Surgical Case Reports最新文献

{"title":"Surgical resection following chemoradiotherapy for thoracic SMARCA4-deficient undifferentiated tumor: a report of two cases.","authors":"Kensuke Takei, Mitsuhiro Isaka, Junji Wasa, Takuya Kawata, Tatsuya Masuda, Shinya Katsumata, Koki Maeda, Hideaki Kojima, Hayato Konno, Yasuhisa Ohde","doi":"10.1186/s40792-024-02053-y","DOIUrl":"10.1186/s40792-024-02053-y","url":null,"abstract":"<p><strong>Background: </strong>Thoracic SMARCA4-deficient undifferentiated tumor (SMARCA4-UT) is a high-grade malignant neoplasm with a poor prognosis. Most cases of SMARCA4-UT have extensive chest wall and mediastinum involvement. The efficacy of surgical resection has not been clearly established. Here, we report two surgical cases of SMARCA4-UT with chest wall invasion after chemoradiotherapy.</p><p><strong>Case presentation: </strong>The first patient was a 40-year-old man with back pain. Computed tomography revealed a 6.8 cm mass in contact with the thoracic vertebrae near the intervertebral foramen, which was suspected to involve the third to fifth ribs. The patient was diagnosed with SMARCA4-UT with clinical T3N0M0 stage IIB. The tumor shrank after chemoradiotherapy, and conversion surgery combined with partial vertebrectomy was performed. Histopathological findings revealed 30% residual tumor in the tumor bed. Thirty-six days after surgery, the patient developed multiple liver metastases and peritoneal dissemination. Chemotherapy combined with immune checkpoint inhibitor treatment was performed, resulting in tumor shrinkage. However, peritoneal dissemination recurred within a short interval. The patient died 5 months postoperatively. The second patient was a 74-year-old man with chest pain. Computed tomography revealed a 7.4-cm mass in the left upper lobe with invasion of the third and fourth ribs. The patient was initially diagnosed with non-small cell lung cancer with clinical T4N1M0 stage IIIA. The tumor shrank after induction chemoradiotherapy, and a left upper lobectomy combined with the chest wall resection was performed. Based on histopathological findings, the patient was diagnosed with SMARCA4-UT. The residual tumor percentage was 3%. The patient was followed up for 12 months postoperatively without recurrence.</p><p><strong>Conclusions: </strong>We performed the complete resection of SMARCA4-UT following chemoradiotherapy. The two surgical cases had different postoperative courses. Radical surgery after chemoradiotherapy is effective for local control. However, its long-term prognostic efficacy remains unclear. Multidisciplinary approaches and further investigations of novel therapeutic options are required.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"253"},"PeriodicalIF":0.7,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11534913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575315","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":"Gastro-tracheal fistula following esophageal cancer surgery through the retrosternal route: a case report.","authors":"Seitaro Nishimura, Kazuhiro Noma, Kento Kawasaki, Masashi Hashimoto, Takuya Kato, Naoaki Maeda, Shunsuke Tanabe, Yasuhiro Shirakawa, Toshiyoshi Fujiwara","doi":"10.1186/s40792-024-02052-z","DOIUrl":"10.1186/s40792-024-02052-z","url":null,"abstract":"<p><strong>Background: </strong>Gastro-tracheal fistula is a rare but serious complication after esophageal surgery, often requiring long-term treatment and invasive procedures. Gastro-tracheal fistula usually occurs through the posterior mediastinal route and rarely through the retrosternal route. No previous reports have described gastro-tracheal fistula after retrosternal route reconstruction was cured by conservative treatment.</p><p><strong>Case presentation: </strong>A 70-year-old man with lower thoracic esophageal cancer underwent thoracoscopic esophagectomy in the prone position and gastric tube reconstruction through the retrosternal route with neck anastomosis after neoadjuvant chemotherapy. Despite anastomotic leakage on postoperative day 10, his general condition was stable, and he was managed conservatively with antibiotics and gastric tube decompression. On day 29, he presented with high fever and a gastro-tracheal fistula was observed by esophagography. Conservative management was continued because the patient remained stable. On day 48, esophagography showed that the fistula was undetectable. The patient was able to take fluids orally. He progressed well on an oral diet and was transferred to a different hospital.</p><p><strong>Conclusions: </strong>A gastro-tracheal fistula, although rare, can occur after retrosternal route reconstruction. When a patient is stable, gastro-tracheal fistula after retrosternal route reconstruction may be cured by conservative treatment.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"252"},"PeriodicalIF":0.7,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11532326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569563","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 laparoscopic arterial ligation of splenic artery aneurysm with a splenomesenteric trunk: a case report and literature review.","authors":"Shigeya Takeo, Hideki Izumi, Hisamichi Yoshii, Rika Fjino, Masaya Mukai, Hidekazu Furuya, Akiyoshi Yamamoto, Shunsuke Kamei, Yukihisa Ogawa, Terumitsu Hasebe, Junichi Kaneko, Hiroyasu Makuuchi","doi":"10.1186/s40792-024-02051-0","DOIUrl":"10.1186/s40792-024-02051-0","url":null,"abstract":"<p><strong>Background: </strong>The mortality rate of splenic artery aneurysm rupture is very high, and patients with aneurysms larger than 30 mm are recommended for treatment, regardless of the presence or absence of symptoms. We herein report a case of splenic artery aneurysm with an abnormal bifurcation that was treated with laparoscopic ligation of the splenic artery.</p><p><strong>Case presentation: </strong>A 51 year-old Japanese male was referred to our hospital because a splenic artery aneurysm was noted on abdominal echocardiography during a medical examination. The splenic artery bifurcated from the superior mesenteric artery (SMA), and a 38-mm splenic artery aneurysm was found just after the bifurcation; thus, surgery was performed. Intraoperative angiography was performed, a balloon catheter was placed before the splenic artery bifurcation, and laparoscopic splenic artery ligation was performed to prepare for sudden bleeding. After ligation of the splenic artery, angiography was performed again to confirm the absence of the splenic artery aneurysm and that the peripheral splenic artery was visible through the peripheral collateral vessels. The patient was discharged on the fourth postoperative day, with good progress. Contrast-enhanced computed tomography performed 1 month postoperatively confirmed the disappearance of the splenic artery aneurysm, and the contrast-enhanced peripheral splenic artery was visible.</p><p><strong>Conclusion: </strong>This is the first report of a safe laparoscopic artery ligation procedure for a splenic artery aneurysm with an abnormal splenic artery bifurcation from the SMA, in which a balloon catheter was placed at the splenic artery bifurcation.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"251"},"PeriodicalIF":0.7,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562842","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":"Correction: A case of laparoscopic partial hepatic S7 resection for postoperative liver metastasis of rectal malignant melanoma.","authors":"Makoto Takahashi, Yasuhiro Morita, Tatsuya Hayashi, Susumu Yanagibashi, Shunsuke Sato, Shu Sasaki, Kunio Takuma, Haruka Okada","doi":"10.1186/s40792-024-02042-1","DOIUrl":"10.1186/s40792-024-02042-1","url":null,"abstract":"","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"250"},"PeriodicalIF":0.7,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11522267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547581","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":"Stapler-induced vascular injury during uniportal VATS lobectomy: lessons learned from a rare complication case.","authors":"Yasuhiro Nakashima, Mariko Hanafusa, Hironori Ishibashi, Hiroshi Hosoda","doi":"10.1186/s40792-024-02048-9","DOIUrl":"10.1186/s40792-024-02048-9","url":null,"abstract":"<p><strong>Background: </strong>Due to advances in video-assisted thoracic surgery (VATS), the majority of lung resections can be performed safely via VATS with low morbidity and mortality. However, pulmonary artery (PA) bleeding often requires emergency conversion to thoracotomy, potentially leading to a life-threatening situation. We report a case of pulmonary artery injury caused by an unexpected stapler-tissue interaction during uniportal VATS lobectomy, highlighting the importance of recognizing and managing such rare complications to improve patient outcomes.</p><p><strong>Case presentation: </strong>A 63-year-old man underwent uniportal VATS left upper lobectomy for a suspected primary lung cancer. During the procedure, unexpected bleeding occurred from the third branch of the pulmonary artery (A3) after withdrawal of an unfired stapler. The protruding staple of the A3 stump was inadvertently hooked and stretched by the groove of the staple anvil. Although the bleeding was controlled by compression with the lung, the injured A3 stump required repair. Due to the extensive intimal injury near the central part of the left main pulmonary artery and the potential risk of fatal postoperative complications, we converted to open thoracotomy for definitive vascular repair by suturing. The patient had no postoperative complications and was discharged on postoperative day 8.</p><p><strong>Conclusions: </strong>This case report provides valuable lessons regarding the rare stapler-related vascular injury during uniportal VATS lobectomy. It is important to note that even during non-vascular dissection, unexpected stapler-tissue interactions can lead to bleeding. To prevent the vessel stump entanglement with stapler components, maintaining separation between the stapler and staple stumps is crucial. In uniportal VATS, manipulation during stapler insertion is one of the most challenging phases for instrument interference, requiring increased caution to prevent complications such as the vascular injury described in this case. Thorough preoperative planning, specific intraoperative precautions, and adapted safety protocols that address the limitations of uniportal VATS are essential for effective management of potential complications. Although techniques for thoracoscopic vascular control exist, they are not always feasible and conversion to open thoracotomy should be considered when necessary to ensure patient safety.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"249"},"PeriodicalIF":0.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519256/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523143","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":"Left inguinal dedifferentiated liposarcoma and primary unclassified sarcoma of the left lung as synchronous multiple sarcomas: a case report.","authors":"Masao Kobayashi, Hidetoshi Satomi, Hisaya Chikaraishi, Hironobu Samejima, Julian Horiguchi, Ryu Kanzaki, Tomohiro Maniwa, Keiichiro Honma, Jiro Okami","doi":"10.1186/s40792-024-02043-0","DOIUrl":"10.1186/s40792-024-02043-0","url":null,"abstract":"<p><strong>Background: </strong>Pulmonary nodules in patients with soft tissue sarcomas are likely pulmonary metastases, whereas synchronous primary pulmonary sarcomas are rare. Without surgery, determining whether a solitary pulmonary nodule is a primary or metastatic nodule is difficult. Herein, we report a rare case of a primary pulmonary sarcoma that presented synchronously with a primary dedifferentiated liposarcoma.</p><p><strong>Case presentation: </strong>A 77-year-old man presented to another hospital with left inguinal swelling and a suspected recurrent inguinal hernia. Computed tomography revealed a left inguinal mass and pure-solid nodule in the left lung and the patient was referred to our hospital for detailed examination and treatment. The inguinal mass was pathologically diagnosed as a dedifferentiated liposarcoma using needle biopsy, whereas bronchoscopic biopsy revealed histological findings suggestive of a sarcoma; however, the primary site could not be determined. Positron emission tomography-computed tomography revealed no high-accumulation lesions except for the two sarcomas. We decided to perform surgery on both sarcomas for diagnostic and curative purposes. The surgical specimens showed that the two sarcomas were different. Based on the immunohistochemical staining findings of MDM2, a left inguinal dedifferentiated liposarcoma and primary pulmonary unclassified sarcoma were diagnosed. The patient displayed no evidence of recurrence 1 year after surgery.</p><p><strong>Conclusions: </strong>We encountered a rare case of synchronous multiple primary sarcomas, one presenting in the lung and the other in the soft tissue. Surgery was required to achieve a definitive diagnosis for the patient, who achieved disease-free survival at 1 year. This case suggests that proactive resection of pulmonary nodules in patients with soft tissue sarcomas may be feasible as a diagnostic treatment if complete resection is achieved.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"248"},"PeriodicalIF":0.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523142","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":"Decortication with uniport video-assisted thoracoscopic surgery for empyema due to postoperative esophageal leakage: a report of two pediatric cases.","authors":"Yudai Goto, Seiya Ogata, Hirofumi Shimizu, Michitoshi Yamashita, Takuya Inoue, Takeo Hasegawa, Yutaka Shio, Hiroyuki Suzuki, Hideaki Tanaka","doi":"10.1186/s40792-024-02049-8","DOIUrl":"10.1186/s40792-024-02049-8","url":null,"abstract":"<p><strong>Background: </strong>Video-assisted thoracoscopic surgery (VATS) is considered useful for the treatment of parapneumonic empyema in children. However, thoracoscopic management of empyema due to esophageal leakage as an operative complication has not been well described in the literature.</p><p><strong>Case presentation: </strong>We successfully decorticated severe empyema using uniport VATS in 2 children (a 2-year-old boy who suffered esophageal perforation after laparoscopic anti-reflux surgery, and a 7-month-old girl who had anastomotic leakage after thoracoscopic repair of esophageal atresia). In these patients, we noticed that pleural effusion rapidly progressed to empyema and caused respiratory insufficiency due to wide-range coverage by fibrotic pleural rind that was successfully decorticated under video-assisted vision from a mini-thoracotomy, followed by spontaneous healing of the leakage.</p><p><strong>Conclusions: </strong>We did not attempt to closely approach or try to repair the esophageal leakage. We believe that this is an important tip for these situations.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"247"},"PeriodicalIF":0.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523140","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":"Case of colon perforation due to segmental absence of intestinal musculature accompanied by cancer treated with colonic resection and anastomosis.","authors":"Eiki Sato, Yuki Seo, Yuta Matsukawa, Chang Shun-Kai, Masanori Kimura, Tomoko Takesue, Norihiro Kishida, Ikumi Hamano, Go Hoshino, Hideyuki Tokura, Takayuki Takahashi, Kazuhiko Shimizu","doi":"10.1186/s40792-024-02050-1","DOIUrl":"10.1186/s40792-024-02050-1","url":null,"abstract":"<p><strong>Background: </strong>Segmental absence of intestinal musculature (SAIM) is a partial defect of intestinal muscularis propria without diverticulum. Many reports indicate that the increase in intestinal pressure caused by enemas or endoscopic examinations leads to bowel perforation, but there are few reports involving malignant tumors. Moreover, few reports have had good outcomes after performing one-stage intestinal anastomosis.</p><p><strong>Case presentation: </strong>A 60-year-old male came to the office with right-side abdominal pain, and was diagnosed with acute generalized peritonitis caused by ascending colon perforation. Emergency laparotomy was performed, and oval and smooth perforation at the ascending colon was observed, which caused ascites with feces. In addition, there was a tumor on the distal side. The terminal ileum was not dilated, so the cause of the perforation was more likely the SAIM-related thin intestinal wall rather than increased internal intestinal pressure due to obstruction of the tumor. Therefore, a right hemicolectomy with functional end-to-end anastomosis (FEEA) between the ascending colon and ileum was performed, rather than creating a stoma. On pathological examination, the resected bowel segments had a partial defect of intestinal muscularis propria around the perforation, leading to the diagnosis of SAIM. The patient had a favorable postoperative course without anastomotic issues and was discharged safely.</p><p><strong>Conclusions: </strong>This case implies that initial intestinal anastomosis can be performed without creating a stoma when SAIM is suspected from the shape of the perforation and proximal intestine. This case report suggests surgeons should keep SAIM in mind during operations for colon perforations.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"244"},"PeriodicalIF":0.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523139","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":"Gastric metastasis from renal cell carcinoma with submucosal invasion treated by surgical full-thickness resection: a case report.","authors":"Nanako Magara, Naoto Takahashi, Yuta Takano, Kenji Takeshita, Naoki Toya, Fumiaki Yano, Ken Eto","doi":"10.1186/s40792-024-02036-z","DOIUrl":"10.1186/s40792-024-02036-z","url":null,"abstract":"<p><strong>Background: </strong>Metastatic gastric tumors are rare and malignant melanoma, breast cancer, lung cancer, and esophageal cancer are common as primary lesions. On the other hand, renal cell carcinoma is easy to metastasize hematogenously to the whole body. However, metastasis to the stomach is rare and the detailed treatment of gastric metastasis is not mentioned. In this study, we report an uncommon case of gastric metastasis from renal cell carcinoma that underwent surgical full-thickness resection and reviewed the literature for treatment options.</p><p><strong>Case presentation: </strong>The patient was a female in her 60s and in January 2007, she underwent a transabdominal left nephrectomy for clear cell carcinoma of the left kidney. The pathological diagnosis was pT2N0M0 stage II. In October 2017, a total pancreatectomy with D2 dissection was performed for multiple pancreatic masses, in which the pathological diagnosis was pancreatic metastasis of renal cell cancer. In May 2019, an esophagogastroduodenoscopy for heartburn revealed redness and erosion in the greater curvature of the residual gastric body. The pathological diagnosis was gastric metastasis from renal cell carcinoma. No metastatic findings were observed and gastric wedge resection was performed. Pathological diagnosis of the resected specimen showed a 4-mm tumor, mainly within the mucosa and partly extended to the submucosal layer in 500 µm. The resected specimen had a clear resection margin.</p><p><strong>Conclusions: </strong>In this study, we report a case in which a full-thickness resection was performed for gastric metastasis 12 years after renal cancer surgery and 2 years after pancreatic metastasis surgery. The patient survived 4 years and 8 months after gastric wedge resection. Although gastric metastasis often takes the form of submucosal tumors, it is necessary to select full-thickness resection for R0 resection, even in small and flat lesions.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"245"},"PeriodicalIF":0.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523141","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":"An adult case of large defect of small mesenteric hiatal hernia causing small bowel obstruction.","authors":"Yuki Horiuchi, Erica Nishimura, Eriko Sashi, Kazuhiro Matsuo, Nozomi Watanobe, Risa Ohtani, Koshiro Matsunami, Takako Muroi, Asuka Hara, Keita Hayashi, Yuki Tajima, Yasushi Kaneko, Rurika Hamanaka, Hiroto Fujisaki, Kumiko Hongo, Kikuo Yo, Kimiyasu Yoneyama, Kiminori Takano, Motohito Nakagawa","doi":"10.1186/s40792-024-02040-3","DOIUrl":"10.1186/s40792-024-02040-3","url":null,"abstract":"<p><strong>Background: </strong>Small mesenteric hiatal hernias (SMHHs) are defined as a small group of internal hernias (IHs) that frequently diagnosed in children. However, SMHHs are relatively rare in adults. Bowel loop herniation via an abnormal mesenteric defect can lead to strangulated intestinal obstruction. Congenital SMHHs are commonly observed in pediatric patients, with some cases involving neonatal death.</p><p><strong>Case presentation: </strong>A 24-year-old healthy male patient visited our hospital with a 2-day history of a sudden onset lower abdominal pain. He was initially diagnosed with enteritis. However, his symptoms worsened, and he was brought to our hospital. Contrast-enhanced computed tomography (CT) scan showed formation of a closed loop in the small intestine within the pelvis and signs of ischemia. As the patient was diagnosed with small bowel obstruction (SBO) caused by IH, emergency laparoscopic surgery was performed to loosen the obstruction. The patient was found to have ascites and small-bowel necrosis. A part of the small intestine that measured 30 cm was strangulated via a large-diameter defect (17 × 11 cm) in the ileal mesentery. Via a small abdominal incision, the necrotic bowel was resected, and the mesenteric defect was repaired.</p><p><strong>Conclusion: </strong>SMHHs are rare in adults, and they should be considered as potential causes of strangulated intestinal obstruction in adults without a history of laparotomy or trauma.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"246"},"PeriodicalIF":0.7,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11519278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523138","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}