Saad Al Mogrampi

Neutrophil and T-cell recruitment contribute to hepatic ischemia/reperfusion injury. The initial inflammatory response is orchestrated by Kupffer cells and liver sinusoid endothelial cells. However, other cell types, including γδ-Τ cells, seem to be key mediators in further inflammatory cell recruitment and proinflammatory cytokine release, including IL17a. In this study, we used an in vivo model of partial hepatic ischemia/reperfusion injury (IRI) to investigate the role of the γδ-Τ-cell receptor (γδTcR) and the role of IL17a in the pathogenesis of liver injury. Forty C57BL6 mice were subjected to 60 min of ischemia followed by 6 h of reperfusion (RN 6339/2/2016). Pretreatment with either anti-γδΤcR antibodies or anti-IL17a antibodies resulted in a reduction in histological and biochemical markers of liver injury as well as neutrophil and T-cell infiltration, inflammatory cytokine production and the downregulation of c-Jun and NF-κΒ. Overall, neutralizing either γδTcR or IL17a seems to have a protective role in liver IRI.

Background: Littre's hernia is the type of hernia where the sac contains Meckel's diverticulum, which is associated with various complications. Strangulation of Meckel's diverticulum and consequent rupture represents a serious and life-threatening condition. Methods: A 62-year-old female, with a 10-d history of abdominal pain, presented in the emergency department with abdominal pain in the past 48 h, accompanied by fever and vomiting. Clinical examination revealed diffuse abdominal pain and an inflamed mass on the right groin. Given the clinical and laboratory findings the patient was taken in the operating room. Results: Diagnostic laparoscopy revealed Littre's hernia accompanied by rupture of Meckel's diverticulum and abscess formation. Because of multiple adhesions and distension of the small bowel, the operation proceeded with open laparotomy, including a sub-umbilical midline incision. Enterectomy and side-to-side anastomosis was performed and the abscess was drained. The post-operative period was uneventful and the patient was symptom free at the two-month follow-up. Conclusions: An inguinal abscess can represent the first manifestation of a strangulated Meckel's diverticulum in Littre's hernia. It should be taken into account in the differential diagnosis of acute abdomen symptoms. Prompt diagnosis and therapy is essential. The preferred treatment is an operation consisting of enterectomy and primary anastomosis.

Background: We present a case of a hydatid cyst located in the left thigh. Case Report: A 67-year-old man was admitted to our department with a 10 × 5 × 4 cm mass in the medial compartment of the left thigh. Computed tomography scan indicated possible hydatidosis. Serological testing (indirect hemagglutination) was positive for hydatidosis. The patient was operated seven years ago for liver hydatidosis. Results: The patient, after evaluation, underwent surgical excision of the cyst under epidural anesthesia. The cyst was located in the left quadriceps muscle; had a soft, elastic substance; was firmly attached to the muscle fibers; and contained transparent fluid and daughter cysts. Histologic examination confirmed the initial diagnosis. The patient was discharged on the fifth postoperative day. Conclusions: The diagnosis of muscular hydatidosis is difficult and the usual diagnostic methods are the serological tests for hydatidosis and imaging (e.g., ultrasound, computed tomography, and magnetic resonance imaging). In every soft tissue mass with benign characteristics the existence of a hydatid cyst should always be considered. Careful surgical excision of the intact cyst is the treatment of choice, but complementary control for liver—or other organ—hydatidosis should be performed.