Faculty of Medicine

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Multiseptate gallbladder accompanied by an incomplete annular pancreas in a 19-year male patient: A case report
(Elsevier BV, 2025-10)
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Misimi, Shqipe
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Trpeski, Stanko
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Atanasov, Zvonko
Multiseptate gallbladder (MG) is a rare congenital malformation that may occur as an isolated anomaly or in conjunction with other abnormalities of the pancreaticobiliary, urinary, and gastrointestinal systems. The coexistence of MG with an annular pancreas is an exceedingly rare phenomenon. The diagnosis is typically established using abdominal ultrasound; however, further imaging modalities are often required to delineate the detailed anatomy and to identify any associated anomalies within the pancreaticobiliary system. We present a case of a symptomatic MG associated with an incomplete annular pancreas. This case underscores the importance of considering additional congenital anomalies in patients diagnosed with MG, as such associations may influence clinical management and outcomes.
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The Incidence of Lymphovascular and Perineural Invasion and their Impact on Survival in Patients with Rectal Cancer
(Walter de Gruyter GmbH, 2023-12)
Misimi, Shqipe
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Cako, Dajana
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Demirel, Ali İlbey
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Ulusoy, Cemal
Aim: Lymphovascular Invasion (LVI) and Perineural Invasion (PNI) represent undesirable but still realistic pathological features of rectal cancer, associated with poor prognosis and worse survival. The aim of this study is to assess the incidence of LVI and PNI in patients treated for rectal cancer and the impact of LVI and PNI on patient survival. Material and Methods: This retrospective single center observational study, conducted in the period of 2016-2019, includes patients with rectal cancer treated with/without long-course neoadjuvant chemoradiotherapy (nCRT). Data collection encompassed demographics, tumor characteristics, type of surgery (abdominal perineal rectal resection - APR and low anterior rectal resection - LAR), and LVI/PNI presence. Survival during follow-up was estimated and compared for patients with/without LVI and PNI involvement. Results: A total number of 234 patients (77 females and 157 males) with mean age of 61.3 enrolled in the study. Neoadjuvant CRT was conducted in 170 patients. APR procedure was performed in 67 of them and LAR in 167. LVI presence was noted in 55 (24.4%) and PNI in 77 (34.2%) patients. Mean survival during follow-up was 42.07 months. The use of nCRT influenced on survival (p < 0.033). Patients treated with LAR had better survival outcomes (p = 0.001). Presence of LVI and PNI was associated with a worse prognosis (p < 0.001). Conclusion: PNI was more frequent than the LVI in this study. Patients with nCRT conduction had better overall survival. LVI and PNI presence was associated with poor prognosis in terms of overall survival in patients with rectal cancer.
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Emphysematous Calculous Cholecystitis Diagnosed with Abdominal CT in a Diabetic Female Patient - Case Report
(Walter de Gruyter GmbH, 2023-12)
Misimi, Shqipe
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Aliu, Ilir
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Kanevce, Petar
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Emphysematous cholecystitis is reported to have a low incidence of less than 1% in all cases of acute cholecystitis and yet a high mortality rate of up to 15%. It is most commonly seen in male diabetic patients with advanced age. The diagnosis is established with the presence of gas in the gallbladder lumen and/or within its wall which can be seen on plain abdominal radiography, abdominal ultrasound, and abdominal computerized tomography. The clinical presentation refers to one of acute cholecystitis, but the treatment requires prompt cholecystectomy since the patient's condition can deteriorate due to the possibility of gallbladder perforation. We present a case of a 71-year-old female diabetic patient with calculous emphysematous cholecystitis treated with emergency open cholecystectomy.
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Large biloma as the initial presentation of gallbladder perforation: a case report and literature review
(Oxford University Press (OUP), 2023-12)
Limani, Nimetula
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Misimi, Shqipe
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Biloma is an encapsulated intra or extra-hepatic collection of bile after biliary tree trauma. Post-procedural and traumatic biliary damage are the most common etiologic causes. Gallbladder perforation due to acute cholecystitis rarely presents with biloma occurrence. We present a case of large extrahepatic biloma formation as a consequence of a perforated gallbladder.
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Metachronous colon cancer metastasis to abdominal wall 7 years after rectosigmoid resection: a case report and literature review
(Oxford University Press (OUP), 2023-12)
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Nevchev, Ivan
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Misimi, Shqipe
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Burovska, Mare
<jats:title>Abstract</jats:title> <jats:p>Distant metastases from colorectal cancer to the abdominal wall are rare presentations of the end-stage of the disease. In this case, we present a female patient treated for Stage I rectosigmoid cancer with the late occurrence of abdominal wall metastasis, 7 years after the primary cancer surgery. The patient was treated with surgical excision and abdominal wall reconstruction with the use of synthetic mesh. Literature research on the abdominal wall recurrence/metastases from colorectal cancer was performed.</jats:p>
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When is surgery indicated in metastatic small intestine neuroendocrine tumor?
(Oxford University Press (OUP), 2023-10)
Draskacheva, Nadica
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Saljamovski, Darko
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Gošić, Violeta
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<jats:title>Abstract</jats:title> <jats:p>Small intestine neuroendocrine tumors are predominantly small but with high potential for distant metastases development. Diagnosis establishment in early-stage is often difficult and challenging. Small intestine neuroendocrine tumors often initially present with liver metastases. According to the Consensus Guidelines of the North American Neuroendocrine Tumor Society, in patients with liver metastases from unknown origin of primary neuroendocrine tumor, surgical exploration should be performed in order to identify the primary location, prevent small intestine obstruction, and treat one if already present. We present a case of a 69-year-old male patient diagnosed with liver and peritoneal metastases due to small bowel neuroendocrine tumor treated with surgery due to the presence of small intestine obstruction.</jats:p>
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Incidentally diagnosed large asymptomatic Morgagni hernia in adult male patient
(SMC Media, 2023-08-31)
Misimi, Shqipe
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Shurlani, Arben
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<jats:p>Background: Congenital diaphragmatic hernias are rare congenital defects resulting in abdominal organ protrusion into the thoracic cavity; they mainly present with pulmonary or gastrointestinal symptoms. Although congenital and discovered in utero or in early childhood, they can be asymptomatic for a long time and even remain asymptomatic despite the growing hernia sac dimensions and the hernia sac contents. Case description: We present a case of a 58-year-old patient with incidentally diagnosed Morgagni hernia during the COVID-19 pandemic following a computerised tomography (CT) scan of the chest. He presented without any symptoms related to the existence of the hernia. Another CT scan was performed 20 months after the initial diagnosis to evaluate the progression of the hernia. The patient refused the offered surgery due to the absence of symptoms. Discussion: A Morgagni hernia is usually discovered during pregnancy or in early childhood, but sometimes can be asymptomatic for years. Main symptoms originate from the respiratory and gastrointestinal system. Conclusion: Due to the refusal of surgery, we were able to follow the CT scan enlargement progression of patients’ hernia over a 20-month period.</jats:p>

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