Surgical Case Reports最新文献

{"title":"Open Cyst Drainage for Reliable Decompression in a Critically Ill Neonate with Congenital Pulmonary Airway Malformation.","authors":"Kazuyoshi Okumura, Soma Sakamura, Insu Kawahara, Ryo Takahashi, Issei Kawakita, Momoko Ara, Shohei Honda, Akinobu Taketomi","doi":"10.70352/scrj.cr.26-0246","DOIUrl":"10.70352/scrj.cr.26-0246","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital pulmonary airway malformation (CPAM) is a rare congenital lung lesion that is often diagnosed prenatally. Large macrocystic lesions can cause severe respiratory compromise after birth, requiring urgent decompression. Although staged management with cyst drainage followed by delayed resection has been reported, the optimal method for achieving reliable decompression in critically unstable neonates remains unclear. We report a case in which emergency open cyst drainage under direct visualization enabled secure catheter placement and reliable decompression before definitive surgery.</p><p><strong>Case presentation: </strong>A female neonate with a large macrocystic CPAM underwent thoracoamniotic shunting during the fetal period. After birth, she developed severe respiratory failure caused by rapid enlargement of the cystic lesion and mediastinal shift. Because the precise extent of the lesion remained unclear and immediate definitive resection was considered unsafe, emergency open cyst drainage was performed. Under direct visualization, the previously placed shunt tubes were removed, and drainage catheters were securely inserted into the cystic lesions and fixed to the cyst walls. Continuous drainage achieved reliable decompression, relieved compression of the normal lung, and improved respiratory status. After sufficient lung expansion and a more accurate assessment of the lesion extent, delayed lower lobectomy was safely performed. The postoperative course was favorable.</p><p><strong>Conclusions: </strong>Emergency open cyst drainage under direct visualization may provide reliable decompression in critically ill neonates with severe CPAM. This technique may be a useful alternative to percutaneous drainage when secure catheter placement and predictable decompression are required. Effective decompression may also facilitate staged management and allow definitive resection under safer conditions.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13275188/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148278978","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":"Pediatric Focal Nodular Hyperplasia Mimicking Hepatic Metastasis from Wilms Tumor: A Case Report.","authors":"Wataru Miyoshino, Katsuhiro Ogawa, Takashi Masuda, Shun Nakamura, Yuiko Nagasawa, Yushi Kaisyakuji, Hiroomi Takayama, Yoko Kawano, Teijiro Hirashita, Yuichi Endo, Masafumi Inomata","doi":"10.70352/scrj.cr.26-0094","DOIUrl":"10.70352/scrj.cr.26-0094","url":null,"abstract":"<p><strong>Introduction: </strong>Focal nodular hyperplasia (FNH) is a rare benign liver lesion in children, representing approximately 2% of pediatric liver tumors and occurring far less frequently than in adults. Preoperative diagnosis is often challenging because FNH can closely mimic malignant or metastatic liver tumors on imaging, particularly in patients with a history of malignancy. Indocyanine green (ICG) fluorescence imaging has emerged as a useful intraoperative navigation tool in pediatric liver surgery; however, its role in distinguishing FNH from metastatic lesions remains underexplored.</p><p><strong>Case presentation: </strong>A 5-year-old girl with a history of stage IV Wilms tumor-treated with systemic chemotherapy and in complete remission since 3 years of age-underwent routine follow-up imaging. MRI identified a small hepatic lesion in segment 1 (S1) that gradually enlarged on serial examinations. Contrast-enhanced CT demonstrated a 10-mm nodule with arterial phase enhancement and gradual relative washout in the portal and venous phases, raising concern for hepatic metastasis. Given the oncologic history and indeterminate imaging findings, laparoscopic partial hepatectomy of S1 was performed for diagnostic confirmation and treatment. For intraoperative localization, ICG (0.5 mg/kg body weight) was administered intravenously 36 h preoperatively. The lesion was not detectable under conventional white-light laparoscopy; however, near-infrared fluorescence imaging revealed diffuse fluorescence corresponding to the tumor location, enabling precise resection with minimal loss of hepatic parenchyma. Histopathological examination confirmed FNH, characterized by hyperplastic hepatocytes with proliferating bile ductules and small vessels, and a central stellate scar. The postoperative course was uneventful, with no evidence of recurrence at 9-month follow-up.</p><p><strong>Conclusions: </strong>Differentiating pediatric FNH from metastatic liver tumors remains challenging. Intraoperative ICG fluorescence imaging may assist not only with tumor localization but also by providing supplementary information about tumor characteristics, potentially facilitating safe and minimal hepatic resection. In this case, the fluorescence pattern was suggestive of FNH in retrospect. Further case accumulation is needed to clarify the utility of ICG fluorescence patterns for differential diagnosis and surgical planning in pediatric liver lesions.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13148888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147842958","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":"Coexistence of Primary Colorectal Cancer and Multiple Colonic Metastases from Pancreatic Tail Cancer: A Case Report.","authors":"Marina Uemura, Yoshihiro Takashima, Yoshinori Munemoto, Susumu Amaya, Takuro Terada, Kenichiro Saito, Masanari Shimada, Sho Yamada, Tatsuhiko Kohno, Toshiki Sakaguchi, Yuie Katsuyama, Renta Kobori, Kodai Hasegawa, Yasuni Nakanuma","doi":"10.70352/scrj.cr.25-0828","DOIUrl":"10.70352/scrj.cr.25-0828","url":null,"abstract":"<p><strong>Introduction: </strong>Colonic metastasis from pancreatic cancer is extremely rare. Distinguishing metastatic pancreatic cancer from primary colorectal cancer is clinically important because the therapeutic strategies differ substantially. We report an exceptionally rare case of pancreatic tail cancer with multiple colonic metastases coexisting with primary colorectal cancer.</p><p><strong>Case presentation: </strong>An 83-year-old man presented with right lower abdominal pain, constipation, and weight loss. Four years earlier, MRI and magnetic resonance cholangiopancreatography (MRCP) had demonstrated a cystic lesion in the pancreatic tail. On admission, contrast-enhanced CT revealed a pancreatic tail tumor with suspected invasion of adjacent organs, lesions in the ascending and sigmoid colon, para-aortic lymph node metastasis, and peritoneal dissemination. Barium enema and colonoscopy showed stenotic lesions, and bowel obstruction developed. Palliative open right hemicolectomy and sigmoid colectomy were therefore performed. Gross examination revealed a mucosa-based type 2 lesion in the ascending colon and separate serosa-predominant lesions in the ascending and sigmoid colon. Histopathological and immunohistochemical analyses showed that the type 2 lesion represented primary colorectal cancer, whereas the other colonic lesions and peritoneal nodules were metastatic pancreatic cancer. The patient developed postoperative ileus and pneumonia, was discharged on POD 24, and died 6 months after surgery.</p><p><strong>Conclusions: </strong>Colonic metastasis from pancreatic cancer may sometimes be difficult to distinguish from primary colorectal cancer. In patients with pancreatic cancer, colonic lesions with relatively preserved mucosa and predominant serosal involvement should be considered in the differential diagnosis of metastatic disease. Markedly elevated carbohydrate antigen 19-9 levels may also provide an additional clue to pancreatic origin, although they are not diagnostic. Careful integrated assessment of the clinical course, imaging, and pathological findings is essential for accurate diagnosis and appropriate management.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975456","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":"Late Pulmonary and Lymph Node Recurrence 14 Years after Curative Resection of Incidentally Diagnosed Appendiceal Adenocarcinoma with Hepatic Metastasis.","authors":"Kazuhisa Nishina, Takamune Yamaguchi, Makoto Furukawa, Yusuke Kitani, Kosuke Nakane, Takayoshi Koseki, Koichiro Kawasaki, Michiro Takahashi, Kentaro Inada","doi":"10.70352/scrj.cr.26-0250","DOIUrl":"10.70352/scrj.cr.26-0250","url":null,"abstract":"<p><strong>Introduction: </strong>Primary appendiceal adenocarcinoma is a rare malignancy, frequently diagnosed incidentally after appendectomy performed for suspected acute appendicitis. Long-term recurrence after curative resection, particularly presenting as an isolated pulmonary metastasis, has rarely been reported.</p><p><strong>Case presentation: </strong>A 35-year-old man underwent emergency appendectomy for acute appendicitis. Postoperative pathology revealed appendiceal adenocarcinoma (pT3N1bM0, stage IIIB). Subsequent right hemicolectomy with D3 lymph node dissection revealed a synchronous hepatic metastasis; simultaneous partial hepatectomy of segment 8 achieved R0 resection, upstaging the disease to pT3N1bM1a, stage IVA (Union for International Cancer Control/American Joint Committee on Cancer 8th edition). Adjuvant chemotherapy with modified folinic acid, fluorouracil (5-FU), and oxaliplatin (modified regimen) was administered. The patient remained recurrence-free for 5 years and was discharged from regular surveillance. Fourteen years and 3 months after the initial operation, he presented with a new cough. Imaging revealed a 10-cm mass in the right lower lung lobe and multiple lymph node metastases. CT-guided biopsy confirmed metastatic adenocarcinoma consistent with the primary appendiceal origin. The patient received first-line S-1 plus oxaliplatin with bevacizumab, followed by second-line capecitabine plus irinotecan with bevacizumab, with ongoing partial responses observed at the time of this report.</p><p><strong>Conclusions: </strong>This case represents an exceptionally rare instance of late pulmonary and multiple lymph node metastases from appendiceal adenocarcinoma occurring 14 years after curative resection, even in the setting of initial hepatic metastasis. It highlights the biological diversity of appendiceal adenocarcinoma and underscores the potential need for extended oncological surveillance beyond the standard 5-year period in high-risk patients.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13268785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265752","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":"Near-Fatal Hemodynamic Collapse during Recovery from Staged Bladder Tumor Resection in a Patient with Giant Left Atrial Myxoma: A Case for Immediate Sequential Surgery.","authors":"Kazuko Tokiya, Michiyoshi Sanuki, Shigeaki Kurita","doi":"10.70352/scrj.cr.25-0832","DOIUrl":"10.70352/scrj.cr.25-0832","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical management of a large, obstructive left atrial (LA) myxoma coexisting with an active bleeding source presents a significant clinical dilemma. The systemic heparinization required for cardiopulmonary bypass (CPB) carries a high risk of exacerbating hemorrhage, whereas delaying cardiac surgery leaves the patient vulnerable to fatal myxoma-related complications.</p><p><strong>Case presentation: </strong>A 77-year-old woman presented with gross hematuria from an 8-cm bladder tumor. Preoperative evaluation revealed a giant (74 × 40 mm) LA myxoma prolapsing through the mitral valve, causing functional mitral stenosis. A multidisciplinary team elected for a \"urology-first\" staged approach. Transurethral resection of the bladder tumor (TURBT) was performed under general anesthesia with successful hemostasis. However, 30 min after extubation, the patient developed acute respiratory failure and cardiogenic shock due to myxoma incarceration. She was stabilized with noninvasive positive pressure ventilation and fluid management before being transferred to the ICU. Emergency myxoma resection was performed 18 h later. No significant bladder bleeding occurred despite full heparinization.</p><p><strong>Conclusions: </strong>This case demonstrates that the post-anesthesia recovery period is a window of extreme vulnerability for patients with obstructive myxomas, likely due to emergence-related tachycardia. The \"urology-first\" staged approach, while logical for bleeding control, failed to prevent a life-threatening cardiac event. Accumulating evidence suggests that bleeding risk following adequate hemostasis at TURBT is low, even under anticoagulation. For patients with high-risk cardiac lesions, an immediate sequential surgical strategy-proceeding directly to cardiac surgery under the same anesthesia once non-cardiac hemostasis is achieved-should be strongly considered to minimize the duration of risk.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033403/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147582465","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 of Clinically Suspected Kounis Syndrome Associated with Platelet Transfusion during Thoracoscopic Right Lower Lobectomy.","authors":"Tomohiro Baba, Hidetoshi Inokawa, Masanori Okada, Riki Okita","doi":"10.70352/scrj.cr.26-0204","DOIUrl":"10.70352/scrj.cr.26-0204","url":null,"abstract":"<p><strong>Introduction: </strong>Kounis syndrome is an acute coronary syndrome associated with allergic or hypersensitivity reactions and is characterized by the concurrent occurrence of allergic manifestations and coronary artery spasm or myocardial ischemia. Transfusion-related cases, particularly those associated with platelet transfusion, are extremely rare. We report a case of clinically suspected intraoperative Kounis syndrome associated with platelet transfusion during thoracoscopic right lower lobectomy.</p><p><strong>Case presentation: </strong>A 70-year-old man with chronic hepatitis C-associated thrombocytopenia underwent thoracoscopic right lower lobectomy for primary lung cancer. Prophylactic antibiotic administration was uneventful. Irradiated platelet concentrate was transfused intraoperatively as planned. Three minutes after completion of the platelet concentrate transfusion, the heart rate increased and hypotension developed, accompanied by flushing of the face and upper extremities. Phenylephrine and ephedrine were administered without improvement, and anaphylactic shock associated with platelet transfusion was suspected. Adrenaline, antihistamines, and methylprednisolone were administered. Shortly after a continuous intravenous adrenaline infusion was started, ST-segment depression in lead II was noted on the intraoperative electrocardiogram (ECG) monitor, and review of the ECG record confirmed that this change had been present since the onset of the hemodynamic deterioration. Cardiac biomarkers, including troponin T, showed no elevation. Because hemodynamics stabilized under continuous intravenous adrenaline infusion and oxygenation and ventilation remained stable, the surgery was continued and completed thoracoscopically. Postoperative 12-lead electrocardiography showed ST-segment depression in leads II, III, and augmented vector foot, which was resolved by POD 1, without echocardiographic wall motion abnormalities. The postoperative course was uneventful.</p><p><strong>Conclusions: </strong>The clinical course and electrocardiographic findings were clinically suggestive of Type I Kounis syndrome. However, because direct coronary assessment, such as coronary angiography, was not performed, a definitive diagnosis could not be established. Under general anesthesia, subjective symptoms cannot be reliably assessed, and hemodynamic instability or ECG abnormalities may be the only clues. Therefore, when allergic reactions and ischemic ECG changes occur intraoperatively, Kounis syndrome should be considered in the differential diagnosis. Platelet transfusion may be associated with intraoperative clinically suspected Kounis syndrome. Prompt recognition, hemodynamic stabilization, and close collaboration between anesthesiologists and surgeons, with strict hemodynamic and electrocardiographic monitoring, are essential for appropriate perioperative management.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13293641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148332985","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":"Jejunal Metastasis from Malignant Pleural Mesothelioma during Long-Term Nivolumab Therapy: A Case Report and Literature Review.","authors":"Hitoshi Minagi, Hideki Aoki, Mikoto Nosaka, Toshihiro Ogawa, Megumi Watanabe, Takashi Arata, Koh Katsuda, Kohji Tanakaya","doi":"10.70352/scrj.cr.25-0774","DOIUrl":"10.70352/scrj.cr.25-0774","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal metastasis from malignant pleural mesothelioma (MPM) is exceedingly rare and lacks a standardized diagnostic work-up.</p><p><strong>Case presentation: </strong>An 87-year-old man with asbestos exposure and a 5-year history of left-sided MPM, radiographically stable on long-term nivolumab therapy, presented with melena and anemia. Contrast-enhanced CT revealed a circumferential jejunal lesion near the duodenojejunal flexure with enlarged mesenteric nodes. Double-balloon enteroscopy confirmed a 40-mm obstructive tumor, but biopsies were non-diagnostic. Partial jejunectomy with targeted mesenteric lymph-node dissection was performed. Histology with a mesothelioma-oriented immunohistochemical panel-negative for CEA and BerEP4 and positive for broad-spectrum cytokeratins-supported a diagnosis of metastatic MPM; nodal metastases were present. Given his age, no further systemic therapy was administered; the patient died 20 months postoperatively from progression of MPM.</p><p><strong>Conclusions: </strong>In MPM receiving immune-checkpoint inhibitor therapy, unexplained gastrointestinal bleeding should prompt comprehensive gastrointestinal evaluation, including small-bowel assessment. Surgery can secure symptom relief and a definitive diagnosis.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12916218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146228370","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 of Mediastinitis Due to Fulminant Group A Streptococcal Infection.","authors":"Yuta Abe, Naoki Haratake, Takahiro Sato, Miyuki Abe, Yohei Takumi, Kenji Sugio, Atsushi Osoegawa","doi":"10.70352/scrj.cr.25-0440","DOIUrl":"10.70352/scrj.cr.25-0440","url":null,"abstract":"<p><strong>Introduction: </strong>Mediastinitis caused by group A <i>Streptococcus</i> (GAS) is extremely rare and often progresses rapidly, with high mortality.</p><p><strong>Case presentation: </strong>A 43-year-old man with no significant medical history developed a sore throat. Several days later, he presented to a local clinic with a high-grade fever of 40°C and chest pain. He was initially advised to rest under observation, but his symptoms persisted. Two days later, he sought care at a nearby hospital, where chest CT revealed findings suggestive of mediastinitis. He was subsequently transferred to our hospital for emergency treatment. On arrival, he was in circulatory shock and showed signs of multiple organ dysfunction. Laboratory tests revealed markedly elevated inflammatory markers, including a C-reactive protein level of 40.0 mg/dL. Emergency surgical drainage of a mediastinal abscess was performed, followed by intensive care and antimicrobial therapy. Blood and pleural fluid cultures identified GAS as the causative organism. The patient's condition gradually improved with continued systemic management. He was discharged from the ICU and began rehabilitation. Despite developing complications such as fingertip necrosis and delayed wound healing, he regained independent mobility. The patient was transferred to a rehabilitation facility on POD 48.</p><p><strong>Conclusions: </strong>This case highlights the importance of early recognition and immediate surgical and medical intervention in treating fulminant mediastinitis caused by GAS. Prompt and aggressive management can result in favorable outcomes, even in cases presenting with shock and multi-organ failure.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13038345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147594823","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":"Giant Postoperative Seroma after Laparoscopic Obturator Hernia Repair: A Case Report.","authors":"Yuki Sakamoto, Masaya Matsumoto, Ryota Omura, Katsunobu Taki, Nobutaka Sato, Shinichi Akahoshi","doi":"10.70352/scrj.cr.26-0388","DOIUrl":"10.70352/scrj.cr.26-0388","url":null,"abstract":"<p><strong>Introduction: </strong>Obturator hernia is frequently seen in thin, elderly women, and is often diagnosed following incarceration. Postoperative seroma formation is a well-recognized complication after inguinal hernia repair. In contrast, reports of seroma formation following obturator hernia repair are scarce, and its clinical features have not been well characterized.</p><p><strong>Case presentation: </strong>A 94-year-old woman presented with nausea and vomiting and was diagnosed with an incarcerated left obturator hernia. Manual reduction was successful and was followed by elective laparoscopic repair using the totally extraperitoneal approach with mesh placement. Although the initial postoperative course was uneventful, a large preperitoneal seroma compressing the urinary bladder developed on POD 23 and required percutaneous aspiration. The seroma subsequently became infected, necessitating repeated drainage and ultimately laparoscopic mesh removal. Despite temporary stabilization, the patient experienced sudden cardiopulmonary arrest and died postoperatively.</p><p><strong>Conclusions: </strong>Postoperative seroma is a complication that can occur following surgery for an obturator hernia. Because obturator hernias are frequently seen in elderly patients with poor nutritional status, careful perioperative management is essential, bearing in mind that postoperative complications can have fatal consequences.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13357010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430485","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":"Falciform Ligament Lipoma: A Rare Cause of Chronic Epigastric Pain.","authors":"Takamune Yamaguchi, Takashi Kokudo, Henri Vuilleumier, Nermin Halkic","doi":"10.70352/scrj.cr.26-0241","DOIUrl":"10.70352/scrj.cr.26-0241","url":null,"abstract":"<p><strong>Introduction: </strong>Lipomas of the falciform ligament are exceptionally rare benign tumors, with only 9 cases reported in the literature since 1983. These lesions can present with chronic abdominal pain and pose significant diagnostic challenges due to their rarity and overlap with other pathological entities.</p><p><strong>Case presentation: </strong>We report a case of a 49-year-old female presenting with chronic epigastric pain radiating to the right hypochondrium. MRI revealed a large fatty mass measuring 9 × 2.7 × 8.5 cm in the falciform ligament region. The patient underwent successful laparoscopic excision with histopathological confirmation of a benign lipoma. Negative MDM2 immunostaining excluded liposarcoma, and negative HMB-45, smooth muscle actin, and melan-A immunostaining excluded perivascular epithelioid cell tumor (PEComa).</p><p><strong>Conclusions: </strong>Although exceptionally rare, falciform ligament lipoma should be considered in the differential diagnosis of chronic epigastric pain alongside other falciform ligament pathologies, including PEComas and liposarcomas. Complete laparoscopic excision represents the treatment of choice with excellent outcomes, although diagnostic laparoscopy may be required for anatomical localization.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"12 1","pages":""},"PeriodicalIF":0.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345635","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}