A rare case report of complete transposition of the femoral artery and vein

In the inguinal region at normal anatomical situation the artery is positioned lateral to vein and by this figure artery and vein get out under inguinal ligament and entrance to this region. Every surgeon (general surgeon, vascular surgeon or orthopaedic) that works at this region should know anatomical anomaly and variation of these vessels in inguinal region. Dissection at this region without knowing these variations could damage the vessels especially femoral artery. Some times this variations could induce compression on the vein and induce deep vein thrombosis. In this case while exploring femoral artery for transfemoral thrombectomy, femoral vein was found in the arteries anatomical position and complete transposition of artery and vein was founded. In conclusion, knowing normal variations and anomalies while dissecting this area helps us for lowering iatrogenic vascular trauma and complications.     &nbsp

Duodenal GIST mass with big management challenges

Introduction: Gastrointestinal stromal tumor (GIST) is a rare mesenchymal tumor of the gastrointestinal (GI) tract that usually occurs in the stomach and the small intestine, respectively. This tumor often occurs in people over the age of 40 years, especially in the fifth and sixth decades of life. The range of symptoms varies from asymptomatic to symptomatic depending on the size and location of the tumor. The standard diagnostic of this tumor is the pathological examination of tissue specimens. Also today, the main treatment for this tumor is surgery and resection of the tumor.  Case Report: A 43-year-old woman presented with melena and a decrease in hemoglobin level to 4. The patient underwent upper and lower GI endoscopy, CT angiography, and EUS, which was reported a vascular lesion below the ampulla of vater. After laparotomy and Whipple procedure, pathology reported tumor as GIST. The patient was discharged from the hospital in good general condition.  Conclusion: we suggest that patients presented with gastrointestinal bleeding and the presence of a lesion in the diagnostic modalities, GIST should always be considered as a differential diagnosis. &nbsp

Folate-conjugated nanoparticles as a potent therapeutic approach in targeted cancer therapy

The selective and efficient drug delivery to tumor cells can remarkably improve different cancer therapeutic approaches. There are several nanoparticles (NPs) which can act as a potent drug carrier for cancer therapy. However, the specific drug delivery to cancer cells is an important issue which should be considered before designing new NPs for in vivo application. It has been shown that cancer cells over-express folate receptor (FR) in order to improve their growth. As normal cells express a significantly lower levels of FR compared to tumor cells, it seems that folate molecules can be used as potent targeting moieties in different nanocarrier-based therapeutic approaches. Moreover, there is evidence which implies folate-conjugated NPs can selectively deliver anti-tumor drugs into cancer cells both in vitro and in vivo. In this review, we will discuss about the efficiency of different folate-conjugated NPs in cancer therapy.NoneManuscrip

Primary Aortoenteric Fistulae: What Every Surgeon Should Know About Its Diagnosis and Treatment

Aortoenteric fistula is a rare finding that is potentially fatal and is usually seen as a fistula between the aorta or an aortic graft and the third part of the duodenum. The type without the presence of an artificial graft is considered as primary and the other type as secondary. The patients usually present with the heralding symptom of minor hematemesis, which later leads to massive and mortal GI bleeding. The most important factor in the diagnosis of an aortoenteric fistula is to have a high clinical suspicion after taking an appropriate and accurate history. In hemodynamically stable patients with clinical suspicion, performing an intravenous-contrast-CT scan of the abdomen and pelvis is of assistance in diagnosis. In general, stable hemodynamics greatly reduces the suspicion for diagnosis. Treatment is often surgical, and in regard to the severity of abdominal contamination or the level of visible infection, the extra anatomical or insitu graft repair is considered as the method of choice. This article tries to transfer our experiences in two patients, each of whom presented with hematemesis and melena without a history of underlying aortic aneurysm