Liver Serosa Research Articles

Cestode and nematode larvae of hygienic-sanitary importance parasitizing Balistes capriscus Gmelin, 1789, collected from fish markets of the state of Rio de Janeiro, Brazil

Balistes capriscus is an appreciated fish species in the state of Rio de Janeiro, Brazil, due its excellent quality flesh. The constant presence of helminth larvae in the abdominal musculature, viscera and serosa of individuals of the species has been the subject of complaints among local fish traders because of economic losses due to their repugnant aspect. Considering their hygienic-sanitary importance and significance for collective health, the presence of helminth larvae was investigated in 44 individual fish of B. capriscus purchased from fish markets in the municipalities of Rio de Janeiro, Niterói, Campos dos Goytacazes and Cabo Frio, state of Rio de Janeiro, in 2017–2018. Cestode larvae, identified as Diphyllobothriidae gen. sp. and Callitetrarhynchus gracilis, were found parasitizing the abdominal cavity, abdominal musculature, mesentery and liver serosa. Nematode (Raphidascaridiidae) third-instar larvae, identified as Hysterothylacium deardorffoverstreetorum and Raphidascaris sp., were found parasitizing stomach, intestine, liver, spleen, liver serosa, mesentery and abdominal cavity. The highest parasitic indices were for Raphidascaris sp., with prevalence of 70.45%, mean intensity of 15.61, mean abundance of 11 and infection range of 1–76 specimens per host. Considerations of the zoonotic potential and hygienic-sanitary significance of these helminths are presented to increase food safety for consumers.

Helminth larvae of hygienic-sanitary importance parasitizing Fistularia petimba Lacepède, 1803, collected from fish markets of the municipality of Cabo Frio, RJ, Brazil

Fistularia petimba is a fish species that has gained growing interest due to its appreciation for sushi and sahimi in Japanese restaurants of the coastal cities of Cabo Frio and Armação de Búzios, state of Rio de Janeiro, Brazil. The constant presence of helminths in the viscera, serosa and adjacent musculature of this fish has been the subject of important complaints among local fish traders, because of economic losses due to their repugnant aspect. Considering their hygienic-sanitary importance and significance for collective health, the presence of helminth larvae was investigated in 32 individual fish of F. petimba purchased from fish markets in the municipality of Cabo Frio in 2019. Cestode larvae, identified as Tentacularia coryphaenae, were found parasitizing the abdominal cavity and mesentery. Nematode larvae, identified as Hysterothylacium fortalezae and H. deardorffoverstreetorum, were found parasitizing stomach, intestine, liver, spleen, liver serosa, mesentery and abdominal cavity. Hysterothylacium fortalezae had the highest parasitic indices, with a prevalence of 43.75%, mean intensity of 8.07, mean abundance of 3.53 and range of infection of 3-25 specimens per host. Considerations of the zoonotic potential and hygienic-sanitary significance of these helminths are presented to increase food safety for consumers.

S1942 Microscopic Hematuria Leading to the Diagnosis of Appendiceal Mucinous Carcinoma

Introduction: Appendiceal mucinous neoplasms (AMNs) are an exceedingly rare gastrointestinal malignancy with in incidence of 2.8 cases per million, accounting for less than 1% of all GI cancers, and approximately 1,500 new cases in the US annually. AMNs typically present as acute appendicitis, given the predilection for appendiceal perforation, however as many as 23% are incidentally diagnosed. They are generally thought to be indolent compared to their colorectal counterparts and rarely metastasize outside of the peritoneum. Case description/methods: A 71-year-old female with a 6 pack-year smoking history and long-term methotrexate use for lichen planus presented to her PCP’s office for her annual evaluation. Routine urinalysis at that time showed microscopic RBCs so CT abdomen/pelvis was ordered and showed a 7.9 × 4.8 × 5.1 cm complex right adnexal cyst with adjacent free fluid. Subsequent pelvic ultrasound re-demonstrated the same plus a thickened 6 mm endometrial strip. MRI pelvis was pursued and showed this large adnexal cystic mass to be contiguous with the tip of the appendix, in addition to multiple uterine fibroids. After an unremarkable cystoscopy, suspicions were raised for an exophytic ovarian neoplasm, so the patient proceeded with laparoscopic bilateral salpingo-oophorectomy, appendectomy, collection of pelvic ascites, peritoneal biopsies and liver serosa biopsy, hysteroscopy and endometrial polypectomy. Intraoperatively, the patient had a mucinous fluid covering her pelvic and abdominal cavity with normal appearing uterus, and a ruptured 6 cm complex mass encompassing the appendix. Pathology revealed low grade primary appendiceal mucinous carcinoma with rupture and mucin extravasation, without gynecologic dysplasia. Colonoscopy was then done and only a 3 mm sessile polyp with benign morphology was found in the descending colon. PET CT showed no evidence of metastatic disease. The hospital course was complication by septic shock with polymicrobial bacteremia requiring prolonged mechanical ventilation and tracheostomy. She was discharged to an acute rehab hospital around 8 weeks later, and at 6-month follow-up had no disease recurrence. Discussion: Demonstrated is of the many potential red herrings observed in the evaluation of invasive GI cancers, emphasizing the importance of maintaining broad differentials and an interdisciplinary approach. Also unique was the lack of substantial symptoms despite rupture of said AMN and peritoneal spread - often an acutely clinically significant and painful event.Figure 1.: Figure A: Whirl sign on CT, with a dilated descending colon. Figure B-C: Benign-appearing, intrinsic twisted stenosis in the descending colon. Markedly dilated descending colon after a gentle advance of the colonoscope. The rectal tube was navigated proximal to the volvulus area. Figure D: Abdominal x-ray showing resolution of massive colonic distension after detorsion and rectal tube placement.

Structure and surgical dissection layers of the bare area of the liver

BackgroundThe bare area was reportedly formed by direct adhesion between the liver and diaphragm, meaning that the bare area lacked serosal components. This study aimed to analyze the structure of the bare area by an integrated study of surgical and laparoscopic images and pathological studies and describe surgical procedures focusing on the multilayered structure.MethodsSeveral surgical specimens of hepatectomy were analyzed histologically to evaluate the macroscopic structure of the bare area. Laparoscopic images and cadaver anatomy of the bare area were also examined.ResultsThe multilayered structure of the bare area comprised the liver, sub-serosal connective tissue, liver serosa, parietal peritoneum, retroperitoneal connective tissue, epimysium of the diaphragm, and diaphragm, in order from the liver to the diaphragm. The liver serosa and the parietal peritoneum fused with each other. This multilayered structure of the bare area is observed almost constantly. There are two layers in the dissection of the bare area in surgical procedures, an outer layer of the fused peritoneum (near the diaphragm) and an inner layer of the fused peritoneum (near the liver). Laparoscopic images enabled us to recognize the multilayered structure of the bare area.ConclusionsHistopathological findings showed the bare area to be a multilayered structure. In cases where tumors are located underneath the bare area, it could be important to dissect the bare area, with careful attention to its multilayered structure. Surgical dissection of the bare area in the outer layer of the fused peritoneum could allow a sufficient safety margin.

Caracteres morfológicos e significí­¢ncia higiênico sanitária de Tentacularia coryphaenae em Coryphaena hippurus do Brasil

Coryphaena hippurus, ou dourado, é uma espécie popular de peixe pescada em torneios de pesca esportiva do Iate Clube do Rio de Janeiro, a qual é comercializada na própria peixaria do clube, devido í­Â apreciação de sua carne. Contudo a presença de helmintos, inclusive na musculatura, resulta em perdas comerciais devido ao seu aspecto repugnante. O objetivo desta investigação foi identificar taxonomicamente estes helmintos utilizando dados de análises morfométricas e morfológicas através das microscopias ótica e eletrônica de varredura e determinar sua significí­¢ncia higiênico-sanitária. Em janeiro e novembro de 2014, sete espécimes de C. hippurus foram necropsiados e seus órgãos investigados. Os helmintos encontrados foram identificados como plerocercoides de Tentacularia coryphaenae, um cestoide Trypanorhyncha. Os sete espécimes de C. hippurus estavam parasitados por um total de 204 plerocercoides, tendo como sí­­tios de infecção a musculatura, mesentério, estômago e serosa do fí­­gado. Além da repugní­¢ncia destes parasitos, a presença de plerocercoides é um fator preocupante, porque há o risco de reações alérgicas em humanos, salientando-se, então, a significí­¢ncia higiênico-sanitária no monitoramento destes parasitos.

Long Term Influence of Carbon Nanoparticles on Health and Liver Status in Rats.

Due to their excellent biocompatibility, carbon nanoparticles have been widely investigated for prospective biomedical applications. However, their impact on an organism with prolonged exposure is still not well understood. Here, we performed an experiment investigating diamond, graphene oxide and graphite nanoparticles, which were repeatedly administrated intraperitoneally into Wistar rats for four weeks. Some of the animals was sacrificed after the last injection, whereas the rest were sacrificed twelve weeks after the last exposure. We evaluated blood morphology and biochemistry, as well as the redox and inflammatory state of the liver. The results show the retention of nanoparticles within the peritoneal cavity in the form of prominent aggregates in proximity to the injection site, as well as the presence of some nanoparticles in the mesentery. Small aggregates were also visible in the liver serosa, suggesting possible transportation to the liver. However, none of the tested nanoparticles affected the health of animals. This lack of toxic effect may suggest the potential applicability of nanoparticles as drug carriers for local therapies, ensuring accumulation and slow release of drugs into a targeted tissue without harmful systemic side effects.

Different Patterns of Disease Spread between Advanced-Stage Type I and II Epithelial Ovarian Cancer

Background and Aims: Two types of epithelial ovarian carcinoma (EOC) have been recently distinguished. Type I comprises low-grade serous, endometrioid and clear-cell tumors. High-grade endometrioid and serous tumors belong to type II. The aim of this study was to compare patterns of disease spread in advanced-stage type I and II EOCs at primary surgery. Methods: Surgical and pathological data of 233 patients with advanced-stage EOCs were collected, 42 with type I and 191 with type II. The two groups were compared for tumor localization at primary surgery. Intraoperative mapping of ovarian cancer (IMO) was used to assess tumor dissemination. Results: Tumor involvement was significantly higher in the type II group for the following: peritoneum (68.1 vs. 40.5%, p < 0.001), pouch of Douglas (60.2 vs. 40.5%, p = 0.06), vesicouterine ligament (40.8 vs. 19%, p = 0.027), diaphragm (45.0 vs. 11.9%, p < 0.001), serosa of liver (17.2 vs. 4.8%, p = 0.05), omentum (81.1 vs. 59.5%, p = 0.007), mesentery (42.9 vs. 16.7%, p = 0.005), pleural effusions (19.4 vs. 4.6%, p = 0.01) and ascites (60.7 vs. 21.4%, p < 0.001). IMO levels were different between the two groups (p = 0.001). Conclusions: This study provides clinical evidence in favor of the dualistic model of carcinogenesis, since types I and II are characterized by different findings at primary surgery.

Anisakidae and Raphidascarididae larvae parasitizing Selene setapinnis (Mitchill, 1815) in the State of Rio de Janeiro, Brazil.

Between February and August, 2012, thirty specimens of Atlantic moonfish, Selene setapinnis, were purchased in local markets in Niterói, State of Rio de Janeiro, Brazil, with the aim of analyzing the presence of anisakid nematodes, establishing their rates of parasitism and infection sites, due to importance in the sanitary inspection. A total of sixty nematode larvae, belonging to at least two species were found: nine larvae of Terranova sp., Anisakidae, with prevalence (P) of 13.3%, mean intensity (MI) of 2.25, mean abundance (MA) of 0.30 and range of infection intensity (RI) from 1 to 6; and 51 larvae of Hysterothylacium fortalezae, Raphidascarididae, with P = 26.7%, MI = 6.40, MA = 1.70, and RI = 1-17. The infection sites for Terranova sp. were the mesentery and liver serosa; and for H. fortalezae, the infection sites were the mesentery, abdominal cavity and liver serosa. New morphological data from scanning electron microscopy, on the external structures of H. fortalezae (mainly at the posterior end), are presented. This is the first report of H. fortalezae parasitizing S. setapinnis.

A novel liver retractor for reduced or single-port laparoscopic surgery

Retraction of either lobe of liver is required for surgical access to the respective organ. A novel liver retractor device and technique is described, which applies a vacuum between the liver and diaphragm to lift the liver, and which does not require additional incisions. A novel liver retractor was tested in two anesthetized sheep at incrementally higher levels of suction from -100 to -700 mmHg (-13 to -93 kPa), and any signs of trauma were recorded. The animals recovered for 5 days, then were humanely killed and postmortem examination of the liver and diaphragms performed. Successful liver retraction was achieved from -200 to -600 mmHg (-27 to -80 kPa) suction. An imprint of the retractor was observed on the liver surface, but there was no breach of the liver serosa. Negligible ecchymoses were observed on the corresponding surface of the diaphragms. Both sheep recovered well after surgery. There was no macroscopic evidence of injury to the liver and diaphragm 5 days postoperatively. Histological examination revealed normal liver parenchyma deep to the site where the devices had been placed, and hemorrhagic changes within the serosa only varied between a few microns to a maximum of 1.4-mm depth. The novel liver retractor described achieved an effective liver retraction without trauma. It has potential application in reduced or single-port laparoscopic upper abdominal surgery.

Nematodes of zoonotic importance in Cynoscion guatucupa (Pisces) in the state of Rio de Janeiro

Between January and August 2012, thirty specimens of Cynoscion guatucupa (Cuvier, 1830) caught off coast of the municipality of Itajaí, state of Santa Catarina, Brazil (26° 54' 28″ S and 48° 39' 43″ W) and commercialized in the state of Rio de Janeiro were investigated for the presence of zoonotic nematodes. In total 853 larvae of four nematode parasite species were found. There were three species of Anisakidae: three larvae of Anisakis sp., with prevalence (P) of 10%, mean intensity (MI) of 1.0, mean abundance (MA) of 0.1 and infection site (IS) in the mesentery; five of Terranova sp. with P = 13.3%, MI = 1.25, MA = 0.17, range of infection (RI) from 1 to 2 and IS = mesentery; and seven of Contracaecum sp. with P = 6.6%, MI = 3.5, MA = 0.23, RI = 1 to 4 and IS = mesentery and abdominal cavity. There was one species of Raphidascarididae: 838 larvae of Hysterothylacium deardorffoverstreetorum with P = 83.3%, MI = 33.52, MA = 27.93, RI = 1 to 219 and IS = mesentery, liver serosa and abdominal cavity. This is the first report of larvae of Anisakis sp. and Contracaecum sp in C. guatucupa in Brazil. Hysterothylacium deardorffoverstreetorum; Anisakis sp.; Terranova sp.; Contracaecum sp.; Cynoscion guatucupa.

An unusual complication of tubal anastomosis

Objective To report an unusual complication associated with the use of a long-term intrafallopian stent during microsurgical tubal anastomosis. Design Case report. Setting Tertiary academic center. Patient(s) A 36-year-old woman in whom an intrafallopian stent used during a sterilization reversal procedure could not be transcervically retrieved in the office. Intervention(s) Hysteroscopic evaluation for removal of intrafallopian stent, followed by operative laparoscopy for postoperative abdominal pain. Main outcome measure(s) Patient symptoms, potential for morbidity, and review of the literature. Result(s) Hysteroscopic view of the uterine cavity failed to identify the intrafallopian stent. Laporoscopic evaluation of postoperative abdominal pain revealed significant formation of pelvic and abdominal adhesions. The 2-0 nylon suture used as an intrafallopian stent was seen sitting freely on top of the liver serosa. Adhesiolysis and successful retrieval of the stent resolved the patient’s symptoms. Conclusion(s) To our knowledge, this is the first report describing complete dislodgment and cephalad migration of an intrafallopian stent. Patient morbidity and health care costs may increase when long-term stents are used for sterilization reversal.

Origin and distribution of potassium bromate-induced testicular and peritoneal mesotheliomas in rats.

Tissue sections were examined from a 2-year bioassay of male Fischer 344 rats treated with potassium bromate administered in drinking water. All animals exhibiting peritoneal mesotheliomas also had mesotheliomas of the tunica vaginalis testis mesorchium (the reverse was not true), and the correlation of these 2 types of mesotheliomas was highly significant (r2 = 0.98). Mapping of the tunica vaginalis tumors at all time points and at all bromate concentrations revealed a pattern of increasing incidence of tumor formation on the mesothelium of the tunica vaginalis testis as a function of proximity to the mesorchial ligament. Thus, the mesorchium appears to be the major mesothelial target site for potassium bromate-mediated carcinogenesis. The frequency of occurrence of mesotheliomas by location was tunica vaginalis testis (25%), mesosplenium (20%), mesentery (10%), mesojejunum/mesocolon (8%), bladder (6.5%), mesogastrium (13%), liver serosa (5%), and kidney, small intestine, and rectum (1% each). A complete cross-section of the rat testis was prepared and used to construct a complete map of the mesothelium. Any attempt to determine the role of local dose and tissue susceptibility for the purpose of interspecies risk extrapolation must take into account the complex anatomy and physiology of this region of the visceral and testicular suspensory apparatus. Improved histologic approaches are needed for adequate assessment of this delicate suspensory system.