Appendicitis is one of the most commonly encountered general surgery emergencies worldwide and has been extensively studied. However, anatomical variations in the position of the appendix may result in atypical clinical presentations, leading to diagnostic difficulty and delays in management. Reported here is a case of subhepatic appendicitis in a young adult patient who successfully underwent laparoscopic appendectomy. Subhepatic appendicitis is a rare surgical entity that should be considered in patients presenting with right upper quadrant abdominal pain. Contrast-enhanced computed tomography and laparoscopy are valuable tools in the diagnosis and management of this uncommon condition.

INTRODUCTION

Simulation based training, which is hypothesized to increase skill proficiency among trainees, is currently gaining popularity in pediatric surgical training. High-fidelity simulators are expensive and not easily replicable in low to middle income countries; thus, the use of low-fidelity simulators are being suggested. This type of educational technique may have a role in complex procedures such as pull-through procedure among patients with Hirschsprung's disease. This study aimed to ascertain the development and associated validity of low-fidelity simulators for transanal pull-through among pediatric patients.

This is a validation study of a low-fidelity simulator for transanal pullthrough in pediatric surgery. The model was assembled by carefully harvesting the anus, colon and rectum from a pig cadaver, ensuring the tissues remained intact including the perianal skin. These tissues were then mounted onto a specially designed basket that simulates the human pelvic cavity. The prototype model underwent initial testing to ensure anatomical accuracy and durability. A panel of five pediatric surgeons were tapped for content validation.

The overall validity index of the simulator was 1.00 which was high. All panel experts agreed on the anatomical realism, educational value, and alignment with training objectives. Some positive feedback on its use included its ability to accurately simulate the surgical procedure and its potential to reduce the learning curve for trainees. Another feedback is that it can help clinicians feel more prepared and comfortable when performing the procedure on actual patients after practicing on the simulator. No negative feedback were reported.

The study showed that the use of an animal simulator for practicing transanal pullthrough in pediatric surgery is feasible and valid. This model has the potential to be adapted for educational purposes and hands-on training before doing actual case surgeries. The realistic anatomy and tactile feedback provided by the simulator can help trainees improve their skills and confidence in performing transanal pullthrough.

Transanal bowel evisceration is a rare, life-threatening condition requiring urgent surgical intervention, with approximately 100 cases documented globally since 1827. While research predominantly addresses spontaneous cases, traumatic occurrences—often associated with stab wounds—remain underreported. The prevalence of traumatic small bowel evisceration is low, ranging from 0.2-1% worldwide, with no documented studies from Northern Luzon or the entire Philippines. Prompt diagnosis and immediate surgical management are essential to prevent serious complications, underscoring the importance of timely intervention for a successful outcome.

This is a rare case of small bowel evisceration secondary to traumatic rectal perforation. A 56-year-old male presented with intestinal protrusion through the anus, illustrating a rare instance of transanal small bowel evisceration. The patient's case provides important insights into the diagnosis and treatment of this uncommon condition.

Early detection was crucial for managing the transanal evisceration of the small bowel, a rare and life-threatening emergency, as timely surgical intervention is essential to prevent severe complications. This case underscores the importance of clinical awareness and prompt diagnosis, particularly given the rarity of traumatic transanal evisceration, to enhance patient outcomes.

The structure of intestinal tissue is complex. In vitro simulation of intestinal structure and function is important for studying intestinal development and diseases. Recently, organoids have been successfully constructed and they have come to play an important role in biomedical research. Organoids are miniaturized three-dimensional (3D) organs, derived from stem cells, which mimic the structure, cell types, and physiological functions of an organ, making them robust models for biomedical research. Intestinal organoids are 3D micro-organs derived from intestinal stem cells or pluripotent stem cells that can successfully simulate the complex structure and function of the intestine, thereby providing a valuable platform for intestinal development and disease research. In this article, we review the latest progress in the construction and application of intestinal organoids.
Organoids/cytology* ; Intestines/physiology* ; Humans ; Animals ; Pluripotent Stem Cells

N-dodecanoyl-l-homoserine lactone (C12-HSL) is a signaling molecule that mediates bacterial quorum sensing, regulating bacterial population behaviors. This study investigated the effects of C12-HSL on the isolation and cultivation of gut microbiota, with the goal of enriching the diversity and number of cultivable bacterial strains from the mouse gut microbiota. Using a culture medium supplemented with C12-HSL, we isolated and cultivated bacterial strains from mouse intestinal contents, obtaining a total of 235 isolates. Preliminary identification based on the 16S rRNA gene revealed 54 bacterial species, including 4 potential new species, 4 potential new genera and 1 potential new family. Compared with the previously established mouse gut microbial biobank (mGMB), this study newly identified 42 bacterial species, enhancing the diversity of the strain library. Statistical analysis showed that the proportion of Gram-negative bacteria, particularly those belonging to Proteobacteria, isolated by this method was significantly higher than that obtained by conventional isolation and cultivation methods without the addition of C12-HSL. Subsequent cultivation experiments with one of the newly discovered bacterial species indicated that exogenous C12-HSL at 20-200 μmol/L significantly promoted the growth of this species, while higher concentrations of C12-HSL significantly reduced the cell density of this bacterium. This work confirms that quorum sensing molecules, such as C12-HSL, can enhance the growth, isolation, and cultivation of Gram-negative bacteria in the gut within a specific concentration range. Although the mechanism by which C12-HSL promotes the growth of gut bacterial strains requires further investigation, the findings of this study provide new insights into the targeted isolation, cultivation, and regulation of gut microbiota using bacterial quorum sensing signal molecules.
Animals ; Mice ; Acyl-Butyrolactones/pharmacology* ; Gastrointestinal Microbiome/drug effects* ; Quorum Sensing ; Gram-Negative Bacteria/classification* ; Intestines/microbiology* ; RNA, Ribosomal, 16S/genetics* ; Culture Media

Liver diseases have become a major challenge threating the global health, posing a heavy burden on both social and personal well-being. In recent years, the development of the gut-liver axis theory has provided new research perspectives and intervention strategies for the prevention and treatment of liver diseases. Natural products, recognized as biological molecules with diverse sources, rich activities, and minimal side effects, demonstrate great potential in regulating intestinal flora and improving liver health. Studies have shown that natural products such as saponins, polyphenols, polysaccharides, and alkaloids can regulate the composition and metabolites of intestinal flora, thereby intervening in liver diseases. In this paper, we systematically review the role of natural products in the regulation of the intestinal flora-gut-liver axis and summarize recent research progress in the prevention and treatment of liver diseases. Furthermore, we outline the challenges and limitations currently facing the study in this field. Finally, this paper makes an outlook on the clinical application of natural products in treating liver diseases and discusses future research directions, aiming to give new insights into the mechanisms by which natural products regulate the intestinal flora-gut-liver axis and the applications of these products in the prevention and treatment of liver diseases.
Humans ; Gastrointestinal Microbiome/drug effects* ; Liver Diseases/prevention & control* ; Biological Products/pharmacology* ; Polyphenols/pharmacology* ; Saponins/pharmacology* ; Intestines/microbiology* ; Alkaloids/pharmacology* ; Polysaccharides/pharmacology* ; Liver

The gut-brain axis is a bidirectional communication pathway connecting the central nervous system and gastrointestinal tract,playing a key role in the occurrence and development of diseases related to this axis.The vermiform appendix,as a part of the gut that is connected to the cecum,has a unique anatomical location,a rich microbiome,and abundant immune cells.Appendicitis and appendectomy have been found to be associated with the development of diseases related to the gut-brain axis.This review first introduces the anatomy and functions of the vermiform appendix and then expounds the associations of appendicitis and appendectomy with diseases related to the gut-brain axis.Furthermore,this review summarizes and prospects the mechanisms of the vermiform appendix in affecting the occurrence and development of diseases related to the gut-brain axis.
Humans ; Appendix/anatomy & histology* ; Brain ; Appendicitis ; Appendectomy/adverse effects* ; Gastrointestinal Microbiome ; Brain-Gut Axis

Mitochondrial neurogastrointestinal encephalomyopathy(MNGIE),a rare mitochondrial disorder caused by TYMP gene mutations,is characterized by severe gastrointestinal dysmotility,peripheral neuropathy,and leukodystrophy.This article summarizes the clinical data and intestinal ultrasound findings of a MNGIE case,aiming to provide insights for clinical diagnosis and treatment.
Humans ; Mitochondrial Encephalomyopathies/diagnostic imaging* ; Ultrasonography ; Intestines/diagnostic imaging* ; Male ; Female ; Intestinal Pseudo-Obstruction/diagnostic imaging* ; Ophthalmoplegia/congenital* ; Muscular Dystrophy, Oculopharyngeal

Objective To compare the diagnostic value of transabdominal intestinal ultrasound (IUS) and magnetic resonance enterography (MRE) for intestinal stenosis in inflammatory bowel disease (IBD). Methods A retrospective analysis was conducted on the imaging features of 51 IBD patients who underwent both IUS and MRE at Beijing Friendship Hospital,Capital Medical University,between January 2021 and February 2025.With endoscopy as the gold standard,the diagnostic performance of the two methods was compared. Results The sensitivity (84.2% vs. 52.6%,P=0.008) and accuracy (66.7% vs. 45.1%,P=0.035) of IUS for stenosis were higher than those of MRE.In the localization of stenosis,IUS demonstrated higher sensitivity than MRE for detecting stenosis in the terminal ileum (78.6% vs. 35.7%,P=0.070) and colorectum (86.7% vs. 53.3%,P=0.060).Furthermore,IUS showed higher diagnostic accuracy than MRE for terminal ileum stenosis (70.6% vs. 29.4%,P=0.039).The intestinal wall thickness[(8.2±2.7) mm vs. (10.3±3.8) mm;t=3.20,P=0.002)] and stenosis inner diameter[(3.0±1.6) mm vs. (4.3±1.8) mm;t=2.15,P=0.035] measured by IUS were lower than those measured by MRE,with a moderate level of consistency (ICC:0.19-0.53).In addition,IUS demonstrated a higher detection rate for mesenteric fat hypertrophy (70.6% vs. 27.5%,Kappa=0.27,P=0.005),whereas MRE was more sensitive in detecting lymphadenopathy (90.2% vs. 56.9%,Kappa=0.16,P=0.080). Conclusions IUS is superior to MRE in the diagnosis and localization sensitivity for intestinal stenosis in IBD.However,the two methods showcase poor consistency in detecting and quantitating some inflammatory signs.IUS can be used as a first-line screening method for diagnosing intestinal stenosis in IBD patients,while its clinical application should be combined with specific needs to optimize diagnosis.
Humans ; Retrospective Studies ; Constriction, Pathologic/diagnostic imaging* ; Ultrasonography/methods* ; Magnetic Resonance Imaging/methods* ; Inflammatory Bowel Diseases/diagnostic imaging* ; Male ; Female ; Adult ; Middle Aged ; Intestines/diagnostic imaging* ; Sensitivity and Specificity

Objective To evaluate the diagnostic value of ultrasound in chronic appendicitis. Methods A retrospective analysis was conducted on the ultrasound imaging features of the appendixes in 68 patients with chronic appendicitis (chronic appendicitis group) confirmed by pathological results at the Affiliated Hospital of Inner Mongolia Medical University from January 2023 to December 2024,as well as 85 healthy volunteers (normal appendix group) of different ages with no history of abdominal pain during the same period.Multivariate Logistic regression was employed to investigate the sensitivity and specificity of different variables in diagnosing chronic appendicitis. Results The chronic appendicitis group had higher appendix diameter (Z=-8.47,P<0.001),unilateral wall thickness (Z=-7.16,P<0.001),and submucosal thickness (Z=-9.73,P<0.001) than the normal appendix group.Appendix diameter (OR=3.11,95%CI=1.37-7.02,P=0.006) and submucosal thickness (OR=5 492.73,95%CI=89.53-336 984.13,P<0.001) were identified as independent factors for diagnosing chronic appendicitis,while gender,age,unilateral wall thickness,and intraluminal conditions had no significant impact on the diagnosis of chronic appendicitis (all P>0.05).When appendix diameter combined with submucosal thickness was used as a joint diagnostic indicator,the model demonstrated the best performance,with the sensitivity of 92.65%,the specificity of 97.65%,and the accuracy increasing to 95.42%. Conclusion The combined use of appendix diameter and submucosal thickness can significantly improve the accuracy,specificity,and reliability of ultrasound in diagnosing chronic appendicitis.
Humans ; Appendicitis/diagnostic imaging* ; Ultrasonography ; Retrospective Studies ; Male ; Female ; Adult ; Chronic Disease ; Middle Aged ; Appendix/diagnostic imaging* ; Sensitivity and Specificity ; Young Adult ; Logistic Models ; Adolescent