Surgery Case Reports最新文献_第2页

Complex perineal injuries from jet ski trauma: Case series highlighting surgical repair and reconstruction principles 水上滑雪创伤引起的复杂会阴损伤：强调手术修复和重建原则的病例系列

Surgery Case Reports Pub Date : 2025-04-24 DOI: 10.1016/j.sycrs.2025.100118

Jonathan Lutgens , Jamielou Breckenridge , Brooklyn Williams , Kristin Clark , Paul Um , Shane McNevin , Quinton Hatch

{"title":"Complex perineal injuries from jet ski trauma: Case series highlighting surgical repair and reconstruction principles","authors":"Jonathan Lutgens , Jamielou Breckenridge , Brooklyn Williams , Kristin Clark , Paul Um , Shane McNevin , Quinton Hatch","doi":"10.1016/j.sycrs.2025.100118","DOIUrl":"10.1016/j.sycrs.2025.100118","url":null,"abstract":"<div><h3>Background</h3><div>Technological advancements have introduced new mechanisms of rectal injury, including hydrostatic pressure injuries from jet ski accidents. Approximately 20 cases have been reported, often involving extensive rectal, vaginal, and perineal disruption. Despite their severity, there are no established guidelines for managing these injuries or determining the optimal timing for reconstruction.</div></div><div><h3>Case presentation</h3><div>This case series highlights the surgical management of four patients who sustained hydrostatic perineal injuries of varying severity. All patients were healthy young women who, while riding as rear passengers on high-speed jet skis, were ejected backward during acceleration, landing in a seated position onto the powerful propulsion stream. The resulting intense hydrostatic forces caused complex injuries, including complete disruption of the vaginal and rectal wall interface, leading to a traumatic cloaca. Each patient underwent fecal diversion and perineal reconstruction during their initial hospitalization, followed by successful colostomy reversal, with restoration of rectal tone and fecal continence.</div></div><div><h3>Conclusion</h3><div>All four patients underwent CT imaging, rigid proctoscopy, distal rectal irrigation, colonic diversion, and anorectal repair with sphincter reconstruction during their index hospitalization. This approach led to satisfactory cosmetic outcomes, restoration of rectal tone, and maintenance of continence. The findings from this case series align with prior reports, further supporting fecal diversion and immediate perineal/sphincter reconstruction as an effective management strategy for hydrostatic perineal injuries.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100118"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143873749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rare and remarkable: Exploring the enigma of ciliated cysts of the gallbladder 罕见而非凡：探索胆囊纤毛囊肿之谜

Surgery Case Reports Pub Date : 2025-04-23 DOI: 10.1016/j.sycrs.2025.100116

Ovidiu Adrian Bitere , Florina Almari , Corina-Elena Minciuna , Mihai Dodot , Iulia Andrei-Bitere , Gabriela Fota , Catalin Vasilescu , Aurel Tonea , Vlad Herlea

{"title":"Rare and remarkable: Exploring the enigma of ciliated cysts of the gallbladder","authors":"Ovidiu Adrian Bitere , Florina Almari , Corina-Elena Minciuna , Mihai Dodot , Iulia Andrei-Bitere , Gabriela Fota , Catalin Vasilescu , Aurel Tonea , Vlad Herlea","doi":"10.1016/j.sycrs.2025.100116","DOIUrl":"10.1016/j.sycrs.2025.100116","url":null,"abstract":"<div><h3>Background</h3><div>Ciliated cysts of the gallbladder are rare congenital anomalies derived from embryonic foregut remnants. These benign lesions, lined by distinctive ciliated columnar epithelium, present diagnostic challenges due to non-specific imaging findings and their extreme rarity.</div></div><div><h3>Case presentation</h3><div>A 51-year-old woman presented with intermittent right upper quadrant abdominal pain lasting two years. Imaging revealed a cystic lesion measuring initially 11 × 10 mm on the gallbladder's lateral wall. Due to lesion growth observed over follow-up, laparoscopic cholecystectomy was performed. Histopathology confirmed a subserosal, unilocular cyst lined with ciliated columnar epithelium, without communication to the gallbladder lumen.</div></div><div><h3>Discussion</h3><div>This report represents the sixteenth documented global case and the first Romanian instance of a gallbladder ciliated cyst. The lesion’s rarity and nonspecific clinical and radiological presentations hinder accurate preoperative diagnosis. Histopathological analysis remains essential to distinguish these cysts from bronchogenic cysts and biliary neoplasms. Surgical excision is advisable, especially when symptoms are present or malignancy cannot be confidently excluded.</div></div><div><h3>Conclusions</h3><div>Despite their rarity, ciliated gallbladder cysts should be included in the differential diagnosis of atypical cystic gallbladder lesions. Laparoscopic cholecystectomy offers a safe, definitive treatment method, providing both diagnostic confirmation and symptom resolution.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100116"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Hybrid odontogenic cysts and tumors-A unique case series 混合牙源性囊肿和肿瘤-一个独特的病例系列

Surgery Case Reports Pub Date : 2025-04-23 DOI: 10.1016/j.sycrs.2025.100119

Tathagata Bhattacharjee, Snehanjan Sarangi, Debarati Ray, Jay Gopal Ray

{"title":"Hybrid odontogenic cysts and tumors-A unique case series","authors":"Tathagata Bhattacharjee, Snehanjan Sarangi, Debarati Ray, Jay Gopal Ray","doi":"10.1016/j.sycrs.2025.100119","DOIUrl":"10.1016/j.sycrs.2025.100119","url":null,"abstract":"<div><h3>Introduction</h3><div>Odontogenic cysts and tumors, which develop from the structures involved in tooth formation, show a wide range of histopathological variations. Sometimes, different types of lesions can appear together within the same tissue sample, resulting in what are known as hybrid odontogenic cysts or tumors—unusual combinations that form distinct and complex pathologies.</div></div><div><h3>Case report</h3><div>This article outlines four unique cases of such hybrid lesions. The first case involved a mix of an Orthokeratinised Odontogenic Cyst (OOC) and a Calcifying Odontogenic Cyst (COC). The second case showed a hybrid of OOC with a Glandular Odontogenic Cyst (GOC). In the third case, the lesion was a combination of Ameloblastoma and an Odontogenic Keratocyst (OKC). The final case presented a rare hybrid tumor consisting of an Adenomatoid Odontogenic Tumor (AOT) and Desmoplastic Ameloblastoma. These diagnoses were reached through a comprehensive, multidisciplinary approach involving clinical evaluations, imaging, histopathological assessments, and immunohistochemical analyses.</div></div><div><h3>Conclusion</h3><div>Hybrid lesions are different from collision lesions, which occur when two separate pathologies overlap in one area. Instead, hybrid odontogenic lesions display a blend of histological traits from two or more recognized types of cysts or tumors. While their exact cause remains uncertain, it’s believed that pluripotent odontogenic epithelial cells might give rise to multiple tissue patterns simultaneously within a single lesion. These cases pose significant challenges for both diagnosis and treatment. More in-depth research—especially at the molecular and immunohistochemical levels—is needed to improve our understanding and management of these complex and rare conditions.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100119"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Rare sporadic endolymphatic sac tumors: A case report and literature review 罕见散发性内淋巴囊肿瘤1例报告并文献复习

Surgery Case Reports Pub Date : 2025-04-23 DOI: 10.1016/j.sycrs.2025.100114

Violina Nacheva , Venelin Gerganov , Mihail Petrov , Branimir Penev , Tsvetelina Velikova , Georgi Angov

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Spontaneously ruptured hepatic hemangioma: A case study and comprehensive review of the literature 肝血管瘤自发性破裂：个案研究及文献综述

Surgery Case Reports Pub Date : 2025-04-23 DOI: 10.1016/j.sycrs.2025.100117

Benjamin C. Kensing , Blake A. Johnson , Marvin Heck , Hishaam N. Ismael

{"title":"Spontaneously ruptured hepatic hemangioma: A case study and comprehensive review of the literature","authors":"Benjamin C. Kensing , Blake A. Johnson , Marvin Heck , Hishaam N. Ismael","doi":"10.1016/j.sycrs.2025.100117","DOIUrl":"10.1016/j.sycrs.2025.100117","url":null,"abstract":"<div><div>Hepatic hemangiomas are benign vascular malformations thought to be of congenital origin. They are typically solitary, small, and asymptomatic. In rare cases, large tumors spontaneously rupture. We present the case of a 29-year-old female who presented with acute onset abdominal pain and nausea. Abdominal imaging showed a large mass in the liver demonstrating progressive nodular enhancement. Further imaging showed free fluid in the pelvis. A diagnostic laparoscopy was followed by an open left lateral hepatic segmentectomy. Pathology confirmed benign hemangioma. Signs and symptoms of spontaneously ruptured hepatic hemangiomas are often nonspecific. MRI is the most sensitive and specific imaging modality for diagnosing hepatic hemangiomas; however, determination of rupture requires clinical suspicion. Management is focused on maintaining hemodynamic stability and addressing the source with resection, enucleating, or embolizing the tumor. A literature review of 34 other cases revealed a mortality rate of 9 %, demonstrating a significant improvement compared to prior studies. The improvement in mortality is attributable to advancements in surgical techniques, critical care, resuscitation of unstable patients, pharmacologic safety profiles, postoperative care, and imagining modalities. In conclusion, spontaneous rupture of hepatic hemangiomas is a rare and life-threatening event. Hepatic resection remains the mainstay of treatment; although, transcatheter arterial embolization offers a minimally invasive route to control bleeding, shrink the hemangioma, and stabilize the patient.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100117"},"PeriodicalIF":0.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143876519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Giant occipital encephalocele in a 20-day old neonate: A case report 20日龄新生儿巨大枕脑膨出1例

Surgery Case Reports Pub Date : 2025-04-23 DOI: 10.1016/j.sycrs.2025.100120

Afaq Ahmad , Lal Rehman , Uswa Hasana , Humaira Bashir , Muhammad Uzair , Maria Amin

引用次数: 0

Fibrosarcomatous dermatofibrosarcoma protuberans of the scalp, extending to the brain – A rare case report 头皮隆突性皮肤纤维肉瘤，延伸至脑部-罕见病例报告

Surgery Case Reports Pub Date : 2025-04-22 DOI: 10.1016/j.sycrs.2025.100113

Kavya Varshney , Naveen Kumar , Charanjeet Ahluwalia , Sunil Ranga

{"title":"Fibrosarcomatous dermatofibrosarcoma protuberans of the scalp, extending to the brain – A rare case report","authors":"Kavya Varshney , Naveen Kumar , Charanjeet Ahluwalia , Sunil Ranga","doi":"10.1016/j.sycrs.2025.100113","DOIUrl":"10.1016/j.sycrs.2025.100113","url":null,"abstract":"<div><div>This case report highlights a rare instance of fibrosarcomatous dermatofibrosarcoma protuberans of the scalp with extension to the brain. Dermatofibrosarcoma protuberans is a slow-growing, locally aggressive soft tissue tumor. Fibrosarcomatous dermatofibrosarcoma protuberans is a rare and more aggressive variant of dermatofibrosarcoma protuberans. Fibrosarcomatous transformation in dermatofibrosarcoma protuberans is observed in only 5 % of cases. Although the recurrence rate is higher, metastasis and local extension are rarely seen, and intracranial extension is also uncommon. Clinically, fibrosarcomatous dermatofibrosarcoma protuberans is indistinguishable from classical dermatofibrosarcoma protuberans; hence, histopathological examination remains the cornerstone for definitive diagnosis. Histopathological examination reveals that areas of classical dermatofibrosarcoma protuberans show tumor cells arranged in a monotonous storiform pattern with a lack of circumscription, while areas with fibrosarcomatous transformation exhibit spindle cells arranged in a herringbone pattern, which are negative for CD34 on immunohistochemistry.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100113"},"PeriodicalIF":0.0,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143868731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Splenic artery aneurysm rupture during pregnancy: A report of two cases 妊娠期脾动脉瘤破裂2例报告

Surgery Case Reports Pub Date : 2025-04-17 DOI: 10.1016/j.sycrs.2025.100112

Kerim Deniz Batun , Ahmet Akmercan , Tayfun Akmercan , Muhammer Ergenç , Tevfik Kıvılcım Uprak

{"title":"Splenic artery aneurysm rupture during pregnancy: A report of two cases","authors":"Kerim Deniz Batun , Ahmet Akmercan , Tayfun Akmercan , Muhammer Ergenç , Tevfik Kıvılcım Uprak","doi":"10.1016/j.sycrs.2025.100112","DOIUrl":"10.1016/j.sycrs.2025.100112","url":null,"abstract":"<div><div>One of the most common aneurysms in the abdomen is the splenic artery aneurysm (SAA). Ruptured SAAs have a significant morbidity and mortality risk, especially for pregnant women and, consequently, for fetuses. The first patient was a twenty-eight-year-old female who, during the 30th week of pregnancy, underwent an urgent cesarean section. Postoperatively, on the 7th day, she developed severe abdominal pain. After the rapid deterioration, imaging revealed SAA rupture, and she underwent an explorative laparotomy and splenectomy. The second patient is thirty-two years old and has had non-cirrhotic portal vein hypertension since the age of 10. During her 28th week of pregnancy, she was admitted to the emergency department with complaints of severe abdominal pain and vomiting, consequently hemorrhagic shock. The imaging revealed massive intraperitoneal fluid and the SAA rupture. She underwent an emergency laparotomy, splenectomy, and cesarean section. Uncommon but has a significant mortality rate for both mother and fetus, and rupture must be considered for any pregnant woman with sudden abdominal pain and hemodynamic instability. Prompt evaluation and intervention are critical for both fetal and maternal morbidity and mortality.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100112"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143847319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Chronic osteomyelitis due to retained war-time shrapnel after 16 years: Case report 16年后遗留战争弹片导致慢性骨髓炎：病例报告

Surgery Case Reports Pub Date : 2025-04-17 DOI: 10.1016/j.sycrs.2025.100111

Madhawa Sasanka Rathnaweera , Kasun Bandara Ekanayake , Sunanda Udagedara

{"title":"Chronic osteomyelitis due to retained war-time shrapnel after 16 years: Case report","authors":"Madhawa Sasanka Rathnaweera , Kasun Bandara Ekanayake , Sunanda Udagedara","doi":"10.1016/j.sycrs.2025.100111","DOIUrl":"10.1016/j.sycrs.2025.100111","url":null,"abstract":"<div><div>Shrapnel, commonly associated with war-related trauma, is often retained without surgical removal due to its inert nature. However, these retained foreign bodies pose a risk of long-term complications, including chronic osteomyelitis (COM). This case report presents a rare instance of COM caused by retained shrapnel 16 years after a combat injury sustained during the Sri Lankan Civil War. A 55-year-old former soldier presented with fever, right thigh pain, and swelling. He had suffered a right femoral shaft open fracture in a mortar artillery blast in 2008, which was treated with intramedullary nailing. The implant was removed the following year due to infection. Imaging revealed multiple shrapnel fragments and osteomyelitic changes in the right distal femur, with one metal fragment causing erosion of the anterior cortex of the femur. The culture of an abscess of the right anterior thigh yielded methicillin-resistant <em>Staphylococcus aureus</em>, sensitive to vancomycin. The patient underwent abscess drainage, surgical retrieval of some shrapnel, and a 6-week course of oral linezolid. Although retained shrapnel is generally inert, its potential to cause COM necessitates a high index of suspicion. Timely imaging, microbiological cultures, and appropriate surgical and antibiotic management are critical in preventing severe long-term complications.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100111"},"PeriodicalIF":0.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Primary adrenal angiosarcoma: Insights into an exceptionally rare malignancy 原发性肾上腺血管肉瘤：一种罕见的恶性肿瘤

Surgery Case Reports Pub Date : 2025-04-16 DOI: 10.1016/j.sycrs.2025.100110

Lauren K. Storm , Breera Khan , Varsha Manucha , Kelly A. Brister , Wayne S. Orr , Wade O. Christopher

{"title":"Primary adrenal angiosarcoma: Insights into an exceptionally rare malignancy","authors":"Lauren K. Storm , Breera Khan , Varsha Manucha , Kelly A. Brister , Wayne S. Orr , Wade O. Christopher","doi":"10.1016/j.sycrs.2025.100110","DOIUrl":"10.1016/j.sycrs.2025.100110","url":null,"abstract":"<div><div>Primary adrenal angiosarcoma is a high-grade vascular malignancy. This case describes a 78-year-old female who presented with left upper quadrant abdominal pain, early satiety, nausea, weight loss, and a feeling of being “cold all the time.” Computed tomography of the abdomen and pelvis demonstrated a 15 cm× 13 cm x 16 cm heterogeneous, enhancing mass with interspersed calcifications, originating from the left adrenal gland. Adrenal labs were collected and were not consistent with a functional adrenal lesion, and lymphoma was ruled out. The patient underwent an exploratory laparotomy with resection of the left retroperitoneal mass, left adrenalectomy, splenectomy, and left partial nephrectomy due to the tumor impeding surrounding structures. All surgical margins were negative, with no evidence of metastatic disease. Immunohistochemical staining showed the tumor to be strongly and diffusely positive for cytokeratin, CD31, and ERG, while negative for CD34. Additional staining for FLI1 was positive. Based on these findings, a final pathological diagnosis of primary epithelioid angiosarcoma of the adrenal gland was made. The patient received asplenia vaccines and was discharged on postoperative day three without complications and was seen two weeks postoperatively in clinic. Recommendations were made in agreement with surgical and medical oncology for surveillance imaging, including computed tomography of the chest, abdomen, and pelvis every three months for a minimum of five years.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"5 ","pages":"Article 100110"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143843624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0