201 cases of foreign body ingestion in a Surgical Emergency Unit A 16-year retrospective study.

AIM: The aim of this study is to analyse clinical characteristics of FB ingestion and predictive factors for complications, in order to reduce mortality and morbidity. MATERIALS AND METHODS: A retrospective study of emergency surgical consultation records has been carried out from June 2005 through June 2015 yielded 201 episodes with the diagnosis of ingestion of foreign objects at the Surgical Unit of the University of Bari. RESULTS: Natural Removal in 44,8% of cases; Endoscopic retrieval in 42,4%, Surgical Procedures 4,4%. Statistical analysis was based on multivariate analysis and the model R2 of the Naegelkerke value. DISCUSSION: First of all, the approach to ingestion should be endoscopic. The second approach is surgical in selected cases. The most frequent site of impaction were oesophagus, stomach and right colon. An EGD proved to be the most used procedure with a no morbidity and no mortality. CONCLUSION: The ingestion of foreign bodies is a frequent, complex and expensive condition to treat. Observation and endoscopy are the most appropriate procedures to be considered to manage the ingestion of FB in Emergency Surgery Unit. KEY WORDS: Emergency surgery, Foreign bodies, Ingestion.

Predictive factors for incidental gallbladder cancer (IGBC) in patients undergoing cholecystectomy for presumed benign disease. A single-center experience.

AIM: The incidence of incidental gallbladder cancer (IGBC) is estimated at 0.3-2.1%. The purpose of our study is to evaluate IGBC incidence in our department and to establish its predictive factors, considering patients' clinical characteristics and pre-operative ultrasound gallbladder features. MATERIAL OF STUDY: From January 2012 to December 2015, 434 patients (225 females and 209 males) were enrolled in this retrospective observational study in our General Surgery Department. To analyze potential predictive factors, we divided all the patients into two groups: patients with and without histological diagnosis of IGBC. We focused our attention on the patients' clinical characteristics and preoperative ultrasound gallbladder measurements RESULTS: Seven cases were post-operatively identified as incidental gallbladder cancer (IGBC) and after histological examination an IGBC incidence of 1.6% was encountered. DISCUSSION: Considering the increasing numbers of video laparoscopic cholecystectomies (VLC) performed worldwide, cases of IGBC are appearing more frequently. In most cases of IGBC, a second surgical look will be necessary because of feasibility and safety procedures. CONCLUSIONS: There is no possibility to establish which risk factors might be predictive for IGBC because of a discordance in the literature and a statistical analysis with low sample size. An accurate surgical procedure needs to be performed to reduce the spread of neoplastic cells and, as a result, improve long-term outcomes. KEY WORDS: Incidental Gallbladder cancer, Laparoscopy, Ultrasound.

Endothelial and Metabolic Function Interactions in Overweight/Obese Children.

AIM: Although the underlined mechanisms are still unknown, metabolic/coagulation alterations related to childhood obesity can induce vascular impairments. The aim of this study was to investigate the relationship between metabolic/coagulation parameters and endothelial function/vascular morphology in overweight/obese children. METHODS: Thirty-five obese/overweight children (22 pre-pubertal, mean age: 9.52±3.35 years) were enrolled. Body mass index (BMI), homeostasis model assessment index (HOMAIR), metabolic and coagulation parameters, [adiponectin, fibrinogen, high molecular weight adiponectin (HMW), endothelin-1, and vonWillebrand factor antigen] ultrasound early markers of atherosclerosis [flow-mediated dilatation (FMD), common carotid intima-media thickness (C-IMT), and anteroposterior diameter of infra-renal abdominal aorta (APAO)] were assessed. RESULTS: APAO was related to anthropometric (age: r=0.520, p=0.001; height: r=0.679, p＜0.001; weight: r=0.548, p=0.001; BMI: r=0.607, p＜0.001; SBP: r=0.377, p=0.026) and metabolic (HOMAIR: r=0.357, p=0.035; HMW: r=－0.355, p=0.036) parameters. Age, height, and systolic blood pressure were positively related to increased C-IMT (r=0.352, p=0.038; r=0.356, p=0.036; r=0.346, p=0.042, respectively). FMD was not related to any clinical and biochemical characteristics of the pediatric population. Age, HOMAIR, fasting glucose levels, and HMW were independent predictors for APAO increase. Each unit decrease in HMW concentrations (1 µg/ml) induced a 0.065 mm increase in APAO. CONCLUSION: High molecular weight adiponectin is related to cardiovascular risk in overweight/obese children.