Early Detection of a Colorectal Carcinoma in an Asymptomatic Patient Using a Combined DNA Stool Test.

BACKGROUND: Modern, simple stool tests could close the gap regarding the recognition rate (sensitivity) between the current test methods and colonoscopy. METHODS: Here we report a case of a 68-year-old asymptomatic patient, who applied an innovative combined DNA stool test. RESULTS: Due to a positive KRAS mutation, a colonoscopy was performed and an invasive adenocarcinoma was diagnosed. After colonoscopical resection in two steps pathological findings could not be identified anymore. All further parameters, including KRAS, stayed continuously negative. CONCLUSIONS: In this case report, it was demonstrated that a combined DNA stool test can also be successfully applied as alternative diagnostic tool.

AFS: identification and quantification of species composition by metagenomic sequencing.

Summary: DNA-based methods to detect and quantify taxon composition in biological materials are often based on species-specific polymerase chain reaction, limited to detecting species targeted by the assay. Next-generation sequencing overcomes this drawback by untargeted shotgun sequencing of whole metagenomes at affordable cost. Here we present AFS, a software pipeline for quantification of species composition in food. AFS uses metagenomic shotgun sequencing and sequence read counting to infer species proportions. Using Illumina data from a reference sausage comprising four species, we reveal that AFS is independent of the sequencing assay and library preparation protocol. Cost-saving short (50-bp) single-end reads and Nextera ® library preparation yield reliable results. Availability and Implementation: Datasets, binaries and usage instructions are available under http://all-food-seq.sourceforge.net. Raw data is available at NCBI's SRA with accession number PRJNA271645. Contact: hankeln@uni-mainz.de. Supplementary information: Supplementary data are available at Bioinformatics online.

Intra- and Inter-rater Reliability of Navigated Ultrasound in the Assessment of Pelvic Tilt in Symptom-Free Young Adults.

OBJECTIVES: Pelvic tilt is the angle between the anterior pelvic plane and the coronal plane. It affects cup positioning in total hip arthroplasty. The primary objective of this study was to test the intra- and inter-rater reliability of a navigated smart device-based ultrasound system for pelvic tilt assessment. The secondary objective was to test the inter-rater variability of the measurements on a hip phantom. METHODS: A repeated-measures design was used. Two raters measured the pelvic tilt of 12 symptom-free young adults in upright and supine positions. Additionally, pelvic tilt was measured on a hip phantom. Each rater performed 3 measurements in each body position on the participants and 12 measurements on the hip phantom. Intra- and inter-rater reliability were calculated with the use of intraclass correlation coefficients. The variability in measurements on the hip phantom was assessed by a Bland-Altman analysis of agreement. RESULTS: Intraclass correlation coefficient 95% confidence intervals for intra-rater reliability ranged from good to excellent and moderate to excellent for the supine and upright positions respectively. Intraclass correlation coefficient 95% confidence intervals for inter-rater reliability ranged from poor to excellent for both positions. Hip phantom measurements showed no significant average bias (P > .05) and no significant proportional bias (P > .05). The 95% inter-rater limits of agreement were ±1.3° and ±1.7° for the supine and upright positions, respectively. CONCLUSIONS: The intra-rater reliability values achieved were suitable. Intraclass correlation coefficient values for inter-rater reliability remained below an acceptable level. Possible reasons and overcoming strategies were presented. The 95% limits of agreement were good, at less than ±2°.

All-Food-Seq (AFS): a quantifiable screen for species in biological samples by deep DNA sequencing.

BACKGROUND: DNA-based methods like PCR efficiently identify and quantify the taxon composition of complex biological materials, but are limited to detecting species targeted by the choice of the primer assay. We show here how untargeted deep sequencing of foodstuff total genomic DNA, followed by bioinformatic analysis of sequence reads, facilitates highly accurate identification of species from all kingdoms of life, at the same time enabling quantitative measurement of the main ingredients and detection of unanticipated food components. RESULTS: Sequence data simulation and real-case Illumina sequencing of DNA from reference sausages composed of mammalian (pig, cow, horse, sheep) and avian (chicken, turkey) species are able to quantify material correctly at the 1% discrimination level via a read counting approach. An additional metagenomic step facilitates identification of traces from animal, plant and microbial DNA including unexpected species, which is prospectively important for the detection of allergens and pathogens. CONCLUSIONS: Our data suggest that deep sequencing of total genomic DNA from samples of heterogeneous taxon composition promises to be a valuable screening tool for reference species identification and quantification in biosurveillance applications like food testing, potentially alleviating some of the problems in taxon representation and quantification associated with targeted PCR-based approaches.

A Ser residue influences the structure and stability of a Pro-kinked transmembrane helix dimer.

When localized adjacent to a Pro-kink, Thr and Ser residues can form hydrogen bonds between their polar hydroxyl group and a backbone carbonyl oxygen and thereby modulate the actual bending angle of a distorted transmembrane α-helix. We have used the homo-dimeric transmembrane cytochrome b(559)' to analyze the potential role of a highly conserved Ser residue for assembly and stabilization of transmembrane proteins. Mutation of the conserved Ser residue to Ala resulted in altered heme binding properties and in increased stability of the holo-protein, most likely by tolerating subtle structural rearrangements upon heme binding. The results suggest a crucial impact of an intrahelical Ser hydrogen bond in defining the structure of a Pro-kinked transmembrane helix dimer.

Phylogenetic analyses of endoparasitic Acanthocephala based on mitochondrial genomes suggest secondary loss of sensory organs.

The metazoan taxon Syndermata (Monogononta, Bdelloidea, Seisonidea, Acanthocephala) comprises species with vastly different lifestyles. The focus of this study is on the phylogeny within the syndermatan subtaxon Acanthocephala (thorny-headed worms, obligate endoparasites). In order to investigate the controversially discussed phylogenetic relationships of acanthocephalan subtaxa we have sequenced the mitochondrial (mt) genomes of Echinorhynchus truttae (Palaeacanthocephala), Paratenuisentis ambiguus (Eoacanthocephala), Macracanthorhynchus hirudinaceus (Archiacanthocephala), and Philodina citrina (Bdelloidea). In doing so, we present the largest molecular phylogenetic dataset so far for this question comprising all major subgroups of Acanthocephala. Alongside with publicly available mt genome data of four additional syndermatans as well as 18 other lophotrochozoan (spiralian) taxa and one outgroup representative, the derived protein-coding sequences were used for Maximum Likelihood as well as Bayesian phylogenetic analyses. We achieved entirely congruent results, whereupon monophyletic Archiacanthocephala represent the sister taxon of a clade comprising Eoacanthocephala and monophyletic Palaeacanthocephala (Echinorhynchida). This topology suggests the secondary loss of lateral sensory organs (sensory pores) within Palaeacanthocephala and is further in line with the emergence of apical sensory organs in the stem lineage of Archiacanthocephala.

[Mid-term, relatively tumor-stable outcome after an initially successful interdisciplinary surgical intervention with locally achieved R0 resection status including a multimodal therapeutic concept of a metastasized leiomyosarcoma of the inferior vena cava]. / Mittelfristiges, relativ tumorstabiles Outcome eines erfolgreich interdisziplinär lokal R0-resezierten, metastasierten Leiomyosarkoms der V. cava inferior mit multimodaler Behandlung.

UNLABELLED: Progredient tumor-growth does not mean necessarily nihilism since (because of the latest multimodal therapeutic options) it might be possible to convert the malignant disease into a chronic stage depending on tumor entity, specific tumor-associated findings and expertise of the interdisciplinary oncological/oncosurgical team to utilize available and potential therapeutic measures. The aim of this report on an unusual case (with its patient-associated, therapeutic and prognostic aspects) of a leiomyosarcoma of the inferior vena cava with advanced tumor growth (characterized initially by pulmonary and hepatic, later on by additional vertebral metastases) is to illustrate its changeful clinical course after and during multimodal treatment episodes comprising surgical (abdomino-/vascular-/cardio- and neurosurgical-locally, R0 resection status), radiological and chemotherapeutic measures. A relatively stable disease over a specific time period of 5 years and 6 months was achieved. The 54-year old female patient with metastasized leiomyosarcoma of the inferior vena cava underwent local tumor resection en bloc with inferior vena cava segmental resection (following vascular surgical interposition of a prosthesis) and hemihepatectomy as well as resection of hepatic segment I. After recovery, a multistep and -modal treatment was initiated comprising of various protocols of systemic chemotherapy, thermoablation of recurrent hepatic metastases, various brachytherapy procedures (for hepatic and pulmonary metastases) and resection of a cerebral metastasis by a neurosurgeon including subsequent radiation. CONCLUSIONS: The patient demonstrates impressively that even in case of advanced tumor stage with initial, novel and recurrent metastases, a relatively stable disease over an intermediate time period (of more than 5 years) with an acceptable quality of life was achieved despite several complications.

Transcriptome analysis of the spalax hypoxia survival response includes suppression of apoptosis and tight control of angiogenesis.

BACKGROUND: The development of complex responses to hypoxia has played a key role in the evolution of mammals, as inadequate response to this condition is frequently associated with cardiovascular diseases, developmental disorders, and cancers. Though numerous studies have used mice and rats in order to explore mechanisms that contribute to hypoxia tolerance, these studies are limited due to the high sensitivity of most rodents to severe hypoxia. The blind subterranean mole rat Spalax is a hypoxia tolerant rodent, which exhibits unique longevity and therefore has invaluable potential in hypoxia and cancer research. RESULTS: Using microarrays, transcript abundance was measured in brain and muscle tissues from Spalax and rat individuals exposed to acute and chronic hypoxia for varying durations. We found that Spalax global gene expression response to hypoxia differs from that of rat and is characterized by the activation of functional groups of genes that have not been strongly associated with the response to hypoxia in hypoxia sensitive mammals. Using functional enrichment analysis of Spalax hypoxia induced genes we found highly significant overrepresentation of groups of genes involved in anti apoptosis, cancer, embryonic/sexual development, epidermal growth factor receptor binding, coordinated suppression and activation of distinct groups of transcription factors and membrane receptors, in addition to angiogenic related processes. We also detected hypoxia induced increases of different critical Spalax hub gene transcripts, including antiangiogenic genes associated with cancer tolerance in Down syndrome human individuals. CONCLUSIONS: This is the most comprehensive study of Spalax large scale gene expression response to hypoxia to date, and the first to use custom Spalax microarrays. Our work presents novel patterns that may underlie mechanisms with critical importance to the evolution of hypoxia tolerance, with special relevance to medical research.

Risk of wound hematoma at carotid endarterectomy under dual antiplatelet therapy.

BACKGROUND AND PURPOSE: This study aims to assess perioperative incidence of wound hematoma and bleeding in patients who underwent carotid endarterectomy (CEA) under dual antiplatelet therapy. METHODS: Consecutive patients with initial CEA receiving aspirin, clopidogrel, or a combination of both were subjected to standard patch endarterectomy. Postoperative wound hematoma was assessed as moderate (subcutaneous bleeding, nonspace-occupying hematoma, and oozing suture bleeding) or severe, i.e., needing operative re-exploration. RESULTS: Six hundred eighty-four (80.9%) patients with one of the three types of antiplatelet therapy out of 844 patients registered from 1995 to 2010 were enrolled. Wound hematoma occurred in 27 of 112 (24.1%) patients under combined aspirin and clopidogrel, 33 of 162 (20.4%) under clopidogrel, and 48 of 410 (11.7 %) under aspirin. Relative risk compared to aspirin was 2.4 (95% CI, 1.4 to 4.1) for aspirin and clopidogrel and 1.9 (95% CI, 1.2 to 3.1) for clopidogrel. Severe space-occupying hematoma needing operative re-exploration occurred in four (3.6%) patients under aspirin and clopidogrel, seven (4.3%) under clopidogrel, and five (1.2%) under aspirin. Corresponding relative risks were 3.0 (95% CI, 0.8 to 11.4) for aspirin and clopidogrel and 3.7 (95% CI, 1.1 to 11.7) for clopidogrel. Relative risks remained without relevant change after adjustment for potentially confounding variables. CONCLUSIONS: Dual antiplatelet therapy with combined aspirin and clopidogrel as well as clopidogrel is associated with an increased incidence of perioperative wound hematoma compared to aspirin but on an acceptable low level of incidence. The latter may be achieved by adapting operative procedures to more intensive antiplatelet regimes.

Internet-Related Disorders and Their Effects on Personality Development in Adolescents from Germany-Results from a Prospective Study.

Internet-related disorders (IRD) are increasingly becoming a major health issue. IRD are defined as the predominant use of online content, related to a loss of control and continued use despite negative consequences. Despite findings from cross-sectional studies, the causality of pathways accelerating the development of IRD are unclear. While etiological models emphasize the role of personality as risk factor, mutual influences between IRD and personality have not been examined. A prospective study with two assessments was conducted with n = 941 adolescents (mean age of 13.1 years; 10-17 years). Our aim was to validate etiological assumptions and to examine the effects of IRD-symptoms on the maturation of personality. IRD were measured with the Scale of the Assessment of Internet and Computer game Addiction (AICA-S). Personality traits were assessed using the Brief Five Factor Inventory (BFI). Conscientiousness and neuroticism were predictive for IRD symptoms one year later, and were likewise prone to changes depending on incidence or remission of IRD. Conscientiousness and openness moderated the course of IRD symptoms. Our findings point to complex trait-pathology associations. Personality influences the risk of development and maintenance of IRD symptoms and pre-existing IRD-symptoms affect the development of personality. Adaptations to etiological models are discussed and perspectives for novel intervention strategies are suggested.

A Robotic System with EMG-Triggered Functional Eletrical Stimulation for Restoring Arm Functions in Stroke Survivors.

BACKGROUND: Robotic systems combined with Functional Electrical Stimulation (FES) showed promising results on upper-limb motor recovery after stroke, but adequately-sized randomized controlled trials (RCTs) are still missing. OBJECTIVE: To evaluate whether arm training supported by RETRAINER, a passive exoskeleton integrated with electromyograph-triggered functional electrical stimulation, is superior to advanced conventional therapy (ACT) of equal intensity in the recovery of arm functions, dexterity, strength, activities of daily living, and quality of life after stroke. METHODS: A single-blind RCT recruiting 72 patients was conducted. Patients, randomly allocated to 2 groups, were trained for 9 weeks, 3 times per week: the experimental group performed task-oriented exercises assisted by RETRAINER for 30 minutes plus ACT (60 minutes), whereas the control group performed only ACT (90 minutes). Patients were assessed before, soon after, and 1 month after the end of the intervention. Outcome measures were as follows: Action Research Arm Test (ARAT), Motricity Index, Motor Activity Log, Box and Blocks Test (BBT), Stroke Specific Quality of Life Scale (SSQoL), and Muscle Research Council. RESULTS: All outcomes but SSQoL significantly improved over time in both groups (P < .001); a significant interaction effect in favor of the experimental group was found for ARAT and BBT. ARAT showed a between-group change of 11.5 points (P = .010) at the end of the intervention, which increased to 13.6 points 1 month after. Patients considered RETRAINER moderately usable (System Usability Score of 61.5 ± 22.8). CONCLUSIONS: Hybrid robotic systems, allowing to perform personalized, intensive, and task-oriented training, with an enriched sensory feedback, was superior to ACT in improving arm functions and dexterity after stroke.

Insights Into Aspects Behind Internet-Related Disorders in Adolescents: The Interplay of Personality and Symptoms of Adjustment Disorders.

PURPOSE: Problematic Internet use (PIU) that has recently been referred to as Internet-related disorder is a growing health concern. Yet, it is unclear why some adolescents are developing problematic use, whereas others sustain control. Based on previous research, we hypothesize that personality traits (low conscientiousness and high neuroticism) act as predispositions for PIU. We further hypothesize that PIU can be understood as a maladaptive reaction toward critical life events and that these maladaptive reactions are exacerbated by dysfunctional personality traits. METHODS: The study investigates the prevalence of distinct subtypes of PIU among a sample of adolescents (n = 1,489; 10-17 years). Personality traits (Big Five Inventory-10 [BFI-10]), perceived stress (Perceived Stress Scale 4 [PSS-4]), and their relations to PIU (Scale for the Assessment of Internet and Computer Game Addiction [AICA-S]) were examined. As novel research questions, associations between PIU and adjustment disorders (Adjustment Disorder-New Module [ADNM]-6) and the mediating role of personality were investigated. RESULTS: The prevalence of PIU was 2.5%; girls (3.0%) were more often affected than boys (1.9%). Social networking sites in girls and online games in boys were most often associated with PIU. Low conscientiousness and high neuroticism generally predicted PIU. Significantly more adolescents with PIU (70%) reported critical life events compared with those without PIU (42%). PIU was related to heightened stress and higher adjustment disorder symptoms. These associations were exacerbated by conscientiousness and neuroticism. CONCLUSIONS: Although the overall prevalence for PIU is in line with previous studies, it appeared unexpectedly that girls were affected more often than boys. Adjustment disorders and stress showed strong associations with PIU. This bears implications for adapting etiopathological assumptions and early intervention strategies.

Heme binding properties of heterologously expressed spinach cytochrome b(6): implications for transmembrane b-type cytochrome formation.

In vivo and in vitro requirements for the formation of cytochrome b(6) were examined to analyze the mechanisms of transmembrane b-type cytochrome formation. After heterologous expression of spinach cytochrome b(6), formation of the holo-cytochrome was observed within the E. coli inner membrane. The transmembrane orientation of cytochrome b(6) appeared not to be critical for heme binding and holo-cytochrome formation. Furthermore, in vitro reconstitution of cytochrome b(6) was possible under oxidizing as well as under reducing conditions. Taken together these observations strongly indicate that transmembrane b-type cytochromes can spontaneously assemble in vitro as well as in a membrane.

A mutational study of transmembrane helix-helix interactions.

Diverse methods have been developed and applied in the recent years to study interaction of transmembrane alpha-helices and often interaction of single transmembrane helices is followed on SDS-gels. Here we compare two measurements of the stability of a transmembrane helix-helix interaction, and the stability of the PsbF transmembrane helix dimer was determined in a biological membrane as well as in SDS. The observations described in this study demonstrate that the environment, in which a transmembrane helix interaction is studied, can be very critical and detergent properties can significantly influence transmembrane helix interactions, especially, when the transmembrane domain contains strongly polar residues.

That Man Behind the Curtain: Investigating the Sexual Online Dating Behavior of Men Who Have Sex With Men but Hide Their Same-Sex Sexual Attraction in Offline Surroundings.

This study investigates how men who have sex with men (MSM) use chat and dating sites based on theories of stigma-related offline behavior and online self-disclosure. We hypothesize that hidden MSM (those who self-label as heterosexual or who hide their same-sex sexual attraction from family, friends, acquaintances, or a female romantic partner) differ from open MSM in how they behave on gay chat and dating sites and in offline gay venues. Drawing on a survey of 12,002 MSM, we show that hidden MSM tend to mask their identity on gay chat and dating sites while avoiding offline gay venues. They also focus more strongly on online sexual activities (e.g., masturbating during online chats) when using gay chat and dating sites. However, they spend the same amount of time on these sites, and they use them to initiate offline sexual encounters as often and as fast as open MSM.

Effect of physical exercise on platelet activity and the von-Willebrand-factor in patients with persistent lone atrial fibrillation.

BACKGROUND: The risk of stroke is of great clinical importance in patients with atrial fibrillation (AF). It is not known whether physical exercise influences plasma coagulation and platelet aggregability during AF. The purpose of this study was to assess the effect of physical exercise on platelet activity, thrombin generation, and levels of von-Willebrand-factor in patients with persistent AF. METHODS: Thirteen patients with lone AF (>or=1 year) were compared with 13 matched patients in sinus rhythm. Patients with AF were anticoagulated effectively with coumarin. All patients underwent bicycle ergometry using a respiratory gas exchange technique for 20 min at one-third of the age-adjusted maximal workload. Thereafter, workload was increased until maximal exercise capacity was reached. Platelet factor-4 (PF-4), beta-thromboglobulin (beta-TG; marker for platelet activation), von-Willebrand-factor (vWF; marker for endothelial dysfunction), prothrombin fragment F1 + 2 (F1 + 2; marker for thrombin generation) and fibrinogen levels were determined throughout the study in all patients. RESULTS: Gas exchange variables, hemodynamic parameters and norepinephrine levels were comparable in the groups during moderate (45 +/- 5 W) and heavy exercise (198 +/- 38 W). In contrast to moderate exercise, PF-4 and beta-TG levels increased to 212 +/- 56% ( p < 0.05) and to 145 +/- 24% ( p < 0.05), respectively, in patients with AF during heavy exercise. In contrast, physical exercise had no significant effect on platelet activity in patients with sinus rhythm. Levels of vWF increased by delta24% ( p < 0.05) in all patients during maximal exercise, whereas F1 + 2 levels increased only in patients with sinus rhythm. CONCLUSIONS: Heavy physical activity increases platelet activity and vWF levels during AF, whereas moderate exercise has no procoagulatory effect. Coumarin therapy prevents exercise-induced thrombin generation only. Future studies are needed to prove the hypothesis that heavy physical exercise is a risk factor for thromboembolic events in patients with AF.

Sympathetic modulation of intestinal microvascular blood flow oscillations in experimental endotoxemia.

Impairment of the intestinal microcirculation has been recognized as an important factor in the pathogenesis of endotoxin related sepsis syndrome. We investigated the effects of endotoxemia on the variability of intestinal microvascular blood flow (IMBF) and arterial blood pressure (BP) in a prospective, randomized, controlled animal study. Recordings of IMBF (laser Doppler fluxmetry) and BP were performed before, two and four hours after i.v. injection of either placebo or endotoxin (5 mg/kg b.w. lipopolysaccharide from E. coli, serotype O55:B5). Control experiments were performed with systemic (clonidine) and local intestinal (surgery) sympathectomy. Spectral analysis was performed using the autoregressive approach. Spectral power was determined in two frequency bands (low frequency (LF): 0.27-0.74 Hz; high frequency (HF): 0.76-3.00 Hz). Two hours after endotoxin challenge a significant decrease in IMBF was observed. LF spectral power of IMBF and BP increased significantly in the endotoxin challenged group, while no effects were observed in the placebo group. Four hours after endotoxin administration IMBF decreased further and LF spectral power of IMBF and BP remained elevated. Denervation prevented the decrease in IMBF but did not abolish the LF power increase. Clonidine administration attenuated the IMBF decrease and significantly diminished the increase in LF spectral power of IMBF and BP. We conclude that endotoxemia is associated with increased sympathetic outflow to the systemic vasculature, as indicated by the increase in LF spectral power of arterial blood pressure. The increase in LF variability of IMBF is secondary to the increase in LF spectral power of BP, since it could be attenuated by systemic and not by local intestinal sympathectomy.

Six amino acids define a minimal dimerization sequence and stabilize a transmembrane helix dimer by close packing and hydrogen bonding.

Distinct amino acid sequences have been described to mediate oligomerization of transmembrane α-helices. However, as the sequence context is crucial to determine specificity in transmembrane helix-helix interaction, the question arises how small a sequence can be without losing specificity. In the present analysis, six amino acids have been identified in the PsbF transmembrane helix dimer, which form the contact region of two interacting helices and are directly involved in helix-helix interactions. However, individual amino acids within the complex sequence pattern only together ensure sequence specificity of the analyzed transmembrane helix-helix interactions by mediating close packing and inter-helical hydrogen bonding.

Blaming the victim: the effects of extraversion and information disclosure on guilt attributions in cyberbullying.

Cyberbullying victims' success in coping with bullying largely depends on schoolmates and other bystanders' social support. However, factors influencing the degree of social support have as yet not been investigated. In this article, the concept of victim blaming is applied to cyberbullying incidents. It is assumed that a cyberbullying victim receives less social support when the victim's behavior is perceived as very overt. It is further assumed that this effect's underlying process is the partial attribution of responsibility for the incident to the victim and not to the bully. The hypotheses are tested with a 2×2 online experiment. In this experiment, varying online self-presentations of a fictitious female cyberbullying victim were presented to 586 Germans aged 16-22. The victim's public Facebook profile was manipulated in terms of the victim's extraversion and the amount of personal information disclosed. The results support the hypotheses. Participants attributed more responsibility for the bullying incident to the victim when the victim was presented as extraverted and very open in revealing personal information. This diminished social support for the victim. The effect was partially mediated by the victim's perceived attractiveness. The study implies that concepts from victimization research can enhance our understanding of cyberbullying incidents. Among other factors, the victim's specific personal characteristics deserve more consideration--not only with regard to the incident itself but also regarding subsequent social dynamics and coping mechanisms.

Rare aneurysm of the hepatic artery with overlap to the gastroduodenal artery in very uncommon coincidence with occurence of hepatomesenteric trunk.

BACKGROUND: Aneurysms of visceral arteries are rare, but in case of rupture, they are potentially life threatening. In addition, there is a broad spectrum of the anatomic variability for the arterial supply of the liver. METHODS: Based on a real but very rare clinical case, including its diagnostic management and short-term course, the extraordinary coincidence of (i) an aneurysm of the gastroduodenal artery at its branching off from the hepatic artery and (ii) occurrence of hepatomesenteric trunk is described by the means of a scientific medical case report as well as an adequate and selective literature search. CASE PRESENTATION, THERAPEUTIC DECISION AND CLINICAL COURSE: A 39-year-old woman (BMI, 24 kg/m) was diagnosed (by coincidence) with an aneurysm of the proper hepatic artery (APHA) with overlap to the gastroduodenal artery in combination with an uncommon hepatomesenteric trunk using abdominal computed tomography (CT) scan (because of slight but recurrent episodes of urinary tract diseases) and, subsequently, systematic diagnostic comprising Duplex ultrasonography, magnetic resonance imaging (MRI), and conventional angiography. However, medical history was not significant for coincidence with possibly relevant chronic occlusive disease, mycotic embolization, trauma, Marfan syndrome, Klippel-Trenaunay syndrome or giant cell arteritis. Despite a moderate progression within a year to a size of actually 18 mm, we still favor watchful-waiting at this size (therapeutic [interventional] consequence, size > 20 mm) with short-term intervals for follow-up investigations using Duplex ultrasonography as the method of choice. CONCLUSIONS: This is the first case in the accessible English-speaking literature to show this very infrequent coincidence especially indicating rare appearance of an APHA in combination with an also infrequent hepatomesenteric trunk (which potentiates the uncommon occurrence of such combination) based on the high anatomic variability of the arterial supply of the liver from the anatomic perspective.