Background/Objectives: Despite its low incidence, complete postoperative abdominal evisceration represents a complication requiring an urgent solution. We aimed to present a rare case of an abdominal evisceration of the omentum and small-bowel loops after a total abdominal hysterectomy and review the literature regarding this condition’s diagnosis and therapeutic management. Case report: On the sixth postoperative day for a uterine fibroid, a 68-year-old patient presented with an abdominal evisceration of the omentum and small bowel that occurred two hours before. An emergency laparotomy was performed to correct the evisceration and restore the integrity of the abdominal wall structure. The literature review was carried out in the PubMed, Embase, and Web of Science databases using the terms “abdominal wall dehiscence”, “abdominal evisceration”, “open abdomen”, “burst abdomen”, “abdominal fascial dehiscence”, “abdominal dehiscence post-hysterectomy”, and “hysterectomy complications” by identifying all-time articles published in English. Results: Seven studies were included in this electronic search. The early diagnosis of abdominal evisceration, the identification of risk factors and comorbidities, followed by the choice of surgical technique, and postoperative follow-up were parts of the standard algorithm for managing this life-threatening case. Conclusions: Abdominal evisceration, as a surgical emergency, requires the diagnosis and treatment of this complication alongside the identification of the risk factors that can lead to its occurrence, as well as careful postoperative monitoring adapted to each case.

Background and aims. Abu al-Qasim Al-Zahrawi (936–1013), known in Western literature as Albucasis, is recognized as one of the founders of modern surgery. Practicing in medieval Andalusia, he played a decisive role in transforming surgery into a systematized medical discipline. His major work, Kitāb al-Taṣrīf, a 30-volume medical encyclopedia, synthesized the surgical knowledge of his era and profoundly influenced European medicine for several centuries. The aim of this article is to examine Albucasis’ contributions to the development of medieval surgery, focusing on instrumentation, and the educational influence of Kitāb al- Taṣrīf on European medical practice. Methods. A narrative and historical analysis of open-access secondary sources was conducted, including the text of Kitāb al-Taṣrīf in medieval Latin translations, and modern academic literature indexed in international databases. Results. Albucasis described advanced surgical procedures in pediatric, abdominal, orthopedic, and urological surgery and introduced more than 200 original surgical instruments, many of which became prototypes of modern tools. He emphasized the need to adapt operative techniques to the physiological particularities of children and highlighted the importance of clinical experience. The Latin translation of Al-Taṣrīf in the 12th century facilitated the integration of his principles into European universities. Conclusions. Kitāb al-Taṣrīf remains a fundamental work in the history of surgery, and the principles formulated by Albucasis continue to influence medical education and modern surgical practice.

Local recurrence (LR) of rectal cancer (RC) has a disease-free survival rate of up to 50% if diagnosed early. Endorectal ultrasound (ERUS) is an outpatient procedure that can be used together with rectal digital examination for patient follow-up. This is the first study to determine the diagnostic test accuracy of ERUS in the detection of LR after RC and whether it is a good follow-up method. Three authors independently searched MEDLINE and ClinicalTrials.gov databases and included relevant original studies based on strict inclusion/exclusion criteria. 3220 articles were identified. After reading the abstracts, 50 articles were selected, out of which 22 were deemed suitable for study inclusion, comprising 3737 patients, which were followed for 59,72 +/- 16,4 months. Based on the available data, sensitivity of ERUS was 88,3% (CI 84,6 - 91,3%), specificity was 94,3 % (CI 92,7 - 95,5%) and diagnostic odds ratio of ERUS was 271,88 (CI 76,998 - 960,04), with ERUS being the only diagnosis method to detect LR in 40 +/- 12%. Area under the curve for ERUS was 0,9723 +/- 0,0131. LR after curative treatment of RC in our study was 15 +/- 2,99%. Concluding, ERUS seems to be a good and efficient follow-up method for diagnosing RC LR.

Pelvic recurrence is a significant concern following curative resection for rectal cancer, regardless of the tumors origin of the rectum. In this retrospective observational study, 219 patients were analyzed, with 213 undergoing surgical treatment for rectal cancer at three surgical centers between 2014 and 2019. Surgical procedures included anterior resection with Hartmanns procedure (39 patients), anterior resection of rectosigmoid with colorectal anastomosis (130 cases), and abdominoperineal resection (44 cases). After a 2-year follow-up, pelvic recurrence occurred in 19 patients, constituting approximately 8.9% of cases. The recurrence rates varied among surgical procedures, with a 15.38% recurrence rate after the Hartmann procedure, 9% after abdominoperineal resection, and 7% after anterior resection of rectosigmoid with colorectal anastomosis. Emphasize the high recurrence rates associated with advanced stages of rectal cancer. Notably, its follow-up was done clinically, by laboratory tests, colonoscopy (the main test for pelvic recurrence) after 6 months of surgery, 12 months, and 2 years, computed tomography (CT), magnetic resonance imaging (MRI), and pelvic ultrasound at one year and 2 years, a lower recurrence rate being indicative of a successful curative surgical treatment. The Hartmann procedure, often performed as an emergency operation for locally advanced lesions, exhibited the highest recurrence rate.

Background/Aim: Locally advanced liver tumours with vascular invasion have been considered for a long period of time as unresectable lesions, so the patient was further deferred to oncology services for palliation. However, improvement of the surgical techniques and the results reported so far came to demonstrate that extended hepatic and vascular resections might be safely performed in such cases and might significantly improve the long-term outcomes. Materials and Methods: A 61-year-old patient was diagnosed with a caudate lobe tumour invading the inferior cava vein and the right hepatic pedicle. Results: The patient was successfully submitted to surgery, and an extended right hepatectomy en bloc with cava vein resection was performed; the continuity of the cava vein was re-established by the placement of a synthetic graft. The postoperative outcome was uneventful. Conclusions: Although initially considered as a formal contraindication for resection, vascular invasion of the greater vessels should not preclude surgery if complete resection is achievable.

Colorectal cancer (CRC) remains a major global health burden, ranking as the third most commonly diagnosed cancer and the second leading cause of cancer-related death worldwide. Despite its prevalence, CRC is one of the most preventable and treatable malignancies when detected early. Screening plays a crucial role in both primary prevention by identifying and removing precancerous polyps and secondary prevention through early detection, significantly improving survival. This chapter provides an overview of the main CRC screening methods, including colonoscopy, fecal immunochemical tests (FIT), stool DNA tests, flexible sigmoidoscopy, CT colonography, and serum tumor biomarkers. Each modality is analyzed by sensitivity, specificity, accessibility, cost, and effectiveness. The importance of individualized strategies based on risk factors such as age, family history, genetic syndromes, and lifestyle is emphasized. Attention is given to disparities in global screening uptake, with examples from national programs in the United Kingdom, the Netherlands, the United States, and Romania, where I work. Barriers to participation such as limited healthcare access, cultural stigma, and lack of awareness are identified, along with evidence-based strategies to improve engagement. The chapter also highlights innovations such as artificial intelligence, digital health tools, and microbiome analysis, which may transform CRC screening in the future. Finally, it underscores the critical role of healthcare professionals and community involvement in increasing adherence and ensuring equitable access. Effective CRC screening is not only a clinical necessity but a public health priority with potential to save lives and reduce costs.