Surgical Case Reports最新文献

{"title":"Benign Cystic Mesothelioma of the Peritoneum Arising at the Greater Omentum in a 14-Year-Old Boy.","authors":"Yutaka Hirayama, Naruki Higashidate, Kengo Nakaya, Yasushi Iinuma","doi":"10.70352/scrj.cr.24-0085","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0085","url":null,"abstract":"<p><strong>Introduction: </strong>Mesothelioma arises from mesothelial cells. This tumor is very rare among pediatric abdominal neoplasms. We herein report an extremely rare case of acute abdomen with cystic mesothelioma of the peritoneum in a child.</p><p><strong>Case presentation: </strong>A 14-year-old boy was referred to our hospital for emergency surgery. Surgery revealed a primary tumor arising from the greater omentum. The tumor was macroscopically diagnosed as a benign omental lymphangioma and was resected en bloc with the greater omentum. A histopathological examination of the tumor revealed a simple columnar epithelium-like mesothelioma with poor cell-atypia. Immunohistochemical examination showed antibody reactivity in the cyst epithelium, including an anti-calretinin antibody. The final pathological diagnosis was a mesothelioma originating from the peritoneum.</p><p><strong>Conclusions: </strong>In pediatric cases diagnosed with cystic lymphatic malformation, the possibility of peritoneal mesothelioma needs to be considered and carefully confirmed or ruled out.</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/PMC12055440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014242","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":"Curative Gastrectomy for Advanced Gastric Cancer in a Patient with Idiopathic Multicentric Castleman Disease: A Rare Case Report.","authors":"Ryohei Kawabata, Yuki Ushimaru, Hisashi Hara, Tomohira Takeoka, Yumiko Yasuhara, Terukazu Yoshihara, Akihiro Kitagawa, Takashi Takeda, Hideo Tomihara, Atsushi Naito, Masahiro Murakami, Shingo Noura, Atsushi Miyamoto","doi":"10.70352/scrj.cr.25-0318","DOIUrl":"10.70352/scrj.cr.25-0318","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic multicentric Castleman disease (iMCD) is a rare lymphoproliferative disorder characterized by systemic inflammation and chronic immunosuppression. When solid malignancies such as gastric cancer arise in patients with iMCD, perioperative management becomes particularly challenging due to nutritional decline, reactive lymphadenopathy, and elevated surgical risk.</p><p><strong>Case presentation: </strong>A 75-year-old man with a 26-year history of suspected iMCD treated with low-dose corticosteroids presented with epigastric discomfort. Endoscopy revealed a Borrmann type 2 lesion, and biopsy confirmed poorly differentiated adenocarcinoma. CT showed mild lymphadenopathy along the lesser curvature and left gastric artery, as well as systemic involvement. Inguinal node biopsy confirmed polyclonal plasma cell proliferation consistent with iMCD. The patient also met the Asian Working Group for Sarcopenia (AWGS) criteria for severe sarcopenia. A multidisciplinary team initiated preoperative respiratory rehabilitation, nutritional support, and resistance exercise therapy. Curative distal gastrectomy with D2 lymphadenectomy was performed without complications. Histopathology revealed pT2N0M0 (pStage IB) disease. Tocilizumab was started 3 months postoperatively, and the patient remains recurrence-free at 24 months.</p><p><strong>Conclusions: </strong>This case highlights that, even in patients with long-standing iMCD and sarcopenia, carefully staged multimodal perioperative care-including accurate nodal evaluation and individualized systemic therapy-can enable successful curative surgery for advanced gastric cancer.</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/PMC12226139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561207","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":"Gastroduodenal Intussusception with Gastric Adenocarcinoma: A Case Report and Review of the Literature.","authors":"Ryota Omura, Satoshi Ida, Hiroki Tsubakihara, Keisuke Kosumi, Kazuto Harada, Kojiro Eto, Yuji Miyamoto, Masaaki Iwatsuki","doi":"10.70352/scrj.cr.25-0184","DOIUrl":"10.70352/scrj.cr.25-0184","url":null,"abstract":"<p><strong>Introduction: </strong>Intussusception in adults is a rare condition, and gastric cancer prolapsing into the duodenum is an even rarer phenomenon. We present a case of early gastric cancer originating in the gastric body with duodenal intussusception and discuss the clinical considerations based on the patient's overall condition and existing literature.</p><p><strong>Case presentation: </strong>A 69-year-old man with a 30-mm tumor arising from the posterior wall of the gastric body was scheduled for elective surgery. During hospitalization for diabetes mellitus management, he developed sudden epigastric pain and nausea. Upper gastrointestinal endoscopy revealed tumor prolapse into the duodenum, leading to a diagnosis of ball valve syndrome. After successful endoscopic reduction, open local gastrectomy was performed. Pathological examination confirmed a well-differentiated tubular adenocarcinoma, classified as pT1b (SM2) N0M0, pStage IA.</p><p><strong>Conclusions: </strong>Gastric cancer with duodenal intussusception is often early-stage and characterized by well-differentiated tubular adenocarcinoma. Depending on the patient's condition, endoscopic resection or limited surgical resection may be viable treatment options for this rare condition.</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/PMC12226140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561208","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":"Two Cases of Small Intestinal Follicular Lymphoma Presenting with Intestinal Stricture.","authors":"Akihiro Nakamura, Syuichi Komori, So Murai, Shiori Shibata, Hideyuki Oyama, Kazuhiro Kijima, Yoshikuni Harada, Gaku Kigawa, Takahiro Umemoto, Takafumi Ogawa, Kuniya Tanaka","doi":"10.70352/scrj.cr.25-0108","DOIUrl":"10.70352/scrj.cr.25-0108","url":null,"abstract":"<p><strong>Introduction: </strong>Primary gastrointestinal follicular lymphoma (FL) rarely causes intestinal stricture. We report two cases of small intestinal FL presenting with stricture.</p><p><strong>Case presentation: </strong>Case 1: A 63-year-old man presented with small intestinal obstruction. CT demonstrated ileal wall thickening and enlarged lymph nodes. Partial ileal resection confirmed primary ileal FL, immunohistochemically positive for CD10, CD20, and BCL-2. Case 2: A 79-year-old woman with a 7-year history of jejunal strictures underwent right hemicolectomy for ascending colon cancer and partial jejunal resection. Pathologic examination showed concurrent jejunal FL and colon adenocarcinoma. Immunohistochemical findings were the same as in Case 1. In both patients, postoperative positron-emission tomography-CT showed no residual lymphoma. Both were monitored clinically without chemotherapy.</p><p><strong>Conclusions: </strong>These cases highlight an unusual presentation of follicular lymphoma as a cause of intestinal stricture. Surgical resection provided diagnostic clarity and relief of symptoms. Postoperative treatment was tailored to individual patient characteristics and residual disease status.</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/PMC12183004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144476771","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":"Curative Resection of Locally Advanced Colon Cancer that Invading the Common Iliac Artery by Creating an Extra-Anatomical Arterial Bypass: A Case Report.","authors":"Tatsuki Noguchi, Yosuke Fukunaga, Toshio Takayama, Takashi Sakamoto, Shimpei Matsui, Toshiki Mukai, Tomohiro Yamaguchi, Manabu Takamatsu, Takashi Akiyoshi","doi":"10.70352/scrj.cr.25-0125","DOIUrl":"10.70352/scrj.cr.25-0125","url":null,"abstract":"<p><strong>Introduction: </strong>Although complete resection during radical surgery is a crucial prognostic factor for locally advanced colorectal cancer, achieving it is often difficult when the tumor invades the iliac artery system. Herein, we report a successful case requiring resection of the common iliac vessels and vascular reconstruction using a femoral-femoral arterial bypass (F-F bypass), with a comparison to 4 previous cases involving F-F bypass.</p><p><strong>Case presentation: </strong>A 47-year-old male presented with advanced cecal cancer involving the right external iliac artery and vein, right femoral nerve, right ureter, right psoas muscle, and right iliacus muscle. He received systemic chemotherapy with a vascular endothelial growth factor inhibitor for 20 months, and percutaneous drainage of a psoas abscess was performed at a previous hospital. Following these interventions, he was referred to our hospital for radical resection. An F-F bypass was performed prior to abdominal surgery, and en bloc resection of the cecal cancer was subsequently achieved, encompassing the common iliac vessels, femoral nerve, iliacus muscle, psoas muscle, and ureter. The patient showed no signs of recurrence, graft infection, or occlusion 2 years postoperatively.</p><p><strong>Conclusions: </strong>This case demonstrates the potential of systemic chemotherapy followed by radical resection with extra-anatomical arterial bypass in achieving favorable long-term outcomes and satisfactory short-term results.</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/PMC12197852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508375","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":"Descending Necrotizing Mediastinitis as a Deadly Complication Following Laparoscopic Sleeve Gastrectomy: A Case Report.","authors":"Kengo Kadoya, Kotaro Wakamatsu","doi":"10.70352/scrj.cr.25-0213","DOIUrl":"10.70352/scrj.cr.25-0213","url":null,"abstract":"<p><strong>Introduction: </strong>Laparoscopic sleeve gastrectomy is a standard and safe surgical procedure for patients with morbid obesity. A potential complication is piriform fossa injury, which can occur during calibration tube insertion. We encountered a case of descending necrotizing mediastinitis, a serious and progressive infection originating from a piriform fossa injury that was potentially exacerbated by diabetes.</p><p><strong>Case presentation: </strong>A female patient with morbid obesity (body mass index, 41 kg/m²) and a heavy smoking habit underwent laparoscopic sleeve gastrectomy and was discharged without any immediate postoperative complications. Six weeks later, the patient presented with severe chest and back pain that required continuous fentanyl injection for pain management. Initially, staple line leakage, commonly observed after sleeve gastrectomy, was suspected. However, her condition progressively worsened, and she was admitted to the ICU. An enhanced abdominal CT scan extending to the cervical region revealed a cervical abscess extending to the lower mediastinal region. The patient was diagnosed with descending necrotizing mediastinitis. Given the rarity of this disease, we hypothesized that her smoking habits exacerbated the piriform fossa injury caused by the calibration tube used during gastrectomy. Following the diagnosis, emergency abscess drainage surgery was performed, and the patient was successfully treated.</p><p><strong>Conclusions: </strong>This is the 1st reported case of descending necrotizing mediastinitis as a fatal complication of laparoscopic sleeve gastrectomy, which was identified and treated successfully owing to the timely and expanded use of an enhanced CT scan that included the cervical region. Traditionally, the cervical area has not been routinely examined when diagnosing complications following abdominal surgery, underscoring the importance of a comprehensive imaging approach from the neck to the abdomen to detect complications after sleeve gastrectomy.</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/PMC12197851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144508376","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":"Congenital Pulmonary Airway Malformation with Pulmonary Arteriovenous Malformation in Adulthood: A Case Report.","authors":"Takehiro Suzuki, Naohiro Kobayashi, Yohei Yatagai, Shinsuke Kitazawa, Hideo Ichimura, Yukio Sato","doi":"10.70352/scrj.cr.25-0176","DOIUrl":"10.70352/scrj.cr.25-0176","url":null,"abstract":"<p><strong>Introduction: </strong>Congenital pulmonary airway malformation (CPAM) is a congenital condition rarely detected in adults because most cases of CPAM are found through prenatal testing or through testing for recurrent pneumonia or lung abscesses in childhood. Pulmonary arteriovenous malformation (PAVM) is an abnormal vascular connection between the pulmonary arteries and veins, which is often related to hereditary hemorrhagic telangiectasia, but can also be induced by infections, trauma, or thoracic surgery. Herein, we report an adult case of coexisting CPAM and PAVM.</p><p><strong>Case presentation: </strong>The patient was a 26-year-old woman. A medical checkup chest X-ray showed abnormalities. The patient had no past medical history, including of bleeding tendency or repeated pneumonia, and no familial history of CPAM and PAVM. A chest CT revealed multiple lung cysts (maximum diameter of 40 mm) in the left lower lobe of the lung, and congenital pulmonary cysts were suspected. The chest CT also showed two PAVMs (vessel diameters of 6 mm and 4 mm) in the same left lower lobe. Serum tests were positive for <i>Aspergillus</i>-specific antibodies and β-D-glucan, and pulmonary aspergillosis was diagnosed. An antifungal agent (itraconazole) was administered. However, consolidations had developed 9 months after, and the antifungal agent was changed to voriconazole. Then, the consolidations diminished slightly but nevertheless remained, and one of the PAVMs increased in diameter from 6 mm to 10 mm. A left lower lobectomy under thoracoscopy was performed owing to the uncontrolled infection and the risk of complications with PAVMs. The pathological diagnosis of the pulmonary cysts was CPAM type 1. The patient had no symptoms or complications after the surgery.</p><p><strong>Conclusions: </strong>Cases of CPAM with PAVM are rare, especially in adults. CPAM often leads to pulmonary infection, and the pulmonary infection is known to be one of the causes of PAVM. In our case, <i>Aspergillus</i> might have infected the pulmonary cysts and affected the enlargement of the vascular diameter of PAVM. If CPAM and PAVM are present simultaneously, surgical treatment should be considered to prevent complications associated with CPAM and PAVM.</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/PMC12145924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249702","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 Inflammatory Myofibroblastic Tumor in the Abdominal Wall with Anaplastic Lymphoma Kinase and Whole Exome Sequencing Analysis.","authors":"Yuya Takahata, Shoichi Hazama, Toshiyuki Fujii, Masahiro Kitahara, Keisuke Hino, Kiwamu Okita, Hiroaki Nagano, Ryouichi Tsunedomi, Hiroshi Hashiyada, Kembu Nakamoto","doi":"10.70352/scrj.cr.25-0181","DOIUrl":"10.70352/scrj.cr.25-0181","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory myofibroblastic tumors (IMTs) are rare mesenchymal neoplasms characterized by spindle cell proliferation and inflammatory infiltration, but with an unclear etiology. Although IMTs most commonly arise in the lungs, extrapulmonary cases have been documented at various anatomical sites. Approximately 50% of IMTs harbor anaplastic lymphoma kinase (ALK) rearrangements; however, the genetic landscape of ALK-negative cases remains largely unknown. We report a rapidly growing IMT in the right rectus abdominis muscle and present whole-exome sequencing (WES) findings that revealed novel genetic mutations beyond ALK rearrangements.</p><p><strong>Case presentation: </strong>A 38-year-old woman with no significant medical history presented with a rapidly enlarging mass in the right lower abdomen. Computed tomography showed a well-defined tumor on the dorsal side of the right rectus abdominis muscle exhibiting progressive enhancement. Fine-needle biopsy initially suggested the presence of proliferative fasciitis. Owing to rapid tumor growth from 40 to 61 mm within 3 months, laparoscopic surgical resection was performed, including a portion of the posterior sheath and rectus abdominis muscle. Pathological examination confirmed the presence of an IMT and revealed spindle cell proliferation, nuclear atypia, and inflammatory infiltration. Immunohistochemical analysis revealed positivity for smooth muscle actin (SMA) and ALK, partial positivity for desmin, and negativity for cluster of differentiation 34 (CD34) and cytokeratin, compatible with an IMT. WES identified 7 genetic mutations, none of which have been previously reported for IMT in the catalogue of somatic mutations in cancer (COSMIC) database, suggesting novel genetic associations.</p><p><strong>Conclusions: </strong>This case highlights a rare and rapidly growing IMT in the rectus abdominis muscle and underscores the value of molecular analysis in understanding the pathogenesis of IMT. Identification of novel mutations through WES expands the genetic landscape of IMT and may provide insights into tumorigenesis and potential therapeutic targets. Further research is required to explore the clinical implications of these mutations in IMT progression and treatment.</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/PMC12268362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660248","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 Acute Pancreatitis after Pancreatectomy in Grade C Leading to Walled-Off Necrosis Successfully Treated with Necrosectomy by Retroperitoneal Approach.","authors":"Makoto Shinohara, Masakazu Hashimoto, Ryo Nagao, Michinori Hamaoka, Masashi Miguchi, Nobuaki Fujikuni, Satoshi Ikeda, Yasuhiro Matsugu, Hideki Nakahara","doi":"10.70352/scrj.cr.24-0002","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0002","url":null,"abstract":"<p><strong>Introduction: </strong>Grade B or C post-pancreatectomy acute pancreatitis (PPAP) is associated with a higher incidence of postoperative complications and mortality. The reason for this is the activation of proteolytic processes that can lead to pancreatic destruction and the activation of systemic reactions that can have adverse consequences such as systemic inflammatory response syndrome, sepsis, and death. We report a case of a patient with Grade C PPAP with walled-off necrosis (WON) who was successfully treated with necrosectomy using a step-up approach.</p><p><strong>Case presentation: </strong>A 73-year-old man was referred to our hospital with elevated biliary enzymes. Results of blood tests, computed tomography (CT), and magnetic resonance imaging led to the diagnosis of distal bile duct cancer. He underwent a pyloric ring-sparing pancreaticoduodenectomy with lymph node dissection. Postoperative P-AMY (pancreatic amylase) was high at 1766 U/L, and contrast-enhanced CT showed increased density of peripancreatic fatty tissue and fluid accumulation on the pancreatic resection surface, leading to the diagnosis of postoperative pancreatitis and pancreatic fistula. On postoperative day (POD) 9, continuous washing with saline solution was started through the drain at the pancreatic anastomosis. Contrast-enhanced CT showed increased fluid retention in the pancreatic body tail. On POD 43, endoscopic ultrasonography drainage was performed for pancreatic necrosis encapsulated in the retroperitoneum; however, the patient self-extracted the drainage tube. On POD 50, CT-guided drainage was performed for a retroperitoneal subcapsular abscess. On POD 69, the patient underwent necrotomy with guided retroperitoneal drainage, a drain was inserted, and continuous flushing was performed. On POD 76, fecal discharge was observed from the drain, and drainage and enterography were performed; a fistula with the colon was confirmed, and an ileal bifurcation colostomy was performed on the same day. On PODs 83, 85, and 100, endoscopic necrotomy was performed through a retroperitoneal incision wound because a contrast-enhanced CT showed a residual abscess on the gastric dorsum. The patient's general condition improved, and his inflammatory response also improved. On POD 139, the patient was transferred for rehabilitation.</p><p><strong>Conclusion: </strong>We describe a case of successful postoperative nutritional management and necrosectomy for Grade C PPAP leading to WON.</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/PMC11868872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543577","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":"Reconstruction of a Complex Posterior Tracheal Wall Defect via Transtracheal Running Suture and Pedicled Pectoralis Major Muscle Flap.","authors":"Tomoyuki Nakagiri, Alaa Selman, Tobias Goecke, Hayan Merhej, Akylbek Saipbaev, Arjang Ruhparwar, Patrick Zardo","doi":"10.70352/scrj.cr.24-0009","DOIUrl":"10.70352/scrj.cr.24-0009","url":null,"abstract":"<p><strong>Introduction: </strong>A tracheal membranous injury is a known complication of tracheostomy. After esophageal resection, such injury may prove fatal. No natural buttressing of the lesion occurs, and severe sepsis and mediastinitis may occur. In these situations, a circumferential tracheal resection is the treatment of choice, sometimes on cardiopulmonary bypass. However, the outcome is not always favorable.</p><p><strong>Case presentation: </strong>We report a case of a long tracheal membranous wall defect (> 7cm) after esophageal resection. We successfully performed a transtracheal direct repair of the defect through a partial sternotomy, and reconstructed the ventrolateral wall with a muscle flap using the right pectoralis major muscle.</p><p><strong>Conclusion: </strong>Tracheal reconstruction through a T-shaped incision and anastomotic buttressing using a pectoralis major muscle flap could prove to be useful when reconstructing a posterior tracheal wall injury, especially after esophageal 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/PMC11850052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493532","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}