Journal of Medical Case Reports最新文献

{"title":"Influenza B-associated acute myositis in a child in Sri Lanka: a case report.","authors":"T T Pattiyakumbura, J M L C K Jayasundara, P B U S Premarathne, S Abeywardana, C J S Jayamaha","doi":"10.1186/s13256-025-05072-x","DOIUrl":"10.1186/s13256-025-05072-x","url":null,"abstract":"<p><strong>Background: </strong>Myositis, characterized by inflammation and weakness of skeletal muscles, is a multifactorial condition caused by various infectious, autoimmune, and neuromuscular disorders. Among these, infective myositis is a rare but significant clinical entity, predominantly caused by viral pathogens. Viruses such as influenza, enteroviruses, rubella, and human immunodeficiency virus are common culprits, with influenza-associated myositis being a particularly well-documented phenomenon. Despite its self-limiting nature in many cases, influenza-associated myositis warrants clinical attention owing to its potential complications and the diagnostic challenges it presents. Influenza B, a less antigenically variable subtype compared with influenza A, has been increasingly recognized as a cause of acute myositis, especially in pediatric populations.</p><p><strong>Case presentation: </strong>We report the case of a 9-year-old Sri Lankan girl from central Sri Lanka who presented with a 4-day history of fever, cough, and cold, followed by bilateral calf pain and difficulty walking. On examination, she exhibited bilateral calf tenderness with normal muscle tone, power, and reflexes, without sensory impairment. Basic hematological investigations were within normal limits, but her creatine kinase levels were markedly elevated at 8370 U/L, indicating significant muscle damage. Ultrasound imaging revealed inflammation of the calf muscles. A nasopharyngeal swab tested positive for influenza B RNA, confirming the viral etiology. Supportive care resulted in complete symptom resolution within 10 days of hospital discharge.</p><p><strong>Conclusion: </strong>Influenza-associated myositis is an important differential diagnosis for children presenting with muscle pain and gait disturbances during the influenza season. Early recognition and laboratory confirmation of the condition can prevent unnecessary investigations and facilitate prompt patient management. This case highlights the clinical and diagnostic aspects of influenza B-associated myositis, underscoring the importance of considering viral etiologies in pediatric patients with acute myositis.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"394"},"PeriodicalIF":0.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789356","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":"Successful management of Candida auris external ventricular shunt infection: a case report.","authors":"Ahmad Elhaj, Duaa Jawhar, Nawal Elfaki","doi":"10.1186/s13256-025-05088-3","DOIUrl":"10.1186/s13256-025-05088-3","url":null,"abstract":"<p><strong>Background: </strong>Candida auris ventriculitis is a rare but serious condition associated with high mortality rates. The available literature on its management is limited, and there are few documented successful treatment strategies or care plans.</p><p><strong>Case presentation: </strong>We report the case of a 34-year-old male patient from South Asia with Candida auris infection of an external ventricular shunt. The patient was initially treated with a combination of injectable amphotericin B liposomal and caspofungin for 21 days. This was followed by a 15-day course of injectable amphotericin liposomal and voriconazole. Subsequently, voriconazole monotherapy was administered orally for an additional 11 days. Notably, all antifungals used were determined to be sensitive on the basis of cerebrospinal fluid culture and sensitivity results. Source control was achieved after 20 days of initiating therapy, leading to the permanent removal of the shunt.</p><p><strong>Conclusion: </strong>Candida auris ventriculitis can be effectively managed with systemic antifungal therapy and appropriate source control measures.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"393"},"PeriodicalIF":0.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789358","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":"Efficacy of hyperbaric oxygen therapy in treating fibromyalgia linked to childhood trauma after late-onset and over a decade of symptoms: a case report.","authors":"Mouzayan Ginzarly, Sherif Khairy, Zemer Wang, Umair Qureshi, Raghda Zaitoun, Shai Efrati","doi":"10.1186/s13256-025-05453-2","DOIUrl":"10.1186/s13256-025-05453-2","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia syndrome is a chronic pain disorder characterized by central sensitization and neuroinflammation. Conventional treatments primarily focus on symptom management but often fail to address the underlying dysfunction. Hyperbaric oxygen therapy has emerged as a promising approach that promotes neuroplasticity and may provide symptom relief.</p><p><strong>Case presentation: </strong>We present the case of a 62-year-old North African female patient with treatment-resistant fibromyalgia and a history of childhood trauma who underwent 60 hyperbaric oxygen therapy sessions over 12 weeks (90 min at 2.0 atmospheres absolute). Baseline and posttreatment assessments included clinical evaluations (Fibromyalgia Impact Questionnaire Revised, widespread pain index, and symptom severity scale), neurocognitive testing, magnetic resonance imaging-diffusion tensor imaging, single-photon emission computed tomography imaging, and functional mobility tests. Following hyperbaric oxygen therapy, the patient reported substantial pain reduction (Fibromyalgia Impact Questionnaire Revised score decreased from 60.5 to 44; Fibromyalgia Diagnostic Criteria Questionnaire score decreased from 16 to 12). Computerized cognitive assessments revealed a 10% improvement in global cognitive function and a 26.9% increase in attention. Medication use was also reduced, with the discontinuation of pregabalin (Lyrica) and a 50% reduction in duloxetine (Cymbalta) dosage. Additionally, physical function improved, with walking speed increasing from 3.2 to 4.5 km/h and notable gains in balance and coordination. Corresponding to the clinical improvements, the brain imaging demonstrated increased perfusion on single-photon emission computed tomography and enhanced white matter integrity on magnetic resonance imaging-diffusion tensor imaging.</p><p><strong>Conclusion: </strong>Hyperbaric oxygen therapy promotes neuroplasticity, resulting in significant clinical improvements in fibromyalgia syndrome, including pain reduction, enhanced cognitive function, and improved physical mobility. These findings highlight the potential of hyperbaric oxygen therapy as a therapeutic strategy targeting the core pathophysiology of fibromyalgia syndrome rather than solely managing symptoms.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"386"},"PeriodicalIF":0.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789355","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":"Anti-centromere antibody positivity with coexisting idiopathic portal hypertension and primary biliary cholangitis progressing to limited cutaneous systemic sclerosis: a case report.","authors":"Yuya Ando, Suguru Mabuchi, Norikazu Mataki, Satoshi Nakayama, Arata Honda, Mari Kamiya, Shinsuke Yasuda, Hiroaki Takeo, Shigeaki Aono, Masayoshi Hashimoto, Kenichi Harada, Naoya Murashima","doi":"10.1186/s13256-025-05426-5","DOIUrl":"10.1186/s13256-025-05426-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Anti-centromere antibodies are autoantibodies that selectively bind to the centromere region of chromosomes. Studies have indicated that anti-centromere antibodies can induce microvascular alterations and tissue remodeling, ultimately leading to fibrosis. They have been implicated in limited cutaneous systemic sclerosis, including calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia syndrome, and primary biliary cholangitis, where anti-centromere antibody positivity can be associated with rapid progression of portal hypertension, although the underlying mechanisms remain unclear. Idiopathic portal hypertension, despite being termed \"idiopathic,\" has distinctive pathological, angiographic, and ultrasound findings, and autoimmune processes have been proposed to mediate its intrahepatic microcirculatory disruptions. Interestingly, idiopathic portal hypertension-related small portal vein and scleroderma skin findings share certain similarities. However, no documented cases have linked anti-centromere antibody-induced intrahepatic vascular endothelial dysfunction to idiopathic portal hypertension and subsequent progression to limited cutaneous systemic sclerosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;A 57-year-old Japanese woman was referred to our hospital with suspected anti-centromere antibody-positive primary biliary cholangitis. Further examination revealed the coexistence of idiopathic portal hypertension, and the patient progressed to limited cutaneous systemic sclerosis over 3 years. On the basis of this case, we suspected that anti-centromere antibodies might cause microvascular endothelial dysfunction, leading to the development of idiopathic portal hypertension and other systemic abnormalities. Supplementary tests were performed to verify this hypothesis, including flow-mediated vasodilation, brachial-ankle pulse wave velocity, nailfold video capillaroscopy, upper gastrointestinal endoscopy, pathological CD34 and indoleamine 2,3-dioxygenase 1 staining, and measurements of soluble lectin-like oxidized low-density lipoprotein receptor-1 and its ligand containing apolipoprotein B. The results indicated vascular abnormalities in the liver, skin, and gastrointestinal tract, highlighting the universal effects of anti-centromere antibodies in vascular and autoimmune pathologies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This is the first documented case of hepatic and systemic microvascular impairment observed in an anti-centromere antibody-positive patient. The pathological evidence of endothelial damage in the liver suggests that the \"idiopathic\" label of idiopathic portal hypertension may need reconsideration in the context of anti-centromere antibody-related pathophysiology, potentially warranting a unifying concept such as \"anti-centromere antibody-related systemic microangiopathy syndrome.\" While our case may provide novel insights into anti-centromere antibody-driven microv","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"392"},"PeriodicalIF":0.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326789/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789251","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":"Infective endocarditis mimicking antineutrophil-cytoplasmic-antibody-associated vasculitis with glomerulonephritis: a case report.","authors":"Ahmad Matarneh, Sundus Sardar, Abdelrauof Akkari, Omar Salameh, Naman Trivedi, Muhammad Abdulbasit, Navin Verma, Ronald Miller, Nasrollah Ghahramani","doi":"10.1186/s13256-025-05470-1","DOIUrl":"10.1186/s13256-025-05470-1","url":null,"abstract":"<p><strong>Background: </strong>Infective endocarditis occasionally presents with antineutrophil cytoplasmic antibody positivity, leading to diagnostic challenges and confusion, as it can be mislabeled antineutrophil-cytoplasmic-antibody-associated vasculitis. Distinguishing between these two factors is crucial for appropriate management.</p><p><strong>Case presentation: </strong>In this case report, we describe a 77-year-old White non-Hispanic male patient who initially presented with features suggestive of antineutrophil-cytoplasmic-antibody-associated vasculitis but was ultimately diagnosed with infective endocarditis.</p><p><strong>Conclusion: </strong>Our findings emphasize the need to rule out infective endocarditis in patients with suspected antineutrophil-cytoplasmic-antibody-associated vasculitis, as it can be the same, and management relies on different lines of therapy. Immunosuppression therapy can lead to devastating effects in patients with infective endocarditis.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"385"},"PeriodicalIF":0.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784536","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 mutation in transthyretin gene in a Mexican patient leading to hereditary amyloidosis: a case report.","authors":"Muhammad Reebal Malik, Tarun Dalia, Zubair Shah","doi":"10.1186/s13256-025-05308-w","DOIUrl":"10.1186/s13256-025-05308-w","url":null,"abstract":"<p><strong>Background: </strong>Transthyretin is a protein produced by the liver, and when normal, it carries out the role of transporting thyroid hormone and vitamin A in the body. Mutations in the gene that codes for this protein can cause it to misfold. A misfolded protein can not carry out its functions and can also build up in different organs leading to a group of diseases known as amyloidosis. Depending upon the site in which this protein accumulates, a large variety of symptoms can be seen. If the protein deposits in the heart, it can lead to heart failure and associated symptoms and is known as cardiac amyloidosis. If in the nerves, it can lead to neuropathy and tingling and numbness and so on. Due to the various symptom's transthyretin amyloidosis can present with, it is difficult to keep it on the differential and diagnose the disease, as suspicions for it should be high. We would like to use this case report to help raise awareness about hereditary transthyretin amyloidosis.</p><p><strong>Case presentation: </strong>A 66-year-old Mexican male patient with a family history significant for hereditary amyloidosis presented with intermittent chest pain, shortness of breath, and neurological symptoms. An echocardiogram done at an outside hospital showed an ejection fraction of 55-60% with grade 2 diastolic dysfunction. A technetium pyrophosphate scan was used to make the diagnosis of transthyretin amyloidosis, and genetic testing showed that the patient was heterozygous for p.G67A (also known as c.2000G > C) pathogenic mutation in the transthyretin (TTR) gene. Due to these findings the patient was started on tafamidis free acid 61 mg daily and vutrisiran (Amvuttra) injections. He was also given vitamin A supplementation to prevent vutrisiran-associated vitamin A deficiency, which is a known side effect.</p><p><strong>Conclusions: </strong>A high index of suspicion is required for diagnosing transthyretin amyloidosis. This case will help raise awareness among physicians regarding the presence of the G67A mutation in Mexican patients and its management.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"384"},"PeriodicalIF":0.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784535","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":"Acute soft head syndrome and orbital compression syndrome in a child with sickle cell disease: a case report.","authors":"David Mukunya, Catherine Nabaggala, Oguttu Faith, Annet Nakirulu, Rebecca Claire Lusobya, Patience Atuhaire, Lyness Bitira, Doris Nduhukire, Robert Kitenge, Dorah Nakayiwa, Ruth Namazzi, Deogratias Munube","doi":"10.1186/s13256-025-05467-w","DOIUrl":"10.1186/s13256-025-05467-w","url":null,"abstract":"<p><strong>Background: </strong>Sickle cell disease affects 7.7 million people worldwide, mostly in sub-Saharan Africa. However, due to migration trends, patients with sickle cell disease are increasingly found in the Western world. As such, knowing rare complications of sickle cell disease, such as acute soft head syndrome and orbital compression syndrome, is important to avoid misdiagnosis and mismanagement.</p><p><strong>Case presentation: </strong>A 9-year-old Ugandan male patient known to have sickle cell anemia presented to our pediatric emergency unit with areas of swelling of the head that progressed in a couple of hours to involve the right eye and were associated with a low-grade fever but no headache. A diagnosis of acute soft head syndrome complicated by orbital compression syndrome was made. The patient was treated conservatively with fluids, analgesia, steroids and prophylactic antibiotics. The orbital compression syndrome was complicated by a corneal ulcer; however, vision was retained in all visual fields due to the corneal ulcer's location below the pupillary axis.</p><p><strong>Conclusion: </strong>We highlight the reversible nature of acute soft head syndrome and orbital compression syndrome in a child with sickle cell disease. We also highlight the importance of protective eye care in orbital compression syndrome to avoid exposure keratopathy. Physicians should resist the temptation to aspirate these areas of swelling, as this can introduce infection.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"383"},"PeriodicalIF":0.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318402/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768672","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":"Synchronous triple-negative breast cancer, rectal adenocarcinoma, and chemotherapy-induced hepatitis B virus reactivation: a case report and review of the literature.","authors":"Ahmad Al-Bitar, Israa Tellawi, Hazem Kamil, Dana Al-Masalma, Karam Jeji, Souheb Al-Mahasna","doi":"10.1186/s13256-025-05423-8","DOIUrl":"10.1186/s13256-025-05423-8","url":null,"abstract":"<p><strong>Background: </strong>The occurrence of multiple primary cancers is increasing, largely due to better diagnostic tools and longer patient survival. However, managing these cases can be complex, especially when treatments such as chemotherapy lead to complications such as hepatitis B virus (HBV) reactivation, which carries a significant risk of severe illness and death.</p><p><strong>Case presentation: </strong>We present the case of a 55-year-old Arab woman diagnosed with a rapidly growing triple-negative breast cancer, found to have a BRCA1/BRCA2 mutation. She began neoadjuvant chemotherapy, but the treatment was stopped early due to severe liver inflammation (transaminitis) and a sharp increase in hepatitis B virus levels, confirming hepatitis B virus reactivation. Antiviral therapy with entecavir was promptly started. Later, the patient developed rectal bleeding, leading to the diagnosis of a mid-rectal invasive adenocarcinoma. She underwent successful surgeries for both cancers: a right modified radical mastectomy and a rectal resection with colostomy. Pathology confirmed two distinct primary tumors. Despite initial concerns due to a positron emission tomography scan, subsequent biopsies showed no recurrence. The patient completed adjuvant radiation and, at a 3-year follow-up, remains healthy and disease-free.</p><p><strong>Conclusion: </strong>This case highlights the intricate challenges of managing synchronous primary cancers and the life-threatening risk of hepatitis B virus reactivation during chemotherapy. It strongly emphasizes the need for routine hepatitis B virus screening before chemotherapy, careful monitoring of liver function and viral loads, and the immediate availability of antiviral treatment. A collaborative, multidisciplinary approach is essential for prioritizing treatments effectively and achieving good outcomes in patients with such complex cancer presentations.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"382"},"PeriodicalIF":0.8,"publicationDate":"2025-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768673","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":"Solitary infantile myofibromatosis presenting as multiple subcutaneous lesions: a case report.","authors":"Hengameh Nazari, Mahsa Geravandi","doi":"10.1186/s13256-025-05469-8","DOIUrl":"10.1186/s13256-025-05469-8","url":null,"abstract":"<p><strong>Background: </strong>Infantile myofibromatosis is a rare benign mesenchymal disorder characterized by the proliferation of myofibroblasts, representing the most common fibrous tumor of infancy and early childhood. Solitary infantile myofibromatosis is the most common variant, typically presenting as a firm, painless dermal or subcutaneous mass. This case is notable for the early prenatal detection of multiple subcutaneous lesions, initially presumed to be lymphangiomas, but later confirmed as infantile myofibromatosis postnatally. The diagnostic challenge highlights the importance of prenatal imaging and histopathological confirmation for accurate diagnosis and management.</p><p><strong>Case presentation: </strong>An Iranian male preterm neonate, born at 34 weeks of gestation, was admitted to the neonatal intensive care unit due to prematurity, respiratory distress syndrome, and multiple subcutaneous masses. Prenatal imaging at 34 weeks identified multiple cystic subcutaneous lesions, leading to a provisional diagnosis of lymphangiomas. Postnatal examination exhibited multiple firm, well-circumscribed subcutaneous nodules over the trunk, back, abdomen, periauricular region, and right thigh. Ultrasonography showed well-defined hypoechoic lesions with some demonstrating necrotic centers. Differential diagnoses included neonatal myofibromatosis, infantile rhabdomyosarcoma, and soft-tissue metastases. The neonate underwent surgical excision of a thoracic lesion, and histopathological examination with immunohistochemistry confirmed infantile myofibromatosis. The patient was discharged in stable condition, with parental counseling on prognosis and follow-up. At 1-year follow-up, no new lesions or morphological progression were noted, and some previously visualized lesions showed regression.</p><p><strong>Conclusions: </strong>This case highlights the importance of prenatal imaging-particularly fetal magnetic resonance imaging-in the identification of soft-tissue lesions and guiding postnatal evaluation. It highlights the necessity of histopathological confirmation for distinguishing infantile myofibromatosis from other neonatal soft-tissue tumors. Given the potential for spontaneous regression, a conservative, individualized management approach is recommended, avoiding unnecessary interventions while ensuring appropriate follow-up.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"378"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764905","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":"Laparoscopic wedge resection and omental patch in an elderly patient with acute abdomen: a case report.","authors":"Parham Khoshdani Farahani","doi":"10.1186/s13256-025-05476-9","DOIUrl":"10.1186/s13256-025-05476-9","url":null,"abstract":"<p><strong>Background: </strong>Perforated gastric ulcers represent life-threatening surgical emergencies with particularly high morbidity and mortality in elderly patients. While omental patch repair remains the standard treatment for duodenal perforations, optimal management of complex gastric perforations, especially those with necrosis or concurrent lesions, remains controversial.</p><p><strong>Case presentation: </strong>We present the case of a 72-year-old Iranian woman with multiple comorbidities who presented with septic shock secondary to gastric perforation. Diagnostic laparoscopy revealed a 1.5-cm perforation with surrounding necrosis and an adjacent gastric polyp. The patient successfully underwent combined laparoscopic wedge resection and omental patch repair, demonstrating the feasibility of this minimally invasive approach in high-risk patients. The procedure included complete excision of necrotic tissue and polyp with stapled wedge resection, followed by reinforcement using a vascularized omental patch. Postoperative recovery was uneventful, with the patient discharged on day 10. Histopathology confirmed benign ulceration without malignancy. At the 3-month follow-up, the patient remained asymptomatic with no recurrence.</p><p><strong>Conclusion: </strong>This case highlights that laparoscopic wedge resection with omental patch repair offers both diagnostic and therapeutic advantages for complex gastric perforations, particularly when tissue viability is questionable or concurrent lesions are present. The technique combines the benefits of minimally invasive surgery, reduced morbidity, and faster recovery with the reliability of traditional omental patching. The successful outcome highlights the expanding role of laparoscopy in emergency general surgery for high-risk populations.</p>","PeriodicalId":16236,"journal":{"name":"Journal of Medical Case Reports","volume":"19 1","pages":"381"},"PeriodicalIF":0.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764903","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}