Journal of Peritoneum (and other serosal surfaces) 2017-12-12T17:11:13+01:00 Paola Granata Open Journal Systems <table border="0"> <tbody> <tr> <td rowspan="2" align="center" valign="top" width="182"> <p><img class="img-responsive" src="/public/site/images/mikimos/mini_cop_joper.jpg" alt="" width="182" height="236"></p> <p><strong>eISSN 2531-4270</strong><br> ---<br><strong>Editors-in-Chief</strong><br> <strong>Luca Ansaloni</strong><br> <em>Department of Emergency and Trauma Surgery, Papa Giovanni XXIII Hospital, Bergamo, Italy</em><br><br> <strong>Pompiliu Piso</strong><br> <em>Department of Surgery, Barmherzige Brueder, Teaching Hospital University of Regensburg, Germany</em></p> </td> <td width="30">&nbsp;</td> <td rowspan="2" valign="top"> <p>The <strong>Journal of Peritoneum (<em>and other serosal surfaces</em>)</strong> (JoPER) is a quarterly open access, peer-reviewed online journal that covers all aspects of clinical and basic research related to either healthy, either diseased peritoneum (and other serosal surfaces, like pericardium and pleura) and its allied subjects. Peritoneum is a word derived from Greek (peritonaion) via Latin (peritonaeum), that results from the merging of peri- "around" (lat. peri-) + teinein "to stretch" (lat. tenet), meaning thus “stretched around” or “stretched over”. Although peritoneum is present in some invertebrates, such as annelids, typically is the serous membrane that forms the internal covering of the abdominal cavity or coelom in amniotes, wrapping most of the intra-abdominal (or coelomic) organs. Although the peritoneum is composed only of a layer of mesothelium supported by a thin stratum of connective tissue, it is involved in many intrabdominal disorders and is an important way of treatment (like, for example, intraperitoneal chemotherapy and peritoneal dialysis). Thus peritoneum spans a wide range of disciplines and interests, including either surgical and medical specialties, but even anatomy, embryology, histology, physiology and basic sciences. The same can be told for other serosal surfaces of human body, like pericardium and pleura. As such JoPER aims to provide a platform for surgeons and physicians to publish their researches and rapidly exchange ideas and findings with the common topic of the peritoneum (and the other serosal surfaces). Areas of interest include, but are not limited to: oncology, inflammatory diseases and adhesions, septic diseases, gynecological diseases and endometriosis. The online presence of JoPER, as well as it's open access policy ensures that the articles published in the journal are highly visible and reach a wide audience, whilst immediate publication on acceptance ensures all findings are disseminated as quickly as possible.</p> </td> </tr> <tr> <td>&nbsp;</td> </tr> </tbody> </table> Acute appendicitis: not just a therapeutic puzzle to solve 2017-12-12T17:11:12+01:00 Emanuele Rausa Michele Pisano Federico Coccolini Marco Ceresoli Niccolo Allevi Elia Poiasina Luca Campanati Luca Ansaloni <p>Over the last 5 years, acute appendicitis (AA) is definitely drawing the scientific attention. As the timing in efficiently and promptly treating patients with AA is essential, any potential blind spot in understanding the disease should be clarified. Consequently, physicians will be able to address the patient towards the more appropriate therapeutic pathway (antibiotic or surgery) and avoid any harmful delay. Currently, neither surgery nor antibiotic seem offer a remarkable advantage to the patients therefore surgery remains the gold-standard in treating AA in accordance to the historical dogma.</p> 2017-12-12T17:03:39+01:00 ##submission.copyrightStatement## Perforated pyometra is a misleading cause of acute abdomen in elderly women: case report and review of literature 2017-12-12T17:11:13+01:00 Matteo Nardi Paola Fugazzola Giacomo Crescentini Filippo Paratore Lucia Morganti Nicola Zanini Gian Marco Palini Luigi Veneroni <p>Even if acute abdomen is associated with gastrointestinal (GI) perforation in more than 90% of cases, spontaneously perforated pyometra is a rare and misleading cause that gynecologists and general surgeons should suspect in elderly postmenopausal women. We report one case of diffuse peritonitis caused by spontaneous uterine perforation. A 94-year-old postmenopausal female was admitted to emergency department with signs of diffuse peritonitis and seven days history of abdominal pain. Abdominal contrast- enhanced CT-scan showed a large amount of ascites and a small amount of intraperitoneal free-air. One hour after the admission septic shock developed and emergency laparotomy was performed for suspected GI perforation. During laparotomy about 1500 mL of purulent, malodorous but not-fecaloid fluid was found in peritoneal cavity, without evidence of GI perforation. A 10 mm perforation on the anterior part of the uterine fundus was found. A total abdominal hysterectomy with a bilateral salpingo-oophorectomy was performed. Patients died on postoperative day four despite intensive care for multi-organ failure due to septic shock. The hysto-pathology examination showed absence of cancer. Pyometra perforation is a rare cause of acute abdomen with a not negligible mortality and it should be considered in the differential diagnosis of acute abdomen, especially in elderly patients. The aim of the study is to report our personal experience and a review of the literature of spontaneous perforation of pyometra in patients with no evidence of malignancy.</p> 2017-12-12T00:00:00+01:00 ##submission.copyrightStatement## Septic abdominal gossypiboma: A life threatening surgical site infection 2017-12-12T17:10:11+01:00 Carlos Augusto Gomes Fausto Catena Cleber Soares Junior Massimo Sartelli Salomone Di Saverio Felipe Couto Gomes Camila Couto Gomes <p>Gossypiboma is an uncommon surgical iatrogenic complication due to the retention of textile material inside natural cavities, especially in abdomen. An important aspect of gossypiboma is linked to the kind of inflammatory-triggered reaction: aseptic or pyogenic. In pyogenic reactions, granulomas and pus appear as a response to contaminated material left in the abdomen. Most patients are symptomatic, and clinical history and physical examination combined with computed tomography are essential to establish the diagnosis. The complication has similar pathophysiology from intra-abdominal abscess, however, has worse clinical course, poor prognosis and needs operative removal. Therefore, the gossypiboma deserves special attention and should be considered as a severe surgical site infection involving organs and/or spaces. Prevention is the key point to control the complication and is based on a systematic and systematized conference of such materials at the end of an operation. The purpose of this paper is to show for the first time all pathophysiologic steps of pyogenic gossypiboma. Moreover, to remind the risk factors associated to fungal infection (female, age, acute care unit stay, upper intestinal tract perforation, prolonged broad spectrum antibacterial therapy, parenteral nutrition and central venous catheter placement). At the same time, highlight that early antifungal therapy (<em>Candida glabrata</em>), should be kept in mind and should not be neglected as these was the agent involved in this patient’s death. Finally, alert the surgeons about this severe surgical site infection, which may lead to litigation.</p> 2017-11-07T15:30:48+01:00 ##submission.copyrightStatement## The International Register of Open Abdomen (IROA): 2017-12-12T17:10:12+01:00 Federico Coccolini Torsten Kaussen Mirco Nacoti Giulia Montori Marco Ceresoli Fausto Catena Paola Fugazzola Matteo Tomasoni Francesco Salvetti Massimo Sartelli Vanni Agnoletti Emiliano Gamberini Ezio Bonanomi Luca Ansaloni <p>In pediatric patients open abdomen (OA) is applied with many and not standardized indications. Several studies have been published regarding the OA management in adults and fewer in pediatrics. Several issues are still unclear and need more high quality data. The World Society of Emergency Surgery (WSES) promoted the International Register of Open Abdomen (IROA) dedicated to adults and pediatric patients. The register is held on a web platform (Clinical Registers®) through a dedicated web site: (ClinicalTrials. gov Identifier: NCT02382770).</p> 2017-10-25T14:27:39+02:00 ##submission.copyrightStatement##