Hydatidosis is a cosmopolitan parasitosis that poses a major public health risk in endemic regions such as Morocco. Secondary implantation of Echinococcus granulosus larvae in the peritoneum is called peritoneal hydatidosis. This condition presents itself in a polymorphic manner, and its detection requires a combination of various aspects, including epidemiological, clinical, biological, and radiological elements. We report an uncommon case of peritoneal hydatidosis in a patient with a history of surgically treated hepatic hydatid disease, who presented with progressive abdominal pain and distension. Physical examination was unremarkable, whereas hydatid serology was strongly positive. CT was essential for establishing the diagnosis by demonstrating both hepatic and peritoneal cystic lesions. The patient had surgery to remove the cyst. Post-operative recovery was uneventful, and albendazole treatment was initiated as adjuvant therapy. Our case report underscores the challenges faced in diagnosing this uncommon condition, the significance of diagnostic imaging in achieving an accurate diagnosis, and the advantages of surgical intervention.

Solitary fibrous tumors (SFTs) are rare mesenchymal tumors that most commonly arise in the thoracic region. Most SFTs are benign; however, some show malignant behavior, such as local recurrence and distant metastasis. Here, we report the case of a 61-year-old man in whom an abdominal mass and multiple pulmonary nodules were incidentally detected on computed tomography (CT). Abdominal magnetic resonance imaging (MRI) showed a well-circumscribed solid tumor arising from the anterior surface of the liver that displaced the round ligament posteriorly. A gastrointestinal stromal tumor (GIST) was initially suspected; however, at laparotomy the tumor was found to arise from the falciform ligament, and a diagnosis of SFT was confirmed histopathologically. Immunohistochemically, the tumor was diffusely positive for STAT6, bcl-2, CD99, and vimentin, partially positive for cytokeratin AE1/AE3, and negative for CD34. Postoperatively, there was no local recurrence, but follow-up CT showed progressive enlargement of the bilateral pulmonary nodules and lymph nodes, and biopsy of a mediastinal lymph node confirmed metastatic SFT. The patient was transferred to a specialized cancer center for systemic therapy 13 months after surgery. To our knowledge, only two cases of SFT of the hepatic falciform ligament have been reported, and neither showed metastasis; the present case is the first with documented distant metastasis. Loss of CD34 expression and aberrant cytokeratin positivity, which have been associated with dedifferentiation and aggressive behavior in SFT, may identify extrapleural SFTs that warrant long-term surveillance for metastasis, although this observation from a single case requires confirmation.

Post-mastectomy breast reconstruction is associated with significant postoperative pain due to the involvement of both the thoracic recipient site and the abdominal donor site. Effective analgesic strategies are essential to optimise recovery, reduce opioid exposure, and support enhanced recovery after surgery (ERAS) pathways. We report the perioperative analgesic management of a patient undergoing mastectomy with immediate breast reconstruction using a pedicled transverse rectus abdominis myocutaneous (TRAM) flap. A multimodal regional anaesthesia strategy based on bilateral multilevel thoracolumbar erector spinae plane blocks (ESPB), supplemented by a serratus anterior plane block, was employed to address wide thoracoabdominal dermatomal pain distribution. The regional analgesic approach was associated with effective postoperative pain control and minimal systemic opioid requirements during the early postoperative period. Pain scores remained low at rest and during movement, and no block-related complications were observed. This case illustrates the feasibility of combining bilateral multilevel ESPB with adjunct interfascial plane blocks as part of a multimodal analgesic strategy for pedicled TRAM flap reconstruction. While no conclusions regarding comparative efficacy or reproducibility can be drawn from a single case, this experience supports further investigation of ESPB-based approaches within ERAS pathways for autologous breast reconstruction.

Ascaris lumbricoides infection is one of the most common helminthiases worldwide and is associated with poor sanitation in tropical and subtropical regions. Although most cases are asymptomatic or present with nonspecific gastrointestinal symptoms, aberrant migration may lead to ectopic disease. We present a case report of a 51-year-old woman with type 2 diabetes mellitus presented with progressive abdominal enlargement, gastrointestinal symptoms, and significant weight loss. Imaging studies revealed a large left perirenal mass initially interpreted as a renal neoplasm. She subsequently developed acute urinary retention and unexpectedly expelled a 30-cm reddish-brown cylindrical helminth with tapered ends, morphologically consistent with Ascaris lumbricoides. Complete symptom resolution and disappearance of the perirenal lesion on follow-up imaging supported the parasitic origin of the condition. This case illustrates a presentation of ectopic ascariasis with possible renal involvement, highlighting abnormal migration mechanisms such as fistulization or retrograde migration.

Limited attention has been paid to the macroscopic topology of small-caliber electrospinning artificial vascular grafts. Here, we fabricated an elastic vascular graft of 2 mm diameter featuring a "ridge-and-valley" macrostructure using a modified near-field coaxial electrospinning technology, which combines the near-field electrospinning direct-writing technique and coaxial electrospinning technology, employing polyurethane (PU) as the outer shell and poly(l-lactide-co-ε-caprolactone) (PLCL) as the inner core. By adjusting the PLCL/PU ratio, the viscosity of the blended solution was tuned to meet electrospinning requirements. The electrospun grafts exhibited oriented filament alignment in the ridge regions and a relatively disordered configuration in the valley regions, demonstrating significantly enhanced kinking resistance in macroscopic testing. In vitro cell experiments and in situ rat abdominal aorta transplantation models verified the graft's ability in inducing vascular smooth muscle cell (vSMC) alignment generated by oriented fiber alignment. Importantly, partial endothelial coverage and circumferentially aligned vSMC proliferation were observed. Critically, the PLCL/PU 0.5/0.5 group showed a great patency rate and a desirable functional structure at the 12-week endpoint. These findings present a novel strategy for fabricating small-caliber biocompatible vascular grafts with favorable mechanical properties via a straightforward, continuous single-step process.

We present a case of a giant ileocecal inflammatory myofibroblastic tumor (IMT), which represents one of the largest pediatric colorectal IMTs reported in the literature. An 11-year-old girl presented with a 1-day history of abdominal pain and developed fever (up to 102.2°F). Laboratory evaluation revealed severe anemia (hemoglobin, 53 g/L) and marked systemic inflammatory abnormalities consistent with paraneoplastic inflammatory syndrome. Exploratory laparotomy revealed a 17 × 17 × 8 cm mass intimately adherent to the ileocecal region. Histopathological examination confirmed IMT with focal ALK positivity. The inflammatory and hematologic abnormalities improved rapidly following complete tumor resection.

Hydatid cyst disease is a common disease in humans and animals. In livestock and agricultural areas, it is caused by the tapeworm Echinococcus. Canines serve as the definitive host, while livestock act as the intermediate host for this parasite. Humans can also be infected with the eggs of this parasite as accidental hosts, and in most cases, the liver and lungs are the primary sites of infection with this parasite and its cysts. In rare cases, other organs such as the spleen can also be infected with this cyst. Its rarity as well as the nonspecific clinical manifestations of splenic hydatid cysts lead to delays in its diagnosis and treatment. Ardabil province in northwestern Iran is one of the largest livestock-breeding areas in Iran, contributing to the spread of Echinococcosis in this region. This case report discusses a 47-year-old female farmer from Ardabil Province who, following 2 years of chronic pain in the left upper quadrant of her abdomen and splenomegaly, was diagnosed with a 13×10×10 cm isolated hydatid cyst of the spleen without involvement of other organs according to paraclinical examinations (e.g., ultrasound, CT scan, Indirect hemagglutination test). Finally, she underwent total splenectomy due to the large size of the cyst and the risk of rupture without any complications, and a histological examination confirmed the diagnosis.

Biliary ascariasis is an uncommon trigger of acute abdomen in endemic areas that can lead to severe biliary obstruction and acute pancreatitis. In low-resource settings, self-medication prior to presentation can create diagnostic distractors, confounding the clinical picture with drug-induced liver injury (DILI). A 22-year-old male from rural Honduras presented in refractory shock (BP 60/40 mmHg), hepatic encephalopathy (GCS 6), jaundice, and upper gastrointestinal bleeding following the massive ingestion of analgesics and herbal extracts. Laboratory findings demonstrated severe hepatic dysfunction (AST 12,750 U/L, ALT 13,150 U/L, total bilirubin 6.7 mg/dL, INR 3.53), acute kidney injury (creatinine 5.04 mg/dL), and rhabdomyolysis. Initial supportive management targeted suspected fulminant drug-induced hepatitis. Subsequent targeted anamnesis on day 7 identified a pre-hospital history of severe epigastric pain radiating to the back with antalgic positioning. Re-evaluation of day 3 diagnostics revealed a serum lipase of 905 U/L and abdominal ultrasonography demonstrating tubular, "railway-track" hyperechoic images within the common bile duct, confirming severe acute pancreatitis secondary to biliary ascariasis overlapping with acute DILI. The patient was managed conservatively with hemodynamic support, blood products, and hemodialysis. Spontaneous oral expulsion of Ascaris parasites occurred during the acute phase, with follow-up ultrasonography confirming biliary clearance. Organ function gradually improved, and the patient was discharged with residual organ sequelae requiring outpatient surveillance. Severe acute pancreatitis due to biliary ascariasis can co-exist with or be masked by drug-induced hepatic toxicity. Clinicians in endemic regions must maintain a high index of suspicion for mechanical parasitic obstruction, using systematic anamnesis and pancreatic enzyme evaluation to prevent diagnostic anchoring biases during critical organ failure management.

Adrenal masses are increasingly detected due to advanced imaging modalities, yet their differential diagnoses remain broad and challenging. Extragastrointestinal stromal tumors (EGISTs) are rare mesenchymal tumors sharing histologic and immunophenotypic features with GISTs but occurring outside the gastrointestinal (GI) tract. EGISTs involving the adrenal region are exceptionally rare, with only five cases previously reported. In this case report, we present the sixth documented case, involving a male patient in his early 60s who presented with acute abdominal pain and a nonfunctioning retroperitoneal mass abutting the adrenal gland. Surgical resection and histopathological analysis confirmed a GIST with cluster of differentiation 117 (CD117) and Discovered on GIST-1 (DOG1) positivity. The patient received adjuvant imatinib and remained recurrence-free at two-year follow-up. This case highlights the diagnostic complexity of EGISTs involving the adrenal region and emphasizes the role of immunohistochemistry and surgical management. While early outcomes appear favorable, the rarity and limited follow-up data call for cautious interpretation and continued reporting to better define the prognosis and optimal treatment strategies.