Abdominal computed tomography and exploratory laparotomy have high agreement in dogs with surgical disease.

OBJECTIVE: To compare the results of abdominal CT with exploratory laparotomy in the dog. ANIMALS: 100 client-owned dogs from 1 academic institution. METHODS: Medical records were searched for dogs that had undergone a preoperative abdominal CT scan read by a board-certified veterinary radiologist followed by an exploratory laparotomy. CT and surgical reports were compared. RESULTS: The overall agreement between abdominal CT scan and exploratory laparotomy in all cases was 97%. Overall, there was no evidence that proportion agreement differed on the basis of body condition score, time interval between CT and surgery, or oncologic versus nononcologic disease. CLINICAL RELEVANCE: Abdominal CT scan read by a board-certified diplomate is a sensitive presurgical diagnostic tool for surgical abdominal disease in the dog. When performing a specific abdominal surgery, it is acceptable for the surgeon to fully explore the abdomen or forego it for a smaller approach to the organ of interest if an abdominal CT was performed prior.

A case report of a giant ileocecal cystic prolapse through the anus and literature review.

Intussusception refers to the invagination of a proximal loop of the bowel into an adjacent distal segment. This condition is rare in adults, especially when it involves a complete folding of the ileocecal area out of the body cavity. Meanwhile, enterogenous cysts are congenital malformations that are largely identified in childhood following symptoms of bowel obstruction. While surgical treatment is ultimately required for both diseases, deciding on the type of surgery and the right time to operate can be a challenge for clinicians. It is especially difficult to decide on treatment for an adult with the coincidental occurrence of both conditions and no definitive pathologic diagnosis prior to surgery. Here, we present the case study of a 19-year-old female patient who presented with a prolapsed anus due to intussusception caused by a large ileocecal mass. The patient was admitted to the emergency department with a "massive anal mass." She remained symptomatic after receiving conventional conservative treatment and had to undergo emergency surgery after developing an intestinal obstruction. While the patient's intraoperative condition also confirmed the preoperative CT findings, the situation became more complicated during surgery. The postoperative pathological report indicated the presence of an enterogenous cyst. After recovery from surgery, the patient was successfully discharged. Intussusception or intestinal obstruction caused by an intestinal mass is a surgical indication, and removal is the only way to cure the condition. This case study provides a helpful reference for general surgeons, especially anorectal surgeons, imaging physicians, and pathologists, and informs the diagnosis and treatment of this patient population.

Sudden and unexpected deaths due to non-traumatic abdominal disorders: A forensic perspective.

Sudden and unexpected deaths due to non-traumatic abdominal disorders are a disregarded topic in the forensic field. These conditions are very heterogenous, accounting for 1-5% of sudden deaths. Specifically, acute gastrointestinal hemorrhages, bowel obstructions, liver cirrhosis, and necrotizing pancreatitis are frequently reported, whereas there are also unusual conditions which deserve careful analysis. Furthermore, the postmortem examinations of such disorders are not straightforward in the forensic setting since advanced putrefaction of the body, alleged medical malpractice, or the absence of any medical records could complicate autopsy procedures. Thus, the use of forensic histopathology, toxicology, microbiology, and postmortem radiology may help the pathologists to identify the abdominal cause of death. In this paper, the authors aim to discuss most of congenital and acquired abdominal conditions that have resulted in sudden and unexpected deaths. Hence, the discussion of the pathological features of each abdominal organ or system is prefaced with practical examples from caseworks of the Milan Institute of Legal Medicine. However, this paper also shows an extensive literature review with selected medicolegal articles to detailly describe the lethal mechanisms related to each condition, along with any associated risk factors or other diseases. Finally, each section shows a focus on either novel forensic approach (when available) or medicolegal implications, such as the use of postmortem radiology, peculiar histopathologic findings, or allegations in medical malpractices.

Abdominal Cocoon With Intestinal Perforation: A Case Report.

Introduction: Abdominal cocoon is a very rare abdominal disease. Abdominal cocoon mainly leads to intestinal obstruction, and abdominal cocoon with gastrointestinal perforation is rare. Case Presentation: We report a 63-year-old man who was admitted to our hospital with "persistent lower abdominal pain for one day". Abdominal CT examination revealed a small amount of free gas in the abdominal cavity, ascites, and gastrointestinal perforation. An emergency operation was performed. During the operation, the end of the right lower abdominal ileum was found to be conglutinated and twisted into a mass, a local intestinal dilatation, and obstruction, local intestinal wall was black and gangrene, and fecal effusion flowed out. The adhesions were carefully separated, and the necrotic small intestine was removed. The operation process went smoothly, and the patient recovered well after the operation. Conclusion: The cases of intestinal perforation caused by the abdominal cocoon are very rare. In clinical work, when we encounter patients with gastrointestinal perforation, we need to carefully ask the history. When the patients had no digestive system diseases in the past, we need to consider the possibility of the abdominal cocoon with perforation.

Tandem Mass Tag (TMT) Proteomic Analysis of Saliva in Horses with Acute Abdominal Disease.

The aim of this study was to investigate the changes in the salivary proteome in horses with acute abdominal disease (AAD) using a tandem mass tags (TMT)-based proteomic approach. The saliva samples from eight horses with AAD were compared with six healthy horses in the proteomic study. Additionally, saliva samples from eight horses with AAD and eight controls were used to validate lactoferrin (LF) in saliva. The TMT analysis quantified 118 proteins. Of these, 17 differed significantly between horses with AAD and the healthy controls, 11 being downregulated and 6 upregulated. Our results showed the downregulation of gamma-enteric smooth muscle actin (ACTA2), latherin isoform X1, and LF. These proteins could be closely related to an impaired primary immune defense and antimicrobial capacity in the mucosa. In addition, there was an upregulation of mucin 19 (MUC19) and the serine protease inhibitor Kazal-type 5 (SPINK5) associated with a protective effect during inflammation. The proteins identified in our study could have the potential to be novel biomarkers for diagnosis or monitoring the physiopathology of the disease, especially LF, which decreased in the saliva of horses with AAD and was successfully measured using a commercially available immunoassay.

Greater-omentum lesion-score (GOLS) as a predictor of residual disease in different regions of the peritoneal cavity in patients undergoing interval cytoreductive surgery for advanced ovarian cancer and its potential clinical utility.

BACKGROUND AND AIM: The greater omentum(GO) is a common site of residual disease in patients receiving neoadjuvant chemotherapy for advanced epithelial ovarian cancer. The presence of tumor in the GO could predict presence of disease in other peritoneal regions. The goal of this study was to perform a correlation between the greater-omentum lesion-score(GOLS) and presence of disease in different peritoneal regions and determine its potential utility in guiding interval cytoreductive surgery(CRS). METHODS: This prospective study included 134 patients undergoing interval CRS from July 1, 2018 to June 30, 2020. Each region of Sugarbaker's Peritobneal Cancer Index(PCI) was given a lesion score(LS) from 0 to 3 according to the diameter of the largest tumor in the region. The GOLS was recorded separately from other structures in the region. Correlation between the GOLS and surgical and pathological LS in each region was performed. RESULTS: As the GOLS increased, the incidence of disease(surgical LS) in other regions of the peritoneal cavity increased. Receiver operating characteristic(ROC) curves showed area under curve more than 80% for regions 1-2 and 7-8 indicating a high probability of disease in these regions in patients with GOLS 1-3. The positive predictive value(PPV) of preoperative imaging for GOLS was 95.7%. No cut-off of the GOLS could predict presence of disease on pathology with more than 70% accuracy. CONCLUSIONS: Presence of disease in the GO warrants performing upper abdominal exploration and/or cytoreduction and interval CRS should be planned accordingly in these patients. Imaging has a high PPV in detecting disease in the GO.

Acute abdominal disease with nonspecific symptoms in the elderly: A case series.

Acute stomach disease in elderly patients often lacks characteristic clinical manifestations. Presentations may differ from those in younger patients and are often complicated by concomitant diseases, delayed presentation, and misdiagnosis. Incorrect diagnosis and treatment can lead to medical-related death claims. We investigated eight cases of elderly fatality due to acute abdominal diseases in forensic autopsy cases. Although most fatalities were unwitnessed, possibly due to the characteristics of elderly individuals, recent social backgrounds, and involvement with health care, some cases of possible misdiagnosis suggested that physicians should carefully consider atypical clinical manifestations and the characteristics of elderly individuals when the managing abdominal symptoms, particularly in primary health care. Our investigation of these forensic autopsy cases indicated the particular importance of peritoneal adhesions as an unexpected cause of acute abdomen in the elderly due to strangulation ileus, even among those with no history of abdominal surgery or trauma. Diagnosis of acute stomach symptoms can be difficult in elderly patients. Pathophysiological examination and autopsy analyses can thus contribute to early-stage diagnosis and prevention of acute stomach symptoms in elderly patient populations.

Extra-abdominal ovarian cancer presenting with breast metastases at diagnosis: Case report and literature review.

OBJECTIVE: Malignant ovarian tumours are diagnosed at an advanced stage in the majority of cases. However, only a small percentage present as extra-abdominal, non-lymph-node solid metastases, as in the breast, and they are usually cases of relapse. The discovery of mono- or bilateral breast lesions with peritoneal carcinosis and/or abdomino-pelvic lesions can be cumbersome in the differential diagnosis of primary tumours. This article aims to summarize current evidence on the detection of breast metastases at diagnosis of ovarian cancer. STUDY DESIGN: A systematic review of the literature in Scopus, PubMed/MEDLINE, ScienceDirect and the Cochrane Library, including case reports and case series, was undertaken. Data regarding study features; population characteristics; clinical, radiological and histological assessment of the disease; treatment and follow-up were collected. In addition, a case report of a patient managed at the authors' centre is provided. RESULTS: According to the search strategy, 16 articles (18 patients) were included in this review. Serous ovarian, fallopian tube or primary peritoneal cancer was detected in 61% of cases, while another type or a non-specified type of epithelial ovarian cancer was detected in 27.7% of cases; there was one case with granulosa cell tumour of the ovary and one case with mucinous ovarian tumour of low malignant potential. Breast metastases were mainly monolateral (66.6%), with other extra-abdominal sites of disease in the majority of the cases. A minority of patients (16.6%) received treatment for primary breast cancer with a subsequent diagnosis of ovarian cancer. Concomitant breast and abdominal surgery can be an option. PAX8, WT1 and CA125 immunohistochemical staining can aid in differential diagnosis. CONCLUSION: Breast metastases of malignant ovarian tumours must be promptly recognized to ensure proper treatment. Specific immunohistochemical analysis can be a decisive assessment in uncertain cases.

Retrospective evaluation of the association between admission blood glucose and l-lactate concentrations in ponies and horses with gastrointestinal disease (2008-2016): 545 cases.

OBJECTIVES: A recent study described increased l-lactate concentrations in ponies with gastrointestinal disease compared to horses, but blood glucose (BG) concentrations were not considered. The study tested the hypothesis that BG and l-lactate concentrations are correlated in horses and ponies with gastrointestinal disease and that BG concentrations, not equid type (pony vs horse), are an independent predictor of L-lactate concentrations. It was further hypothesized that equid type was an independent predictor of BG concentrations. DESIGN: Retrospective study 2008-2016. SETTING: University teaching hospital. ANIMALS: Admission data from 545 animals (384 horses and 161 ponies) with gastrointestinal disease. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Data collected included signalment, clinicopathological findings on admission, and nature and location of the gastrointestinal lesion (strangulating vs non-strangulating and large vs small intestinal lesion). The association between admission blood l-lactate concentrations, equid type (pony or horse) and BG concentrations was investigated in a multivariable model. Admission l-lactate and BG concentrations were strongly correlated (n = 522; r = 0.63; P < 0.001). Ponies had significantly higher l-lactate (2.7 mmol/L (0.5-18.0 mmol/L) vs 1.4 mmol/L (0.3-19 mmol/L); P < 0.001) and BG concentrations than horses (8.4 mmol/L (4.2-24.4 mmol/L); 151 mg/dL (76-439 mg/dL) vs 6.9 mmol/L (3.4-26.8 mmol/L); 124 mg/dL (61-482 mg/dL); P < 0.001). In the multivariable analysis, l-lactate concentrations were significantly and positively associated with admission BG concentrations in all animals and also with equid type. For each millimole per liter (18 mg/dL) increase in BG, l-lactate concentrations increased by 7.9% (5.9, 9.9); P < 0.001. In comparison to ponies, l-lactate concentrations were decreased by 27.7% (37.4, 16.5); P < 0.001 in horses. Admission BG concentrations were significantly and positively associated with l-lactate concentrations in all animals. For each millimole per liter increase in l-lactate concentration, BG concentration increased by 6.2% (4.7, 7.6; P < 0.001). Admission BG concentrations were not associated with equid type. CONCLUSION: Admission BG concentrations and equid type are independent predictors of blood l-lactate concentrations in equids with gastrointestinal disease, but their relationship requires further investigation.

Further analysis of the compatibility application of Inonotus obliquus in the treatment of gastrointestinal disordersin Russia / 国际中医中药杂志

This paper introduces the application of Inonotus obliquus in the rehabilitation treatment of gastrointestinal diseases in Russia. It is found that Inonotus obliquus is widely used in the treatment of gastrointestinal diseases. Inonotus obliquus can be compatible with Mentha nigrum, green walnut peel, Hypericum perforatum, chamomile, red Sorbus, Daisy, yarrow, Schisandra, Tilia, chamomile, fennel seed, marigold, plantain juice, dried potted leaves, burdock root, etc., and it has a good effect on diarrhea, constipation, gastric and duodenal ulcer, low acid gastritis, acute gastritis, dodecadactyly Enteritis and so on have certain curative effect.

Analysis on the compatibility of Inonotus obliquus in the treatment of gastrointestinal disordersin Russia / 国际中医中药杂志

Inonotus obliquus is a commonly used edible fungus in Russia. For centuries, it has been used to treat digestive tract diseases and tumors in the northern Russian countryside. Based on the relevant researches of the Soviet Union and Russia, this paper summarizes and analyzes the compatibility application of inonotus obliquus in the rehabilitation of gastrointestinal diseases. In the rehabilitation treatment of various gastrointestinal diseases, inonotus obliquus can be used alone or in combination with other drugs. In China, the difference in the source and the dosages should be paid the attention before the application..

Analysis on the compatibility of Inonotus obliquus in the treatment of gastrointestinal disordersin Russia / 国际中医中药杂志

Inonotus obliquus is a commonly used edible fungus in Russia. For centuries, it has been used to treat digestive tract diseases and tumors in the northern Russian countryside. Based on the relevant researches of the Soviet Union and Russia, this paper summarizes and analyzes the compatibility application of inonotus obliquus in the rehabilitation of gastrointestinal diseases. In the rehabilitation treatment of various gastrointestinal diseases, inonotus obliquus can be used alone or in combination with other drugs. In China, the difference in the source and the dosages should be paid the attention before the application..

Application of contrast-enhanced ultrasonography in pediatric abdominal disease / 中华超声影像学杂志

Objective To investigate the security,applicability and diagnostic capacity of intravenous contrast-enhanced ultrasound (CEUS) in a pediatric population. Methods A total of 53 pediatric patients (8 months to 18 years old) received 66 intravenous applications of ultrasound contrast agent SonoVue.Side effects were documented.Histology,reference imaging or clinical diagnosis were compared with CEUS diagnostic results. Results Adverse effects occurred in 1/66 applications (1.5% ). For 44 focal liver lesions,the sensitivity was 100%,the specificity was 95.65%,the positive predictive value was 95.45% and the negative predictive value was 100%.The diagnostic accuracy was 97.73%.All 22 other lesions were diagnosed correctly.Conclusions It is safe and feasible to use intravenous CEUS in children.CEUS is worthy of promotion in pediatric patients with abdominal diseases.

Blood lactate concentrations in ponies and miniature horses with gastrointestinal disease.

REASONS FOR PERFORMING STUDY: Clinical impression suggested that pony and miniature breeds (collectively referred to as ponies) presenting to a referral hospital for investigation of gastrointestinal disease had higher blood lactate concentrations on admission than large breed horses. OBJECTIVES: The study tested the hypothesis that ponies with gastrointestinal disease had higher blood lactate concentrations on admission than large breed horses with similar disease severity. STUDY DESIGN: Retrospective case-control study. METHODS: Medical records from September 2006 to July 2011 were reviewed for ponies with a primary presenting complaint of gastrointestinal disease. Two larger breed horses with gastrointestinal disease were selected as controls for each case. Data collected included case details, historical and clinicopathological findings, diagnosis and outcome. RESULTS: Information was collected on 50 ponies and 100 horses. Ponies had higher mean ± s.d. respiratory rates (27 ± 13 vs. 21 ± 13 beats/min; P = 0.01) and rectal temperatures (37.9 ± 0.6 vs. 37.4 ± 0.6°C; P = 0.006) and a longer median duration of clinical signs prior to presentation (10 h [1-72 h] vs. 6 h [1-120]; P<0.001). Median blood lactate concentrations on admission were higher in ponies than in horses (2.8 mmol/l [0.7-18.0] vs. 1.6 mmol/l [0.4-8.1]; P = 0.001). All other parameters relating to colic severity were not significantly different between groups, although more horses underwent exploratory laparotomy (19/50 ponies and 55/100 horses; P = 0.05). Median blood lactate concentrations in ponies with large intestinal disease, nonstrangulating lesions, undergoing medical treatment and surviving ponies were significantly higher than in horses in the same category. In contrast to horses, no differences in blood lactate concentrations exist between ponies with medical vs. surgical treatment, strangulating and nonstrangulating lesions and surviving and nonsurviving ponies. CONCLUSION AND POTENTIAL RELEVANCE: Ponies might present with higher blood lactate concentrations than horses and might falsely be suspected of having a surgical lesion or a poorer prognosis if veterinarians are not aware of breed differences.

Diagnosis of Abdominal Organs Diseases by Contrast-Enhanced Ultrasonography / 昆明医科大学学报

Objective To investigate the efficacy of contrast-enhanced ultrasound (CEUS) in diagnosing liver, gallbladder, spleen and renal diseases. Methods 27 patients with liver diseases, 30 patients with gallbladder diseases, 5 patients with renal diseases, 5 patients with renal trauma and 6 patients with spleen disease were examined by CEUS. Results There were 3 cases of primary hepatocellular carcinomas, 4 cases of metastatic hepatic carcinomas, 4 cases of liver abscess, 10 cases of hepatic hemangiomas and 3 cases of liver repture with active bleeding. The diagnostic coincidence rate of CEUS was 90%. 30 patients with gallbladder polyposis were diagnosed by CEUS, and the diagnostic coincidence rate was 100%. 5 cases with renal diaseses included 1 of renal abscess, 1 of renal column hypertrophy and 3 of renal hemangioma. In 5 cases with renal trauma, there were 3 cases with renal contusion and 2 cases with renal rupture and active bleeding. The coincidence rate was 61%. In 6 cases with spleen diseases, there were 1 case with splenic infraction, 1 case with splenic abscess and 4 cases with splenic rupture and hemorrhage. The coincidence rate was 100%. Conclusion CEUS has great value of clinical application in diagnosis of liver, gallbladder, spleen and renal diseases.

Operation of Acute Abdominal Disease in HIV Carriers / 中国医师杂志

Objective To explore the method and efficacy of treating acute abdominal disease in HIV carriers.Methods To summarize experience of performing operations on eight HIV carriers suffering acute abdominal disease in an east African country from March 1997 to May 1999.Results The eight HIV carriers received treatment by performing emergency operation and taking anti-virus medicine. Among the eight HIV carriers followed up for 6-32 months post-operatively, seven carriers have recovered well up to present, while one carrier died of AIDS after completing the operation for three months. The died HIV carrier with peritonitis conducted a abdominal drainage in the operation, after which, the carrier's CD 4 lymphocyte number was checked below 100/mm 3.Conclusions We can achieve satisfied therapeutic effects under the condition that we do not adapt a discriminate and dilatory attitude towards curing HIV carriers suffering acute abdominal disease. Furthermore, it is very important to prevent the HIV spreading during and after the operation.So medical staffs in hospital should also strengthen self-prevention from HIV.

Treating intra-abdominal fluid collection holes

From 1999 to July 2000, 17 cases (3 female and 14 male) of intra-abdominal fluid collection after a surgical intervention or an injury of liver, pancreas, or after an acute pancreatitis without any signs of peritonitis were treated. The sizes of collection holes were ranged from 49 to 76 mm. 14 cases were treated by percutaneous drainage with ultrasonic guiding. Good results were recorded in 13 cases, only 1 failure in the case of fistula of cecum. No complication was noted.

CT Diagnosis of Atraumatic Acute Abdominal Disease / 实用放射学杂志

Objective To study the value of CT diagnosis of atraumatic acute abdominal disease and how to select CT scan rationally.Methods The CT findings of 319 cases of atraumatic acute abdominal disease were reviewed restrospectively.Results Of 319 cases,226 cases of non-traumatic acute abdomen had positive findings on CT,the positive rate was 70.84%.Of them,the diseases included:urinary tract system in 63 cases,bile system in 62 cases,pancreas in 41 cases,gastro-intestinal system in 37 cases and others in 23 cases.The positive rate of CT findings was higher with aging in non-traumatic acute abdomen.Conclusion CT is of diagnostic value in atraumatic acute abdominal disease.

Analysis and prevention of complications in abdominal disease patients with liver cirrhosis / 中国现代普通外科进展

Objective:To study the methods of prevention and occurrence of complications in abdominal operation patients with liver cirrhosis.Methods:Analys is the occurrence of postoperative complications and influencing factors in 41 cases in abdominal diseases patients with liver cirrhosis.Results:The incidence rate of postoperative complications was 63.4%(26/41),19 patients with 1 complication,7 patients with 2 or more than 2 complications.Five patients died,Mortality was 12.2%(5/41).Ascites,Child classification,portal hypertension,esophageal varices and intraopera-tive bleeding were influencing factors of occurrence of postoperative complications in abdominal disease patients with liver cirrhos is analyzed using Logistic regression analysis.Conclusion:Positive perioperative management,reducing the intraoperative and postoperative bleeding,Intra-abdominalinfection prevention and ascitic treatment are importent factors in reducing postoperative complications and mortality.