International Medical Case Reports Journal最新文献

{"title":"Male Systemic Lupus Erythematosus: A Rare Case of Multisystem Involvement.","authors":"Alanood Alsaleh, Hatham Alkanhal","doi":"10.2147/IMCRJ.S614112","DOIUrl":"10.2147/IMCRJ.S614112","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations. Although SLE predominantly affects women, male patients may present atypically, leading to diagnostic challenges and delays in treatment. Neuropsychiatric involvement and lupus nephritis represent severe manifestations associated with increased morbidity.</p><p><strong>Case presentation: </strong>A 31-year-old man presented with fatigue, joint pain, fever, and a photosensitive skin rash. Laboratory investigations showed positive antinuclear antibodies and elevated anti-double-stranded DNA levels. Brain MRI demonstrated scattered T2-weighted and FLAIR hyperintensities suggestive of central nervous system vasculitis, while renal biopsy confirmed class IV lupus nephritis. The patient was treated with corticosteroids, hydroxychloroquine, and mycophenolate mofetil. Follow-up MRI and MRA performed after three weeks showed partial resolution of white matter lesions with stable vasculature. Clinical symptoms improved, and renal function stabilised.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering neuropsychiatric SLE in male patients presenting with neurological symptoms and multisystem involvement. MRI and MRA can play an important role in detecting central nervous system involvement and monitoring treatment response, while early recognition and prompt treatment may help prevent irreversible neurological complications.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"614112"},"PeriodicalIF":0.7,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Modification of the Yamane Intrascleral Haptic Fixation Technique with Scleral Groove-Flap Coverage: A Case Series Study.","authors":"Ali Hendi Alghamdi","doi":"10.2147/IMCRJ.S620459","DOIUrl":"10.2147/IMCRJ.S620459","url":null,"abstract":"<p><strong>Purpose: </strong>To describe a modification of the Yamane double-needle technique using partial-thickness scleral groove-flap coverage of the terminal haptic flanges for secondary IOL implantation in eyes without adequate capsular support.</p><p><strong>Methods: </strong>This surgical technique report describes a modified approach to flanged intrascleral haptic fixation (ISHF). At two fixation sites 180° apart, partial-thickness scleral grooves are created. After haptic externalization and cauterization, the terminal flanges are guided into the grooves and buried beneath scleral tissue rather than positioned directly beneath the conjunctiva.</p><p><strong>Results: </strong>The technique was successfully performed in three eyes requiring secondary IOL implantation without adequate capsular support. At 12 months postoperatively, all patients demonstrated stable IOL centration with complete conjunctival epithelialization over the haptic sites. No cases of haptic exposure, endophthalmitis, or flange-related irritation were observed.</p><p><strong>Conclusion: </strong>The scleral groove-flap modification preserves the essential workflow of the Yamane technique while providing additional scleral tissue coverage over the terminal haptic flanges. In this small case series without a comparison group, the technique was associated with stable IOL centration, complete conjunctival epithelialization, and no observed haptic exposure during 12 months of follow-up.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"620459"},"PeriodicalIF":0.7,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615741/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pure Motor Axonal Neuropathy Associated with Sjögren's Syndrome: A Rare Case Report.","authors":"Alyaa Kheirbek, Mohamad Yousef Almawaz, Yasmin Alsaadi, Rama Ibrahim Alhallak, Mohamad Adnan Almahasneh, Ghassan Hamzeh","doi":"10.2147/IMCRJ.S633592","DOIUrl":"10.2147/IMCRJ.S633592","url":null,"abstract":"<p><strong>Background: </strong>Peripheral nervous system involvement is a recognized extraglandular manifestation of Sjögren's syndrome (SjS), most commonly presenting as sensory or mixed sensorimotor axonal neuropathies. Pure motor axonal neuropathy is exceptionally rare in this context and may closely mimic anterior horn cell disorders, posing significant diagnostic and therapeutic challenges.</p><p><strong>Case presentation: </strong>We report the case of a 47-year-old man with long-standing sicca symptoms who developed progressive, asymmetric motor weakness affecting all four limbs without sensory involvement. Neurological examination revealed predominantly left-sided motor deficits with preserved reflexes and normal sensory testing. Electrodiagnostic studies demonstrated a motor-predominant axonal neuropathy with reduced compound muscle action potential amplitudes and preserved sensory conduction. Serological testing showed high titers of anti-SSA antibodies, and minor salivary gland biopsy confirmed focal lymphocytic sialadenitis consistent with Sjögren's syndrome. Despite treatment with cyclophosphamide, plasma exchange, and high-dose corticosteroids, the patient showed no significant clinical improvement. Rituximab therapy was subsequently initiated; however, after four months of follow-up, motor weakness remained functionally limiting without meaningful neurological recovery.</p><p><strong>Conclusion: </strong>This case describes a rare pure motor axonal neuropathy in a patient with Sjögren syndrome. The clinical and electrodiagnostic findings were compatible with Sjögren syndrome-associated motor axonal neuropathy after consideration of alternative causes. The limited response to immunosuppressive therapy highlights the potential importance of early recognition of this uncommon neurological manifestation.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"633592"},"PeriodicalIF":0.7,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Radiographic Axial Spondyloarthritis Presenting with Anterior Chest Wall Pain without Inflammatory Back Pain in an HLA-B27-Negative Young Man: A Case Report Highlighting Diagnostic Challenges.","authors":"Roddy Gergeus, Ahmad Bishr Nasra, Rawia Barghouth, Dalaa Sheikh Ali","doi":"10.2147/IMCRJ.S639166","DOIUrl":"10.2147/IMCRJ.S639166","url":null,"abstract":"<p><strong>Background: </strong>Non-radiographic axial spondyloarthritis (nr-axSpA) may present with heterogeneous and misleading clinical features, particularly when inflammatory back pain is absent and HLA-B27 is negative. Such presentations can delay recognition and make classification frameworks difficult to apply in routine diagnosis.</p><p><strong>Case presentation: </strong>We report a 22-year-old Syrian HLA-B27-negative male who initially presented with mild anterior chest wall pain that was clinically interpreted as mechanical and resolved with nonsteroidal anti-inflammatory drugs. Eight months later, he developed a generalized inflammatory flare characterized by severe right hip pain, limping, recurrent anterior chest wall pain, and sacroiliac tenderness, without inflammatory back pain, morning stiffness, or axial rigidity at any stage of follow-up. Inflammatory markers were elevated, while autoimmune and infectious workup was negative. Baseline chest radiography showed no evident cardiopulmonary abnormality or rib osseous lesion, and pelvic radiography showed no definite radiographic sacroiliitis. Magnetic resonance imaging of the sacroiliac joints demonstrated unilateral active sacroiliitis without erosive or destructive change, supporting a diagnosis of nr-axSpA. Serial radiography and computed tomography over 12 months showed no structural progression. The anterior chest wall and hip symptoms were clinically important but not independently image-proven inflammatory lesions. Initial treatment with nonsteroidal anti-inflammatory drugs, low-dose corticosteroids, and conventional synthetic disease-modifying antirheumatic drugs resulted in partial improvement. Anti-tumor necrosis factor therapy was delayed due to access limitations; after subcutaneous golimumab initiation, the patient achieved rapid clinical improvement and sustained remission.</p><p><strong>Conclusion: </strong>This case illustrates the diagnostic value of MRI in an atypical nr-axSpA presentation characterized by HLA-B27 negativity and persistent absence of inflammatory back pain. When conventional imaging is non-diagnostic, MRI can provide important objective evidence, while clinically suspected anterior chest wall and hip manifestations should be distinguished from independently image-confirmed inflammatory lesions.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"639166"},"PeriodicalIF":0.7,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fatal Cutaneous Mucormycosis Initially Misdiagnosed as Necrotizing Fasciitis in an Uncontrolled Diabetic Patient: A Case Report Highlighting Diagnostic Delay.","authors":"Yovita Hartantri, Stephanie Victoria Gunadi, Ferdy Ferdian, Indra Wijaya, Risa Miliawati Nurul Hidayah, Nada Nisrina Aisyah, Naufal Fakhri Nugraha, Nisa Fauziah","doi":"10.2147/IMCRJ.S612465","DOIUrl":"https://doi.org/10.2147/IMCRJ.S612465","url":null,"abstract":"<p><strong>Background: </strong>Mucormycosis is a rare yet highly aggressive invasive fungal infection associated with significant mortality, particularly among patients with uncontrolled diabetes mellitus. Early diagnosis remains challenging because its clinical presentation may closely mimic bacterial necrotizing soft tissue infections, particularly in critically ill patients, while conventional diagnostic tests such as potassium hydroxide (KOH) smear have limited sensitivity.</p><p><strong>Case presentation: </strong>We report a 64-year-old male with undiagnosed diabetes who presented with progressive decline in consciousness and extensive necrotic lesions over the occipital and periorbital regions. On admission, he was in septic shock with complications including acute kidney injury, arrhythmia, and multi-organ dysfunction. The initial working diagnosis was bacterial necrotizing fasciitis, supported by an initial false-negative KOH smear, resulting in empiric broad-spectrum antibiotic therapy and surgical debridement. Subsequently, wound cultures grew carbapenem-resistant <i>Acinetobacter baumannii</i> (CRAB), further reinforcing the presumed bacterial etiology and complicating clinical management. Necrotic tissue culture ultimately confirmed mucormycosis, and amphotericin B was initiated only after fungal culture confirmation. Despite combined medical and surgical interventions, the patient's condition deteriorated, and he died on the twelfth day of hospitalization. This case illustrates how diagnostic anchoring, limited sensitivity of initial mycological investigations, and bacterial co-infection contributed to delayed recognition of invasive mucormycosis and postponed appropriate antifungal therapy.</p><p><strong>Conclusion: </strong>Mucormycosis in uncontrolled diabetes carries a poor prognosis when diagnosis and treatment are delayed. Clinicians should maintain a high index of suspicion for mucormycosis in diabetic patients presenting with rapidly progressive necrotic soft tissue infections despite negative initial fungal microscopy or the isolation of bacterial pathogens. Early deep tissue biopsy, repeat mycological investigations, and timely empirical antifungal therapy should be considered when clinical suspicion remains high.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"612465"},"PeriodicalIF":0.7,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149038331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Takayasu Arteritis in a 15-Year-Old Male Presenting with Constitutional Symptoms and Upper Limb Pulse Deficit: A Case Report a Resource-Limited Settings.","authors":"Hamda Abdirahman Mohamed, Nouh Ismail Botan, Sadam Ismail Ahmed, Mustafe Jamal Qawdhan","doi":"10.2147/IMCRJ.S583050","DOIUrl":"10.2147/IMCRJ.S583050","url":null,"abstract":"<p><strong>Background: </strong>Takayasu arteritis (TA) is a chronic granulomatous large-vessel vasculitis that primarily affects the aorta and its major branches. It is rare in children and adolescents, often leading to diagnostic delays due to its nonspecific initial symptoms such as fever, fatigue, and arthralgia.</p><p><strong>Case presentation: </strong>We report a 15-year-old male who presented with a several-month history of low-grade fever, easy fatigability, and progressive bilateral multiple joint pain. Notably, he had a history of BCG vaccination and no known tuberculosis exposure. Three weeks prior to diagnosis, he developed chest pain, vomiting, and significant weight loss. Physical examination was notable for absence of left radial and brachial pulses, The right arm blood pressure was 130/87 mmHg despite stable vital signs and unremarkable cardiac auscultation. Initial laboratory findings revealed normocytic anemia (hemoglobin 12 g/dL), elevated erythrocyte sedimentation rate (70 mm/hr), negative rheumatoid factor, and normal renal function. Echocardiography was normal. Computed tomography angiography (CTA) of the abdominal aorta demonstrated concentric arterial wall thickening of the superior mesenteric artery (SMA) with severe stenosis and collateral formation. CTA of the left upper limb revealed long-segment concentric thickening involving the left common carotid, subclavian, axillary, and proximal brachial arteries, Renal arteries were spared with focal occlusion of the brachial artery and distal collaterals. A diagnosis of Takayasu arteritis was made. The patient was initiated on prednisolone 60 mg daily (maximum dose) and methotrexate. Follow-up was arranged for one month.</p><p><strong>Conclusion: </strong>This case highlights a novel diagnostic pathway in a resource-limited setting, where a high index of clinical suspicion and meticulous physical examination-specifically bilateral pulse palpation-bridged the gap left by a lack of specialized rheumatology services. It demonstrates that even without advanced imaging like PET or MRA, timely diagnosis and intervention are possible in developing healthcare systems.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"583050"},"PeriodicalIF":0.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Massive Esophagogastric Variceal Bleeding from Chronic Portal Vein Thrombosis in a Non-Cirrhotic Young Man: A Resource-Limited Endoscopic Management Dilemma.","authors":"Osman Ahmed Tahajud, Omar Hassan Ahmed","doi":"10.2147/IMCRJ.S640530","DOIUrl":"10.2147/IMCRJ.S640530","url":null,"abstract":"<p><strong>Introduction: </strong>Variceal upper gastrointestinal bleeding is a life-threatening manifestation of portal hypertension. Chronic portal vein thrombosis can cause clinically significant noncirrhotic portal hypertension with esophagogastric varices, and management is particularly challenging in resource-limited settings when definitive endoscopic or radiologic therapy is unavailable.</p><p><strong>Case presentation: </strong>A 31-year-old man presented with massive hematemesis, melena, loss of consciousness, and hemorrhagic shock. Hemoglobin was 3.5 g/dL. He was stabilized with crystalloid resuscitation, packed red blood cell transfusion, octreotide infusion, proton pump inhibitor therapy during the initial undifferentiated upper gastrointestinal bleeding phase, and antibiotics. Upper gastrointestinal endoscopy showed four large esophageal variceal columns with red color signs and evidence of recent bleeding, together with a large fundal gastroesophageal varix type 2 (GOV2) with evidence of recent bleeding. Because the recently bleeding GOV2 was considered the immediate therapeutic priority and definitive gastric-variceal therapy was unavailable locally, immediate esophageal band ligation was deferred. Urgent referral for definitive gastric-variceal therapy was arranged, with staged esophageal variceal ligation planned thereafter. Contrast-enhanced computed tomography showed chronic portal vein thrombosis with cavernous transformation, collateral vessels, splenomegaly, and ascites, with preserved hepatic morphology and no radiologic features of cirrhosis, supporting noncirrhotic portal hypertension. He was discharged on hospital day 5 without early rebleeding.</p><p><strong>Conclusion: </strong>This case highlights the management dilemma posed by recently bleeding GOV2 gastric varices with advanced esophageal varices in chronic portal vein thrombosis. It illustrates the challenges of managing acute variceal hemorrhage in resource-limited settings and highlights the importance of prompt resuscitation, vasoactive therapy, antibiotics, careful endoscopic risk assessment, and timely referral when definitive gastric-variceal treatment is not locally available.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"640530"},"PeriodicalIF":0.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13592357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delayed Recognition and Drainage of a Pediatric Retropharyngeal Abscess with Parapharyngeal Extension in a Resource-Limited Setting: A Case Report.","authors":"Mohamed Abdirahman Mohamud, Tabu Geoffrey","doi":"10.2147/IMCRJ.S628731","DOIUrl":"10.2147/IMCRJ.S628731","url":null,"abstract":"<p><p>Deep neck space infections in children can deteriorate quickly, especially when diagnosis and source control are delayed. We describe a 4-year-old boy admitted on 28 March 2026 with 4 days of progressive right lateral neck swelling, fever, muffled voice, and breathing difficulty. Ultrasonography showed a right cervical inflammatory mass with moderate upper-airway compression but was reported as Ludwig's angina, which did not match the lateral clinical findings. Needle aspiration yielded no pus, contrast-enhanced computed tomography was not obtained, and surgical drainage was not performed at that stage. The child deteriorated and required emergency tracheostomy with parapharyngeal incision and drainage on 1 April; approximately 20 mL of pus was evacuated. Persistent illness and delayed lateral neck radiography later identified a retropharyngeal component, prompting wider drainage of both spaces on 11 April. Gram stain and pus and blood cultures were negative. He improved after definitive drainage, airway care, antimicrobial escalation, and nutritional support and was discharged on hospital day 20. This course highlights the clinical cost of delayed anatomic definition and source control. In a child with progressive neck swelling and airway symptoms, a negative aspiration or discordant ultrasound should prompt urgent cross-sectional imaging where feasible or operative reassessment; early multidisciplinary action may prevent avoidable airway deterioration.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"628731"},"PeriodicalIF":0.7,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13594524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nonoperative Management of a T1 Spinous Process Apophyseal Stress Fracture in an Adolescent Baseball Pitcher: A Case Report.","authors":"Yuya Fukuda, Kinshi Kato, Kenichi Otoshi, Takahiro Kaga, Yoshihiro Matsumoto","doi":"10.2147/IMCRJ.S621391","DOIUrl":"10.2147/IMCRJ.S621391","url":null,"abstract":"<p><strong>Introduction: </strong>Overuse-related stress injuries of the thoracic spine are uncommon among adolescent athletes, and apophyseal stress fractures in this region are particularly rare.</p><p><strong>Case presentation: </strong>We report a rare case of an apophyseal stress fracture of the first thoracic (T1) spinous process in a 13-year-old elite baseball pitcher. The patient presented with focal upper thoracic pain without any history of trauma. Magnetic resonance imaging (MRI) revealed an open apophyseal physis with cortical irregularity and bone marrow edema at the T1 spinous process, consistent with an apophyseal stress fracture. The patient was managed nonoperatively with upper body rest, followed by a gradual return-to-throwing program. His symptoms resolved, allowing a return to competitive pitching approximately 12 weeks after symptom onset. However, at the 7-month follow-up, CT showed persistent apophyseal fragmentation without osseous union, despite the patient being clinically asymptomatic.</p><p><strong>Conclusion: </strong>This case highlights the value of MRI for early detection of thoracic apophyseal stress fractures in adolescent athletes. Importantly, it demonstrates that clinical recovery and return-to-sport can occur even in the absence of radiologic union.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"621391"},"PeriodicalIF":0.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13589535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small Intestinal Cavernous Hemangioma Presenting with Recurrent Gastrointestinal Bleeding: A Case Report and Narrative Review.","authors":"Ya-Lin Liu, Hai-Rui Shang, Liang-Bi Xu, Xiao-Wen Xu, Yuan-Xue Ji, Yi-Yang He, Shao-Jie Chen","doi":"10.2147/IMCRJ.S628343","DOIUrl":"10.2147/IMCRJ.S628343","url":null,"abstract":"<p><strong>Background: </strong> Small intestinal cavernous hemangiomas are rare vascular malformations that present diagnostic and therapeutic challenges due to their deep location and propensity for recurrent bleeding. This report aims to describe a case with a sequential management approach and to synthesize existing evidence through a narrative literature review.</p><p><strong>Case presentation: </strong>A 74-year-old female presented with recurrent melena for five months. Initial imaging (gastroscopy, colonoscopy, computed tomography angiography, and computed tomography enterography) revealed no bleeding source. Balloon-assisted enteroscopy identified a 0.6 cm mucosal protrusion 520 cm distal to the pylorus, with active oozing. Endoscopic hemostasis was achieved using metal clip occlusion and lauromacrogol sclerotherapy, following which a biopsy was performed safely to confirm the diagnosis of hemangioma. Six months later, melena recurred, and the patient underwent surgical resection of the same lesion. Pathological examination confirmed a cavernous hemangioma. At two-year follow-up, the patient remained free from recurrent gastrointestinal bleeding.</p><p><strong>Conclusion: </strong> This case highlights the value of balloon-assisted enteroscopy for localizing obscure small intestinal bleeding and achieving temporary hemostasis. While endoscopic intervention facilitates diagnosis and acute bleeding control, surgical resection remains the definitive treatment for selected cases. Close follow-up may be considered to monitor for potential recurrence. A narrative review of the literature supports the rarity of this condition and the limited evidence base for treatment standardization.</p>","PeriodicalId":14337,"journal":{"name":"International Medical Case Reports Journal","volume":"19 ","pages":"628343"},"PeriodicalIF":0.7,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}