Ileum perforation due to accidental chicken bone ingestion a rare cause of the acute abdomen

Ingestion of foreign bodies is not an uncommon occurrence, but most of them will pass through the gastrointestinal tract without consequences. Complication such as perforation is rare. We present a case of small bowel perforation secondary to the accidental ingestion of a chicken bone. The patient presented with abdominal pain, constipation and vomiting. Clinical examination confirmed generalized abdominal tenderness and rebound tenderness. Abdominal radiography showed multiple dilated loops of small bowel, and abdominal ultrasound (US) showed inflammatory changes on small bowel loops, with free fluid and fluid collection around intestinal loops. The patient underwent an emergency laparotomy. Intra operative findings revealed diffuse fibro purulent peritonitis with abscess between central small bowels loops. At about 60 cm from Bauchini valve we found a perforation of ileum at the anti-mesenteric site caused by a sharp chicken wishbone. The patient was treated with resection of the ileum segment (10 cm) and primary end-to-end anastomosis. Even that intestinal perforation by a foreign body is rare, physicians should consider possibility of intestinal perforation by a foreign body in the differential diagnosis of acute abdomen in patients presenting with abdominal pain

Procena koeficijenta naslednosti za osobine porasta kod ovaca

The objective of this research paper was to estimate heritability coefficients (heritability) of growth traits in the lambs of indigenous Sjenicka Pramenka breed. The research was conducted on a sample which included 421 lambs the descendants of 15 sires and 187 sheep-dams, raised on 3 private farms in Kolubarski district, Serbia. The effect of fixed factors was studied while the values of heritability coefficients were estimated within the frame of SAS software package. A statistically highly significant (**=P lt 0.01) effect on studied traits had following parameters: sex, year of lambing, type of lambing, farm and method of applied reproductive technology. By means of REML method and using the sire model the values of heritability coefficients were determined for the following traits: average lamb birth weight (BW0), average lamb body weight at 30 days (BW30) and average lamb body weight at 90 days (BW90) being: 0.0355; 0.4642 and 0.3018, respectively.Cilj rada bio je da se procene koeficijenti naslednosti (heritabilitet) osobina porasta kod jagnjadi sjeničke pramenke. Istraživanje je sprovedeno na uzorku od 421 jagnjadi, potomaka 15 očeva i 187 ovaca-majki sa 3 privatne farme u Kolubarskom okrugu. Ispitan je uticaj fiksnih faktora i procenjene su vrednosti koeficijenata naslednosti u okviru SAS softverskog paketa. Visoko statistički značajan (**=P lt 0,01) uticaj na ispitivane osobine imali su: pol, godina jagnjenja, tip jagnjenja, farma i metod primenjene reproduktivne tehnologije. Metodom intraklasne korelacije polusrodnika po ocu utvrđene su vrednosti koeficijenta naslednosti za osobine: prosečna telesna masa jagnjadi na rođenju (BW0), prosečna telesna masa jagnjadi sa 30 dana starosti (BW30) i prosečna telesna masa jagnjadi sa 90 dana starosti (BW90) i iznosile su: 0,0355; 0,4642 i 0,3018, respektivno

ACCESORY AND ECTOPIC LIVER LOBE AT SAME PATIENT:CASE REPORT

ntroduction: Accessory liver lobes (ALL) are defined as supranumerary liver lobes, composed of normal liver parenchyma in continuity with the liver, in contrast to ectopic liver lobes (ELL) that have no anatomical continuity with the normal liver. Case report:In this article we report on a rare radiological diagnosis of an synchronous accessory and ectopic liver lobe using ultrasonography (US) and computed tomography (CT). A 59-year-old female with no symptoms was admitted to our hospital due to preventive exam. Abdominal ultrasonography revealed a high echoic 6cm x 5cm soft tissue area in right anterior subhepatic space with distinct margins, a uniform echo and blood flow and was suspected to be abdominal tumor. An enhanced abdominal computed tomography (CT) showed the irregular 65mm x 48mm x 32mm mass in the right hypochondrium below IV and V liver segment with clear margins, a uniform density, texture and contrast enhancement as normal liver tissue. In same patient CT also showed small 16mm x 12mm mass in posterior mediastinum in right retrocrural space so diagnosis of accessory and ectopic liver lobe was confirmed. An accessory liver lobe is adjacent and attached to the liver by its own mesentery, while an ectopic liver lobe is one that is completely detached from the normal liver parenchyma. Conclusion:Ultrasound can show mass in the abdomen, which is most commonly in the subhepatic area, but very rarely can initially diagnose ALL or ELL due to different echogenicity of the liver parenchyma in different acoustic windows. In the case of an atypical CT presentation, an MR examination of the abdomen is indicated but it is very rarely. Fast and accurate radiological diagnosis of ALL and ELL is important in the prevention of unnecessary invasive diagnostic procedures such as laparotomy and thoracotomy which are needed only in cases of complications

Influence of genotype, farm and test year on trait variability in performance test of gilts

The production traits of gilts were examined in two pig herds for three consecutive years. The study included 3,610 gilts of 3 genotypes, originating from 84 boar sires. The test included only those boar sires who had 10 or more daughters. At the end of the test, the weight and thickness of the fat (FT1 and FT2) and depth were measured by anBMD ultrasound apparatus. The aim of this study was to determine the phenotypic and genotypic variability of the observed traits in the performance test of gilts: age at the end of the test (FA – final age), lifetime daily gain (LDG), fat thickness 1 and 2 (FT1 and FT2) and back muscle depth (BMD). In the first herd there were 1228 gilts and in the second 2382 gilts tested. Within the Landrace (L) breed there were 1962 gilts, Large white (LW) 1324 and Duroc (D) 319 gilts. In the first year, 885 gilts were tested, in the second 1145 and in the third 1580 gilts. Based on the results obtained, the genotype of gilts was found to have a statistically significant effect (P0.05). Considering the farm as a source of variation in gilt traits, it was concluded that the farm had a highly significant statistical effect on the traits tested (P<0.001). The year of testing of gilts as a source of variation in their traits showed a high statistical influence (P <0.001) on all traits examined. Observed traits - fat thickness 1, 2 and BMD were highly statistically dependent (P <0.001) on the weight at the end of the test

Effect of year, lambing season, sex and birth type on early performance in MIS lambs

Considering the fact that sheep production has an important role in agriculture of Serbia, lamb performance is essential. Objective of the study was to investigate effect of year, lambing season, sex and birth type on growth performances in lambs of MIS breed. Animal data (birth date, birth type, sex, birth weight -BW0, body weight after 30 days - BW30 and body weight after 90 days – BW90) are gained from control of productive parameters maintained from 2011 to 2020. Research was conducted on the sample of 1592 lambs. Average daily gain from birth to 30 days (ADG1), from 30 to 90 days (ADG2), and from birth until 90 days (ADG3), were calculated and included in analysis. Calendar year was divided in four seasons, each season consists from 3 months: winter, spring, summer and autumn. Average body weights (± standard deviation) at birth, after 30 and 90 days were 4.41 kg (± 0.99), 14.11 kg (± 2.80), 24.05 kg (± 3.86), respectively. Average daily gains were 319.87 g (± 74.97), 164.98 g (± 35.39) and 216.88 g (± 36.86) for ADG1, ADG2 and ADG3, respectively. Lambing type and sex of the lambs affected all of the observed traits very significantly (p < 0.01). Lambing year had very significant effect (p < 0.01) on BW30, on ADG1 and ADG2, while lambing season significantly (p < 0.05) affected BW90, ADG2 and ADG3.Based on the results it can be concluded that birth type and sex had strongest effects in early productive parameters of lambs.S obzirom na to da ovčarstvo ima važnu ulogu u poljoprivredi Srbije, produktivnost jagnjadi je od izuzetnog značaja. Cilj istraživanja je bio da se ispita uticaj godine, sezone jagnjenja, pola i tipa rođenja na produktivne parametre jagnjadi MIS rase. Podaci o životinjama (datum rođenja, tip rođenja, pol, telesna masa na rođenju -BW0, telesna masa posle 30 dana - BW30 i telesna masa nakon 90 dana - BW90) su dobijeni kontrolom proizvodnih parametara održanih od 2011. do 2020. godine, na uzorku od 1592 jagnjadi. Prosečan dnevni prirast od rođenja do 30 dana (ADG1), od 30 do 90 dana (ADG2), i od rođenja do 90 dana (ADG3), izračunat je i uključen u analizu. Kalendarska godina je podeljena na četiri godišnja doba (zima, proleće, leto i jesen), a svako godišnje doba sastoji se od 3 meseca. Prosečna telesna masa (± standardna devijacija) pri rođenju, posle 30 i 90 dana bila je 4,41 kg (± 0,99), 14,11 kg (± 2,80), 24,05 kg (± 3,86), redom. Prosečni dnevni prirasti iznosili su 319,87 g (± 74,97), 164,98 g (± 35,39) i 216,88 g (± 36,86) za ADG1, ADG2 i ADG3, redom. Tip rođenja i pol jagnjadi značajno su uticali na sve ispitivane osobine (p < 0,01). Godina rođenja imala je veoma značajan uticaj (p < 0,01) na BW30, na ADG1 i ADG2, dok je sezona jagnjenja značajno (p < 0,05) uticala na BW90, ADG2 i ADG3. Na osnovu rezultata može se zaključiti da su tip i pol rođenja imali najjače efekti u ranim produktivnim parametrima jagnjadi

RUPTURE OF A PANCREATIC PSEUDOANEURYSM AS A CONSEQUENCE OF CHRONIC PANCREATITIS: CASE REPORT OF A SURGICAL EMERGENCY

Introduction: Pseudoaneurysms of the pancreaticoduodenal arcade are rare, accounting for approximately 2% of all visceral artery aneurysms. They typically arise as complications of chronic pancreatitis, peptic ulcer disease, trauma, pancreatic and biliary surgery, or pancreas transplantation. Diagnosis often occurs only after rupture, leading to life-threatening internal bleeding. Bleeding may occur within a pseudocyst, with blood passing through the Vater’s papilla into the digestive tract, or may result in the formation of a retroperitoneal hematoma that can rupture into the abdominal cavity, causing hemoperitoneum. The cell-saver is a tool that can be utilized for intraoperative blood cell salvage and autologous transfusions. Case Report: Our patient, a 54-year-old male, an untreated alcoholic with no prior medical history or documented treatment, presented to the Clinic for Emergency Surgery at the University Clinical Center of Serbia with a sudden onset of upper abdominal pain. A quick ultrasound of the abdomen was performed, followed by an urgent CT scan of the chest and abdomen, revealing a hematoma extending from the right retroperitoneum and mesentery of the intestine, measuring 150x109x180mm in diameter, with signs of active bleeding in the region beneath the pancreas, indicative of hemoperitoneum. Due to hemodynamic instability, accompanied by a drop in arterial blood pressure and hemoglobin levels, an urgent laparotomy was performed. Active bleeding was identified from a ruptured pseudoaneurysm originating from the pancreaticoduodenal arcade. Hemostasis was achieved followed by tamponade, and the tampons were removed 30 hours post-surgery. The patient remained hemodynamically stable thereafter, recovered well from the surgery, and was discharged home in good general condition. Intraoperatively, we utilized the Cell-saver to collect the patient’s blood and subsequently administered autologous transfusion. Conclusion: In patients with chronic pancreatitis presenting with sudden abdominal pain and hemodynamic instability accompanied by a drop in arterial pressure, hemoglobin, and hematocrit levels, the possibility of a ruptured pseudoaneurysm in the pancreatic or peripancreatic region should be considered. Timely diagnosis and prompt surgical intervention are crucial for a successful outcome. Effective collaboration among radiologists, anesthesiologists, and surgeons is essential. The utilization of the Cell-saver system significantly aids in maintaining cardiac output and hemodynamic stability in these patients

Spontaneous atypical muscle bleeding of the anterior abdominal wall in patient with COVID-19 – case report

COVID-19 is an unpredictable disease that can lead to multiorgan dysfunctions. There is a high frequency of venous and arterial thrombosis, among other symptoms,. Spontaneous bleeding in COVID-19 patients has also been described, but rarely, whether or not they are on anticoagulant therapy. We report a case of a 65-year-old female COVID-19 patient treated in our hospital. During the hospitalisation, she experienced sudden, severe pain in the lower part of the abdomen and had signs of hemorrhagic shock. CT of the abdomen and pelvis revealed a spontaneous giant haematoma of the anterior abdominal wall. A surgical procedure was done. We identified spontaneous bleeding in the muscles of the anterior abdominal wall. The patient recovered well. Rapid diagnosis and timely intervention are crucial to ensure a good patient outcome

The impact of breeding region and lactation on milk yield traits in the of Simmental cattle population of the Republic of Serbia

The objective of this research was to study phenotypic expression and factors that can affect milk yield traits in the population of Simmental cattle breed in the Republic of Serbia. The research was conducted on a set of data that included records on the production and origin of Simmental breed cows displayed both in regional and municipal exhibitions in the territory of the Republic of Serbia in the period from 2004 to 2017. A final data set included records on production and origin of 1176 Simmental breed cows. The animals were raised in the area covering 9 regions of the Republic of Serbia. The research included most important milk yield traits in standard lactation: milk yield, milk fat content, milk fat yield, yield of 4% fat corrected milk (4%FCM). An average milk yield in studied population accounted for 5.520±919 kg, milk fat content 3.94±0.11%, milk fat yield 218±38 kg, while the yield of 4% fat-corrected milk accounted for 5.474±933 kg. It was determined that region, age and lactation had a very high statistically significant effect on studied traits while the age of cows had no statistical effect

Postoperative pain management in non-traumatic emergency general surgery: WSES-GAIS-SIAARTI-AAST guidelines

Background Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. Material and methods An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Conclusion Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies

Postoperative pain management in non-traumatic emergency general surgery : WSES-GAIS-SIAARTI-AAST guidelines

Background Non-traumatic emergency general surgery involves a heterogeneous population that may present with several underlying diseases. Timeous emergency surgical treatment should be supplemented with high-quality perioperative care, ideally performed by multidisciplinary teams trained to identify and handle complex postoperative courses. Uncontrolled or poorly controlled acute postoperative pain may result in significant complications. While pain management after elective surgery has been standardized in perioperative pathways, the traditional perioperative treatment of patients undergoing emergency surgery is often a haphazard practice. The present recommended pain management guidelines are for pain management after non-traumatic emergency surgical intervention. It is meant to provide clinicians a list of indications to prescribe the optimal analgesics even in the absence of a multidisciplinary pain team. Material and methods An international expert panel discussed the different issues in subsequent rounds. Four international recognized scientific societies: World Society of Emergency Surgery (WSES), Global Alliance for Infection in Surgery (GAIS), Italian Society of Anesthesia, Analgesia Intensive Care (SIAARTI), and American Association for the Surgery of Trauma (AAST), endorsed the project and approved the final manuscript. Conclusion Dealing with acute postoperative pain in the emergency abdominal surgery setting is complex, requires special attention, and should be multidisciplinary. Several tools are available, and their combination is mandatory whenever is possible. Analgesic approach to the various situations and conditions should be patient based and tailored according to procedure, pathology, age, response, and available expertise. A better understanding of the patho-mechanisms of postoperative pain for short- and long-term outcomes is necessary to improve prophylactic and treatment strategies.Peer reviewe