An Unexpected Cause of Acute Abdomen Late After Heart Transplantation—A Case Report

Cytomegalovirus (CMV) infection is a frequent complication after a solid organ transplant, and in 86% of the cases, CMV disease occurred during the first 6 months after transplantation. Invasive CMV infections may be present as ulcerative infections of the upper gastrointestinal tract with esophagitis, gastritis, and ulcerations of the duodenum and the small bowel; however, CMV infections of the pancreatobiliary system, especially papillitis, are rarely observed. We present a case report of a man who underwent a heart transplant 6 years before, with a clinical picture of duodenitis and a simultaneous pseudotumor of major duodenal papilla who developed signs of acute abdomen caused by gastrointestinal CMV infection, successfully treated with medical therapy with valganciclovir. There is an urgent need for developments in CMV and solid organ transplantation to stratify the risk of late-onset CMV disease.     

Meckel’s Diverticulum Enterolith: A Rare Cause of Acute Abdomen

Meckel’s diverticulum (MD) is the most common congenital anomaly of the gastro-intestinal tract. Inflammation, bleeding and obstruction are its main complications. Formation of enterolith is rare. A case of acute abdomen caused by Meckel’s diverticulitis with enterolith is reported.     

Radical “Fleur-de-Lis” Abdominoplasty after Bariatric Surgery

The massive weight loss produced by bariatric surgical procedures on the morbidly obese can result in gross redundancy of abdominal and trunk skin. Standard abdominoplasty procedures may be insufficient to correct this debilitating deformity. A radical version of the “Fleur-de-Lis” abdominoplasty has been carried out on 45 such patients, with good cosmetic and functional results and low morbidity.     

Editorial Commentary: Safe Innovation? Arthroscopy After Traumatic Hip Dislocation

Hip arthroscopy can be helpful relative to conventional imaging when diagnosing (and treating) intra-articular injuries after a hip dislocation, but more evidence is required before adopting this approach diagnostic and therapeutic strategy.     

A “Beehive” in the Abdomen

A 22 years-old woman presenting with intestinal occlusion by a giant fecaloma. Fecal impaction is often misdiagnosed, especially in non collaborating patients. This demonstrates the necessity of particular attention to avoid unnecessary surgical intervention.     

Editorial Commentary: Opioids After Orthopaedic Surgery: Who Needs ‘Em?

Multimodal analgesia protocols have been developed to reduce the number of opioids prescribed after orthopaedic surgery, although no previous studies have examined the effectiveness of a nonopioid multimodal analgesia protocol following common sports medicine procedures. Clinicians should feel assured that this type of strategy can be effective at reducing pain and the number of opioids needed for breakthrough pain with minimal side effects and without compromising patient satisfaction. The use of rescue opioids is associated with pain level, procedure type, and psychiatric illness.