Surgical Interventions for the Management of Obesity-Related Joint Pain: A Narrative Review.

Obesity-related joint pain is a common and debilitating condition that significantly impacts the quality of life, primarily due to the excess weight straining the joints. This results in inflammation and degeneration, which can cause pain, stiffness, and difficulty moving. We aimed to comprehensively review the literature discussing surgical interventions for obesity-related joint pain. We searched across databases (PubMed, Scopus, and Cochrane Library) to identify studies published between 2000 and 2023 that assessed surgical interventions for obesity-related joint pain. This review highlights the complex interplay of mechanical, inflammatory, and metabolic factors contributing to joint pain in obese individuals, highlighting both surgical and non-surgical interventions. Non-surgical interventions include weight loss, exercise, physical therapy, and medications. Surgical interventions include bariatric surgery and joint replacement surgery. Bariatric surgery significantly reduces body weight and improves the quality of life outcomes; however, multiple studies have found no improvement or worsening of joint pain post-surgery. Total joint arthroplasty has demonstrated good improvement in pain and function outcomes based on recent meta-analyses, although risks of complications are higher in obese patients. The treatment choice for obesity-related joint pain depends on the individual patient's circumstances. Non-surgical interventions are usually the first line of treatment. However, if these interventions are not effective, surgical interventions may be an option.

Retraction: Colonic Angiolipoma: An Extremely Rare Tumor Clinically Masquerading as Acute Appendicitis.

[This retracts the article DOI: 10.7759/cureus.20659.].

Pediatric Neck Swelling: A Case Report of Fourth Branchial Cleft Cyst.

Pediatric neck masses present a diagnostic challenge, encompassing various etiologies, including rare entities like branchial cleft anomalies. Branchial cleft cysts, resulting from incomplete embryonic cleft obliteration, may become symptomatic. This case report describes a seven-year-old boy who presented with a week-long history of fever and progressively enlarging left anterior cervical swelling. Physical examination revealed a fluctuant, non-tender mass, prompting diagnostic investigations. Laboratory results indicated an elevated white blood cell count and inflammatory markers. Computed tomography identified a hypodense, rim-enhancing mass consistent with an abscess secondary to a fourth branchial cleft cyst. Ultrasound-guided aspiration yielded purulent material, confirming Staphylococcus aureus infection. This case highlights the clinical significance of fourth branchial cleft cysts as rare inflammatory neck masses in pediatric patients. The embryological context informs their diverse anatomical manifestations. Surgical excision remains the primary treatment, demanding consideration of anatomical complexities.

Colonic Angiolipoma: An Extremely Rare Tumor Clinically Masquerading as Acute Appendicitis.

The clinical presentation of right iliac fossa pain, anorexia, and vomiting are the classic clinical features of acute appendicitis. However, a broad spectrum of manifestations may result in a similar clinical picture, including gastrointestinal, genitourinary, and gynecologic pathologies. Imaging studies are crucial to establishing the diagnosis. Here, we report the case of a 58-year-old man who presented to the emergency department with a one-week history of right lower quadrant abdominal pain. The pain was associated with nausea, vomiting, and frequent bowel motions. There was no history of fever or weight loss. The examination of the abdomen showed localized tenderness and guarding in the right iliac fossa. The basic laboratory investigation was within the reference range. The computed tomography scan demonstrated a well-circumscribed intraluminal mass lesion in the ascending colon with no evidence of complete obstruction. The mass was slightly heterogeneous but had fat attenuation. There was no evidence of invasion. There was no stranding of the adjacent fat. The radiological findings were consistent with colonic lipoma. The patient underwent laparoscopic surgery and had a segmental resection of the tumor with primary anastomosis. The appendix was also resected. Histopathological examination showed mature adipose cells along with thin-walled, capillary-sized vessels representing a benign angiolipoma. Further, the resected appendix was completely normal and showed no evidence of acute inflammation. Colonic angiolipoma is an extremely rare tumor. This case demonstrated that a large angiolipoma of the ascending colon may show a presenting clinical picture similar to that of acute appendicitis. Complete resection of the tumor is associated with an excellent outcome.