Background: The splenic cysts constitute a very rare clinical entity. They may occur secondary to trauma or even being more seldom due to parasitic infestations, mainly caused by ecchinocccus granulosus. Literature lacks a defined concencus including the treatment plans and follow up strategies, nor long term results of the patients. In the current study, we aimed to evaluate the diagnosis, management of patients with parasitic and non-parasitic splenic cysts together with their long term follow up progresses.Methods: Twenty-four patients with splenic cysts have undergone surgery in our department over the last 9 years. Data from eighteen of the twenty-four patients were collected prospectively, while data from six were retrospectively collected. All patients were assessed in terms of age, gender, hospital stay, preoperative diagnosis, additional disease, serology, ultrasonography, computed tomography (CT), cyst recurrences and treatment.Results: In this study, the majority of patients presented with abdominal discomfort and palpable swelling in the left hypochondrium. All patients were operated on electively. The patients included 14 female and 10 male patients, with a mean age of 44.77 years (range 20–62). Splenic hydatid cysts were present in 16 patients, one of whom also had liver hydatid cysts (6.25%). Four other patients were operated on for a simple cyst (16%) two patients for an epithelial cyst, and the last two for splenic lymphangioma. Of the 16 patients diagnosed as having splenic hydatit cysts, 11 (68.7%) were correctly diagnosed. Only two of these patients were administered benzimidazole therapy pre-operatively because of the risk of multicystic disease The mean follow-up period was 64 months (6–108). There were no recurrences of splenic cysts.Conclusion: Surgeons should keep in mind the possibility of a parasitic cyst when no definitive alternative diagnosis can be made. In the treatment of splenic hydatidosis, benzimidazole therapy is not necessary, although it is crucial to perform splenectomy without rupturing and spilling the cysts.

Surgical procedures with curative or palliative intentions in subjects aged over 70 represent a colorectal surgical challenge due to the issue they raise: Benefits versus increased morbidity. In this study, we proposed to compare the impact of surgery with the surgical intervention short-term results and analyze the factors that may influence these results in elderly age groups.

Ganglioneuromas are rare benign tumors arising from the neural crest tissue and are most commonly located in the posterior mediastinum and retroperitoneum; they are rarely found in the adrenal gland. This tumor is usually asymptomatic and in the majority of cases is detected incidentally. Although the characteristics of adrenal ganglioneuroma on computerized tomography and magnetic resonance imaging have been well described, the exact diagnosis is difficult. Histopathological examination is currently the mainstay of diagnosis. Ganglioneuromas have a very good prognosis with surgical removal. We report the case of a male patient with an incidentally identified adrenal ganglioneuroma with high standardized uptake values in a positron emission tomography scan.

The epigenetic features contribute to variations in host susceptibility to SARS-CoV-2 infection and severity of symptoms. This study aimed to evaluate the relationship between the relative expression of microRNAs (miRNAs) and the severity of the disease in COVID-19 patients. The miRNA profiles were monitored during the different stages of the disease course using reverse transcription–quantitative polymerase chain reaction (RT-qPCR). The expression levels of the selected 11 miRNAs were measured in the blood samples collected from 73 patients (moderate, n = 37; severe, n = 25; critically ill, n = 11, a total of 219 longitudinal samples) on hospitalization day and days 7 and 21. Expression changes were expressed as “fold change” compared to healthy controls (n = 10). Our study found that several miRNAs differed according to disease severity, with the miR-155-5p the most strongly upregulated (p = 0.0001). A statistically significant negative correlation was observed between the expression of miR-155-5p and its target gene, the suppressor of cytokine signaling 1 (SOCS1). The relative expression of miR-155-5p was significantly increased and SOCS1 was significantly decreased with the disease progression (r = −0.805 p = 0.0001, r = −0.940 p = 0.0001, r = −0.933 p = 0.0001 for admission, day 7, and day 21, respectively). The overexpression of miR-155-5p has significantly increased inflammatory cytokine production and promoted COVID-19 progression. We speculated that microRNA-155 facilitates immune inflammation via targeting SOCS1, thus establishing its association with disease prognosis.

Background: We aim to evaluate the metabolic and inflammatory responses after ERCP procedure in patients who have common bile duct stones. Methods: Between September 2009 and October 2010, we studied prospectively 50 patients who diagnosed with common bile duct stones. Our study was included patients who had previously been suspected with common biliary duct stone via radiological and biochemical examinations. We investigated parameters of pro-inflammatory cytokines (IL-1β, IL-6, Il-8, IL-12, IFN-γ, TNF-α), anti inflammatory cytokines (IL-4, IL-10, IL-13), stress hormones (ACTH, cortisol, growth hormone, aldosterone) and acute phase reactant (CRP). All venous blood samples were taken firstly 1hr before endoscopic intervention as a control. After ERCP procedure, venous blood samples were taken two more times, the first in 1hr, the second in 24 hours. Results: We performed ERCP successfully to 50 patients due to common bile duct stones. All of them had higher serum cytokine levels (p<0.01) after an hour and 24 hours later ERCP than before endoscopic intervention except IL-13 level. A significant increase (p0.05). CRP level was significiantly increased 1 hour and 24 hours after ERCP. Conclusion: ERCP procedure is a kind of invasive attempt as known, also causes, with its effects, systemically inflammatory response in the body. This response, mostly not staying at the local stage, becomes systemic inflammatory response. Therefore, before ERCP is performed, the applications of other non-invasive methods of diagnosis are strongly advised

Unexpected inflammatory cecal masses of uncertain etiology, encountered in the emergency surgical departments can be indistinguishable, and appropriate operative management of these cases is a dilemma for the surgeons. Over a 30-months period between January 2009 and June 2011, a series of 3032 patients who live in sub-urban underwent emergency surgery for clinical diagnosis of acute appendicitis and ileocecal resection or right hemicolectomy for inflammatory cecal mass were performed in 48 patients. 28 men and 20 women from suburban between ages 16–73 presented with right iliac fossa pain. The major presenting symptom was pain in the right iliac fossa (100%). On physical examination; tenderness at or near the McBurney point was detected in 44 (91,6%) patients. The range of the leucocyte level was between 8.000 to 24.000 and mean level is 16.000. After initial laparoscopic exploration, ileocecal resection or right hemicolectomy was performed conservatively because of the uncertainty of the diagnosis. Overall 32 patients underwent ileocecal resection and 16 patients underwent right hemicolectomy. Pathology revealed appendicular phlegmon in 18 patients, perforated cecal diverticulitis in 12 patients, tuberculosis in 6 patients, appendiceal and cecal rupture in 4 patients, malign mesenquimal neoplasm in 4 patients, non-spesific granulomatous in 2 patients and appendecular endometriosis in 2 patients. Most inflammatory cecal masses are due to benign pathologies and can be managed safely and sufficiently with ileocecal resection or right hemicolectomy. The choice of the surgical procedure depends on the experience of the surgical team.