We present case series of simultaneous surgery for coexisting cardiac and non-cardiac pathologies to evaluate the feasibility of the treatment. The retrospective analysis included 27 patients aged between 28 and 74 years. The most often heart diseases were coronary arterial disease and valve defects, and the most often heart surgery was coronary artery bypass grafting. The non-cardiac diseases included neoplasms in the abdominal cavity, urinary system, and chest organs. The average duration of surgery was 277 ± 87 minutes, blood loss 285 ± 182 ml. The in-hospital mortality was 0%, with median stay of 2 and 12 days in the intensive care unit (ICU) and emergency room, respectively. The 1 and 5-year survival rates were 85.7% and 76.2%, respectively. Simultaneous surgeries can be a treatment of choice for patients with cardiac pathology and concomitant neoplasm in abdominal, thoracic, or urinary system. This is the first such study conducted in the Central-Asian region and, in particular, in Kazakhstan.

Ex vivo liver resection and autotransplantation (ELRA) in extensive abdominal alveolar echinococcosis (AE) is a relatively rare treatment. We present the first case, ever reported in Kazakhstan, of successfully performed ELRA of a patient with extensive abdominal AE with invasion into the inferior vena cava (IVC). A 64-year-old woman was diagnosed with AE of the brain, alveococcectomy from the left frontal lobe was performed. At the same time, liver AE metastased to the lungs and brain was diagnosed. The patient was admitted to our center for the following surgical treatments: (1) laparotomy, (2) extended left hemihepatectomy with resection of IVC ex vivo, (3) plastic surgery of IVC with a synthetic prosthesis, (4) orthotopic transplantation of the remnant right lobe of the liver. The postoperative period proceeded smoothly. The patient was mechanically ventilated for 1.5 days and prescribed strict bed rest with in-bed activity for up to 11 days. Empirical antibiotic therapy was initiated as follows: meropenem 1000 mg three times a day for 10 days, omeprazole 40 mg once a day for 14 days, anticoagulant therapy was not administered in the first post-operation day due to high risk of bleeding. Clexane was prescribed subcutaneously once a day: 0.2 mL for 2 days, then 0.4 mL for next 10 days. Daily transfusion of 100 mL of 10% Albumin was performed to prevent hypoalbuminemia. Drainage systems were removed on the 9th day. On the 12th day, the patient was transferred from the intensive care unit to a hospital room, and discharged with improvement on the 20th day. During a 6-month follow-up, no relapse was observed. Radical surgery for widespread AE, in this case – ELRA, is the preferred treatment, since it does not require immunosuppressive therapy and is quite feasible even with invasion of the portal vein bifurcation, IVC and hepatocaval confluence.

Major abdominal surgeries including pancreatic resection are rarely performed in patients on chronic dialysis due to perioperative morbidity associated with end-stage renal disease. This case report presents a 71-year-old female on hemodialysis with pancreatic head cancer who underwent successful pancreaticoduodenectomy. The patient had the following severe comorbidities: type 2 diabetes mellitus, hypertension, and chronic kidney disease. Therefore, meticulous preoperative preparation, intraoperative care and postoperative management including hemodialysis and nutritional support were performed. Postoperative recovery was uneventful, bowel function was restored on day 5, and the patient was discharged in good condition. This case provides the feasibility of pancreaticoduodenectomy (also known as Whipple procedure) in carefully monitored patients, particularly those on dialysis, despite the increased risk of complications like cardiovascular, immune, and coagulation disorders. Brief literature review confirms that patients with end-stage renal disease can be considered for abdominal surgery with acceptable morbidity and mortality in complex surgical procedures.

Добавочная селезенка, встречающаяся с частотой 10-30%, обычно обнаруживается случайно при инструментальных исследованиях брюшной полости и редко вызывает клинические симптомы. В двух клинических случаях, описанных в данной статье, добавочная селезенка, локализованная в хвосте поджелудочной железы, имитировала нейроэндокринную опухоль, что привело к лапароскопической спленосохранной каудальной резекции поджелудочной железы. Гистологическое исследование подтвердило наличие добавочной селезенки. Эти случаи подчеркивают важность дифференциальной диагностики, так как добавочная селезенка выполняет все функции основной селезенки и её наличие не требует хирургического вмешательства. Методы визуализации, такие как ПЭТ/КТ с 68Ga-DOTA-TOC и сцинтиграфия с мечеными эритроцитами, могут значительно улучшить точность диагностики и помочь различить добавочную селезенку и нейроэндокринные опухоли поджелудочной железы, тем самым уменьшая риск ненужных операций. Однако данные методы исследования были недоступны, поэтому решение об оперативном лечении было принято на основании КТ с контрастированием. An additional spleen, occurring with a frequency of 10-30%, is usually detected accidentally during instrumental studies of the abdominal cavity and rarely causes clinical symptoms. In two clinical cases described in this article, an accessory spleen localized in the tail of the pancreas mimicked a neuroendocrine tumor, which led to laparoscopic splenoservative caudal resection of the pancreas. Histological examination confirmed the presence of an additional spleen. These cases emphasize the importance of differential diagnosis, since the accessory spleen performs all the functions of the main spleen and its presence does not require surgical intervention. Imaging techniques such as PET/CT with 68Ga-DOTA-TOC and scintigraphy with labeled erythrocytes can significantly improve the accuracy of diagnosis and help distinguish between the accessory spleen and neuroendocrine tumors of the pancreas, thereby reducing the risk of unnecessary operations. However, these research methods were not available, so the decision on surgical treatment was made on the basis of CT with contrast. Қосалқы көкбауыр әдетте 10-30% жиілікте кездесіп, іш қуысын аспаптық тексеру кезінде кездейсоқ анықталады және клиникалық белгілерді сирек болады. Осы мақалада сипатталған екі клиникалық жағдайда ұйқы безінің құйрығында орналасқан қосалқы көкбауыр нейроэндокринді ісікке ұқсап, көкбауырды сақтайтын лапароскопиялық каудальды панкреатэктомияға әкелді. Гистологиялық зерттеуде қосалқы көкбауырдың болуы расталды. Бұл жағдайлар дифференциалды диагностиканың маңыздылығын көрсетеді, өйткені қосалқы көкбауыр негізгі көкбауырдың барлық функцияларын орындайды және оның болуы хирургиялық араласуды қажет етпейді. 68Ga-DOTA-TOC ПET/КT және таңбаланған эритроциттер сцинтиграфиясы сияқты бейнелеу әдістері диагностикалық дәлдікті айтарлықтай жақсартады және қосалқы көкбауыр мен ұйқы безінің нейроэндокриндік ісіктерін ажыратуға көмектеседі, осылайша қажетсіз хирургиялық араласу қаупін азайтады. Алайда, бұл зерттеу әдістері қол жетімді болмады, сондықтан хирургиялық емдеуден өту туралы шешім қабылданды. Дегенмен, бұл зерттеу әдістері қол жетімді болмады, сондықтан хирургиялық емдеу туралы шешім контрастты КТ негізінде қабылданды.

Background: Splenic artery embolization (SAE) is commonly used in cirrhosis to manage hypersplenism and cytopenia. However, its longer-term clinical impact beyond hematologic parameters remains insufficiently characterized. Aim: To characterize longitudinal inpatient trajectories, clinical patterns, and follow-up features after SAE in patients with cirrhosis treated at a tertiary referral center in Kazakhstan. Methods: This retrospective single-center study included 149 patients with cirrhosis who underwent SAE. Clinical, laboratory, and imaging data were collected across sequential inpatient episodes. Outcomes included longitudinal patterns of hospitalization, laboratory trends, and baseline factors associated with a favorable clinical course. Subsequent hospitalization was defined as any inpatient episode following the index SAE admission, regardless of whether it was planned or unplanned. Results: During follow-up, 59.1% of patients had a second inpatient episode, with progressively fewer patients contributing to later observations. Liver disease severity remained largely stable, with no significant changes in Child–Pugh distribution. Portal hypertension manifestations, including varices and splenomegaly, remained highly prevalent, while recurrent variceal bleeding was relatively uncommon. Laboratory parameters demonstrated modest changes without sustained statistically significant improvement, and the number of recorded inpatient episodes decreased across sequential follow-up. Relatively stable documented follow-up trajectories were more frequently observed in patients with preserved liver function (Child–Pugh A), absence of ascites, and higher albumin levels. The most common causes of subsequent hospitalization were ascites and hepatic decompensation (38.9%) and varices without bleeding (26.2%), while documented major procedure-related complications were infrequent. Conclusions: In this retrospective single-center cohort, predominantly coil-based proximal or selective SAE demonstrated an acceptable documented major complication profile in selected patients with cirrhosis and portal hypertension. Because no untreated control group was available, the findings should be interpreted as descriptive real-world longitudinal data rather than causal evidence of reduced hospitalization burden.

Relevance: Gastric cancer is the second leading cause of malignancies of the gastrointestinal tract and the fifth leading cause in overall cancer statistics. Diseases of the cardiovascular system are the leading cause of death worldwide. A high prevalence of both diseases increases the chances of their co-morbidity. The article aimed present a case where a patient undergoes two simultaneous procedures for two diseases and discuss possible surgical tactics, advantages, and disadvantages. Results: In this case report, we present simultaneous surgical procedures performed on a 49-year-old male with a history of congenital bicuspid aortic valve and gastric cancer, found incidentally on upper gastrointestinal (GI) endoscopy. Since the patient was a good fit, he qualified for simultaneous surgery on the heart and abdomen. The surgery results were good, and the patient was discharged 8 days after surgery. Conclusion: Performing simultaneous surgery for both the abdomen and heart can be a safe procedure that allows people with malignant diseases to receive adjuvant therapy faster by minimizing the interval between surgeries.