Surgical treatment of type 2 giant mesenteric cyst: case report and literature review

Mesenteric lesions, including cysts, are rare abdominal tumours and in most cases non-neoplastic. They may have an asymptomatic course or present with pain, abdominal distension or intestinal obstruction. The suggested management is surgical resection of the lesions by laparotomy or minimally invasive surgery. We presented the case of a 48-year-old patient with progressive abdominal distension attributed to liver cirrhosis. Ultrasound and computed tomography of the abdomen showed evidence of a giant cyst of the mesentery with no evidence of tumor activity. We therefore decided to perform an exploratory laparotomy with cystectomy and omentectomy, follow-up and pathology report negative for malignancy

Chilaiditi's sign in complicated acute appendicitis: case report and literature review

Chilaiditi's condition refers to the presence of a loop of small intestine or colon between the diaphragm and the hepatic rim, usually due to alterations in the attachment of the liver to the diaphragm. Chilaiditi syndrome is associated with abdominal pain as the most common clinical manifestation. Pneumoperitoneum should always be ruled out in the context of these patients. We presented the case of a male in his eighth decade of life who presented with data suggestive of drug-modified acute appendicitis, for which computed tomography of the abdomen identified acute appendicitis and Chilaiditi's condition. An open appendectomy was performed without complications and the condition resolved

Clinical and genetic characteristics of late-onset Huntington's disease

Background: The frequency of late-onset Huntington's disease (>59 years) is assumed to be low and the clinical course milder. However, previous literature on late-onset disease is scarce and inconclusive. Objective: Our aim is to study clinical characteristics of late-onset compared to common-onset HD patients in a large cohort of HD patients from the Registry database. Methods: Participants with late- and common-onset (30–50 years)were compared for first clinical symptoms, disease progression, CAG repeat size and family history. Participants with a missing CAG repeat size, a repeat size of ≤35 or a UHDRS motor score of ≤5 were excluded. Results: Of 6007 eligible participants, 687 had late-onset (11.4%) and 3216 (53.5%) common-onset HD. Late-onset (n = 577) had significantly more gait and balance problems as first symptom compared to common-onset (n = 2408) (P <.001). Overall motor and cognitive performance (P <.001) were worse, however only disease motor progression was slower (coefficient, −0.58; SE 0.16; P <.001) compared to the common-onset group. Repeat size was significantly lower in the late-onset (n = 40.8; SD 1.6) compared to common-onset (n = 44.4; SD 2.8) (P <.001). Fewer late-onset patients (n = 451) had a positive family history compared to common-onset (n = 2940) (P <.001). Conclusions: Late-onset patients present more frequently with gait and balance problems as first symptom, and disease progression is not milder compared to common-onset HD patients apart from motor progression. The family history is likely to be negative, which might make diagnosing HD more difficult in this population. However, the balance and gait problems might be helpful in diagnosing HD in elderly patients