Surgical Case Reports最新文献

{"title":"Thoracic Endovascular Aortic Repair Using Stent Grafts in Japan.","authors":"Akihiko Usui, Rena Usui, Shunsuke Nakata","doi":"10.70352/scrj.ed.25-2001","DOIUrl":"10.70352/scrj.ed.25-2001","url":null,"abstract":"<p><p>A stent-graft technique was developed by Parodi et al. and has been used clinically for thoracic endovascular aortic repair (TEVAR) since the 1990s. We evaluated how the new stent-graft technology contributed to expanding aortic surgery and improving surgical outcomes of aortic surgery. TEVAR was performed in a limited number of institutes in the early 2000s and was greatly enhanced by the approval of commercially available stent grafts in 2008. Its performance increased steadily thereafter, with 0 cases performed in 1999, 1658 in 2009, and 6461 in 2019. The ratio of TEVAR was 0% in 1999, which increased to 13.9% in 2009 and 28.5% in 2019, respectively. TEVAR has greatly contributed to the improvement of surgical outcomes, especially in non-dissection ruptured aneurysms and type B acute aortic dissection. TEVAR was performed in 53% of ruptured aneurysms, and the 30-day mortality rate improved to 13.9% in 2019 due to a 30-day mortality rate of 12.5% in TEVAR. The effect of TEVAR was more remarkable in patients with acute type B aortic dissection, where the 30-day mortality rate was 5.7%, and the procedure was performed in 75% of cases. The overall 30-day mortality rate improved to 7.0% for all patients with type B acute aortic dissection in 2019. The expansion of TEVAR using stent grafts greatly increased the number of aortic surgeries and played a significant role in improving surgical outcomes. Stent-graft technology has influenced the field of aortic surgery.</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/PMC11835547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459416","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 Adult-Onset Intestinal Duplication Manifested as Acute Abdomen: Case Report and Review of the Literature.","authors":"Yuki Nomura, Satoshi Nagayama, Sachie Fujioka, Go Takeuchi, Yuma Takeuchi, Michio Okamoto, Riki Ganeko, Yusuke Nakayama, Kyoichi Hashimoto, Yoshihiro Kubota","doi":"10.70352/scrj.cr.24-0023","DOIUrl":"10.70352/scrj.cr.24-0023","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal duplication is a rare congenital anomaly, usually occurring in childhood and rarely in adults. It is most common in the ileum, but can occur anywhere in the gastrointestinal tract from the mouth to the anus. An adult case of intestinal duplication is accompanied by non-specific symptoms and, hence, it is often difficult to establish accurate diagnosis preoperatively in adults.</p><p><strong>Case presentation: </strong>We experienced two cases of ileal duplication that was manifested as acute abdomen. In both cases, we performed emergency surgery with a tentative preoperative diagnosis of perforation peritonitis related to intestinal duplication. The first case was a 36-year-old male presenting with a cystic non-communicating intestinal duplication, which was perforated, causing abdominal pain. The second case was a 77-year-old male presenting with tubular communicating intestinal duplication, in which a fecal stone was fitted into the root of the duplicated intestine, and the duplicated intestine itself became abscessed, causing abdominal pain. Their postoperative courses were uneventful and the patients were discharged from hospital without any sequelae on the 5th and 10th postoperative day, respectively.</p><p><strong>Conclusion: </strong>Although preoperative diagnosis is not easy, because the clinical presentation varies depending on the occurrence site, in-depth evaluation of preoperative CT images could lead to a precise diagnosis especially when considering intestinal duplication as one of the differential diagnoses of acute abdomen.</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/PMC11850214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504335","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 Obturator Hernia Involving the Urinary Bladder Discovered Following a Femoral Incarcerated Hernia.","authors":"Nobuhiro Naito, Toshiki Hirakawa, Mikio Nambara, Naoki Kametani, Akiko Tachimori, Nobuya Yamada, Shigehiko Nishimura, Naoyuki Taenaka","doi":"10.70352/scrj.cr.25-0097","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0097","url":null,"abstract":"<p><strong>Introduction: </strong>Obturator hernias are rare, accounting for 0.05%-1.4% of all hernias, and typically affect elderly, thin women. Bladder hernias, though uncommon, comprise 1%-4% of groin hernias, with bladder herniation through the obturator foramen being extremely rare. We report a case of an obturator hernia involving the urinary bladder, which was incidentally discovered during femoral hernia repair.</p><p><strong>Case presentation: </strong>A 70-year-old woman presented with a 2-day history of abdominal pain and vomiting. She had no urinary symptoms. Abdominal computed tomography (CT) revealed a right femoral hernia and an unexpected bladder herniation through the obturator foramen. Laparoscopic transabdominal preperitoneal (TAPP) repair was performed using 3 ports. The incarcerated bowel was reduced after incising the lacunar ligament. The prolapsed bladder was carefully dissected to prevent injury, and a dual-layered Bard mesh (Medicon, Franklin Lakes, NJ, USA) was placed to reinforce the defect. The patient recovered uneventfully and was discharged on the 7th postoperative day. No recurrence or urinary symptoms were observed several months postoperatively.</p><p><strong>Conclusions: </strong>Bladder herniation through the obturator foramen is extremely rare and often asymptomatic, making preoperative diagnosis challenging. Surgeons should consider this condition during hernia repair to prevent intraoperative bladder injury. Preoperative imaging is crucial for safe and complete surgical management.</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/PMC12019870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013261","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":"Recurrent Tumor in Colorectal Cancer Requiring Combined Resection of Iliac or Femoral Vessels: Report of Four Cases.","authors":"Kentaro Abe, Hiroaki Nozawa, Katsuyuki Hoshina, Toshio Takayama, Kazuhito Sasaki, Koji Murono, Shigenobu Emoto, Yuichiro Yokoyama, Kensuke Kaneko, Takuro Shirasu, Shinya Abe, Yuzo Nagai, Masaru Kimura, Takahide Shinagawa, Yuichi Tachikawa, Satoshi Okada, Munetoshi Hinata, Akiko Takase, Tetsuo Ushiku, Soichiro Ishihara","doi":"10.70352/scrj.cr.24-0159","DOIUrl":"https://doi.org/10.70352/scrj.cr.24-0159","url":null,"abstract":"<p><strong>Introduction: </strong>Recurrent tumors in colorectal cancer may be removed along with adjacent blood vessels to achieve R0 resection. However, it remains unclear whether to aggressively perform this procedure because it may cause serious intraoperative or postoperative complications.</p><p><strong>Case presentation: </strong>In Case 1, a 62-year-old man underwent radical surgery for rectosigmoid cancer. Three years later, computed tomography scans revealed a disseminated nodule near the left external iliac vessels. We resected the tumor and vessels that were reconstructed by bypass surgery. Histologically, the margins of the tumor were in contact with the adventitia of the vessels. In Case 2, a 63-year-old man underwent radical surgery for ascending colon cancer. A nodule was detected at the right iliac fossa 16 years later and appeared to invade the right femoral vessels. After systemic chemotherapy, the nodule was removed with partial resection of the right femoral artery and vein that were reconstructed by end-to-end anastomosis and bypass surgery, respectively. Histologically, the tumor was located 0.7 mm from the vessels. In Case 3, a 67-year-old woman underwent radical multivisceral resection for obstructive rectosigmoid cancer invading the adjacent organs. Fifteen months later, she developed local recurrence and subsequently received chemotherapy. She underwent en bloc resection of the tumor and the left internal iliac artery (IIA) near the bifurcation. The left external iliac artery was reconstructed by end-to-end anastomosis. Direct invasion of the IIA was proven histologically. In Case 4, a 74-year-old woman underwent radical surgery for ascending colon cancer with high microsatellite instability. Eight months later, a recurrent tumor was detected near the right external iliac vessels. After pembrolizumab and chemoradiotherapy, we resected the tumor and part of the external iliac vein; the defect was primarily closed with sutures. No viable tumor cells were found in the specimen. During the follow-up period (median: 52 months), 3 patients were alive without vascular surgery-related complications.</p><p><strong>Conclusions: </strong>It is difficult to accurately evaluate whether a recurrent tumor from colorectal cancer directly invades vessels using preoperative imaging. However, the combined resection of recurrent tumor and vessels may be required to achieve R0 resection, considering a short distance even in invasion-negative cases.</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/PMC12056520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049219","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 Management of Occult Breast Cancer with a Background of Anti-Melanoma Differentiation-Associated Gene 5 Antibody-Positive Interstitial Pneumonia: A Case Report.","authors":"Mikako Ishii, Yoshiya Horimoto, Yoichi Koyama, Kayo Adachi, Ai Ueda, Takahiko Kawate, Hiroshi Kaise, Kimito Yamada, Eiichi Sato, Shinji Abe, Takashi Ishikawa","doi":"10.70352/scrj.cr.25-0050","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0050","url":null,"abstract":"<p><strong>Introduction: </strong>Anti-MDA5 (melanoma differentiation-associated gene 5) antibody-positive dermatomyositis is a severe subtype of dermatomyositis associated with rapidly progressive interstitial lung disease, which carries an extremely high mortality rate. Prompt diagnosis and therapeutic intervention are crucial for survival. Here, we report a rare case of occult breast cancer in a patient with anti-MDA5 antibody-positive associated interstitial pneumonia. Following the control of the lung disease with immunosuppressive therapy, the patient successfully underwent neoadjuvant chemotherapy (NAC) and curative surgery.</p><p><strong>Case presentation: </strong>A 63-year-old woman presented with progressive dyspnea. Imaging tests revealed diffuse ground-glass opacities in both lungs and enlarged left axillary lymph nodes. Blood tests showed elevated KL-6 levels and anti-MDA5 antibodies. Although no skin lesions or myositis were observed, she was diagnosed with anti-MDA5 antibody-positive associated interstitial pneumonia. Immunosuppressive therapy, including steroid pulse therapy, tacrolimus, cyclophosphamide pulse therapy, and plasma exchange, was initiated, leading to an improvement in her lung condition. She was then initially referred to the department of plastic surgery for further evaluation of the enlarged left axillary lymph node. Excisional biopsy of the enlarged left axillary lymph node revealed triple-negative occult breast cancer (cTXN1M0, Stage IIA). After the patient was referred to our department, NAC was initiated, achieving a clinical partial response while avoiding exacerbation of the interstitial pneumonia. After completing NAC, a left axillary lymph node dissection was performed, and the final pathological diagnosis was ypTXN2aM0 (Stage IIIA). Postoperative radiotherapy was omitted due to the risk of worsening the interstitial lung disease, and capecitabine was administered for 6 months. The patient has remained recurrence-free for 3 years following treatment.</p><p><strong>Conclusions: </strong>This case highlights the successful management of triple-negative breast cancer under the constraints of anti-MDA5 antibody-positive associated interstitial pneumonia. To ensure the smooth implementation of breast cancer treatment while controlling interstitial pneumonia, close collaboration with respiratory physicians was essential for a successful outcome.</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/PMC12066209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144049225","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":"Idiopathic Adult Ileocolic Intussusception Mimicking Cecal Carcinoma: A Case Report and Literature Review.","authors":"Rina Hashimoto, Tatsuo Kanda, Toshiyuki Saginoya, Masafumi Ishikawa, Hidetaka Kawamura, Yasushi Teranishi","doi":"10.70352/scrj.cr.25-0030","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0030","url":null,"abstract":"<p><strong>Introduction: </strong>Adult intussusception is rare, accounting for approximately 5%-16% of all cases. Unlike pediatric intussusception, which is predominantly idiopathic, most adult cases are associated with organic lesions, nearly half of which are malignant. Idiopathic intussusception without a lead point is uncommon but appears to be increasingly recognized. We report a case of idiopathic adult ileocolic intussusception that mimicked cecal carcinoma in imaging studies.</p><p><strong>Case presentation: </strong>A 63-year-old male with a history of gastric cancer recurrence presented with a 3-month history of abdominal pain. Contrast-enhanced computed tomography (CT) revealed circumferential thickening of the right colon, forming a \"target sign,\" and invagination of the ileocecal region into the right colon, suggesting ileocolic intussusception. Colonoscopy identified a nodular lesion presumed to be cecal carcinoma; however, the biopsy did not provide a definitive diagnosis of malignancy. Preoperative ¹⁸F-fluorodeoxyglucose-positron emission tomography (¹⁸F-FDG-PET/CT) revealed high FDG uptake at the leading edge of the intussusception; however, no findings indicative of metastatic disease were observed. The patient underwent elective surgery, and a right colectomy with lymph node dissection was performed. However, the intussusception was found to have spontaneously resolved at laparotomy. Histopathological examination showed mild intramural congestion in the ileocecal valve. Postoperative imaging confirmed the absence of any lead point lesion, resulting in a final diagnosis of idiopathic intussusception.</p><p><strong>Conclusions: </strong>This case highlights the diagnostic limitations of CT and PET/CT in evaluating lead points in adult intussusception, as false-positive findings are common. Given the possibility of spontaneous resolution, a conservative approach, including repeat imaging immediately before surgery, may be suitable in select cases of adult intussusception.</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/PMC12040438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047851","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":"Cholangiolocarcinoma with Ductal Plate Malformation Pattern: A 6-Year Follow-Up.","authors":"Yuta Ushida, Gen Sugawara, Takayuki Minami, Yoriko Yamashita, Masaya Inoue","doi":"10.70352/scrj.cr.25-0086","DOIUrl":"https://doi.org/10.70352/scrj.cr.25-0086","url":null,"abstract":"<p><strong>Introduction: </strong>Cholangiolocarcinoma (CLC) with ductal plate malformation (DPM) is a rare primary liver cancer originating from the canals of Hering. It often exhibits intermediate behavior between hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Diagnosing CLC with DPM is challenging due to overlapping imaging features with other liver malignancies.</p><p><strong>Case presentation: </strong>An 82-year-old man under surveillance for bladder cancer was incidentally found to have a liver nodule in segment 8. Over 6 years, the lesion grew from 10 mm to 41 mm and showed dynamic changes on imaging. Despite two inconclusive biopsies, a diagnosis of CLC with DPM was confirmed after a third biopsy and consultation with a specialized institution. The patient underwent a right hepatectomy, and pathological examination confirmed CLC with DPM. No evidence of recurrence was observed 19 months post-surgery.</p><p><strong>Conclusions: </strong>This case underscores the importance of long-term follow-up and a multidisciplinary approach in managing rare hepatic malignancies. The clinical course provides valuable insights into the progression of CLC with DPM and may aid in diagnosing similar challenging cases.</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/PMC12055238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018394","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 Transanal Total Mesorectal Excision Using the Senhance Digital Laparoscopy System for Rectal Cancer.","authors":"Yasuhiro Ishiyama, Yasumitsu Hirano, Yume Minagawa, Misuzu Yamato, Sohei Akuta, Akihito Nakanishi, Takatsugu Fujii, Naoto Okazaki, Chikashi Hiranuma, Isamu Koyama","doi":"10.70352/scrj.cr.24-0024","DOIUrl":"10.70352/scrj.cr.24-0024","url":null,"abstract":"<p><strong>Introduction: </strong>This case report presents the world's first transanal total mesorectal excision (taTME) using the Senhance Digital Laparoscopy System for rectal cancer. Senhance has been gaining attention as an advanced surgical robot, providing better visualization, stable dissection, and reduced surgeon fatigue compared to conventional methods.</p><p><strong>Case presentation: </strong>A 68-year-old woman underwent Senhance-assisted taTME for a rectal tumor located 4 cm from the anal verge. The procedure was completed safely with a total operation time of 209 minutes, a cockpit time of 85 minutes, and a blood loss of 40 mL. Pathological evaluation confirmed complete resection (R0) with no residual cancer or lymph node metastases. The patient was discharged on postoperative day 7 without complications.</p><p><strong>Conclusions: </strong>This case demonstrates the potential advantages of Senhance-assisted taTME, including improved visualization, stable dissection, and reduced surgeon fatigue. Further studies are needed to evaluate long-term outcomes and establish the role of this technique in rectal cancer surgery.</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/PMC11842874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484031","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":"Acute Myocardial Infarction Caused by Pulmonary Vein Stump Thrombosis after Thoracoscopic Left Upper Lobectomy.","authors":"Takahito Fukushima, Masaaki Nagano, Yue Cong, Tatsuki Furusawa, Akihito Saito, Shun Minatsuki, Satoshi Kodera, Norihiko Takeda, Masaaki Sato","doi":"10.70352/scrj.cr.24-0003","DOIUrl":"10.70352/scrj.cr.24-0003","url":null,"abstract":"<p><strong>Introduction: </strong>Pulmonary vein stump thrombosis can sometimes occur at the pulmonary vein stump after lung surgery, possibly causing systemic infarction. Here, we report a rare case of acute myocardial infarction (AMI) caused by pulmonary vein stump thrombosis after the left upper lobectomy.</p><p><strong>Case presentation: </strong>A 43-year-old male patient with a nodule in the left lingular segment was referred to our hospital. A bronchoscopic biopsy performed at the previous hospital was negative for malignancy; however, the nodule was highly suspicious of primary lung cancer. Therefore, we decided to perform a thoracoscopic lung resection for a definite diagnosis and treatment. Lingular segmentectomy was performed to diagnose the nodule, and a rapid pathological diagnosis confirmed that the nodule was an adenocarcinoma. Subsequently, a left upper lobectomy and systemic lymph node dissection were performed. The left lingular and superior segmental veins were separately dissected using a stapler. The day after the operation, the patient suddenly developed cardiac arrest. Cardiopulmonary resuscitation and venoarterial extracorporeal membrane oxygenation were immediately initiated. After the return of spontaneous circulation was obtained, contrast computed tomography was performed, which suggested thrombosis of the pulmonary vein stump without any signs of brain hemorrhage or infarction. As intermittent ventricular fibrillation persisted, the patient underwent coronary angiography and was diagnosed with AMI due to pulmonary vein stump thrombosis. The thrombosis of the coronary artery was removed using percutaneous coronary intervention. The patient recovered gradually after the intervention and was discharged 2 weeks later from the intensive care unit. One month after rehabilitation for higher brain dysfunction, the patient was discharged from our hospital without any sequelae and received adjuvant chemotherapy for lung cancer.</p><p><strong>Conclusions: </strong>We encountered a case of AMI caused by pulmonary vein stump infarction after the left upper lobectomy. Given that this complication is rare but lethal, clinicians should consider it and take great care of the residual length of the pulmonary vein stump to prevent thrombosis.</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/PMC11793104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415362","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 Sigmoid Colon Perforation Associated with Sodium Zirconium Cyclosilicate in a Patient with Advanced Rectal Cancer.","authors":"Takaki Kamiya, Toru Miyake, Osamu Inatomi, Tomoharu Shimizu","doi":"10.70352/scrj.cr.24-0123","DOIUrl":"10.70352/scrj.cr.24-0123","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium zirconium cyclosilicate (SZC) binds with potassium in the gastrointestinal tract and increases fecal potassium excretion. Since SZC is a novel and non-swelling drug, the risk of intestinal perforation is not mentioned in the package insert. We hereby report the case of sigmoid colon perforation caused by hard stools and severe hypokalemia in a patient suffering from advanced rectal cancer, who was taking SZC.</p><p><strong>Case presentation: </strong>A woman in her 80s with a history of primary biliary cirrhosis and decompensated cirrhosis accompanied by hyperkalemia was administered SZC. The patient was rushed to the hospital on the 23rd day following the commencement of SZC, complaining of abdominal pain and nausea. She suffered from sigmoid colon perforation. Hartmann's operation with drainage was performed. SZC was discontinued after admission, following which the serum potassium levels normalized. Despite the diagnosis of advanced rectal cancer during her hospital stay, the curative operation and stoma closure were judged to be inoperable because of her physical condition.</p><p><strong>Conclusions: </strong>SZC is said to be associated with a lower risk of intestinal perforation compared with other similar drugs; however, in patients with certain conditions, such as intestinal obstruction or transit disorder resulting from malignant disease, adhesion, and inflammatory diseases, the accumulation of SZC in the intestinal lumen might increase the risk of perforation.</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/PMC11925643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671045","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}