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Diagnostics
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Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition
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Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 July 2026 | Viewed by 3709

Editor

Dr. Bogdan Socea

E-Mail Website
Guest Editor
Department of Surgery, Sf. Pantelimon Emergency Clinical Hospital Bucharest, Carol Davila University of Medicine and Pharmacy, 021659 Bucharest, Romania
Interests: pancreatic cancer; acute pancreatitis; abdominal compartment syndrome; FAST, POCUS and pulmonary ultrasound; colorectal cancer; abdominal wall defects: hernias and incisional hernias
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Diagnostics (ISSN 2075-4418) is an international peer-reviewed open access journal on medical diagnosis, published semimonthly online by MDPI. Diagnostics has a Journal Impact Factor of 3.3(2024), and ranks JCR Q1 in the 'Medicine, General and Internal' category. I happily accepted being a Guest Editor for the Special Issue ‘Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition’ of this valuable journal, and I invite all of you to offer your scientific contributions in abdominal diseases.

Abdominal surgical conditions often raise challenging diagnostic, therapeutic and management issues. The surgeon is often faced with difficult decision-making situations, especially in emergency conditions. Imagistic methods are very useful in diagnostic guidance and are often an important part of image-guided surgery/treatment. Minimally invasive techniques occupy an important aspect, being preferred whenever possible. Laparoscopy is the first choice in most cases. Our defined scope of the topic for this Special Issue is to establish modern management protocols in the diagnosis, treatment and management of abdominal diseases.

Dr. Bogdan Socea
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 250 words) can be sent to the Editorial Office for assessment.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Publisher’s Notice

The Special Issue, together with its publications, has been shifted from Section Medical Imaging and Theranostics to Section Clinical Diagnosis and Prognosis on 21 April 2026. The publications remain available in the regular issues in which they were originally published. The Editorial Office confirms that these articles adhered to MDPI's standard editorial process (https://www.mdpi.com/editorial_process).

Keywords

  • abdominal diseases
  • abdominal surgery
  • diagnosis
  • image-guided surgery/treatment
  • minimally invasive techniques
  • laparoscopy

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Published Papers (6 papers)

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Research

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13 pages, 773 KB  
Article
Postoperative Outcomes After Rectal Cancer Surgery With or Without Primary Anastomosis: A Propensity Score–Weighted Study
by Nicoleta Aurelia Sanda, Petruta Violeta Filip, Florin Teodor Bobirca, Andreea-Nicoleta Marinescu, Alexandru Chirca, Daniela Aurora Peșu, Roxana Florina Ristea and Radu Virgil Costea
Diagnostics 2026, 16(10), 1533; https://doi.org/10.3390/diagnostics16101533 - 19 May 2026
Viewed by 320
Abstract
Background: The role of primary anastomosis in rectal cancer surgery remains debated, particularly due to concerns regarding postoperative morbidity. Evidence from randomized trials is limited, and observational studies are frequently affected by selection bias. Methods: We conducted a retrospective observational study including patients [...] Read more.
Background: The role of primary anastomosis in rectal cancer surgery remains debated, particularly due to concerns regarding postoperative morbidity. Evidence from randomized trials is limited, and observational studies are frequently affected by selection bias. Methods: We conducted a retrospective observational study including patients undergoing rectal cancer surgery with or without primary anastomosis. To reduce confounding, propensity scores were estimated using relevant clinical and oncologic covariates, and overlap weighting was applied to estimate treatment effects in a population with clinical equipoise. The primary outcome was any postoperative complication. Secondary outcomes included severe postoperative complications, reintervention, in-hospital mortality, and measures of healthcare resource utilization. Absolute risk differences (RDs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated. Stabilized inverse probability of treatment weighting was used as a sensitivity analysis. Results: A total of 173 patients were included. After overlap weighting, primary anastomosis was not associated with a statistically significant difference in overall postoperative complications compared with no anastomosis (RD +0.01, 95% CI −0.14 to +0.17). Severe postoperative complications were numerically more frequent in the primary anastomosis group, while reintervention rates were numerically lower; however, these differences did not reach statistical significance. In-hospital mortality was significantly lower among patients undergoing primary anastomosis (RD −0.08, 95% CI −0.16 to −0.02). No significant differences were observed in length of hospital stay or intensive care unit utilization. Conclusions: Postoperative outcomes after rectal cancer surgery appeared broadly comparable between patients managed with or without primary anastomosis after adjustment for measured baseline characteristics. These findings should be interpreted in the context of residual confounding and surgical selection, and support individualized decision-making rather than routine use of either restorative or non-restorative strategy. Full article
(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition)
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14 pages, 636 KB  
Article
Discordance Between Conventional Ultrasound and Transient Elastography in Hepatic Steatosis Assessment: Clinical Factors Associated with Discrepant Findings
by Mihaela Cristina Brisc, Elena Emilia Babeș, Sabina Florina Călugăr-Șolea, Simona Bota, Laura Maghiar, Ciprian Mihai Brisc and Ciprian Brisc
Diagnostics 2026, 16(8), 1188; https://doi.org/10.3390/diagnostics16081188 - 16 Apr 2026
Viewed by 433
Abstract
Background: Discrepancies are frequently observed between liver steatosis grading assessed by conventional B-mode ultrasonography and vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). This study aimed to identify factors associated with these differences and to evaluate whether the two imaging methods [...] Read more.
Background: Discrepancies are frequently observed between liver steatosis grading assessed by conventional B-mode ultrasonography and vibration-controlled transient elastography (VCTE) with controlled attenuation parameter (CAP). This study aimed to identify factors associated with these differences and to evaluate whether the two imaging methods provide comparable steatosis classifications. Methods: We conducted a retrospective cross-sectional observational study including 130 hospitalized patients evaluated over a two-year period who underwent laboratory testing, abdominal ultrasonography, and transient elastography. The analyzed variables included demographic characteristics, nutritional status, comorbidities, and biochemical parameters such as alanine aminotransferase (ALAT), total cholesterol, triglycerides, gamma-glutamyl transferase (GGT), and the fibrosis-4 index (FIB-4). Patients were classified into two groups: concordant steatosis grading between the two methods (n = 61) and discordant results (n = 69). Results: Concordant steatosis grading was more frequently observed in patients with serum total cholesterol > 200 mg/dL (45.9%) and FIB-4 values between 1.45–3.25 (44.2%). A trend toward higher concordance was also observed in patients with elevated triglycerides. In contrast, viral liver disease was significantly associated with discordant results (26.2%). Higher fibrosis stages assessed by VCTE (F ≥ 2) and FIB-4 values > 3.25 showed a non-significant trend toward discordance. Conclusions: Several clinical and biochemical factors influence the agreement between ultrasound and VCTE-based CAP in the assessment of hepatic steatosis. Elevated cholesterol and intermediate FIB-4 values were associated with concordant results, whereas viral liver disease was associated with discordance between the two imaging modalities. Full article
(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition)
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17 pages, 897 KB  
Article
Understanding Anastomotic Healing in Colo-Rectal Surgery; a Multicentric 5-Year Analysis of Predictive Factors for Integrity and Fistula Formation
by Dumitru-Dragos Chitca, Octavian Mihalache, Florin Bobircă, Cristian Botezatu, Valentin Popescu, Dan Andras, Maria-Theodora Lapadat, Martina Nichilo, Dragos Eugen Georgescu, Petronel Mustățea, Horia Doran, Bogdan Mastalier and Traian Pătrașcu
Diagnostics 2026, 16(6), 837; https://doi.org/10.3390/diagnostics16060837 - 11 Mar 2026
Cited by 1 | Viewed by 597
Abstract
Background: Anastomotic leakage (AL) remains one of the most feared complications after colorectal surgery. This study aimed to identify preoperative risk factors for AL using a five-year dataset from two Romanian surgical clinics. Materials and Methods: A retrospective cohort of 155 [...] Read more.
Background: Anastomotic leakage (AL) remains one of the most feared complications after colorectal surgery. This study aimed to identify preoperative risk factors for AL using a five-year dataset from two Romanian surgical clinics. Materials and Methods: A retrospective cohort of 155 patients undergoing colorectal resection with primary anastomosis (105 from “Colentina” Hospital and 50 from “Dr. I. Cantacuzino” Hospital) was analyzed. Preoperative demographic, clinical, and laboratory data were extracted and assessed using univariate and multivariable logistic regression. Statistical analyses were performed using IBM SPSS. Results: The overall AL rate was 10.3%. Multivariable analysis identified high ASA class (OR 17.6; p = 0.001), emergency surgery (OR 32.2; p = 0.0007), and heavy alcohol use (OR 15.3; p = 0.004) as independent predictors of leakage. While low preoperative albumin and smoking were associated with leakage in a bivariate analysis, these did not remain significant after adjustment. Notably, all laboratory markers were based on preoperative values, distinguishing our approach from prior studies that commonly evaluated postoperative biomarkers. No statistically significant effect was found for neoadjuvant chemotherapy or radiotherapy after controlling for other covariates. Conclusions: High ASA score, alcohol abuse, and emergency surgery were the strongest independent predictors of AL in our cohort. The lack of predictive power of certain widely reported factors, such as low albumin, may reflect our dataset’s focus on preoperative optimization. These findings support the use of individualized risk assessment and reinforce the role of preoperative preparation in reducing leak incidence in colorectal surgery. Full article
(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition)
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Review

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24 pages, 3556 KB  
Review
An Integrated Review of Conventional and Emerging Diagnostic and Therapeutic Modalities to Reduce the Risk of Surgical Resections in Intestinal Tuberculosis
by Khalid Alyahyawi
Diagnostics 2026, 16(9), 1332; https://doi.org/10.3390/diagnostics16091332 - 29 Apr 2026
Viewed by 528
Abstract
Intestinal tuberculosis (ITB) is a complex form of extrapulmonary tuberculosis characterized by nonspecific gastrointestinal symptoms and substantial overlap with conditions such as Crohn’s disease and gastrointestinal malignancies. These similarities frequently lead to diagnostic uncertainty, delayed diagnosis, and inappropriate management. This systematic review summarizes [...] Read more.
Intestinal tuberculosis (ITB) is a complex form of extrapulmonary tuberculosis characterized by nonspecific gastrointestinal symptoms and substantial overlap with conditions such as Crohn’s disease and gastrointestinal malignancies. These similarities frequently lead to diagnostic uncertainty, delayed diagnosis, and inappropriate management. This systematic review summarizes current evidence on the clinical presentation, diagnostic approaches, and therapeutic strategies for ITB, with particular emphasis on emerging diagnostic technologies and their role in reducing surgical interventions. A systematic literature search was conducted using PubMed, Scopus, and Google Scholar following PRISMA guidelines to identify relevant studies published from 2000 to 2025. The review focused on clinical manifestations, imaging findings, endoscopic features, histopathological characteristics, molecular diagnostics, pharmacological therapy, and minimally invasive therapeutic interventions. Accurate diagnosis requires an integrated approach combining clinical assessment with imaging, endoscopic evaluation, and histopathological confirmation. Molecular techniques such as GeneXpert MTB/RIF and GeneXpert MTB/RIF Ultra and multiplex polymerase chain reaction assays improve diagnostic accuracy and shorten detection time. Emerging technologies including artificial intelligence-assisted radiologic interpretation and CRISPR-based stool sequencing platforms show promise for earlier detection. Standard anti-tubercular therapy remains the cornerstone of treatment, while minimally invasive endoscopic and surgical procedures are effective for managing complications such as strictures, obstruction, and perforation. Early and precise diagnosis of intestinal tuberculosis is essential to prevent complications and optimize patient outcomes. Integrating conventional diagnostic approaches with emerging molecular and artificial intelligence-based technologies may enhance diagnostic precision and support individualized treatment strategies. Further ITB-specific clinical studies are needed to validate novel diagnostic tools and refine therapeutic approaches for improved patient care. Full article
(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition)
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Other

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20 pages, 2562 KB  
Systematic Review
Intraoperative Hyperspectral Imaging for Perfusion Assessment and Emerging Decision Support in Abdominal Surgery: A Systematic Review of Clinical Studies
by Calin Muntean, Melania Veronica Ardelean, Vasile Gaborean, Alaviana Monique Faur and Catalin Vladut Ionut Feier
Diagnostics 2026, 16(9), 1336; https://doi.org/10.3390/diagnostics16091336 - 29 Apr 2026
Viewed by 408
Abstract
Background and Objectives: Intraoperative assessment of tissue perfusion remains a decisive but imperfect step in abdominal surgery. Surgeons still rely heavily on visual judgement when choosing bowel transection lines, constructing anastomoses, judging intestinal viability, or assessing graft reperfusion, even though these decisions are [...] Read more.
Background and Objectives: Intraoperative assessment of tissue perfusion remains a decisive but imperfect step in abdominal surgery. Surgeons still rely heavily on visual judgement when choosing bowel transection lines, constructing anastomoses, judging intestinal viability, or assessing graft reperfusion, even though these decisions are directly linked to anastomotic leak, conduit ischemia, postoperative liver dysfunction, and graft failure. Hyperspectral imaging (HSI) is an emerging contrast-free optical technology that generates quantitative maps of tissue oxygenation, hemoglobin distribution, water content, and near-infrared perfusion. The present review was designed to evaluate whether clinical intraoperative HSI has matured sufficiently to support a focused systematic review topic in abdominal surgery and to synthesize the currently available human evidence. Methods: A literature search was conducted up to 20 February 2026 using combinations of the terms “hyperspectral imaging”, “HSI”, “abdominal surgery”, “colorectal”, “hepatectomy”, “transplantation”, “pancreatoduodenectomy”, “esophagectomy”, “mesenteric ischemia”, and “intraoperative”. Eligible records were original human clinical studies evaluating intraoperative HSI in abdominal or transplant-related operations with perfusion, oxygenation, or tissue viability as a central endpoint. Review articles, animal studies, non-surgical diagnostic studies, and single-patient case reports were excluded. Data were synthesized narratively because of major heterogeneity in indications, designs, devices, timing of measurements, and reported outcomes. Results: Thirteen studies published between 2019 and 2024 met the eligibility criteria, representing 391 patients. The literature covered colorectal resection, acute mesenteric ischemia, esophageal reconstruction with gastric or colonic conduits, pancreatoduodenectomy, pancreas transplantation, major hepatectomy, liver transplantation, and minimally invasive system validation. Across colorectal studies, HSI frequently demonstrated discordance between visually selected and objectively perfused transection lines, with clinically relevant strategy changes in a substantial proportion of patients. In ischemic and transplant settings, HSI discriminated poorly perfused tissue, identified low near-infrared perfusion values associated with early allograft dysfunction, and quantified reperfusion patterns after clamping or implantation. The evidence base was dominated by prospective single-center feasibility studies with small to moderate sample sizes, and no randomized trials were identified. Conclusions: Clinical intraoperative HSI in abdominal surgery is a genuinely niche yet rapidly expanding topic with a sufficient number of human studies to support a relevant systematic review. Current evidence consistently supports feasibility, quantitative perfusion discrimination, and plausible intraoperative utility, especially in colorectal and transplant-related surgery. However, the field remains methodologically heterogeneous, and the next research priority is multicenter standardization with clinically anchored thresholds and outcome-driven comparative studies. Full article
(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition)
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10 pages, 1089 KB  
Case Report
Synchronous Colon Adenocarcinoma and Renal Cell Carcinoma: Diagnostic Challenges and Simultaneous Laparoscopic Management in Two Cases
by Cristian Iorga, Cristina Raluca Iorga and Victor Strambu
Diagnostics 2026, 16(2), 287; https://doi.org/10.3390/diagnostics16020287 - 16 Jan 2026
Viewed by 853
Abstract
Background: There is an increasing number of synchronous tumor diagnoses, mainly due to new investigative techniques and diagnostic guidelines. While renal and colonic malignancies are common, synchronous cases remain rare. They are usually diagnosed during the staging work-up performed for the primary cancer. [...] Read more.
Background: There is an increasing number of synchronous tumor diagnoses, mainly due to new investigative techniques and diagnostic guidelines. While renal and colonic malignancies are common, synchronous cases remain rare. They are usually diagnosed during the staging work-up performed for the primary cancer. Case Presentation: We share our experience with two cases of synchronous colon adenocarcinoma and renal cell carcinoma. The surgical intervention was performed simultaneously and laparoscopically, with good results and prognosis. Reviewing the literature, we found few studies reporting these synchronous tumors, which reflects their low incidence. Renal tumors are often identified during imaging studies performed for staging colonic tumors, and performing surgical treatment during the same operation is widely accepted. We performed a search of the literature to identify similar cases and to look for associations that can lead to synchronous colonic and renal malignancies. We also wanted to highlight the potential for therapeutic management as a single step, thereby avoiding a second surgical procedure. Conclusions: Synchronous renal and colonic malignancies are rare and are generally sporadic. Due to their rarity, there are no established guidelines, and management can be challenging. Presently, the treatment needs to be individualized based on discussions from the tumor board. Full article
(This article belongs to the Special Issue Abdominal Diseases: Diagnosis, Treatment and Management—2nd Edition)
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