Solitary fibrous tumor of the omentum: Presentation of a case and literature review

Solitary fibrous tumor (SFT) and hemangiopericytoma (HPC) were considered, since their firsts description in the literature, as separate entities. The World Health Organization (WHO) classification of soft tissue tumors in 2013 declared the term HPC obsolete, and considered these lesions as features of the extrapleural SFT category. Herein we present a rare case of SFT originating from the great omentum. A 68 years old woman was admitted to our hospital with acute abdominal pain. Computed tomography revealed a 142 x 102 x 100 mm solid mass located in the pelvis, that simulated an adnexal lesion. An explorative laparotomy was performed, and a mass of the great omentum with a significant vascular pedicle arising from a branch of the left gastroepiploic artery was revealed. The tumor was completely resected. Microscopically it was composed by non-organized and spindle-shaped cells exhibiting atypical nuclei, arranged in short fascicles, and was diagnosed as. An extensive search was conducted in public scientific databases for published articles on the topic, with the aim to comprehensively describe the demographic, clinical, pathological and prognostic features of SFT; 60 previous cases have been identified and reviewed

FIRST RESULTS ON THE PRESENCE AND THE MOLECULAR CHARACTERIZATION OF ANISAKID NEMATODES IN MARINE FISH CAUGHT OFF NORTHERN SARDINIA

Anisakidosis is a parasitic zoonosis caused by nematodes of the family Anisakidae, belonging to the genera Anisakis, Contracaecum and Pseudoterranova. Molecular studies have shown that Anisakis larvae comprise a number of sibling species, which have different genetic structures, hosts and geographical distribution. A great variety of fish species can harbour infectious third stage larvae of this nematode. The preliminary results of a study carried out to evaluate the occurrence of this parasite in commercial fish caught off northern Sardinia are herein reported. From October 2008 to November 2009, 599 specimens of 8 commercial fish species were examined for anisakid larvae through visual inspection of body cavity and peptic digestion of the muscle. Isolated Anisakis sp. larvae were observed at light microscope and identified as Type I or Type II (sensu Berland, 1961). Out of 599 fish examined, 239 (40%) were infected by 1187 anisakid larvae, belonging to the genera Anisakis (1169 Type I and 18 Type II) and Hysterothylacium (692). The molecular identification of Anisakis spp. was carried out on a subsample of 30% of Type I larvae and all Type II larvae. Specimens were firstly examined using a species-specific PCR, with primers designed for Anisakis pegreffii (APEF) and Anisakis physeteris (APHF), and ITS-2 of nuclear rDNA. The results were confirmed by the analysis of the ITS region of nuclear rDNA (ITS-1, 5.8S and ITS-2) using the restriction enzymes HinfI and HhaI in PCR-RFLP. Type I larvae examined were all identified as A. pegreffii, and Type II were all A. physeteris. This is the first contribution to the epidemiology and molecular characterization of Anisakis spp. in commercial fish caught off Sardinia

Ileocecal Fistula Caused by Multiple Foreign Magnetic Bodies Ingestion

The incidence of accidental foreign body (FBs) ingestion is 100,000 cases/year in the US, with over than 80% of cases occurring in children below 5 years of age. Although a single FB may pass spontaneously and uneventfully through the digestive tract, the ingestion of multiple magnetics can cause serious morbidity due to proximate attraction through the intestinal wall. Morbidity and mortality depend on a prompt and correct diagnosis which is often difficult and delayed due to the patient's age and because the accidental ingestion may go unnoticed. We report our experience in the treatment of an 11-year-old child who presented to the emergency department with increasing abdominal pain, vomiting, diarrhea, and fever. Surgery evidenced an ileocecal fistula secondary to multiple magnetic FB ingestion with attraction by both sides of the intestinal wall. A 5-centimeter ileal resection was performed, and the cecal fistula was closed with a longitudinal manual suture. The child was discharged at postoperative day 8. After one year, the patient's clinical condition was good

The Dilemma of Pneumatosis Intestinalis with Pneumoperitoneum: Nonoperative or Surgical Management—Analysis of a Case

Pneumatosis intestinalis (PI) is an uncommon condition and can be associated with a wide spectrum of diseases, ranging from life-threatening to innocuous conditions. We report the case of a 46-year-old women coming to our attention for an acute abdominal pain, nausea, vomiting, constipation, and increased inflammatory marks, with a CT showing pneumoperitoneum and pneumatosis intestinalis. The previous diagnosis was advanced neoplasia of unknown origin. Despite the surgical intervention, which excluded an ischemic colitis, the patient died in the early postoperative period. The postmortem diagnosis was carcinoma of thymus gland, and the presence of pneumatosis was put down to metastasis nodes in the pulmonary parenchima. This case demonstrates the wide spectrum of presentation of pneumatosis intestinalis, the importance of a careful radiologic evaluation beside the clinical history, since the identification of correct pathogenesis and treatment can be very difficult

MICROBIOLOGICAL AND CHEMICAL TESTING OF FOOD SNAILS MARKETEDS IN SARDINIA

A total of 29 samples of snails belonging to the species Helix aspersa, Helix aperta and Helix vermiculata were analysed for the presence of Salmonella spp. and Clostridium perfringens; Cadmium and Lead concentrations were determined by ICP-MS. One sample contained Salmonella sp.; Clostridium perfringens were not detected. The means of toxic metals (expressed as mg/Kg wet weight) were the following: Cd 0,995, Pb 0,274. Key word

Long-Term Functional Outcome after Internal Delorme's Procedure for Obstructed Defecation Syndrome, and the Role of Postoperative Rehabilitation

PURPOSE: To evaluate long-term functional outcomes of Internal Delorme's Procedure (IDP) in patients refractory to conservative treatment for Obstructed Defecation Syndrome (ODS), and to compare those who received postoperative rehabilitation with those who did not. MATERIALS AND METHODS: All patients with ODS refractory to nonoperative therapy were identified across three regional pelvic floor referral hospitals, and IDP was performed. Postoperatively selected patients received biofeedback therapy. Functional outcomes were established using the Cleveland Clinic Constipation (CCC) score and obstructed defecation score (OD score) preoperatively at 12 months and at the last available follow-up. Patient satisfaction was assessed with a visual analogue score. RESULTS: From October 2006 to September 2013, IDP was performed in 170 patients: 77 received postoperative biofeedback and 93 did not. Mean follow-up was 6.3 years (range 1-8 years). CCC and OD scores improved significantly in both groups after 12 months and at the last follow-up (p > 0.05). When comparing two groups while there was no significant difference between CCC and OD scores at 12 months, score was significantly better in the group that received rehabilitation at the last follow-up (p = 0.001). Patient satisfaction was higher in the rehabilitation group (67%) compared with those without rehabilitation (55%). Clinical recurrence was recorded in nine patients who did not have postoperative rehabilitation. CONCLUSIONS: It has been demonstrated that IDP is associated with good long-term functional outcomes. Patients receiving rehabilitation had a better long-term follow-up, a higher overall satisfaction, and lower recurrence rate when compared with the patients who did not receive postoperative rehabilitation

Association between the donor to recipient ICG-PDR variation rate and the functional recovery of the graft after orthotopic liver transplantation: A case series

Background: Despite current advances in liver transplant surgery, post-operative early allograft dysfunction still complicates the patient prognosis and graft survival. The transition from the donor has not been yet fully understood, and no study quantifies if and how the liver function changes through its transfer to the recipient. The indocyanine green dye plasma disappearance rate (ICG-PDR) is a simple validated tool of liver function assessment. The variation rate between the donor and recipient ICG-PDR still needs to be investigated. Materials and methods: Single-center retrospective study. ICG-PDR determinations were performed before graft retrieval (T1) and 24 hours after transplant (T2). The ICG-PDR relative variation rate between T1 and T2 was calculated to assess the graft function and suffering/recovering. Matched data were compared with the MEAF model of graft dysfunction. Objective: To investigate whether the variation rate between the donor ICG-PDR value and the recipient ICG-PDR measurement on first postoperative day (POD1) can be associated with the MEAF score. Results: 36 ICG-PDR measurements between 18 donors and 18 graft recipients were performed. The mean donor ICG-PDR was 22.64 (SD 6.35), and the mean receiver's ICG-PDR on 1st POD was 17.68 (SD 6.60), with a mean MEAF value of 4.51 (SD 1.23). Pearson's test stressed a good, linear inverse correlation between the ICG-PDR relative variation and the MEAF values, correlation coefficient -0.580 (p = 0.012). Conclusion: The direct correlation between the donor to recipient ICG-PDR variation rate and MEAF was found. Measurements at T1 and T2 showed an up- or downtrend of the graft performance that reflect the MEAF values

Obstructed defaecation syndrome: European consensus guidelines on the surgical management.

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