0001) and of C5a (20.8ng/ml [5.6-27.5] vs 12.7ng/ml [3.2-24.6]; P=0.004), which decreased three months after delivery (SC5b9 190ng/ml [83-446] vs 160ng/ml [107-219]; C5a 9.28ng/ml [2.3-21.6] vs 10.7ng/ml [2.5-21.2]). A significantly higher frequency of genetic variants involving complement regulatory genes was also observed (52.6% vs 15.8%; P=0.016). Moreover, at HELLP diagnosis, patients showed increased coagulation markers (fragment F1+2 and D-dimer; P=0.0001) while both patients and controls had high thrombin-generation potential that decreased after delivery. In the pathophysiology of HELLP syndrome, complement dysregulation, in addition to coagulation activation, is involved and may represent a potential target for treatment with the aim of delaying delivery. In the pathophysiology of HELLP syndrome, complement dysregulation, in addition to coagulation activation, is involved and may represent a potential target for treatment with the aim of delaying delivery. Intestinal involvement of schistosomiasis uncommonly involves the formation of non-obstructive polypoid lesions; however, obstructing fibrotic stenoses and strictures secondary to chronic infection are extremely rare with only nine reported cases in the literature. An 85-year-old Southeast Asian female originating from the Philippines presents with a one-day history of obstructive symptoms in the setting of chronic constipation over the past four months. Subsequent CT imaging and colonoscopy biopsy revealed a nodular cecal mural wall thickening with chronic inflammation and a single Schistosoma egg. Despite treatment with praziquantel, and medical optimization the patient did not improve. Additionally, a malignancy as the underlying cause of obstruction could not be ruled out as such, she had a right hemicolectomy. Final pathology confirmed the diagnosis of intestinal submucosal schistosomiasis causing fibrotic stenosis. Obstructing lesions including fibrotic stenoses secondary to Schistosomiasis infection can be managed safely with medical co-morbidity optimization when possible, treatment with Praziquantel and surgical resection of the involved area of colon. Given the risk of malignancy and the inability to clinically distinguish between infectious and neoplastic processes, surgical management is recommended. Obstructing lesions including fibrotic stenoses secondary to Schistosomiasis infection can be managed safely with medical co-morbidity optimization when possible, treatment with Praziquantel and surgical resection of the involved area of colon. Given the risk of malignancy and the inability to clinically distinguish between infectious and neoplastic processes, surgical management is recommended. Although formerly considered a rarity, biliary endoclip-related complications are being diagnosed with increasing frequencies. Among these, migration of endoclip into the common bile duct (CBD) is a rare encounter that usually presents in the first two years after surgery. This case demonstrates a late biliary endoclip migration after laparoscopic cholecystectomy. An 82-year-old male patient, with a history of laparoscopic cholecystectomy 22 years ago, presented with two-day history of severe upper abdominal pain. Routine hemogram and serum chemistry were remarkable for slightly raised alanine aminotransferase and C-reactive protein. A computed tomographic (CT) scan demonstrated a new metallic density within the CBD when compared to a previous CT scan 14 months earlier. An endoscopic retrograde cholangiography confirmed a metal endoclip within the mid-CBD contained within a choledochal stone. Balloon extraction of the endoclip and stone was successfully performed. https://www.selleckchem.com/products/Sunitinib-Malate-(Sutent).html The patient was discharged 2 days later, and remained symptom free for 1 year. To our knowledge, a latency of 22 years between cholecystectomy and clip migration has never been reported before. In cases of post-cholecystectomy abdominal pain the awareness of the surgeon should always be drawn to a clinical suspicion of endoclip migration into the CBD that can be easily remedied. Endoscopic biliary sphincterotomy with endoclip/stone removal is the therapeutic procedure of choice which usually circumvents the need for surgical extraction. To our knowledge, a latency of 22 years between cholecystectomy and clip migration has never been reported before. In cases of post-cholecystectomy abdominal pain the awareness of the surgeon should always be drawn to a clinical suspicion of endoclip migration into the CBD that can be easily remedied. Endoscopic biliary sphincterotomy with endoclip/stone removal is the therapeutic procedure of choice which usually circumvents the need for surgical extraction. Approximately 5 % of gastrointestinal bleeding is due to small intestinal bleeding. Bleeding from small intestinal arteriovenous malformation (AVM) is rare, with few reported cases. Finding the precise location and boundary is difficult during surgery, so we tried using intravenous injection of indocyanine green (ICG). Use of ICG in a case of intestinal AVM is reported here for the first time, with a review of the literature. A 48-YEAR-old male had anemia and low hemoglobin level (Hb) 4.0 g/dL. After several examinations including small intestinal endoscopy, capsule endoscopy and angiography, AVM was identified. Preoperative diagnosis was AVM caused by branching of the ileocolic artery (ICA). Meanwhile, macroscopy showed engorgement of the vein in the ileum wall and mesentery, the boundary of which was unclear. We performed intra-operative monitoring with ICG. After intravenous injection of ICG, the boundary and location became clear. The abnormal ileum was 30 cm in length and located 130 cm from the Treitz ligament, which was different from angiographic findings. Pathology showed dilated vascular hyperplasia of the submucosa, tunica and chorionic membrane. Final diagnosis was ileum AVM. The postoperative course was uneventful and gastrointestinal bleeding stopped. ICG monitoring aided diagnosis and treatment of Ileum AVM, which was treated by laparoscopic surgery. ICG monitoring aided diagnosis and treatment of Ileum AVM, which was treated by laparoscopic surgery.