BACKGROUND: A vitello-intestinal duct connects the developing mid-gut to the yolk sac and regresses by the ninth week of gestation. In approximately 2% of cases, this duct remains patent. While usually detected in infancy or early childhood, it can occasionally present in adults, causing small bowel obstruction (SBO), which can result in significant morbidity and mortality. CASE PRESENTATION: A 28-year-old male presented to the Emergency Department with an 8-day history of severe abdominal pain, vomiting, and abdominal distention. Physical examination revealed a distended abdomen with generalized tenderness. Ultrasonography and contrast-enhanced computed tomography (CECT) of the abdomen indicated multiple adhesions and marked circumferential wall thickening involving bowel loops, suggesting SBO. Emergency exploratory laparotomy revealed a 9 cm tubular structure enclosing the ileum, diagnosed as a patent vitello-intestinal duct upon histopathological examination. The patient recovered uneventfully post-surgery. CONCLUSIONS: Acute SBO is a common surgical emergency that necessitates prompt diagnosis and treatment to prevent severe complications such as intestinal gangrene and peritonitis. While most cases of SBO are due to adhesions, tumors, or infections, a patent vitello-intestinal duct, although rare, should be considered, especially in cases without a clear etiology. Literature reports indicate that a patent vitello-intestinal duct can present as an umbilical sinus, polyp, or cause SBO due to fibrotic bands or adhesions, often requiring surgical intervention. Acute SBO can have severe outcomes if not promptly treated. Surgeons should include a patent vitello-intestinal duct in the differential diagnosis during exploratory laparotomy to enhance surgical care and improve patient outcomes.
BACKGROUND: The emergence of antibiotic-resistant bacteria has created a significant burden on humanity in terms of combating illnesses that were usually responding to classical antibiotics. Therefore, there is a growing focus and effort trying to investigate and develop new therapeutic agents with higher efficacy. Metallic nanoparticles are one of the promising choices. METHODS: We tried to investigate the silver nanoparticles (AgNPs) utilizing green synthesis techniques and an alcoholic Barberry (Berberis vulgaris L.) fruit extract. After synthesizing them, we tested their antibacterial properties on antibiotic-resistant Pseudomonas aeruginosa biofilms. It is a cross-sectional study on 6 isolates antibiotic resistant P. aeruginosa. Moreover, their optical properties, structure, and morphology have been studied using a variety of advanced methods, including energy-dispersive X-ray (EDX) analysis, scanning electron microscopy (SEM), and atomic force microscopy (AFM). The antibiotics investigated are cefepime, amikacin, aztreonam, piperacillin, levofloxacin, gentamycin, ciprofloxacin, and tobramycin. RESULTS: Barberry extract-derived nanoparticles have shown action against clinical isolates of antibiotic-resistant P. aeruginosa. CONCLUSIONS: Silver nanoparticles are an effective and promising choice that could be implemented in the treatment of antibiotic-resistant bacteria. Further studies are essential to prepare these nanoparticles for commercial use.
