Surgical Case Reports最新文献

{"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}

{"title":"An innovative surgical approach for solid pseudopapillary neoplasm with duodenal invasion in a pediatric patient: a case report.","authors":"Yukihiro Tsuzuki, Kiyotetsu Ooshiro, Yukihiro Tatekawa, Rin Tamashiro, Takeshi Yagi, Takeshi Higa","doi":"10.1186/s40792-024-02047-w","DOIUrl":"https://doi.org/10.1186/s40792-024-02047-w","url":null,"abstract":"<p><strong>Background: </strong>Pediatric pancreatic tumors, especially with duodenal invasion, are exceptionally rare and a strategy for their treatment has not been established. A pancreaticoduodenectomy is often the desired treatment, but may be over-invasive for solid pseudopapillary neoplasm (SPN). This study reports an innovative surgical approach for SPN with duodenal invasion using pancreatic enucleation and endoscopically guided partial duodenectomy.</p><p><strong>Case presentation: </strong>An 11-year-old girl complained of malaise and presented with severe anemia; imaging revealed a tumor of undetermined origin, involving the pancreatic head and descending duodenum. Intraoperative findings showed tumor adherence to the pancreatic head and endoscopy revealed invasion of the duodenum. The tumor was enucleated from the pancreatic head, and partial duodenectomy was performed under endoscopically guided direct visualization. Pathology confirmed SPN with duodenal invasion, and no residual tumor. Although a Grade B pancreatic fistula occurred postoperatively, it was managed conservatively. At the 15-month follow-up, no signs of tumor recurrence, duodenal stenosis, or pancreatic dysfunction were evident.</p><p><strong>Conclusions: </strong>Given the good prognosis of SPN, we believe that enucleation from the pancreatic head combined with an endoscopically guided partial duodenectomy could be a useful and less invasive alternative to pancreaticoduodenectomy for cases with duodenal invasion.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"243"},"PeriodicalIF":0.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508382","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 successful surgical repair for supravalvular aortic stenosis with a bicuspid valve and malpositioned coronary orifices by partial Brom's technique: a case report.","authors":"Midori Hara, Yoshihiro Honda, Shigeaki Kaga, Kisaburo Sakamoto, Hiroyuki Nakajima","doi":"10.1186/s40792-024-02039-w","DOIUrl":"https://doi.org/10.1186/s40792-024-02039-w","url":null,"abstract":"<p><strong>Background: </strong>Supravalvular aortic stenosis (SVAS) is a relatively rare form of left ventricular outflow tract obstruction, often accompanied by other cardiac conditions. However, a standard surgical reparative technique has not been established and repairing SVAS remains challenging.</p><p><strong>Case presentation: </strong>We repaired SVAS of a 3-year-old boy accompanied by a bicuspid aortic valve and malpositioned coronary orifices by partial Brom's technique with two glutaraldehyde-treated autologous pericardial patches, using recent advanced preoperative information, including geometric and effective heights. Echocardiography after the surgery revealed release of SVAS without aortic regurgitation.</p><p><strong>Conclusions: </strong>In repair for SVAS, it is important not only to release stenosis but also to make a functional aortic valve, using recent advanced preoperative information. In the case of children, repairing the aortic valve by only using autologous tissue having growth potential, is also important.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"242"},"PeriodicalIF":0.7,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499491/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508380","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":"Ruptured solitary fibrous tumor of the pleura with hemothorax: a case report.","authors":"Hiroaki Komatsu, Nao Furukawa, Kosuke Imamoto, Kazunori Okabe","doi":"10.1186/s40792-024-02044-z","DOIUrl":"https://doi.org/10.1186/s40792-024-02044-z","url":null,"abstract":"<p><strong>Background: </strong>The majority of the patients with a solitary fibrous tumor (SFT) of the pleura are asymptomatic, and rupture of an SFT with hemothorax is rare.</p><p><strong>Case presentation: </strong>A 48-year-old man was taken by ambulance to our hospital because of sudden onset of left chest pain. Two months before the referral, a tumor was detected in the left upper lobe of the lung by screening computed tomography at another hospital, and further observation was recommended, because the tumor was suspected to be benign. Our contrast-enhanced computed tomography analysis of the chest revealed a solid tumor (5 cm in diameter) with an irregular enhancement effect close to the pericardium and pleural effusion in the left thoracic cavity. Pleural effusion was not detected in the previous imaging analysis. CT number of the pleural effusion was 40 HU, and the pleural effusion was suspected to be hematogenous. Therefore, rupture of the tumor with bleeding was suspected as the cause of the effusion because of the sudden onset. Preoperative diagnosis was a mediastinal tumor, such as a teratoma, because the tumor was close to the pericardium. Thoracoscopic surgery was performed with the patient in the right lateral decubitus position; bloody pleural effusion was observed and drained. The tumor originated from the visceral pleura of the left upper lobe of the lung and was resected with a surgical stapler. Macroscopic analyses of the resected tumor indicated that bleeding were caused by the rupture of the tumor at the defect of the capsule wall. The operation took 63 min. The postoperative pathological diagnosis was a benign SFT. Hemorrhage was observed just under the capsule wall of the tumor. The postoperative course of the patient was uneventful, and he was discharged 2 days after surgery.</p><p><strong>Conclusions: </strong>Even when an SFT is neither huge nor malignant, rupture can occur, and resection should be considered regardless of the size or malignant characteristics. After an SFT rupture, careful follow-up is needed to monitor for the intrathoracic recurrence or dissemination of the tumor.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"239"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508385","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 aggressive gastric CIC-DUX4 sarcoma surgically resected with multivisceral organs: a case report.","authors":"Mizuki Koba, Atsushi Takeno, Hiroko Hasegawa, Ryotaro Sakamori, Rei Higashiura, Masaaki Yamamoto, Shinji Tokuyama, Reishi Toshiyama, Kenji Kawai, Yusuke Takahashi, Kenji Sakai, Naoki Hama, Kunihito Gotoh, Takeshi Kato, Yumiko Hirose, Kiyoshi Mori, Masayuki Mano, Motohiro Hirao","doi":"10.1186/s40792-024-02035-0","DOIUrl":"https://doi.org/10.1186/s40792-024-02035-0","url":null,"abstract":"<p><strong>Background: </strong>Capicua transcriptional repressor-double homeobox 4 sarcoma (CDS) is a rare and aggressive malignant soft tissue tumor that typically arises within the soft tissues. We report an exceptionally rare case of a gastric CDS successfully resected despite its extensive invasion into surrounding organs.</p><p><strong>Case presentation: </strong>A 48-year-old male presented with a progressively enlarging abdominal mass. Upper gastrointestinal endoscopy revealed a large ulcerative tumor on the posterior gastric wall. Biopsy results initially suggested a neuroendocrine cell carcinoma. Contrast-enhanced computed tomography showed a 20 cm tumor protruding from the posterior stomach wall, directly invading the pancreas and colon. We performed a multivisceral resection (stomach, pancreatic tail, spleen, and transverse colon) achieving an R0 resection. Pathological examination of the permanent specimen revealed small round cells with high nuclear-to-cytoplasmic ratios. Immunohistochemical staining confirmed the diagnosis of CDS. The patient recovered well and was discharged on postoperative day 33.</p><p><strong>Conclusions: </strong>This case report describes the first detailed account of a surgically resected aggressive CDS originating from the stomach.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"241"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508381","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":"Gastrointestinal stromal tumor in Carney's triad with laparoscopic total gastrectomy: a case report.","authors":"Hajime Midoritani, Hironori Kawada, Kosuke Kaneda, Shuichiro Toda, Kento Awane, Keisuke Tanino, Kaichiro Harada, Keigo Tachibana, Masahiko Honjo, Koji Kitamura, Mami Yoshitomi, Yoshiharu Shirakata, Ryuta Nishitai","doi":"10.1186/s40792-024-02041-2","DOIUrl":"https://doi.org/10.1186/s40792-024-02041-2","url":null,"abstract":"<p><strong>Introduction: </strong>Carney's triad is a rare syndrome characterized by the co-occurrence of gastric gastrointestinal stromal tumor (GIST), pulmonary chondroma, and extra-adrenal paraganglioma. We present a case of a young woman with GISTs associated with this triad.</p><p><strong>Case presentation: </strong>A 28-year-old woman was identified with multiple gastric tumors and a right lung nodule during a routine health check-up. CT scans and upper gastrointestinal endoscopy revealed a 50 mm mass on the lesser curvature of the stomach, along with two additional gastric lesions and a 20 mm nodule in the right lung. The patient had a history of right middle lobectomy at the age of 19 for pulmonary chondroma. During surgery, enlarged lymph nodes were observed, indicating metastasis, which necessitated a total gastrectomy with radical (D2) lymph node dissection. Pathological examination confirmed seven GISTs, with immunohistochemical staining positive for KIT (+), DOG1 (+), and negative for SDHB (-). The postoperative course was uneventful, and the patient was discharged on the seventh postoperative day. Despite opting out of adjuvant imatinib therapy, she remains disease-free 2 years postoperatively.</p><p><strong>Conclusions: </strong>This case underscores the necessity of total gastrectomy with lymph node dissection due to the high incidence of metastasis in GISTs associated with Carney's triad. Further research is required to determine the optimal extent of lymph node dissection in such cases.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"240"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508383","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":"Lobar graft evaluation in cadaveric lobar lung redo transplantation after living-donor lobar lung transplantation: a case report.","authors":"Yui Watanabe, Tatsuaki Watanabe, Takashi Hirama, Sho Murai, Kazunori Ueda, Hisashi Oishi, Miki Akiba, Toshikazu Watanabe, Takaya Suzuki, Hirotsugu Notsuda, Ken Onodera, Takeo Togo, Hiromichi Niikawa, Masafumi Noda, Yoshinori Okada","doi":"10.1186/s40792-024-02046-x","DOIUrl":"https://doi.org/10.1186/s40792-024-02046-x","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation is a vital option for patients with end-stage lung disease. However, it faces a significant challenge due to the shortage of compatible donors, which particularly affects individuals with small chest cavities and pediatric patients. The novel approach of cadaveric lobar lung transplantation is a promising solution to alleviate the donor shortage crisis. Both the mid-term and long-term outcomes of lobar lung transplantation are comparable to those of standard lung transplantation. However, patients undergoing lobar lung transplantation reported a significantly higher rate of primary graft dysfunction compared to patients undergoing standard lung transplantation. Therefore, careful donor selection is critical to improve outcomes after lobar transplantation. However, no established method exists to evaluate each lung lobar graft of deceased donors. This case report describes a case of cadaveric lobar lung transplantation to overcome size mismatch and donor shortage, with particular emphasis on lobar graft evaluation.</p><p><strong>Case presentation: </strong>A 39-year-old woman with scleroderma-related respiratory failure was listed for deceased donor lung transplantation due to a rapidly progressing disease. Faced with a long waiting list and impending mortality, she underwent bilateral living-donor lobar lung transplantation donated by her relatives. Post-transplant complications included progressive pulmonary vein obstruction and pleural effusion, which ultimately required retransplantation. An oversized donor with pneumonia in the bilateral lower lobes was allocated. Lung ultrasound was used to evaluate each lung lobar graft during procurement. The right upper and middle lobes and left upper lobe were confirmed to be transplantable, and lobar lung redo transplantation was performed. The patient's post-transplant course was uneventful, and she was discharged home and returned to her daily activities.</p><p><strong>Conclusions: </strong>This case highlights the clinical impact of cadaveric lobar lung transplantation as a feasible and effective strategy to overcome the shortage of donor lungs, especially in patients with small thoracic cavities. By establishing donor lung evaluation techniques and overcoming anatomical and logistical challenges, cadaveric lobar lung transplantation can significantly expand the donor pool and offer hope to those previously considered ineligible for transplantation.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"238"},"PeriodicalIF":0.7,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11499546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508384","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":"Thoracoscopic and endoscopic cooperative surgery for esophageal gastrointestinal stromal tumor: a case report.","authors":"Ryo Kanoda, Tomohiro Kikuchi, Akihito Utsumi, Shotaro Mochizuki, Akira Matsuishi, Akinao Kaneta, Azuma Nirei, Hiroyuki Hanayama, Zenichiro Saze, Takuto Hikichi, Yuko Hashimoto, Koji Kono","doi":"10.1186/s40792-024-02045-y","DOIUrl":"https://doi.org/10.1186/s40792-024-02045-y","url":null,"abstract":"<p><strong>Background: </strong>Esophageal gastrointestinal stromal tumors (GISTs) are relatively rare, accounting for 2-5% of all GISTs. Typically, the treatment is surgery in nature. However, no standard procedure established for esophageal GISTs, and in many cases, subtotal esophagectomy or local resection via thoracoscopy or mediastinoscopy is performed. Thoracoscopic and endoscopic cooperative surgery (TECS) is a surgical approach similar to laparoscopic and endoscopic cooperative surgery used for gastric GIST; however, no reports of its use for esophageal GIST have been published to date. We herein report such a case along with a review of past literature.</p><p><strong>Case presentation: </strong>The patient was a 60-year-old man. Upper gastrointestinal contrast imaging revealed a subepithelial lesion in the esophagus. An 18 × 17 mm subepithelial lesion was identified in the left wall, 35 cm from the upper incisors, during upper gastrointestinal endoscopy, and was diagnosed as a GIST through endoscopic ultrasound-guided fine needle biopsy. TECS was therefore performed. The patient was placed in a prone position with his face to the left. After confirming the lesion under endoscopy and left thoracoscopy, the periesophageal area of the lesion was dissected under thoracoscopy. Subsequently, an endoscopic full-layer resection was performed. Finally, the excision site of the lesion was sutured under thoracoscopy. The operation took a total of 3 h and 22 min, with a blood loss of 50 mL.</p><p><strong>Conclusions: </strong>The appropriate surgical procedure for esophageal GIST should be considered according to the location and size of the lesion. TECS ensures that the resection margins are secured using an endoscopic or thoracoscopic approach. Furthermore, TECS is minimally invasive, avoiding esophagectomy and reconstruction, which makes it a potential surgical option for esophageal GISTs.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"237"},"PeriodicalIF":0.7,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11486862/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475247","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 repair of gastric conduit obstruction after robot-assisted minimally invasive esophagectomy: a case report.","authors":"Toshiyuki Moriuchi, Yuki Katsura, Yasuhiro Shirakawa, Ayane Uehara, Kazuki Matsubara, Michihiro Ishida, Yasuhiro Choda, Hiroaki Mashima, Hiroyuki Sawada, Masanori Yoshimitsu, Hiroyoshi Matsukawa, Shigehiro Shiozaki","doi":"10.1186/s40792-024-02038-x","DOIUrl":"https://doi.org/10.1186/s40792-024-02038-x","url":null,"abstract":"<p><strong>Background: </strong>Gastric conduit obstruction (GCO) is a known complication after esophagectomy. Laparoscopic revision surgery for GCO is relatively rare, with limited reports in the literature. Here, we report a case of GCO after robot-assisted subtotal esophagectomy and posterior mediastinal gastric conduit reconstruction, which was successfully repaired laparoscopically.</p><p><strong>Case presentation: </strong>A 66-year-old man presented with a passage disorder that became noticeable 14 months after surgery. Fluid passage was difficult, and the patient opted for revision surgery. The conduit had entered and deflected into the mediastinum; it also twisted due to band formation. The revision surgery was performed laparoscopically through five ports. The bands were dissected, esophageal hiatus was sutured, and conduit re-fixed. The intraoperative endoscopy was used to confirm that the obstruction had been released. The lack of adhesion of the posterior half of the gastric conduit wall, combined with postoperative weight loss leading to a decrease in omental volume, as well as inadequate fixation during the initial surgery, are believed to have contributed to the ease of the conduit deviation into the intrathoracic cavity. In addition, the twisting of the conduit due to band formation exacerbated the obstruction.</p><p><strong>Conclusions: </strong>Laparoscopic revision surgery may become an effective treatment option as the number of minimally invasive esophagectomies is expected to increase in the future. Furthermore, the fixation method during initial surgery should be carefully considered and optimized to prevent gastric conduit obstruction. Additionally, the use of intraoperative endoscopy to evaluate the lumen of the conduit during surgery proved beneficial in this case, highlighting its potential value in identifying and addressing obstruction.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"236"},"PeriodicalIF":0.7,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11485008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475246","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":"Management of gastroschisis in an extremely low birth weight infant: report of a case.","authors":"Noboru Oyachi, Fuminori Numano, Tamao Shinohara, Yasushi Murakami, Atsushi Nemoto, Atsushi Naito","doi":"10.1186/s40792-024-02028-z","DOIUrl":"10.1186/s40792-024-02028-z","url":null,"abstract":"<p><strong>Background: </strong>Gastroschisis is a rare congenital anomaly in which abdominal organs herniate through a defect in the abdominal wall. Managing gastroschisis in extremely low birth weight (ELBW) infants presents significant challenges because of their immature physiologies and increased risk of complications.</p><p><strong>Case presentation: </strong>This report discusses the case of a female ELBW infant born via an emergency cesarean section at 29 weeks of gestation, weighing 768 g, who had a prenatal diagnosis of gastroschisis. Postnatal management included immediate surgical intervention using a hand-made silo manufactured from expanded polytetrafluoroethylene (ePTFE) sheets that were sutured to the patient's abdominal wall to accommodate her small abdominal cavity and preserve mesenteric blood flow. Necrotizing enterocolitis with bowel perforation emerged as a complication, which led to the excision of a 10 cm segment of the ileum and the creation of an ileostomy. The infant experienced insufficient weight gain and liver dysfunction. However, she was eventually discharged on day 142 of life, weighing 2774 g, on oral feeding, without significant complications.</p><p><strong>Conclusions: </strong>This case emphasizes how prematurity significantly affected the patient's clinical outcomes, and highlights the importance of individualized management strategies. Our experience demonstrates that custom silo placement allows for the size to be adapted to the abdominal defect, and highlights the critical need to prioritize postnatal bowel perfusion in ELBW infants with gastroschisis.</p>","PeriodicalId":22096,"journal":{"name":"Surgical Case Reports","volume":"10 1","pages":"235"},"PeriodicalIF":0.7,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11461376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393519","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}