Neoplastic sigmoid-uterine fistula. An exceptional complication of large intestine cancer

Endometrial cavity-myoma fistula after uterine artery embolization diagnosed by pelvic MRI: case report

Uterine cavity-myoma fistula is a rare entity which has scarcely been reported in the literature. They are mainly secondary to a treatment and intervention. The reported options for patient evaluation and treatment are mainly invasive such as hysteroscopy. The case, described here, is a 26-year-old woman who had significant symptoms for myoma and went through uterine artery embolization. After few months of being asymptomatic, she complained of continuous spotting with minimal pain; subsequently, pelvic MRI was performed and a clear connection between endometrial cavity and myoma was shown resulting in the final treatment by radio-frequency ablation and the complete relief of the symptoms. The case highlights the importance of the necessity of the proper case selection in terms of size and the site of myoma and also the significance of imaging, mainly MRI, for rare complications corresponding to myoma treatments.

Colouterine and Jejunouterine Fistula Secondary to Chronic Diverticulitis

Fistulae between the colon or the small intestine and the uterus are extremely rare as the uterus is a thick, muscular organ. Here, we present the case of a 74-year-old female presenting to our surgical department because of fecal vaginal discharge for the past few months, which proved to be caused by a combined colouterine and jejunouterine fistula due to chronic diverticulitis. Total abdominal hysterectomy with bilateral oophorectomy with en bloc resection of part of the jejunum and the sigmoid colon and primary anastomoses were performed. This case represents an unusual type of diverticulitis complication and aims to point out the diagnostic and therapeutic issues of such a rare medical condition.

PAHs in seafood from the Mediterranean Sea: An exposure risk assessment

Seafood represent an important food source for human, and seafood quality is associated with marine environment quality. PAHs are one of the main organic environmental contaminants and they can be introduced into the body through different way (ingestion, inhalation, dermal absorption). We present data on bioaccumulation of the sixteen PAHs, defined priority by the U.S.- EPA, in Sardina pilchardus, Solea solea and Donax trunculus, three species caught in the Catania Gulf and highly consumed by the local population. The risk to develop chronic systemic and carcinogenic effects due to the consumption of these target species was evaluated through the EDI, THQ and CR. EDI derived from D. trunculus ingestion falls within the range calculated by the EFSA. The THQ is less than 1, and the CR calculated for the Benzo(a)Pyrene is at the limit of the ARL (1✕10^-5). EDI derived from S. pilchardus and S. solea ingestion are below the range calculated by the EFSA. The THQ is less than 1, and the CR is below the acceptable risk level. The contamination level found in local seafood determines a low risk to develop chronic systemic effects, but the cancer risk could be of health concern especially for high-frequency molluscs consumers.

Case Report: Spontaneous cholecystocutaneous fistula, a rare cholethiasis complication

One of the most unusual complications in cholethiasis is spontaneous cholecystocutaneous fistula, which has only been reported a few times in the literature.  We report the case of a 76 year old man who presented with a right hypochondrium subcutaneous abscess, with pain evoked through palpation.  No comorbidity in the patient’s medical history were noted.   Confirmation of cholecystocutaneous fistula was made using the proper diagnostic process, which is computed tomography with contrast media, followed by hepatobiliary MRI. This confirmed the presence of a fistulous pathway between the gallbladder and the skin.  The patient underwent cholecystectomy surgery and open laparotomy with en block aponeurotic muscle, skin and fistula orifice excision.