%, data were analyzed using SPSS version 25.0, and statistical significance was set at P<0.05. Results: Out of 110 trauma patients who were enrolled, 81 (73.6%) of them were incorrectly subjected to FAST scan examination. And of these patients, 15.50% had abdominal and chest injuries, while the rest had other injuries. Effective implementation of FAST scan examination is affected by clinician factors such as education level, working experience, training of FAST scan examination, and performing physical examination before FAST scan examination. While patient factors affecting the effective implementation of the FAST scan examination include the patient’s condition, site of injury, and mechanism of injury. Conclusions: The result of the study shows that there is ineffective implementation of FAST scan examination among trauma patients who attended the EMD department at KCMC. More than half of the patients were incorrectly subjected to FAST scan examination, and this was influenced by both clinician and patient factors. There is a need for collaboration among senior staff and junior and regular provision of refresher training to overcome the problem of ineffective implementation of FAST scan examinations.

Adrenocortical cancer is a rare and highly aggressive tumor of the adrenal cortex, which is most often diagnosed in advanced stages, resulting in an unfavorable prognosis for most patients. This article describes a clinical case of hormone-active adrenocortical cancer of the left adrenal gland in a young woman. The patient had symptoms of hypercorticism (dysplastic obesity, bluish-purple striae, hypertension, diabetes mellitus, amenorrhea, hirsutism). An examination at the outpatient stage revealed an increased level of cortisol in daily urine >100 micrograms / day, an ultrasound of the abdominal cavity organs in the projection of the left kidney with the size of 200*129*195 mm, with fuzzy uneven contours. Ultrasound signs of multiple focal liver formations (probably mts). An additional examination by an endocrinologist is recommended, but the patient did not seek advice. After 5 months, due to the increased symptoms of hypercorticism and the appearance of abdominal and lumbar pain, the patient urgently went to the hospital on duty. Where the additional examination was carried out: a laboratory study aimed at detecting hormonal disorders and topical diagnostics (MSCT of the thoracic and abdominal organs – in the projection of the left adrenal gland, and the upper pole of the left kidney, the formation is determined by the size of up to 22*12*10 see, secondary damage to the liver, lungs, and lymph nodes). The patient was consulted by an oncologist at an oncological dispensary. Surgical treatment is not indicated for the patient, palliative treatment is recommended. 6 months after the onset of symptoms, the patient develops hepatic-renal insufficiency, cerebral edema and death of the patient occurs.

The occurrence of ovarian vein thrombosis(OVT) prior to delivery and during cesarean section is exceedingly rare. Presently, the literature contains minimal reports on this condition, and there is a lack of clinical experience regarding the management of OVT when identified intraoperatively during cesarean section. This case report describes a rare instance of non-right OVT identified during a cesarean section. The intraoperative procedures and postoperative coagulation management presented significant challenges. A 31-year-old female, with a history of cesarean delivery five years ago, was admitted for elective cesarean section. During the cesarean section, the patient exhibited bilateral pelvic venous distension. Notably, the venous dilation was more pronounced in the left adnexal region, accompanied by the presence of purple, block-like thrombotic formations in the left ovarian vein. A gynecologist was consulted for a surgical evaluation. Following the exclusion of factors such as uterine wound bleeding and hematoma, the finding was considered suspicious for OVT with pelvic venous congestion. Because the abdomen was still open and the diagnosis was uncertain, with concern for venous bleeding or hematoma as well as thrombosis, the gynecologists and obstetricians selectively ligated the visibly abnormal venous branch as a pragmatic intraoperative risk mitigation step before closure. On the day of the surgical procedure, the coagulation parameters of the parturient indicated a trend towards hyperfibrinolysis. The patient received a fibrinogen infusion, and subsequent imaging studies suggested the presence of pelvic venous congestion and left OVT, while effectively excluding the possibility of secondary hemorrhage within the pelvic and abdominal cavities. Following an urgent multidisciplinary consultation, the patient was administered a therapeutic dose of anticoagulation in conjunction with anti-inflammatory treatment. Follow-up ultrasound at postpartum day 42 showed no sonographic evidence of residual thrombus in the left ovarian vein and a marked reduction in dilatation of the left parauterine vein. In contrast, the right parauterine vein, which did not undergo surgical intervention, remained more dilated than the left side. This case illustrates that when unexpected adnexal venous abnormalities are encountered prior to abdominal closure during cesarean delivery, OVT should be considered. In such situations, a structured differential diagnosis and multidisciplinary input are essential, and timely postoperative imaging should be obtained. In carefully selected scenarios under diagnostic uncertainty, selective ligation of a suspicious venous branch may be considered as an intraoperative risk-mitigation step, followed by standard therapeutic anticoagulation, with antibiotics administered when indicated. At 42-day follow-up, ultrasound showed no sonographic evidence of residual thrombus on the ligated side, with improved left-sided parauterine venous dilatation compared with the contralateral side.

A case of mesenteric lipoma of the small intestine in an adult patient

Gastric cancer is the fifth most common malignant tumor worldwide and the third leading cause of cancer-related deaths, posing a serious threat to global public health. Despite notable advancements in surgical techniques, systemic chemotherapy, targeted therapy, and immunotherapy in recent years, the overall prognosis for patients with locally advanced gastric cancer (AGC) remains suboptimal, primarily due to the high propensity for local and distant metastasis. Peritoneal metastasis (PM), in particular, has become one of the most formidable clinical challenges owing to its high incidence, inherent resistance to systemic chemotherapy, and extremely poor prognosis. To address this challenge, Prophylactic Hyperthermic Intraperitoneal Chemotherapy (P-HIPEC) has emerged as a focal point of research. This therapeutic modality aims to eradicate microscopic residual tumors and free cancer cells in the abdominal cavity following radical gastrectomy, thereby effectively reducing the risk of peritoneal metastasis and improving long-term patient survival. This review systematically examines the latest research progress of P-HIPEC in the treatment of gastric cancer, provides an in-depth analysis of its mechanism of action, indications, criteria for patient and drug selection, evidence of clinical efficacy, safety controversies, and challenges in standardization. It also looks forward to future research directions in this field, with the aim of providing a valuable reference for clinical practice and academic research.

Background and Objectives: Anastomotic leak following total gastrectomy and Roux-en-Y reconstruction remains a challenging and potentially morbid clinical scenario. Systemic support and resuscitation with simultaneous local sepsis control remain pillars of treatment. The therapeutic strategy may vary among different centers depending on the severity of clinical presentation, the degree of contamination and the hospital resources. The aim of this study is to introduce the rendezvous stenting technique, which combines washout of the abdominal cavity and endoscopic stenting under direct vision in selected patients who require reoperation. Materials and Methods: A retrospective descriptive analysis of severely ill patients suffering an anastomotic leak from an esophagojejunal anastomosis, who had been operated on in our department during the last five years was performed. Patient demographics, perioperative data and surgical outcomes were collected. Results: Since 2018, six anastomotic leak patients underwent stenting of anastomotic leak using the rendezvous technique during reoperation. Stenting was effective in controlling local contamination in five out of six patients (83.3%). One patient required repeat stent placement due to improper stent width. Conclusions: Anastomotic stenting using the rendezvous technique is a safe and feasible technique. Combining drainage of the abdominal cavity and stent fixation allows for control of the contaminated field as well as minimizing the risk of stent migration.

Phage therapy is emerging as a promising alternative to antibiotics for treating various infections. However, there have been no prior studies on using bacteriophages for peritonitis in patients undergoing peritoneal dialysis. This report presents the successful treatment of refractory peritonitis in a 71-year-old male peritoneal dialysis patient using bacteriophages combined with antibiotics. The patient has a history of refractory and repeat peritonitis caused by Staphylococcus haemolyticus, which was resolved through simultaneous catheter replacement (SCR). Subsequently, the patient experiences another episode of refractory peritonitis due to Klebsiella pneumoniae. Although this strain is found to be susceptible to amikacin and imipenem, a 14-day course of treatment with these antibiotics in the abdominal cavity fails to resolve the peritonitis. Combined with antibiotic therapy, the patient is successfully treated with intraperitoneal phage therapy targeting his bacterial isolate. We monitor the longitudinal progression of phage loads, phage-neutralizing antibodies, interleukin-6 levels, and lipopolysaccharide concentrations in the dialysate effluent during the bacteriophage therapy. The combination of a phage cocktail and imipenem (IPM) demonstrates a greater effect in killing bacteria than either treatment alone, which indicates that a synergistic effect exists between the phage cocktail and IPM. Intraperitoneal IPM is discontinued after a 3-week course of treatment. At the same time, oral fluconazole is given to prevent fungal infections. The patient is discharged without any antibiotics. After this round of treatment, the patient remains healthy during the one-month follow-up. Our study suggests that personalized phage therapy combined with sensitive antibiotics can play a significant role in managing refractory peritonitis in patients undergoing peritoneal dialysis, showing promise for future applications.

Patients with epithelial ovarian cancer (EOC) are often diagnosed with peritoneal metastasis and ascites, the accumulation of intraperitoneal fluid containing nonmalignant cells. However, the interactions between EOC and nonmalignant cells before peritoneal metastasis remain unclear. To investigate this, whole EOC spheroids were observed using a multiphoton microscope, and their invasion ability was assessed. Mesothelial cells were identified as notable components of ascites through morphological assessment, immunohistochemical/immunofluorescence staining, and single-cell RNA sequencing analyses. Almost all EOC cells were spheroids, with 60% containing mesothelial cells. EOC cells quickly generate aggregated spheroids with mesothelial cells, and these aggregated cancer-mesothelial spheroids (ACMSs) invade collagen or mesothelial layers. Mesothelial cells forming ACMSs initiated the invasion. RNA sequencing analysis revealed marked RNA expression changes in mesothelial cells, whereas the changes in EOC cells were minor. Transforming growth factor-β1-stimulated mesothelial cells showed increased invadopodium formation along with fascin-1 up-regulation. These findings suggest that EOC cells alter mesothelial cells through ACMSs, thereby elucidating the rapid spread of EOC in the abdominal cavity.

T cell senescence significantly impairs the efficacy of immune checkpoint blockade (ICB) therapy in cancer. Metabolic reprogramming is a crucial factor in T cell senescence in tumor microenvironment (TME). Ovarian cancer (OvCa) patients derive limited benefit from ICB treatment, probably related to T cell senescence. OvCa cells metastasize to the abdominal cavity rich in omental fat and raise ascites, forming a unique TME, adipocyte-rich TME. In this study, we investigated the effects of adipocyte-rich TME on T cell senescence. Using the single-cell RNA sequencing of OvCa and clinical samples, we found that adipocyte-rich TME is strongly associated with the formation of senescence CD8+T (CD8+Tsen) cells. Mechanistically, adipocyte-derived factors (MATES) and oleic acid (OA)-the predominant fatty acid in OvCa ascites-promoted tumor-induced CD8+Tsen formation by enhancing fatty acid (FA) uptake via FABP4, triggering lipid peroxidation rather than energy production. Inhibition of FABP4 (using the inhibitor BMS309403 or siRNA knockdown) blocked CD8+Tsen cell formation, reduced lipid peroxidation, restored CD8+T cell effector function, and suppressed immunosuppressive cytokines. Moreover, using an OvCa mouse model, we found that in OvCa mice BMS309403 treatment partially diminished CD8+Tsen formation by reducing FA uptake, and improved anti-tumor immunity, and prolonged the survival time of OvCa mice when combined with chemotherapy. Our work suggests FABP4-mediated FA metabolism as a therapeutic target to counteract T cell senescence in adipocyte-rich TME, providing a novel immunotherapeutic strategy for OvCa.

Dromedary camels (Camelus dromedarius) are vital to the socioeconomic and cultural fabric of arid regions, yet their healthcare is less developed than that of other domestic species. Their unique anatomy-including deep thoracoabdominal cavities, thick skin, and dense musculature-challenges conventional diagnostics and interventions. Ultrasound has emerged as a crucial, field-appropriate imaging modality, enabling rapid, non-invasive, real-time visualization of internal structures. This review examines ultrasound-guided diagnostic and therapeutic procedures in dromedary camels. Key diagnostic techniques, including thoracocentesis, abdominocentesis, portocentesis, and organ biopsies, are discussed with respect to clinical indications, protocols, advantages, and potential complications. Ultrasound guidance enhances accuracy and safety by ensuring precise needle placement, minimizing trauma, and improving diagnostic yield. Therapeutic applications, such as pleural effusion drainage and abscess evacuation, highlight ultrasound's role in minimally invasive alternatives to surgery. Camel-specific anatomical and behavioral factors influencing ultrasonography, including sternal recumbency and adapted equipment, are addressed. Ultrasound features that differentiate types of ascitic fluid-transudates, exudates, and hemorrhagic effusions-are critical for targeted treatment. It also aids in managing complex conditions such as uroperitoneum, peritonitis, and thoracic or abdominal effusions, with ultrasound-guided paracentesis improving differentiation between urinary bladder rupture and obstruction. Challenges remain due to camel anatomy, environmental conditions, sedation risks, and the need for trained operators. Future directions include developing camel-specific protocols, portable devices, AI-assisted and tele-guided diagnostics, and integration into veterinary education. Widespread adoption of ultrasound-guided interventions can enhance camel healthcare, animal welfare, and pastoral livelihoods in arid regions worldwide.

Case Report: Intra-abdominal Mucormycosis Diagnosed at the Time of Liver Transplantation for Surgically Induced Acute Liver Failure.

Specimen retrieval in laparoscopy involves extraction of a resected specimen from a patient's abdominal cavity. A major challenge is the spillage of retrieved content, causing dissemination of malignancy. This paper presents RoboRetrieve, a hand-held robot to perform spillage-free retrieval in minimally invasive surgery. RoboRetrieve enables a surgeon to deploy a forceps and a specimen-retrieval bag through a single port into the abdomen and perform spillage-free retrieval of an excised specimen. Experimental results revealed that RoboRetrieve can manipulate porcine meat samples up to a mass of 100g and perform spillage-free retrieval of phantom blood up to a volume of 1500μL. Further, RoboRetrieve is tested for single-tissue retrieval, multi-tissue retrieval, and retrieval in a realistic scenario using a laparoscopic simulator. RoboRetrieve has great potential in performing spillage-free retrieval tasks. Future work involves design improvements and more rigorous robot testing in realistic scenarios.

Detection of cryptic Taenia species from domestic and sylvatic transmission cycles in southern pudu deer (Pudu puda), Chile.

Chyloptysis indicates the presence of a lymphangio-bronchial fistula. This study compared the chest CT imaging features and clinical manifestations between CLA (complex lymphatic anomalies) patients with and without chyloptysis. A retrospective analysis was performed on 291 thoracic CLA patients (142 males, 149 females) admitted from December 2008 to February 2024. Divided into chyloptysis (152) and non-chyloptysis (139) groups, we compared their clinical data and chest CT features to find differences related to chyloptysis in CLA patients. The chyloptysis group had a significantly higher incidence of chyle pericardium, as well as more cystic lesions at the right lymphatic duct, and of the thoracic duct itself. In contrast, the non-chyloptysis group showed more cystic lesions of the liver, spleen, abdominal cavity, neck, and skeleton. All these differences were statistically significant (P < 0.05).The incidence of lymphedema in the non-chyloptysis group was higher than that in the chyloptysis group (P < 0.05), among which there was a significant statistical correlation between lymphedema of the lower limbs, lymphedema of the scrotum, lymphedema of the face and lymphedema of the upper limbs and chyloptysis (P < 0.05). The severity of chylopulmonary disease was closely related to the appearance of chyloptysis (P < 0.001). In terms of the characteristics of chest CT findings, the incidence of GGO, consolidation, grid shadow, vacuolar sign, nodular pleural thickening, solid nodules, perifascicular interstitial thickening, hilar opacity or swelling, and parapericardial effusion were higher in the chyloptysis group than in the non-chyloptysis group (P < 0.05). The analysis of these differences is of great clinical significance for understanding the distribution of chyloptysis in CLA patients with different CT signs, and it is convenient for clinicians to strengthen the risk prediction and management of chyloptysis in CLA patients.

Closure of the open abdominal cavity as a function of tension at the fascial edges: A prospective cohort trial.

Comprehensive evaluation of the abdominal cavity in ovarian cancer using hybrid minimally invasive surgery with the da vinci xi system: integrating mini-laparotomy and robotic techniques for optimal staging and cytoreduction.

ObjectivesPseudomyxoma peritonei (PMP), generally spread of low grade appendiceal mucinous neoplasm (mucinous appendix neoplasms) into the abdominal cavity, is conventionally treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Prognostic factors of small cohort sizes remain incomplete and conflicting. This large-scale study aimed to characterize long-term survival outcomes and identify prognostic factors in PMP patients following CRS-HIPEC.Materials and methodsWe conducted a retrospective cohort study of 432 consecutive PMP patients treated with CRS-HIPEC at Aerospace Center Hospital (Beijing, China) from June 2014 to December 2020. Overall survival (OS) served as the primary endpoint, with event-free survival (EFS) as the secondary endpoint. Multivariable Cox proportional hazards models were employed to identify independent prognostic factors.ResultsWith median survival durations of 56 months (OS) and 45 months (EFS), cumulative mortality and event incidence reached 21.4% and 32.4%, respectively. Independent predictors for poorer OS included: preoperative raised tumor markers (hazard ratio [HR] = 4.90–10.20; 95% confidence interval [95% CI]: 1.11–46.67; P < 0.05), completeness of cytoreduction (CC) score (HR = 3.37–9.41; 95% CI: 1.05–16.37; P < 0.05), and high-grade PMP (HR = 1.80; 95% CI: 1.10, 2.93; P = 0.019). EFS was significantly associated with preoperative Barthel index (HR = 0.86; 95% CI: 0.74, 0.98; P = 0.019) in addition to the aforementioned factors. Intraoperative hypotension and hyperthermia were not associated with both OS and EFS.ConclusionsKey factors impacting outcomes of patients with PMP of mucinous appendix neoplasms included preoperative elevated tumor markers, Barthel index, CC-score, and the PMP histology, without intraoperative hypotension and hyperthermia.

Introduction: An inguinal hernia occurs when tissue protrudes from the abdominal cavity through the inguinal canal. While several theories have been proposed regarding their origin, larger datasets on inguinal hernia incidence can help clarify its pathophysiology. This study aimed to identify the various types of inguinal hernias observed at our center and to investigate the associated risk factors.Methods: This retrospective study included 318 cases of inguinal hernia from February 2024 to February 2025. Complaints recorded were groin swelling with or without pain, family history, lifestyle choices, recurring constipation, bladder issues, and cough. Diagnosis relied on visible groin swelling or a palpable abdominal wall defect.Results: Out of 318 adult patients, 294 were male and 24 female, with a significant difference (P &lt; 0.01). The most common age group was 40–49 years (27% males, 45.74% females), followed by 50–59 years (22% males, 20.83% females). Most patients (58.5%) experienced swelling for less than a year; 7.1% for over two years. There was a significant difference (p&lt;0.05): 163 had right-side hernia, 74 left, and 81 both sides. Types included direct (182), indirect (102), and combined (34). Risk factors: heavy lifting (57.23%), improper bowel movements (43.3%), chronic cough (45%), smoking (41.2%), alcohol use (36.1%), straining during urination (33.33%), and coexisting conditions (13.2%). No risk factors were identified in 18%.Conclusion: In males, especially the right-sided direct type, inguinal hernias are more common than in females. Risk factors include lifting heavy objects, bladder problems, alcohol use, and other health conditions.