Primary omental torsion with clinical masquerading as acute appendicitis and radiological key for diagnosis.

Omental torsion is a medical condition characterized by the twisting of the omentum along its longitudinal axis, which leads to compromised blood flow. This condition is rarely diagnosed before surgery and can present symptoms similar to other causes of acute surgical abdomen. This report details a case of primary omental torsion initially suspected to be acute appendicitis. The patient was admitted to the hospital with symptoms of lower right quadrant abdominal pain and mild fever. Computed tomography imaging revealed a twisted mass of fatty tissue with surrounding fat stranding changes, but no signs of appendicitis were found, indicating omental torsion. The patient underwent surgery to remove the twisted and necrotic omentum, leading to an improvement in symptoms. This case highlights the challenges in diagnosis and the crucial role of computed tomography imaging in managing this rare condition.

Expression of SUMO and NF-κB genes in hepatitis B virus-associated hepatocellular carcinoma patients: An observational study.

Alterations in signaling pathways and modulation of cell metabolism are associated with the pathogenesis of cancers, including hepatocellular carcinoma (HCC). Small ubiquitin-like modifier (SUMO) proteins and NF-κB family play major roles in various cellular processes. The current study aims to determine the expression profile of SUMO and NF-κB genes in HCC tumors and investigate their association with the clinical outcome of HCC. The expression of 5 genes - SUMO1, SUMO2, SUMO3, NF-κB p65, and NF-κB p50 - was quantified in tumor and adjacent non-tumor tissues of 58 HBV-related HCC patients by real-time quantitative PCR and was analyzed for the possible association with clinical parameters of HCC. The expression of SUMO2 was significantly higher in HCC tumor tissues compared to the adjacent non-tumor tissues (P = .01), while no significant difference in SUMO1, SUMO3, NF-κB p65, and NF-κB p50 expression was observed between HCC tumor and non-tumor tissues (P > .05). In HCC tissues, a strong correlation was observed between the expression of SUMO2 and NF-κB p50, between SUMO3 and NF-κB p50, between SUMO3 and NF-κB p65 (Spearman rho = 0.83; 0.82; 0.772 respectively; P < .001). The expression of SUMO1, SUMO2, SUMO3, NF-κB p65, and NF-κB p50 was decreased in grade 3 compared to grades 1 and 2 in HCC tumors according to the World Health Organization grades system. Our results highlighted that the SUMO2 gene is upregulated in tumor tissues of patients with HCC, and is related to the development of HCC, thus it may be associated with the pathogenesis of HCC.

Acute appendicitis induced by bone fragment ingestion: A pediatrics case report.

Acute appendicitis is an ordinary surgical emergency, typically attributed to luminal obstruction by fecaliths or lymphoid hyperplasia. However, ingested foreign bodies as an etiology are rare but increasingly recognized, particularly in pediatric patients. We present the case of a 9-year-old male patient who presented to the emergency department with symptoms consistent with acute appendicitis. Further investigation revealed the presence of a bone fragment within the appendix, leading to acute inflammation. Foreign body ingestion should be considered in pediatric patients with acute appendicitis. This case report underscores the importance of comprehensive clinical evaluation and appropriate diagnostic imaging modalities in guiding optimal treatment strategies.

Epidural injection-related pneumorrhachis: A case report with cauda equina syndrome.

Pneumorrhachis (PR) is an uncommon condition characterized by the accumulation of air within the spinal canal. This finding may occur due to various causes, mostly after trauma and medical procedures. It can manifest with various features depending on the underlying cause, the location, and the extent of the air trapped. Clinically, the symptoms in affected patients can span a spectrum, ranging from being asymptomatic to manifesting as radiculopathies resulting from compression. The pneumorrhachis-related cauda equina syndrome is incredibly rare and typically appears as a large volume of air causing compression or irritation of the nerve roots in the lower spinal cord. In this report, we present a female patient whose cauda equina syndrome developed as a result of accidental extradural pneumorrhachis after epidural injection in the lumbar spine.

Acute edematous pancreatitis caused by Fasciola hepatica infection: A rare case report.

Acute edematous pancreatitis is a medical emergency characterized by a sudden pancreas inflammation. It can be caused by various factors, primarily gallstones, alcohol consumption, or medication. Acute edematous pancreatitis caused by Fasciola hepatica infection is exceptionally rare and could be overlooked. We report a case of a 24-year-old female patient who presented with onsets of clinical and paraclinical signs of acute pancreatitis (AP). The patient was diagnosed with Fasciola hepatica-induced edematous pancreatitis, a rare parasitic infection that can cause AP. This case highlights the importance of considering parasitic infections in the differential diagnosis of edematous pancreatitis, particularly in young patients with no significant medical history.