UNASSIGNED: Malignant transformation of ovarian teratomas is rare, provoking peritonitis and death are exceedingly rare.
METHODS: We present the case of a 75-year-old woman who was admitted to the emergency department for severe abdominal pain with septic shock due to acute peritonitis caused by perforation of the ovarian mass.
UNASSIGNED: Teratomas are germ cell tumors usually composed of multiple cell types derived from one or more of the three germ layers. Pathologically, malignant transformation of ovarian dermoid cysts is rare due to the thickness of the capsule, spontaneous rupture is a very rare complication, acute peritonitis presents with features of acute abdomen or shock, treatment is essentially surgical and includes at least unilateral adnexectomy, complete exploration of the pelvis and abdominal cavity, peritoneal washing and/or sampling of any ascites.
CONCLUSIONS: In conclusion, although ovarian teratoma with granulomatous peritonitis is rare, rupture leading to generalised acute peritonitis further worsens the prognosis. Which will ensure correct management that will provide a good outcome with less complications.

Although organ transplantation is associated with significant survival rates and cost benefits, postoperative complications still occur. Gastrointestinal complications, including those involving the stomach and intestines, account for 1-6% of posttransplant complications, with intestinal perforation specifically accounting for approximately 9%, depending on the center. In Vietnam, there are no comprehensive reports on these complications. Therefore, we report three clinical cases of gastrointestinal perforation following transplantation. Three cases of intestinal perforation are described in this case series. In 2023, a 16-year-old female patient who underwent heart transplantation for congenital heart disease was diagnosed with intestinal perforation on the 12th day. The patient required continued blood filtration support after surgery. In 2018, six days after liver transplantation, a 56-year-old male patient was diagnosed with intestinal perforation, which was subsequently repaired, and the ends of his intestines were removed. The patient was discharged in stable condition after 30 days. In 2017, five days after kidney transplantation, a 46-year-old female patient was diagnosed with intestinal perforation, which was repaired, and the perforation site was left open. The patient was discharged in stable condition after 40 days. Intestinal perforation is a relatively rare, but not uncommon, complication. Early diagnosis is challenging due to nonspecific clinical symptoms and signs. Considering the possibility of intestinal perforation and obtaining early abdominal computed tomography imaging can help prevent delayed diagnosis.

UNASSIGNED: Abdominal pregnancy is still seen in developing countries due to inadequate medical facilities. The clinical indicators manifest in various forms and are nonspecific, making it challenging to diagnose and often leading to delayed detection. The occurrence of an infectious complication that leads to the development of generalised acute peritonitis is rare. The author present a case of 34-year-old patient who presented with febril generalised acute peritonitis caused by an abdominal pregnancy. The result of the abdominal ultrasound and the serum β-human chorionic gonadotropin (β-HCG) level led to initial diagnostic confusion.
UNASSIGNED: A 34-year-old primigravida with no medical or surgical history of comorbidity prior consulted in the authors\' department for generalised abdominal pain in the context of fever and amenorrhoea for more than 4 months. Physical examination revealed a painful and contracted abdomen. The biological assessment showed white blood cells at 27 100/ul, the haemoglobin level at 11.8 g/dl. The serum β-HCG level was less than 5 UI/l. The abdominal ultrasound noted a peritonitis secondary to an abscess of the appendix. Exploratory laparotmy revealed 200 ml of pus in the peritoneum and a mass in the right iliac fossa at the expense of the ovary with agglutination of the intestines loops. After adesyolysis, a single-piece excision of the mass was performed, the break-in showing a macerated foetus, a right adnexectomy and an appendectomy. The maternal outcome was good.
UNASSIGNED: Abdominal pregnancy remains an inadequately diagnosed condition in developing countries. This case reminds clinicians that abdominal pregnancy remains a differential diagnosis of all abdominal pain in a woman of childbearing age including when the serum β-HCG level was less than 5 UI/l.
UNASSIGNED: It is imperative to increase awareness among pregnant women about high-quality prenatal care, including early obstetric ultrasound, from conception. Meanwhile, healthcare professionals should receive continuous training and the technical platform modernised.

BACKGROUND: Due to treatment of end-stage-renal-disease (ESRD), continuous peritoneal dialysis (CAPD) is used in 11% of cases and is associated with several PD-associated infections.
METHODS: Clinical data on 71 patients with CAPD were evaluated in addition to exit site infections and episodes of acute peritonitis (AP).
RESULTS: There were 39 men and 32 women. Average age was 61 years when we began CAPD and average time spent on CAPD program was 3.35 years. Illness that dominantly caused ESRD was diabetes (23 patients). Exit site infection was mostly caused by S epidermidis-MRSE and AP was most commonly caused by Staphylococcus sp. group. Most common cause of death was cardiovascular disease. At the end of this study, 9 patients were alive and still on CAPD, 10 were transplanted, 15 switched to HD and 36 died.
CONCLUSIONS: Optimal prevention measures and treatment of infectious complications in CAPD is necessary for better treatment possibilities.

Laparoscopy is widely adopted across nearly all surgical subspecialties in the elective setting. Initially finding indication in minor abdominal emergencies, it has gradually become the standard approach in the majority of elective general surgery procedures. Despite many technological advances and increasing acceptance, the laparoscopic approach remains underutilized in emergency general surgery and in abdominal trauma. Emergency laparotomy continues to carry a high morbidity and mortality. In recent years, there has been a growing interest from emergency and trauma surgeons in adopting minimally invasive surgery approaches in the acute surgical setting. The present position paper, supported by the World Society of Emergency Surgery (WSES), aims to provide a review of the literature to reach a consensus on the indications and benefits of a laparoscopic-first approach in patients requiring emergency abdominal surgery for general surgery emergencies or abdominal trauma.
This position paper was developed according to the WSES methodology. A steering committee performed the literature review and drafted the position paper. An international panel of 54 experts then critically revised the manuscript and discussed it in detail, to develop a consensus on a position statement.
A total of 323 studies (systematic review and meta-analysis, randomized clinical trial, retrospective comparative cohort studies, case series) have been selected from an initial pool of 7409 studies. Evidence demonstrates several benefits of the laparoscopic approach in stable patients undergoing emergency abdominal surgery for general surgical emergencies or abdominal trauma. The selection of a stable patient seems to be of paramount importance for a safe adoption of a laparoscopic approach. In hemodynamically stable patients, the laparoscopic approach was found to be safe, feasible and effective as a therapeutic tool or helpful to identify further management steps and needs, resulting in improved outcomes, regardless of conversion. Appropriate patient selection, surgeon experience and rigorous minimally invasive surgical training, remain crucial factors to increase the adoption of laparoscopy in emergency general surgery and abdominal trauma.
The WSES expert panel suggests laparoscopy as the first approach for stable patients undergoing emergency abdominal surgery for general surgery emergencies and abdominal trauma.

Foreign body ingestion is a common reason for emergency department (ED) visits, with rare complications necessitating immediate surgical intervention. This case report discusses diagnosis and treatment, emphasizing the importance of prompt intervention. A 45-year-old male with dentures presented with acute left abdominal pain. Diagnostic tests identified a foreign body in the descending colon, leading to laparoscopic surgery. Early laparoscopy offers a safe and reliable alternative to exploratory laparotomy. This case underscores the significance of swift diagnosis, preventing severe complications like peritonitis, obstruction, and hemorrhage. In conclusion, while foreign body ingestion is common, intestinal perforation remains extremely rare. Physicians should consider it in their differential diagnosis, with computed tomography (CT) and rapid surgical intervention as crucial components of proper management.

BACKGROUND: Few reports have described living foreign bodies in the human body. The current manuscript demonstrates that computed tomography (CT) is an effective tool for accurate preoperative evaluation of living foreign bodies in clinic. The three-dimensional (3D) reconstruction technology could clearly display anatomical structures, lesions and adjacent organs, improving diagnostic accuracy and guiding the surgical decision-making process.
METHODS: Herein we describe a 68-year-old man diagnosed with digestive tract perforation and acute peritonitis caused by a foreign body of Monopterus albus. The patient presented to the emergency department with complaints of dull abdominal pain, profuse sweating and a pale complexion during work. A Monopterus albus had entered the patient\'s body through the anus two hours ago. During hospitalization, the 3D reconstruction technology revealed a perforation of the middle rectum complicated with acute peritonitis and showed a clear and complete Monopterus albus bone morphology in the abdominal and pelvic cavities, with the Monopterus albus biting the mesentery. Laparoscopic examination detected a large (diameter of about 1.5 cm) perforation in the mid-rectum. It could be seen that a Monopterus albus had completely entered the abdominal cavity and had tightly bitten the mesentery of the small intestine. During the operation, the dead Monopterus albus was taken out.
CONCLUSIONS: The current manuscript demonstrates that CT is an effective tool for accurate preoperative evaluation of living foreign bodies in clinic.

Peritoneal metastasis from breast cancer is a relatively rare life-threatening condition. The gold standard for diagnosing peritoneal metastasis is a direct peritoneal biopsy. In this report, we describe an interesting case of peritoneal inflammation mimicking peritoneal metastasis in a patient with breast cancer, as confirmed by laparoscopic peritoneal biopsy. A 45-year-old woman with a history of right breast cancer presented with a peritoneal wall mass seen on an abdominal computed tomography (CT) in routine follow-up. She underwent right skin-sparing mastectomy with sentinel lymph node biopsy with direct to implant reconstruction 6 years prior and underwent right salpingo-oophorectomy 2 years before. Positron emission tomography-computed tomography (PET-CT) and abdominopelvic CT showed multiple enhancing nodules in small bowel mesentery and right peritoneal wall with a small amount of ascites, which led to a strong suspicion of peritoneal metastasis. After a multidisciplinary conference, the possibility of peritoneal seeding became doubtful. Laparoscopic biopsy was performed, and peritoneal wall mass biopsy was subsequently performed. Pathologic results showed no evidence of peritoneal metastasis of breast cancer. The peritoneal biopsy specimen revealed postoperative fibrosis and inflammation with some meal content. Although rare in breast cancer, peritoneal metastasis can produce a devastating outcome if left undiagnosed. Despite the imaging findings strongly suggesting metastasis, biopsy confirmation for the suspected lesion was necessary. This not only verifies true metastasis but also determines the treatment options available for the patient and thus unnecessary treatment can be avoided.

The coproliths of the appendix are accumulations of fecal remnants within its lumen. They are categorized based on their size into coproliths < 1cm, which are the most common, and giant coproliths, with a diameter > 2cm. It\'s important to note that the pathophysiology of acute appendicitis is characterized by the obstruction of the appendix lumen. This leads to distension due to the inability to expel secretions, ischemia, and ultimately rupture of its wall. This presentation discusses an interesting case of acute appendicitis caused by a giant coprolith. It also covers the clinical approach and information according to international literature. A 38-year-old man presented with sudden-onset right lower quadrant pain. Clinical examination revealed tenderness, a positive McBurney\'s point, elevated inflammation markers, and a radiopaque finding on an X-ray. A CT scan revealed a 2.5cm coprolith in the appendix. An exploratory laparoscopy revealed appendix wall rupture, followed by subumbilical incision appendicectomy and cleansing of purulent collection. The patient was discharged from the hospital on the fourth postoperative day without any complications, demonstrating a smooth recovery process. The presence of a coprolith predisposes the development of acute appendicitis. This condition is associated with a worse prognosis, as it increases the likelihood of perforation and the formation of intraperitoneal abscesses. This case underscores the clinical significance of giant coproliths as a potential etiology for acute appendicitis. Early recognition and timely surgical intervention are pivotal in achieving favorable patient outcomes.

Duodenal perforation most commonly presents with life-threatening symptoms of acute abdomen. However, in rare cases, a perforation may have an indolent course due to subclinical progression, and the patient may present with complications at the first visit. We present a case of an anterior abdominal abscess as the initial presentation of a duodenal perforation in a 65-year-old female with no pre-morbidities. The patient presented with a painful mass in the right upper quadrant associated with fever. Physical examination revealed a tender, erythematous swelling in the right hypochondrium and lumbar regions with no signs of peritonitis. Contrast-enhanced CT (CECT) of the abdomen showed a subcapsular hepatic abscess with parietal extension, but no signs of hollow viscus perforation were visible. Empirical antibiotics were given, and incision and drainage (I&D) were performed to drain around 100 mL of pus. However, drain on postop day one demonstrated bile suggesting a hollow viscus perforation, which was confirmed by a Gastrografin study.