Surgical Case Reports最新文献

{"title":"A Rare Case of Solitary Primary and Recurrent Hepatic Epithelioid Hemangioendothelioma Undergoing Repeat Liver Resections.","authors":"Yuhi Yoshizaki, Fuyuki Inagaki, Mai Nakamura, Takashi Kokudo, Fuminori Mihara, Nobuyuki Takemura, Norihiro Kokudo","doi":"10.70352/scrj.cr.24-0084","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0084","url":null,"abstract":"<p><strong>Introduction: </strong>Hepatic epithelioid hemangioendothelioma (HEHE) is a rare vascular tumor. Treatment strategy remains controversial because of its rarity. Liver resection is considered as the optimal treatment for solitary HEHE, while a small subset of patients have a solitary tumor. We present the rare case of a patient with solitary primary HEHE who experienced solitary recurrence following liver resection and underwent subsequent liver resection.</p><p><strong>Case presentation: </strong>A 55-year-old man was referred to our department with a suspected intrahepatic cholangiocarcinoma, based on imaging findings. Anatomic liver resection of segment 8 was performed, and the tumor was confirmed to be HEHE from the pathological findings. Fifteen months later, a solitary recurrence developed in segment 7. After a 5-month observation period, partial liver resection was performed, and the tumor was consistent with recurrent HEHE. The postoperative course was uneventful, and the patient remained recurrence-free for 9 months following the procedure.</p><p><strong>Conclusions: </strong>Repeat liver resection may be a feasible treatment option for patients with solitary recurrent HEHE.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015604","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":"Pneumoperitoneum Caused by a Ruptured Splenic Abscess Mimicking Gastrointestinal Perforation: A Case Report.","authors":"Naoki Kawahara, Mitsuaki Kojima, Koji Morishita","doi":"10.70352/scrj.cr.24-0098","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0098","url":null,"abstract":"<p><strong>Introduction: </strong>Splenic abscess is a rare but potentially life-threatening condition that can rupture, leading to pneumoperitoneum and symptoms that mimic gastrointestinal perforation in rare cases. This can significantly complicate accurate diagnosis and prompt treatment. A splenic abscess can become life-threatening by rupturing, which may cause diffuse peritonitis or sepsis.</p><p><strong>Case presentation: </strong>A 68-year-old man with uncontrolled diabetes presented with fever, chills, and abdominal pain. Initial evaluation at a previous hospital, including computed tomography (CT), suggested a lower gastrointestinal perforation, leading to his transfer to our facility. CT revealed a non-enhancing lesion with gas in the spleen and free intraperitoneal air; however, there was no clear evidence of gastrointestinal perforation. An emergency exploratory laparotomy was performed, which revealed purulent ascites and a ruptured splenic abscess without any gastrointestinal perforation. After thorough lavage to eliminate contamination, open abdominal management was initiated owing to a need for catecholamine support and an inability to completely rule out the possibility of gastrointestinal perforation. A second-look laparotomy confirmed that there was no further contamination or gastrointestinal tract perforation. Blood and abscess cultures revealed <i>Escherichia coli</i>, leading us to initiate targeted antibiotic therapy. The patient recovered successfully and was discharged on postoperative day 40 without any recurrence. Ruptured splenic abscess with pneumoperitoneum is rare and poses significant diagnostic challenges, particularly in patients with diabetes, owing to its clinical similarity to gastrointestinal perforation. This study highlights the utility of exploratory laparotomy and staged open abdominal management when gastrointestinal perforation cannot be ruled out.</p><p><strong>Conclusions: </strong>Physicians should consider ruptured splenic abscesses in patients with pneumoperitoneum, particularly those with diabetes. Exploratory laparotomy with staged open abdominal management may represent an effective approach that facilitates safe monitoring and targeted treatment, thereby reducing the risk of fatal complications.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049061","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":"Adenocarcinoma with Enteroblastic Differentiation and Neuroendocrine Features in Autoimmune Gastritis: Novel Insights into Tumor Development from Endocrine Cell Micronests.","authors":"Hidetoshi Satomi, Shingo Ishiguro, Sei Murayama, Yoshiaki Andoh, Noriya Uedo, Tomoki Michida, Ryu Ishihara, Keiichiro Honma","doi":"10.70352/scrj.lte.25-0017","DOIUrl":"10.70352/scrj.lte.25-0017","url":null,"abstract":"","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11957943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765220","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":"Salvage Right Ventricular Outflow Tract Reconstruction for Pulmonary Embolization with Pulmonary Artery Sarcoma.","authors":"Tsubasa Nagai, Yusuke Misumi, Daisuke Yoshioka, Masashi Kawamura, Takuji Kawamura, Ryohei Matsuura, Ai Kawamura, Masaki Taira, Kazuo Shimamura, Daisuke Sakai, Taro Sato, Shigeru Miyagawa","doi":"10.70352/scrj.cr.24-0068","DOIUrl":"10.70352/scrj.cr.24-0068","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary artery intimal sarcoma (PAIS) is extremely rare and highly malignant. Although improved outcomes have been reported after complete surgical resection and chemotherapy, limited information is available regarding the indications, procedures, and prognosis of palliative surgery for PAIS. This report describes a successful salvage surgical case for rapid hemodynamic deterioration due to PAIS obstructing the pulmonary artery trunk.</p><p><strong>Case presentation: </strong>A 64-year-old woman, complaining of dyspnea for a month, was referred for a pulmonary artery tumor. Imaging studies confirmed an intraluminal tumor that obstructs the pulmonary artery trunk and extends to the right ventricular wall and interventricular septum, suspecting a malignancy. During preoperative workups, she developed acute hemodynamic and respiratory deterioration due to pulmonary embolization, so emergency surgery was planned on a salvage basis. The tumor originated from the pulmonary artery intima just distal to the pulmonary valve, obstructed the pulmonary artery trunk, and extensively involved the left main coronary artery and the interventricular septum, where complete resection of the tumor was not achieved. Reconstruction of the pulmonary valve, the right ventricular outflow tract (RVOT), and bilateral pulmonary arteries were performed using a composite of a prosthetic valve and vascular grafts. The patient's postoperative course was uneventful, and she was discharged home asymptomatic. Pathological diagnosis of the operative specimen confirmed pulmonary intimal sarcoma. After 4 months of postoperative chemotherapy, tumor progression was confirmed. The patient passed away at home 8 months after surgery.</p><p><strong>Conclusion: </strong>We reported a case of PAIS presenting with RVOT obstruction and rapid hemodynamic and respiratory deterioration, who underwent succeeding emergent surgery and was discharged home asymptomatic. Palliative RVOT reconstruction can be a useful surgical option for PAIS accompanying pulmonary embolization on a salvage basis.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143754536","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":"En bloc Right Hemicolectomy with Pancreaticoduodenectomy for Advanced Ascending Colon Cancer.","authors":"Hiroyuki Takeda, Tetsuo Ishizaki, Ryutaro Udo, Tomoya Tago, Kenta Kasahara, Junichi Mazaki, Keiichiro Inoue, Yuichi Nagakawa","doi":"10.70352/scrj.cr.24-0146","DOIUrl":"10.70352/scrj.cr.24-0146","url":null,"abstract":"<p><strong>Introduction: </strong>While simultaneous complex surgical procedures such as right hemicolectomies with pancreaticoduodenectomies (RHPD) may increase overall surgical complexity, complications, and risk of death, it is the only cure for advanced ascending colon cancer (AACC) that has directly invaded the duodenum/pancreas. There are a few reports, especially from Japan. Here, we report an extremely rare case of a patient who underwent RHPD for AACC with direct invasion to the duodenum and liver and describe the patient's long-term survival after en bloc resection.</p><p><strong>Case presentation: </strong>The patient was a 76-year-old man who presented with a chief complaint of right abdominal pain and weight loss of 12 kg over the past month. Colonoscopy revealed the entire circumference of a type 2 tumor in the ascending colon. Preoperative computed tomography showed a 12 cm mass lesion with wall thickening in the ascending colon which was also invading the second portion of the duodenum. MSI-H/dMMR was negative. RHPD and partial hepatectomy were performed with open surgery because of a preoperative diagnosis of clinical T4b (duodenum and liver) N1bM0 stage IIIc cancer. Although grade 2 adverse effects, which delayed gastric emptying was observed during the patient's postoperative course, the patient's condition resolved through conservative therapy. Oral intake started on postoperative day 17, and the patient was discharged on postoperative day 25. Capecitabine plus oxaliplatin was administered as adjuvant chemotherapy for 6 months. Hematoxylin and eosin staining revealed moderately differentiated adenocarcinoma invading the duodenum and liver. The patient was diagnosed as pathological T4b (duodenum and liver) N1bM0 stage IIIc cancer. No recurrence was noted up to 40 months after the surgery.</p><p><strong>Conclusions: </strong>The only curative therapy for AACC with involvement of the duodenum is en bloc RHPD. Here, we described a case in which long-term survival was achieved by ensuring R0 with en bloc resection.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11972922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804010","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":"Spontaneous Regression of Advanced Transverse Colon Cancer: A Case Report.","authors":"Shinya Ohno, Yoshinori Iwata, Saki Mitsutome, Shusaku Kawai, Manabu Neo, Moe Fukuda, Bei Wang, Tomonari Suetsugu, Taku Watanabe, Shuji Komori, Chihiro Tanaka, Narutoshi Nagao, Masahiko Kawai","doi":"10.70352/scrj.cr.24-0018","DOIUrl":"10.70352/scrj.cr.24-0018","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of spontaneous regression (SR) of malignancy is one in 60000-100000 cancer patients and spontaneous regression in colorectal cancer is quite rare, reported to account for less than 2% of spontaneous regression of malignancy. In recent years, some reports of spontaneous regression in colorectal cancer in patients with high-frequency microsatellite instability have suggested a deep association between high-frequency microsatellite instability and spontaneous regression. We report our experience of spontaneous regression of advanced colorectal cancer with high-frequency microsatellite instability and provide a review of spontaneous regression in colorectal cancer.</p><p><strong>Case presentation: </strong>An 83-year-old woman was diagnosed as having advanced colorectal cancer in the transverse colon by lower gastrointestinal endoscopy, and biopsy results revealed moderately differentiated adenocarcinoma. Contrast-enhanced computed tomography showed a tumor located near the hepatic flexure and an enlarged lymph node near the tumor. No distant metastasis was observed, and the preoperative diagnosis was cT3N1aM0 cStage IIIb cancer. Immunohistochemical analysis of the biopsy specimen suggested deficient mismatch repair. During the wait for surgery, the patient was urgently hospitalized due to severe dehydration. After her general condition improved, 38 days after the biopsy, we performed laparoscopic resection of the partial ascending and transverse colon with D3 lymph node dissection. The tumor noted preoperatively was not present in the specimen, and intraoperative endoscopy revealed no tumor on the anorectal side. Additional ileocecal resection was performed, but no tumor was found in the specimen, and another intraoperative endoscopy was performed, which revealed a discolored scar near the anal margin. We determined that tumor loss or morphological change had occurred, so after additional resection of the same area, ultimately, an extended right hemicolectomy was performed. Histopathological diagnosis was pT0N0M0 pStage0 cancer with no residual tumor. The patient has progressed without recurrence at 1 year after the operation.</p><p><strong>Conclusions: </strong>The immunological response due to high-frequency microsatellite instability may be related to the mechanism of spontaneous regression in colorectal cancer. If high-frequency microsatellite instability is diagnosed preoperatively, we recommend that the tumor location should be confirmed preoperatively.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11842877/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484053","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":"Intrahepatic Cholangiocarcinoma with <i>BRCA</i> Mutation Achieved Pathological Complete Response after Neoadjuvant Gemcitabine, Cisplatin, and S-1 Therapy: A Case Report.","authors":"Yoshifumi Morita, Koki Oda, Akio Matsumoto, Shinya Ida, Ryo Kitajima, Satoru Furuhashi, Makoto Takeda, Hirotoshi Kikuchi, Yoshihiro Hiramatsu, Jun Ito, Takeshi Chida, Hidenao Noritake, Kazuhito Kawata, Yuka Nagakura, Mana Goto, Satoshi Baba, Hiroya Takeuchi","doi":"10.70352/scrj.cr.24-0042","DOIUrl":"10.70352/scrj.cr.24-0042","url":null,"abstract":"<p><strong>Introduction: </strong>Intrahepatic cholangiocarcinoma (ICC) is a highly malignant cancer for which surgery is the only curative treatment. The prognosis of ICC is extremely poor, especially in cases of lymph node metastasis (LNM), owing to the high postoperative recurrence rate. Herein, we present a case of advanced ICC with a breast cancer susceptibility gene-2 (<i>BRCA2</i>) mutation, treated with preoperative chemotherapy, including cisplatin, followed by surgery, in which we achieved a pathologic complete response.</p><p><strong>Case presentation: </strong>A 52-year-old woman was referred to our hospital and was subsequently diagnosed with bilateral breast cancer. Computed tomography (CT) and magnetic resonance imaging incidentally detected a liver tumor in the hilar region and lymph node enlargement in the hepatoduodenal ligament. A 19 mm tumor was observed in the area surrounded by the right and left branches of the portal vein and an abnormal portal branch of segment 7. Positron emission tomography-CT showed fluorodeoxyglucose uptake in the liver tumor, hepatoduodenal ligament lymph nodes, and bilateral breasts. A tumor biopsy showed a papillary tumor, and ICC was suspected. As ICC with LNM has a poor prognosis, neoadjuvant chemotherapy was planned. Genetic testing using a blood sample revealed a <i>BRCA2</i> mutation, indicating the patient would benefit from chemotherapy, particularly cisplatin. The patient received a chemotherapy regimen comprised of gemcitabine, cisplatin, and S-1 (GCS), and after 7 courses, her carbohydrate antigen 19-9 level decreased from 2433 to 15 U/mL. CT showed that the tumor had shrunk and the LNMs were indistinct. The patient was referred to our department for curative surgery, which included a left hepatectomy, caudate lobectomy, hepatoduodenal ligament lymph node dissection, bile duct resection, and choledocojejunostomy. The postoperative course was generally uneventful, and the patient was discharged on postoperative day 18. Pathological examination of the resected specimen revealed an absence of malignant cells. At 24 months postoperative, there was no evidence of recurrence.</p><p><strong>Conclusions: </strong>We encountered a patient with advanced ICC with a <i>BRCA2</i> mutation, which was successfully treated with preoperative GCS therapy followed by surgical resection, and a pathologic complete response was achieved. GCS therapy, therefore, appears promising as neoadjuvant chemotherapy for the treatment of ICC.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11835984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459131","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 Case Report of Severe Thrombocytopenic Purpura during Neoadjuvant Pembrolizumab Administration for Triple-Negative Breast Cancer.","authors":"Ryoko Semba, Shiori Tohyama, Yumiko Ushiyama, Fumi Murakami, Sakiko Harada, Kanako Ogura, Junichiro Watanabe","doi":"10.70352/scrj.cr.24-0036","DOIUrl":"10.70352/scrj.cr.24-0036","url":null,"abstract":"<p><strong>Introduction: </strong>Immune thrombocytopenic purpura (ITP) is one of the immune-related adverse events (irAEs) related to immune checkpoint inhibitors (ICIs). Here, we report a case of a 51-year-old woman with triple-negative breast cancer (TNBC) who experienced severe thrombocytopenic purpura during the neoadjuvant chemotherapy (NAC), including pembrolizumab.</p><p><strong>Case presentation: </strong>A 51-year-old woman was diagnosed with Stage II B TNBC and underwent NAC using pembrolizumab + paclitaxel + carboplatin. Her blood test on cycle 4, day 15 (C4D15) showed a significant decrease in platelets to <2000/μL accompanied by overt bleeding tendency. She was hospitalized for further investigation and treatment. Her platelet count recovered after platelet concentrate transfusion and corticosteroid administration. Her bone marrow examination showed normal cellularity, and she was judged as ITP. Due to the event and good clinical response to NAC, she underwent a right partial mastectomy and axillary lymph node dissection without completion of the planned NAC. The surgical specimen showed a complete pathological response.</p><p><strong>Conclusions: </strong>Thrombocytopenia is known as one of the hematologic irAEs; however, severe thrombocytopenia with a bleeding tendency is rarely reported. Sufficient explanations to patients and appropriate referral to other related departments are important for earlier detection and treatment of irAE.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11832221/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441966","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 Right Upper Lung Segmentectomy after Esophagectomy: Utilization of 4K 3-Dimensional Endoscopy and Near-Infrared Fluorescence in High-Risk Surgery.","authors":"Masaya Otabe, Sayaka Yamada, Atsushi Kagimoto, Takeshi Mimura","doi":"10.70352/scrj.cr.24-0144","DOIUrl":"10.70352/scrj.cr.24-0144","url":null,"abstract":"<p><strong>Introduction: </strong>Lung resection after open esophagectomy poses significant technical challenges, particularly when the reconstructed gastrointestinal tract is on the same side as the lung lesion. The advent of 4K 3-dimensional (3D) endoscopic systems with near-infrared (NIR) fluorescence imaging using indocyanine green (ICG) has improved the precision of thoracic surgeries. We present a case of successful right upper lung segmentectomy for primary lung cancer after open esophagectomy, utilizing a 4K 3D endoscopic system and NIR imaging.</p><p><strong>Case presentation: </strong>An 85-year-old female with a history of open esophagectomy for esophageal cancer 19 years earlier and comorbidities, including aplastic anemia and diabetes mellitus, was referred for the evaluation of a growing lesion in the right upper lung. Computed tomography (CT) revealed a 43-mm tumor and the gastric tube, reconstructed during the prior esophagectomy, located in the right thoracic cavity. A CT-guided biopsy confirmed lung adenocarcinoma (cT2bN0M0, Stage IIA). Surgical challenges included severe adhesions from the previous thoracotomy and thrombocytopenia (platelet count: 20000) due to aplastic anemia. A thoracoscopic segmentectomy of the anterior segment of the right upper lobe was performed using a 4K 3D endoscopic system (TIPCAM1 Rubina; Karl Storz, Tuttlingen, Germany). Adhesions were meticulously dissected, and intraoperative platelet transfusions were administered. NIR imaging with ICG identified the intersegmental plane and confirmed blood flow to the gastric tube, preventing ischemic complications. The lung segmentectomy was completed using staplers, preserving the right gastroepiploic artery. Histopathology revealed acinar adenocarcinoma (pT3N0M0, Stage IIB). The patient resumed oral intake on postoperative Day 1 and was discharged on Day 13 without complications. No recurrence was noted during the follow-up.</p><p><strong>Conclusions: </strong>This case demonstrates the effective use of 4K 3D endoscopic systems and NIR imaging with ICG in complex lung resections following open esophagectomy. These technologies facilitate precise dissection and blood flow assessment, which are crucial for preserving reconstructed structures and enhancing surgical safety.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11836011/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459398","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":"Esophageal Atresia Caused by Corrosive Esophagitis for over 50 Years: A Case Report.","authors":"Keisuke Fujimoto, Seiya Inoue, Masakazu Goto, Shinichi Sakamoto, Mariko Misaki, Satoshi Fujiwara, Takahiro Yoshida, Hiroaki Toba, Hiromitsu Takizawa","doi":"10.70352/scrj.cr.24-0116","DOIUrl":"10.70352/scrj.cr.24-0116","url":null,"abstract":"<p><strong>Introduction: </strong>Corrosive esophagitis, often caused by the ingestion of alkalis, acids, or heavy metals, can result in severe esophageal damage and complications, such as stenosis or closure. Although initial treatment is conservative, surgical intervention is necessary when a chronic stricture occurs. A case of esophageal atresia persisting for 50 years due to corrosive esophagitis has not yet been reported. Here, we describe such a case.</p><p><strong>Case presentation: </strong>The patient was a 72-year-old woman. At 20 years of age, she ingested an alkali substance in a suicide attempt, leading to the development of corrosive esophagitis. Surgery was initially considered for esophageal atresia but was deemed unfeasible at the time; therefore, gastrostomy was performed instead. Subsequently, for over 50 years, she manually chewed food and inserted it into her gastric tube. She was urgently transported to a nearby hospital after her general condition deteriorated due to an influenza infection. During hospitalization, her nutritional intake was reassessed, and given her strong desire for oral intake, she was referred to our hospital for surgical treatment. Her gastric mucosa was intact, and imaging revealed mild mediastinal inflammation and fibrosis, rendering esophageal resection and reconstruction feasible. Considering surgical invasiveness, we opted for a mediastinoscopic esophagectomy and performed posterior mediastinal reconstruction using a gastric tube with a cervical hand-sewn anastomosis. The patient recovered without any complications and was discharged. Although postoperative aspiration and swallowing disorders were anticipated, the patient experienced none, likely because her unique self-feeding method preserved the functions of her masticatory and swallowing muscles.</p><p><strong>Conclusions: </strong>We report an extremely rare case of a patient with a unique history of esophageal atresia following corrosive esophagitis for over 50 years who successfully underwent minimally invasive esophagectomy using mediastinoscopy and had a favorable outcome. Mediastinoscopic esophagectomy is a minimally invasive option for such patients.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"11 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11925641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671049","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}