Alteration of the anatomy following Roux-en-Y gastric bypass (RYGB) poses a significant challenge in choledocholithiasis management patients who have undergone this operation. Many options exist, including endoscopic, surgical, percutaneous, or hybrid means with variable success rates. Treatment should progress from least to most invasive options. We present case two years managed percutaneous transhepatic stone advancement duodenum. The aim is highlight different for dealing pathology.

Cystic artery pseudoaneurysms (CAP) are rare and occur as a result of chronic inflammatory conditions or trauma including difficult laparoscopic cholecystectomy. We present case 66-year-old female who presented to our emergency room with two-day history abdominal pain, jaundice, melena, symptoms which were retrospectively identified components Quincke's triad. After an initial endoscopic retrograde cholangiopancreatography (ERCP), the patient underwent attempted cholecystectomy complicated...

Abstract Background Anorectal malformations and Hirschsprung’s disease are congenital conditions impacting the digestive system, with a particularly uncommon co-occurrence, estimated at 2–3% of all ARM cases. This case series explores this rare association through three distinct cases, each presenting unique clinical challenges insights. Methods We report five patients who were concurrently diagnosed HD based on radiological evaluations, definitive confirmation obtained rectal biopsy. In...

ABSTRACT Objectives: The purpose of the present study was to ascertain whether pediatric patients with chronic abdominal pain had concurrent fructose intolerance as determined by a standardized dose breath hydrogen test (BHT), and symptoms would improve low‐fructose diet. Methods: BHT administered evaluated in clinic unexplained alone or associated constipation, gas bloating, and/or diarrhea. were given standard 1 g/kg maximum 25 g. Hydrogen methane measured at 8 time points. presumed...

Abstract Background Hepatocellular carcinoma (HCC) is the prevailing primary liver tumor. To pick HCC at initial stages quite strenuous, despite advent of serum biomarkers, mainly alpha-fetoprotein (AFP), to predict development and progression HCC. One proposed biomarker for diagnosis micro-RNA 486-5p (miRNA 486-5p). Hence, current study was conducted interrogate role miRNA in a cohort Egyptian patients with hepatitis C virus (HCV) related cirrhosis (LC). This case–control included...

Abstract Disclosure: K. Barney: None. D. Tahir: A. Pannu: R. Saeed: Background: Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist which has been proven to reduce weight in those with obesity and improve glycemic control patients type II diabetes mellitus. The effect of semaglutide on kidney function not well established. phase 3b SUSTAIN trials revealed that when compared other GLP-1 agonists, exhibited more frequent acute injuries [1-3]. 6 trial reported two instances renal...

Pectoralis major (PM) rupture is a rare injury, commonly misdiagnosed, that affects mostly young male athletes aged 20-40 years. This type of injury typically associated with weight lifting, especially bench pressing. In an occupational medicine setting, it extremely and not much reported in the literature. We present case 30-year-old trauma technician who presented right shoulder chest pain following popping sensation while pushing full momentum patient on gurney accidentally set break...

Small bowel obstruction (SBO) is associated with high morbidity and mortality in acute care surgery practice, hernias constituting a significant portion of the underlying etiology. Physical examination maneuvers such as changing extremity position patient can further improve clinician's diagnostic acumen to identify cause disease. We present case SBO an 83-year-old female whose physical exam was consistent obturator hernia.

Intussusception is a rare cause of bowel obstruction caused by both benign and malignant pathology. We are presenting the case an elderly patient who had been diagnosed with irritable syndrome for many years prior to us ileocecal intussusception causing small obstruction. Laparoscopic resection terminal ileum cecum was performed. Pathology revealed multiple submucosal lipomas as underlying cause.

Distributive (vasodilatory) shock is common in patients admitted to the intensive care unit (ICU). Treating distributive presents a challenge, especially if patient tachyphylactic commonly used vasopressors. This case report illustrates use of newly approved vasopressor with vasodilatory resulting from motor vehicle injury. A 56-year-old man was brought our emergency department (ED) hemodynamically unstable requiring aggressive resuscitation. The results his evaluation were consistent...

Meckel's diverticulum (MD) is a common congenital defect of the small intestinal tract resulting from incomplete obliteration vitellointestinal duct. It presents with unexplained gastrointestinal bleeding, bowel obstruction, and inflammation. In rare instances, presentation perforation similar to acute appendicitis perforation. The symptoms, clinical exam, radiological findings our patient, 38-year-old male, were consistent perforated appendicitis; he was found have intraoperatively.

Intussusception, defined as the telescoping of one segment gastrointestinal tract into an adjacent one, is a rare cause abdominal pain in adult population due to underlying benign or malignant pathology. With liberal use CT evaluation patients with pain, diagnosis became more reliable. Resection bowel recommended treatment most cases. We are presenting case 76-year-old male patient who presented three-week history and diarrhea. The was consistent ileocolic intussusception. Robotic resection...

Purpura fulminans (PF) is a dermatologic manifestation of an underlying life-threatening condition associated with disseminated intravascular coagulation and skin necrosis. The known categories include protein C deficiency or abnormalities other systems (inherited acquired), acute infectious PF idiopathic. We describe case induced by Escherichia coli-associated bacteremia.

Intrathoracic esophageal anastomotic leaks after cancer resection are very morbid and challenging problems. Esophageal stents play an integral role in the management of these patients. Herein, we present a case lower who developed leak at his gastroesophageal anastomosis was successfully managed with fully covered metal stent. Our objective to remind our colleagues regarding safe alternative treatment for this complication.

De novo thrombosis of the inferior vena cava (IVC) can cause significant morbidity and mortality. Calcified thrombus IVC is an extremely rare incidental finding associated with recurrent deep venous (DVT) pulmonary embolism (PE). We present a case abdominal pain secondary to calcified in supra-hepatic region IVC.

Our patient is a 58-year-old female who presented to our emergency room with left upper quadrant abdominal pain the day after outpatient screening colonoscopy. A computed tomography (CT) scan of abdomen and pelvis revealed grade III spleen injury. She was admitted intensive care unit, gradual decline in her hematocrit noticed. The did well discharged from hospital splenic artery embolization.

Small bowel obstruction (SBO) is a major cause of morbidity and financial burden in hospitals around the world. Foreign body (FB) ingestion as rare. While most cases are straight forward, some can be extremely subtle. We present case SBO caused by an undigested piece pineapple core.

Intussusception, as a rare cause of small bowel obstruction, can be secondary to benign or malignant pathology. Malignant lesions causing intussusception primary metastatic lesions. Metastasis occur many years later. We present case melanoma in 69-year-old man the underlying etiology his intussusception. The patient had laparoscopic Roux-en-Y gastric bypass four prior presentation and did recall excision skin at age 64. Laparoscopic open surgical resection is best therapeutic option cases such this.

A 35-year-old male, a horse trainer, was brought to the emergency room after being kicked in abdomen, which resulted an abdominal wall hematoma and blow-out rupture of proximal jejunum, with mesenteric tear posterior lumbar disc herniation. The initial evaluation did not raise significant concerns; however, patient's pain progressively worsened administration oral contrast preparation for computed tomography (CT) scan. patient well exploration operative repair small bowel injury. Our...

Pseudoaneurysm of the hepatic and/or less frequently cystic artery is a rare but potentially fatal complication following laparoscopic cholecystectomy. While procedure safe with minimal morbidity, complications do occur even in experienced hands. Moreover, patient selection utmost importance. These aneurysms usually present hemobilia few weeks after surgery; however, free rupture into peritoneal cavity can occur. Transarterial embolization initial management approach when available and...

A 53-year-old mentally retarded male was brought to our emergency room after vomiting a plastic glove. Computed tomography revealed marked gastric distention containing large amount of residual food debris. Endoscopic retrieval unsuccessful. Surgical removal the foreign bodies done. The patient did well and discharged from hospital.

Eighteen-year-old restrained male driver involved in a flip over motor vehicle accident resulting seatbelt injury triad ( rectus abdominis muscle disruption, to the sigmoid colon and infra-renal aortic dissection). The patient did well after surgical resection of colon, repair endovascular aorta. Our objective is shed light on this potentially fatal injury.

Angiomyolipoma (AML) is a mesenchymal tumor that arises from perivascular epithelioid cells most commonly seen in the kidney and rarely extrarenal sites. Adrenal AML rare clinical entity with only 16 cases reported literature according to World Health Organization report 2017. We present 68-year-old male evaluated our emergency room worsening chronic right upper quadrant abdominal pain. Computerize tomography (CT) revealed large adrenal mass. Adrenelectomy was performed, histopathology...