Retroperitoneal necrosectomy using lavage circuit as a new technique in the management of pancreatic infected walled off necrosis (WON): A case report.

INTRODUCTION: Walled off necrosis (WON) is clarified according to the revised Atlanta classification, 2013, as a late phase complication of acute necrotizing pancreatitis. Not all cases with WON need intervention but, if indicated both open approach and minimally invasive techniques were clarified. We are discussing here, a case presented to us with infected WON. We adopted the step up approach as the main line of treatment; the case was managed by percutaneous catheter drainage (PCD) followed by retroperitoneal necrosectomy using lavage circuit. CASE PRESENTATION: Diabetic male patient aged 58 year old gave to us with left hypochondrial pain accompanied with easy fatigability and poorly controlled DM. The patient had an attack of acute pancreatitis (AP) 2 months before admission. Abdominal CECT revealed infected WON. The case was managed successfully by retroperitoneal necrozectomy using lavage circuit after failure of PCD. DISCUSSION: A step up approach is followed for determining the optimal interventional strategy for patients presented with infected necrosis. We adopt retroperitoneal debridement using lavage circuit as a 2nd step in this approach. The concept of this technique is to facilitate the detachment of necrotic tissue using the force of saline while minimizing the risk of bleeding. CONCLUSION: Infected WON cases are representing as challenging, we require to get rid of the necrotic material with infected fluid and reduce the hazard of complications. In this technique, we have the advantage of retroperitoneal necrosectomy where we can remove only the loose necrotic tissue by saline force and so, reduce the possible bleeding risk.

Strategies for Molecular Imprinting and the Evolution of MIP Nanoparticles as Plastic Antibodies-Synthesis and Applications.

Materials that can mimic the molecular recognition-based functions found in biology are a significant goal for science and technology. Molecular imprinting is a technology that addresses this challenge by providing polymeric materials with antibody-like recognition characteristics. Recently, significant progress has been achieved in solving many of the practical problems traditionally associated with molecularly imprinted polymers (MIPs), such as difficulties with imprinting of proteins, poor compatibility with aqueous environments, template leakage, and the presence of heterogeneous populations of binding sites in the polymers that contribute to high levels of non-specific binding. This success is closely related to the technology-driven shift in MIP research from traditional bulk polymer formats into the nanomaterial domain. The aim of this article is to throw light on recent developments in this field and to present a critical discussion of the current state of molecular imprinting and its potential in real world applications.