Giant peritoneal loose body: an instance of incidentaloma or warranted concern?

SUMMARY: In non-specific abdominal pain, cross-sectional imaging, often valued more than clinical examination in today's technologically advanced age, may reveal a large incidentaloma, posing questions regarding its relation to symptoms and the need for surgical removal. This is a situation that highlights the potential for early detection and treatment yet raises the question as to whether surgery is indeed indicated. This report relates the case of a 79-year-old male, with a longstanding history of abdominal pain, who had a giant loose peritoneal body removed. We discuss the reasons for removal and its pathogenesis.

Intestinal volvulus after conservative management of incidental midgut malrotation discovered at laparoscopic appendectomy in a teenager.

Midgut malrotation (MMR) is the abnormal rotation of the foetal midgut around the axis of the superior mesenteric artery which in symptomatic neonates requires a Ladd's procedure. We present a rare case of midgut volvulus occurring in a teenager 3 days after observational management of incidentally discovered MMR during laparoscopic appendectomy. A Ladd's procedure was performed and the patient is well at one-year follow up. We suggest prophylactic Ladd's procedure remains the treatment of choice for MMR even when discovered incidentally.

Hospitalization experiences of U.S. servicemembers before, during, and after participation in peacekeeping operations in Bosnia-Herzegovina.

BACKGROUND: There are relationships among morbidity experiences before, during, and after participation in overseas military operations. METHODS: U.S. servicemembers who deployed to Bosnia-Herzegovina during a 4-year period were classified based on their last hospitalizations prior to deploying. Hospitalization rates during and following deployment were calculated in relation to the timing and causes of pre-deployment hospitalizations. RESULTS: Deployers ever hospitalized pre-deployment were 120% and 50% more likely to be hospitalized during and following deployment, respectively. For nearly every category of diagnoses, hospitalization rates during and following deployment were highest among those hospitalized for the same category, intermediate among those hospitalized for other categories, and lowest among those not hospitalized prior to deploying. Deployers hospitalized within 1 month, 2-3 months, or > 3 months of deploying were 3.8, 2.6, and 1.4-times more likely to be hospitalized during deployment. CONCLUSIONS: The nature and recency of prior hospitalizations significantly determine during and post-deployment hospitalization risks.