Solitary Bladder Fibrous Tumor: A Case Report

The solitary fibrous tumor is an infrequent neoplasm of mesenchymal origin, mainly pleural, exceptionally urogenital. Our patient is 71 years old with no specific history who was presented to the emergency room for acute retention of urine relieved by a bladder catheter. An Uroscanner showed a thickening of the bladder wall which prompted the medical staff to perform a RTUV whose histological and immunohistochemical study confirmed the diagnosis of a solitary fibrous tumor of the bladder. Solitary fibrous tumors remain slow-growing neoplasms regardless of their site. The prognosis and aggressiveness are difficult to specify. Recurrences, locoregional extension and distant metastases can be seen in 10 to 20% of cases.

Jewish Holiday “Tu Bishvat” or Two Cases of Small Bowel Obstruction with Dried Apricot

Introduction: Small bowel obstruction caused by bezoars is rare. One of the causes of phytobezoars is dried fruits. We present two cases of small bowel obstruction caused by dried apricots during Jewish holiday “Tu BiShvat”. Case Presentation: Two men, 54 and 86 years old hospitalized with acute abdomen attributed to small bowel obstruction. In the first case - intoxicated patient, due to suspicion of mesenteric ischemia underwent laparotomy. A lead point caused obstruction was found and after enterotomy whole dried apricot was removed. The patient swallowed it whole three days before hospitalization. In the second case, edentulous patient with small bowel obstruction and peritonitis underwent laparotomy. The cause of obstruction was a dried apricot swallowed whole by the patient. Discussion: Presentation of bezoar with features of acute surgical abdomen is extremely rare, accounting for only 1% of the patients. The expansion of phytobezoar that is high in cellulose content can absorb a large amount of fluid causing an obstruction of the small bowel. The treatment of small bowel obstruction caused by bezoars varies from dissolving with cellulase, papain and even Coca-Cola, followed by endoscopic and surgical removal. Conclusion: A high level of suspicion needs to exist in the presence of a history of eating dried fruit, which can cause gastrointestinal obstruction. Especially on background gastric bypass surgery and inadequate mastication.

Unusual Case of Sclerosing Angiomatoid Nodular Transformation of the Spleen in an Adolescent Patient: Case Report and Literature Review

Sclerosing Angiomatoid Nodular Transformation (SANT) is a rare and benign lesion arising from the red pulp of the spleen, with an unknown etiopathogenesis. These tumors are usually asymptomatic and are found incidentally on radiographic examination. Therefore, high clinical suspicion is of great importance for the diagnosis. Splenectomy provides complete cure, and no recurrence and/or malignant transformation was reported to date. In this study, a rare case of SANT was reported in aadolescent male, and was discussed with the relevant literature.

The Effect of Biopolymer Coatings on Hernia Meshes in a Rat Model

Purpose: To improve biocompatibility and texture of hernia meshes has played a key role in tissue engineering for decades. Biopolymer (Polyethylenimine (PEI) and 3-Glycidoxypropyltrimethoxysilane (GOPS)) coating on Polypropylene (PP) and expanded Polytetrafluoroethylene (ePTFE) mesh showed promising results in fibroblast adhesion and cell growth in an invitro analysis. The objective of this animal study was to evaluate whether this may influence the incorporation into host tissue. Methods: 30 male Lewis rats were divided into 3 groups (n=10): Group 1: ePTFE/PEI, Group 2: ePTFE/GOPS, Group 3: PP/PEI. In each animal, a 3x0.5 cm coated mesh was implanted in the right rectus sheath in sublay position, the uncoated mesh was implanted on the left equally. After 90 days, the rats were sacrificed and each side of the rectus sheath was analyzed separately for adhesions and mechanical strength. Histopathological assessment included Gieson’s stain and haematoxylin-eosin staining. The Wilcoxon test was used for statistical analyses. Results: The GOPS-coated ePTFE tends to cause more adhesions. There was no significant difference in the mechanical strength within and between the groups, but the PEI-coated polypropylene was significantly less extendible (p<0.05) compared to the uncoated PP. In group 2, Gieson’s stain showed a significantly lower surrounding tissue reaction of foreign-body giant cells and scar tissue around the PEI-coated mesh compared to the uncoated ePTFE (p<0.05). Conclusions: It is possible to coat surgical mesh devices with biopolymers. They do not lead to a lack of mechanical strength. The GOPS-coating did not show any general positive effect on the biocompatibility of meshes. The PEIcoating resulted in a lower surrounding tissue reaction and in a less extendible abdominal wall and should therefore be investigated further.

Iliopsoas Hematoma Mimicking Femoral Neuropathy

Iliopsoas hematoma should be considered in the differential diagnosis of femoral neuropathy in patients who are on chronic warfarin therapy. It usually presents with groin or thigh pain, and in rare instances, large bleeding may cause hypovolaemic shock. Conservative management has a good clinical and neurological outcome in such cases.