Severe complications of chronic cholelithiasis treatment.

BACKGROUND: Gallstone disease is a burden affecting about 15% percent of the population around the world. The complications of gallstone disease are numerous and many require emergency care. Severe complications are not uncommon and require special attention, as lethal outcome is possible. CASE PRESENTATION: We present a retrospective analysis of eight cases describing severe complications of gallstones in patients undergoing endoscopic treatment of chronic gallstones conditions. All patients were admitted to our emergency care department following symptoms onset. The diagnostic difficulties, treatment strategies and outcomes are presented. The associated risk factors and preventative measures are discussed. Two patients developed profuse bleeding, two developed acute pancreatitis, two patients had perforation related complications. One rare case of bilioma and one case of iatrogenic injury are presented. All patients had severe condition, in two cases lethal outcome was a result of co-morbidity and difficulties in management. CONCLUSION: Special care should be taken in patients with risk factors of severe complications in order to improve outcome and prevent the development of life-threatening conditions.

Colorectal Serrated Lesions: A Current View on Clinical, Morphological, Molecular, and Genetic Diagnostic Criteria.

OBJECTIVE: Serrated colorectal lesions are a group of colonic lesions with a serrated (saw-tooth) profile of the surface epithelium and crypts, and peculiar molecular and genetic developmental mechanisms that are incompletely understood. These formations cause concern due to their premalignant potential. AIM: The review is dedicated to serrated lesions of colon and appendix. We focused on modern classification, role in carcinogenesis, as well as new approaches to morphological diagnosis. METHODS: A literature search was performed using PubMed, Scopus, ResearchGate, Google, MEDLINE, and ScienceDirect databases to find studies of serrated colorectal lesions related cancer published between 2000 and 2020 that address epidemiological risk factors, underlying pathophysiological mechanism and enable our review of these factors as well as molecular, genetics, and structural patterns. RESULTS: Serrated colorectal lesions take one third of all benign neoplasms of the colon in the pathologist's practice. The active study of serrated lesions began in the 1900s. Terminology and diagnostic criteria changed in the updated classification in 2019. Morphological criteria, immunohistochemical and molecular profile, endoscopic and clinical characteristics are reviewed. CONCLUSION: Although significant efforts were made in attempt to improve our understanding and diagnostic criteria of serrated polyps of colorectum, very little has changed since the original morphologic description of preneoplastic serrated lesions in early 2000s. There remains a need for more research in order to develop more definitive immuophenotypic and molecular biomarkers in order to distinguish between non-neoplastic and neoplastic serrated lesions.