Appendiceal intussusception complicated by adenocarcinoma of the cecum:A case report

BACKGROUND Appendiceal intussusception is a pathological condition in which the appendix is inverted into the cecum,which may cause symptoms that resemble those of other gastrointestinal disorders and may induce intestinal obstruction.The rarity of this case presentation is the co-occurrence of appendiceal intussusception and cecal adenocarcinoma,a combination that to our knowledge has not previously been reported in the medical literature.This case provides new insights into the complexities of diagnosing and managing overlapping pathologies.CASE SUMMARY A 25-year-old woman presented with persistent periumbilical pain and bloody stools.An initial biopsy showed cecal cancer;however,subsequent colonoscopy and computed tomography findings raised the suspicion of appendiceal intussus-ception,which was later confirmed postoperatively.This unique case was charac-terized by a combination of intussusception and adenocarcinoma of the cecum.The intervention included a laparoscopic right hemicolectomy,which led to the histopathological diagnosis of mucinous adenocarcinoma with appendiceal intussusception.The patient recovered well postoperatively and was advised to initiate adjuvant chemotherapy.This case highlights not only the importance of considering appendiceal intussusception in the differential diagnosis,but also the possibility of appendicitis and the atypical presentation of neoplastic lesions.CONCLUSIONS Physicians should consider the possibility of appendiceal intussusception in cases of atypical appendicitis,particularly when associated with neoplastic presentation.

Colon Adenocarcinoma in a Retrograde Intussusception: A Case Report and Literature Review

Background: Intussusception is defined as a telescoping of a proximal gastrointestinal segment with its mesentery to a distal one, only 5% occur in adults and in colon the probability that it is caused by a malignant disease is up to 65%. Only 1% occurs in a retrograde manner, the rest occur in an anterograde manner. Aim: Describe the clinical presentation of an intussusception in the adult patient as well as its most frequent causes and possible complications that influence decision making for a definitive treatment. Case Presentation: A 66-year-old woman diagnosed with colon adenocarcinoma who underwent elective transverse colectomy and colonic anastomosis with an incidental finding of a transverse colon tumor in a retrograde intussusception was studied. Conclusion: In any adult patient with an intussusception especially in colon a neoplasia should be suspected and the affected segment should be resected without being reduced due to the risk of perforation and tumor dissemination.

Colo-colonic intussusception as a rare complication of colonoscopy with polypectomy: Two case reports

BACKGROUND Colonoscopy is the most frequently used diagnostic and therapeutic tool for the treatment of colorectal diseases.Although the complication rate is low,it can be potentially serious.Intussusception is a rare and severe complication often associated with polypectomy.Only a handful of post-colonoscopy intussusception cases have been reported,making this study a valuable addition to the medical literature.CASE SUMMARY Case 1:A 61-year-old man underwent colonoscopy with polypectomy for chronic abdominal pain.The patient experienced abdominal pain 11 hours later but was still discharged after pain management.He was readmitted due to recurring pain.Computed tomography(CT)showed colo-colonic intussusception.Initial conservative management and attempts at endoscopic reduction failed;therefore,laparoscopic right hemicolectomy was performed.Histopathological examination revealed tubular adenomas in the polyps and inflammation in the resected specimens.Case 2:A 59-year-old woman underwent colonoscopy with polypectomy for a polyp in the transverse colon.She experienced upper abdominal pain,fever,nausea,and vomiting 9 hours after the procedure.Emergency CT and blood tests revealed a colo-colonic intussusception near the hepatic flexure and an elevated white blood cell count.Initial attempts at endoscopic reduction failed and conservative treatment showed no improvement.She underwent successful laparoscopic reduction and recovered uneventfully.Histopathological examination of the resected polyp revealed hyperplasia.CONCLUSION Post-colonoscopy intussusception in adults is rare,and polypectomy may contribute to its occurrence.Early diagnosis is crucial,with prompt CT examination serving as key.After excluding malignancies,conservative management and reduction of intussusception should be considered before surgical bowel resection.

Adult sigmoid intussusception resembling rectal prolapse:A case report

BACKGROUND Rectal prolapse arises from benign etiology.When symptoms of internal intussusception mirror those of rectal prolapse,a misdiagnosis is possible,especially under limited clinical presentation.It is crucial to recognize and differentiate rectal prolapse from internal intussusception because the two diagnoses have different prognoses.Here,we describe a case of adult sigmoid intussusception presenting as rectal prolapse.CASE SUMMARY A 64-year-old woman with no known medical history visited a gastrointestinal outpatient department due to hard bloody stool defecation for 1 wk followed by constipation for 3 d.Colonoscopy revealed a huge polypoid ulcerated tumor at the sigmoid colon with lumen stenosis.The patient was admitted due to postprocedural dull abdominal pain.Due to failed colonoscopy reduction and stent insertion,the patient underwent sigmoid colon resection with primary end-to-end anastomosis,with the transverse colostomy pathological report showing adenocarcinoma,pT3N0M0.She recovered well from the operation and was discharged with regular outpatient clinic follow-up.CONCLUSION Presentation and manifestation of sigmoid intussusception may resemble that of rectal prolapse,necessitating careful observation due to distinct prognostic implications.

Rare etiology of colonic intussusception involving an adult with emphysematous cystic enteropathy:A case report and review of literature

BACKGROUND Pneumatosis cystoides intestinalis(PCI),characterized by a collection of gas-filled cysts in the intestinal wall,is an uncommon but well-known condition in gastroenterology.Abdominal pain is the most frequent symptom associated with PCI.Intussusception represents a potential cause of recurrent abdominal pain or emergency presentation.However,the occurrence of colonic intussusception secondary to PCI is very unusual in adulthood.CASE SUMMARY A 52-year-old male,known with idiopathic PCI,presented seventeen months after initial diagnosis with a new right upper quadrant pain.A computed tomographyscan demonstrated a colonic intussusception at the hepatic flexure.PCI did not progress compared with initial investigation.The patient underwent an emergency right hemicolectomy.CONCLUSION Resection was recommended in this case because PCI proved to be persisting with no identified curable cause.Surgery allowed to address the underlying pathology,the potential relapse of intussusception,and the likely cause of recurrent abdominal pain,either invagination or PCI itself.

Relationship between postoperative rehabilitation style, gastrointestinal function, and inflammatory factor levels in children with intussusception

BACKGROUND Intussusception occurs in children and progresses rapidly.If not treated in time,it may lead to secondary complications such as intestinal perforation,which affect the quality of life and health of children.Surgery is the most common clinical treatment and has a good effect.However,the postoperative prognosis of children with intussusception has a correlation with the postoperative rehabilitation method.Therefore,in this study,we explored the relationship between postopera-tive rehabilitation,gastrointestinal function,and the expression of inflammatory factors in children with intussusception.The medical records of 18 children who were admitted to our hospital for intussusception surgery between October 2022 and May 2024 were retrospectively reviewed.The patients were divided into the routine nursing group(n=6)and rehabilitation training group(n=12)according to the postoperative rehabilitation method.The general data,gastrointestinal function,and inflammatory factor levels of the two groups were statistically analyzed.Pearson correlation analysis of gastrointestinal function,inflammatory factors,and postoperative rehabil-itation was performed.RESULTS We found no significant intergroup differences in sex,age,or disease course(P>0.05).The times to first defecation,bowel sound recovery,and anal exhaust were shorter and inflammatory factor levels were lower in the rehabilitation training group than in the routine nursing group(P<0.05).Pearson correlation analysis showed that gastrin and motilin levels were positively correlated with postoperative rehabilitation(P<0.05).Interleukin(IL)-2,IL-4,IL-6,IL-10,high-sensitivity C-reactive protein,and tumor necrosis factor-αlevels were negatively correlated with postoperative rehabilitation(P<0.05).Gastrointestinal function was positively correlated(P<0.05),and levels of inflammatory factors were negatively correlated with postoperative recovery time(P<0.05).CONCLUSION We found a positive correlation between gastrointestinal function and postoperative rehabilitation training,and a negative correlation between inflammatory factor levels and rehabilitation training in children with intussus-ception.

Clinical Research of Transumbilical Singleport Laparoscopic Treatment For Pediatric Intussusception

Objective:To explore the feasibility and clinical efficacy of single port laparoscopic surgery through the umbilical cord for the treatment of pediatric intussusception.Method:Clinical data of 38 cases of pediatric intussusception treated with umbilical single port laparoscopic surgery from December 2017 to June 2019 were collected.The surgical method involves placing Trocar through the umbilical incision to establish pneumoperitoneum,inserting a single hole with a 0°laparoscopic operating channel,exploring intussusception,and performing non-invasive forceps to completely reduce it.After the reduction of intussusception,if intestinal malformation is found,the umbilical incision can be expanded to lift the diseased intestinal tract out of the abdominal cavity for resection.At the same time,clinical data of 24 children who underwent traditional porous laparoscopic intussusception surgery during the same period were collected,and the surgical time,intraoperative blood loss,postoperative hospital stay,and satisfaction score of incision aesthetics were compared between the two groups of children.Result:Both groups of patients successfully completed the surgery,and compared with the porous laparoscopic group,the single hole laparoscopic group had a shorter surgical time[(32.4±8.6)minutes vs.(40.6±9.8)minutes,P<0.05],decreased bleeding volume[(5.5±1.5)mL vs.(8.6±2.2)mL,P<0.05],significantly shortened postoperative hospital stay[(4.6±1.2)d vs.(6.2±1.4)d,P<0.05],and significantly increased satisfaction score with incision aesthetics[(4.2±0.8)points vs.(3.2±0.7)points,P<0.05].Follow up for 6 months to 2 years showed no recurrence of intussusception.Conclusion:Transumbilical single port laparoscopic surgery is a safe and effective method for children with intussusception,which is characterized by small trauma,fast recovery,short operation time,and better aesthetic effect.

The Value of Ultrasound in the Application of Water Enema in Intussusception

Objective:To introduce high-frequency ultrasound diagnostic technology to cooperate with diagnosis and treatment for patients with intussusception,and to observe its clinical application effect.Methods:The study took patients with intussusception as the object of observation,with a total of 52 cases participating,all of which were clinically admitted from December 2022 to December 2023.After enrollment,the patients underwent high-frequency ultrasound detection in sequence,recording the ultrasound imaging characteristics,and referring to the results of surgical or leaky saline enema reset to confirm the diagnosis(the gold standard)to assess the diagnostic efficacy of high-frequency ultrasound technology.Results:Comparing the confirmed diagnostic results of surgery or leaking saline enema restoration,the detection rate of high-frequency ultrasound technology was 98.07%(P>0.05).Among the 52 patients treated with hydropneumatic enema restoration with the cooperation of high-frequency ultrasound monitoring,39 patients were successfully reset in the first treatment(75.00%),while 9 patients were successfully reset(17.30%)after multiple treatments(≥2 times);the remaining 4 patients were unsuccessful and then converted to surgical treatment,and all of them were successfully treated and cured.Conclusion:For the diagnosis of intussusception,high-frequency color Doppler ultrasound has the advantages of high accuracy and simple operation,which provides a scientific and accurate reference basis for the clinical diagnosis and treatment of patients.

New direction for surgery:Super minimally invasive surgery

The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their sickness.Minimally invasive surgery(MIS)has dominated the surgical realm because of its lesser invasiveness.However,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients post-operation.Thus,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.

Bariatric surgery and diabetes:Current challenges and perspectives

Diabetes mellitus(DM)and obesity have become public issues of global concern.Bariatric surgery for the treatment of obesity combined with type 2 DM has been shown to be a safe and effective approach;however,there are limited studies that have systematically addressed the challenges of surgical treatment of obesity combined with DM.In this review,we summarize and answer the most pressing questions in the field of surgical treatment of obesity-associated DM.I believe that our insights will be of great help to clinicians in their daily practice.

Surgery for Cronkhite-Canada syndrome complicated with intussusception:A case report and review of literature

BACKGROUND Cronkhite-Canada syndrome(CCS)is a rare nonhereditary disease with a syndrome of multiple gastrointestinal polyps,skin pigmentation,hair loss,and fingernail/toenail dystrophy.Intussusception is a serious condition with an occurrence rate of 5%in adults,which is mainly caused by intestinal tumors or other intestinal occupations.CASE SUMMARY A 57-year-old woman was admitted to our hospital due to abdominal distension and pain for the past year.Her nausea and vomiting symptoms had been aggravated for the past month.Previous transoral enteroscopy results one year prior showed chronic erosive gastritis protuberans,duodenitis,and jejunitis.She had sparse body hair and brown pigmentation on the skin of her hands and bilateral anterior tibias.The nails of both hands were pale and lacked luster,and the fingernail of her ring finger was longitudinally cracked.Gastroscopy showed extensive diffuse polypoid lump changes in the gastric body and antrum,of 0.5-3 cm in size.Colonoscopy showed multiple polypoid mucosal bulges in the terminal ileum and multiple polyps(0.3-5 cm)throughout the colon.The patient was diagnosed with CCS and underwent partial excision of the polyps,but she refused hormone therapy.One month later,the patient complained of nausea and vomiting,accompanied by abdominal pain and inability to pass gas or stool.Contrast-enhanced computed tomography of the abdomen showed gastrointestinal polyposis and ileocecal intussusception.She underwent stomach and bowel surgery.CONCLUSION CCS,as a rare disease with poor prognosis,should be treated aggressively.Systematic steroids,immunosuppressive agents,and biological agents were not applied;thus,the patient’s symptoms quickly progressed,and intussusception occurred.She had to undergo surgery.Improved compliance may lead to a better prognosis.

Artificial Intelligence and Computer Vision during Surgery: Discussing Laparoscopic Images with ChatGPT4—Preliminary Results

Introduction: Ultrafast latest developments in artificial intelligence (ΑΙ) have recently multiplied concerns regarding the future of robotic autonomy in surgery. However, the literature on the topic is still scarce. Aim: To test a novel AI commercially available tool for image analysis on a series of laparoscopic scenes. Methods: The research tools included OPENAI CHATGPT 4.0 with its corresponding image recognition plugin which was fed with a list of 100 laparoscopic selected snapshots from common surgical procedures. In order to score reliability of received responses from image-recognition bot, two corresponding scales were developed ranging from 0 - 5. The set of images was divided into two groups: unlabeled (Group A) and labeled (Group B), and according to the type of surgical procedure or image resolution. Results: AI was able to recognize correctly the context of surgical-related images in 97% of its reports. For the labeled surgical pictures, the image-processing bot scored 3.95/5 (79%), whilst for the unlabeled, it scored 2.905/5 (58.1%). Phases of the procedure were commented in detail, after all successful interpretations. With rates 4 - 5/5, the chatbot was able to talk in detail about the indications, contraindications, stages, instrumentation, complications and outcome rates of the operation discussed. Conclusion: Interaction between surgeon and chatbot appears to be an interesting frontend for further research by clinicians in parallel with evolution of its complex underlying infrastructure. In this early phase of using artificial intelligence for image recognition in surgery, no safe conclusions can be drawn by small cohorts with commercially available software. Further development of medically-oriented AI software and clinical world awareness are expected to bring fruitful information on the topic in the years to come.

Fully automatic AI segmentation of oral surgery-related tissues based on cone beam computed tomography images

Accurate segmentation of oral surgery-related tissues from cone beam computed tomography(CBCT)images can significantly accelerate treatment planning and improve surgical accuracy.In this paper,we propose a fully automated tissue segmentation system for dental implant surgery.Specifically,we propose an image preprocessing method based on data distribution histograms,which can adaptively process CBCT images with different parameters.Based on this,we use the bone segmentation network to obtain the segmentation results of alveolar bone,teeth,and maxillary sinus.We use the tooth and mandibular regions as the ROI regions of tooth segmentation and mandibular nerve tube segmentation to achieve the corresponding tasks.The tooth segmentation results can obtain the order information of the dentition.The corresponding experimental results show that our method can achieve higher segmentation accuracy and efficiency compared to existing methods.Its average Dice scores on the tooth,alveolar bone,maxillary sinus,and mandibular canal segmentation tasks were 96.5%,95.4%,93.6%,and 94.8%,respectively.These results demonstrate that it can accelerate the development of digital dentistry.

Surgical treatments of recurrent small intestine metastatic melanoma manifesting with gastrointestinal hemorrhage and intussusception:A case report

BACKGROUND Melanoma is the most aggressive form of skin cancer,with a tendency to metastasize to any organ.Malignant melanoma is the most frequent cause of skin cancer-related deaths worldwide.Small intestine cancers especially small intestine metastases are relatively rare.Small intestine metastases are seldom described and likely underdiagnosed.Intussusception is most common in pediatric age,and in adults are almost 5%of all cases.CASE SUMMARY A 75-year-old man with a history of acral malignant melanoma was admitted to the Gastroenterology Department of our hospital,complaining of intermittent melena for 1 mo.Magnetic resonance enterography showed partial thickening of the jejunal wall and formation of a soft tissue mass,indicating a neoplastic lesion with jejunojejunal intussusception.The patient underwent partial small bowel resection.Pathological findings and immunohistochemical staining indicated small intestine metastatic melanoma.The patient refused further anti-tumor treatment after the surgery.Ten months after the first surgery,the patient presented with melena again.Computed tomography enterography showed the anastomotic stoma was normal without thickening of the intestinal wall,and routine conservative treatment was given.Three months later,the patient developed melena again.The patient underwent a second surgery,and multiple metastatic melanoma lesions were found.The patient refused adjuvant anti-tumor treatment and was alive at the latest follow-up.CONCLUSION Small intestine metastatic melanoma should be suspected in any patient with a history of malignant melanoma and gastrointestinal symptoms.

Cohort analysis of pediatric intussusception score to diagnose intussusception

BACKGROUND Intussusception is a primary cause of intestinal obstruction in young children.Delayed diagnosis is associated with increased morbidity.Ultrasonography(USG)is the gold standard for diagnosis,but it is operator dependent and often unavailable in limited resource areas.AIM To study the clinical characteristics of intussusception including management and evaluation of the diagnostic accuracy of abdominal radiography(AR)and the promising parameters found in the pediatric intussusception score(PIS).METHODS Children with suspected intussusception in our center from 2006 to 2018 were recruited.Clinical manifestations,investigations,and treatment outcomes were recorded.AR images were interpreted by a pediatric radiologist.Diagnosis of intussusception was composed of compatible USG and response with reduction.The diagnostic value of the proposed PIS was evaluated.RESULTS Ninety-seven children were diagnosed with intussusception(2.06±2.67 years,62.9%male),of whom 74%were<2 years old and 37.1%were referrals.The common manifestations of intussusception were irritability or abdominal pain(86.7%)and vomiting(59.2%).Children aged 6 mo to 2 years,pallor,palpable abdominal mass,and positive AR were the parameters that could discriminate intussusception from other mimics(P<0.05).Referral case was the only significant parameter for failure to reduce intussusception(P<0.05).AR to diagnose intussusception had a sensitivity of 59.2%.The proposed PIS,a combination of clinical irritability or abdominal pain,children aged 6 mo to 2 years,and compatible AR,had a sensitivity of 85.7%.CONCLUSION AR alone provides poor screening for intussusception.The proposed PIS in combination with common manifestations and AR data was shown to increase the diagnostic sensitivity,leading to timely clinical management.

Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Enhanced recovery after surgery in elderly patients with non-small cell lung cancer who underwent video-assisted thoracic surgery

BACKGROUND This study was designed to investigate the clinical outcomes of enhanced recovery after surgery(ERAS)in the perioperative period in elderly patients with nonsmall cell lung cancer(NSCLC).AIM To investigate the potential enhancement of video-assisted thoracic surgery(VATS)in postoperative recovery in elderly patients with NSCLC.METHODS We retrospectively analysed the clinical data of 85 elderly NSCLC patients who underwent ERAS(the ERAS group)and 327 elderly NSCLC patients who received routine care(the control group)after VATS at the Department of Thoracic Surgery of Peking University Shenzhen Hospital between May 2015 and April 2017.After propensity score matching of baseline data,we analysed the postoperative stay,total hospital expenses,postoperative 48-h pain score,and postoperative complication rate for the 2 groups of patients who underwent lobectomy or sublobar resection.RESULTS After propensity score matching,ERAS significantly reduced the postoperative hospital stay(6.96±4.16 vs 8.48±4.18 d,P=0.001)and total hospital expenses(48875.27±18437.5 vs 55497.64±21168.63 CNY,P=0.014)and improved the satisfaction score(79.8±7.55 vs 77.35±7.72,P=0.029)relative to those for routine care.No significant between-group difference was observed in postoperative 48-h pain score(4.68±1.69 vs 5.28±2.1,P=0.090)or postoperative complication rate(21.2%vs 27.1%,P=0.371).Subgroup analysis showed that ERAS significantly reduced the postoperative hospital stay and total hospital expenses and increased the satisfaction score of patients who underwent lobectomy but not of patients who underwent sublobar resection.CONCLUSION ERAS effectively reduced the postoperative hospital stay and total hospital expenses and improved the satisfaction score in the perioperative period for elderly NSCLC patients who underwent lobectomy but not for patients who underwent sublobar resection.

Glaucoma surgery experiments using digital microscope-integrated optical coherence tomography and OCT-compatible instruments

There is a certain failure rate in traditional glaucoma surgery because of the lack of depth information in microscope images.In this work,we present a digital microscope-integrated optical coherence tomography(MIOCT)system and several custom-made OCT-compatible instruments for glaucoma surgery.Sixteen ophthalmologists were asked to perform trabeculectomy and canaloplasty on live porcine eyes using the system and instruments.After surgery,a subjective feedback survey about the user experience was taken.The experiment results showed that our system can help surgeons easily locate important tissue structures during surgery.The custom-made instruments also solved the shadowing problem in OCT imaging.Surgeons preferred to use the system in their future practice.

Uterine artery pseudoaneurysm caused by hysteroscopic surgery: A case report

BACKGROUND We report a case of uterine artery pseudoaneurysm(UAP)occurrence during hysteroscopic endometrial polypectomy and its treatment via uterine artery embolization(UAE).CASE SUMMARY A 48-year-old primigravid,primiparous patient was incidentally found to have an endometrial polyp during a health checkup,and underwent a hysteroscopic polypectomy at another hospital.Her cervix was dilated with a Laminken-R®device.After the Laminken-R®was withdrawn,a large amount of genital bleeding was observed.This bleeding persisted after the hysteroscopic polypectomy,and,as hemostasis became impossible,the patient was transferred to our hospital by ambulance.On arrival,transvaginal ultrasonography revealed a 3-cm hypoechoic mass with a swirling internal pulse on the right side of the uterus,and color Doppler ultrasonography showed feeder vessels penetrating the mass.Pelvic contrast-enhanced computed tomography(CT)confirmed the presence of a mass at this site,and vascular proliferation was observed within the uterine cavity.Consequently,UAP was diagnosed,and UAE was performed.The patient’s postoperative course was uneventful,and 6 mo post-UAE,no recurrence of blood flow to the UAP was observed.CONCLUSION When abnormal genital bleeding occurs during hysteroscopic surgery,ultrasonography and contrast-enhanced CT can assist in the detection of early UAPs.

Effect of bariatric surgery on metabolism in diabetes and obesity comorbidity:Insight from recent research

Obesity is a prevalent cause of diabetes mellitus(DM)and is a serious danger to human health.Type 2 DM(T2DM)mostly occurs along with obesity.Foodborne obesity-induced DM is caused by an excessive long-term diet and surplus energy.Bariatric surgery can improve the symptoms of T2DM in some obese patients.But different types of bariatric surgery may have different effects.There are some models built by researchers to discuss the surgical procedures’effects on me-tabolism in diabetes animal models and diabetes patients.It is high time to conclude all this effects and recommend procedures that can better improve metabolism.