World Journal of Clinical Cases最新文献

{"title":"Stoma occlusion caused by abdominal cocoon after abdominal abscess surgery: A case report.","authors":"Rui Xu, Li-Xin Sun, Yan Chen, Chuang Ding, Ming Zhang, Teng-Fei Chen, Ling-Yong Kong","doi":"10.12998/wjcc.v13.i15.98608","DOIUrl":"10.12998/wjcc.v13.i15.98608","url":null,"abstract":"<p><strong>Background: </strong>Abdominal cocoons (ACs) lack characteristic clinical manifestations and are mainly intestinal obstructions that are difficult to distinguish from intestinal obstruction caused by other causes, resulting in difficult preoperative diagnosis and misdiagnosis and mistreatment. There are no reports of enterostomy occlusion caused by ACs in the literature at home and abroad.</p><p><strong>Case summary: </strong>Here, we report a 16-year-old female patient with intestinal obstruction due to AC. She was treated with abdominal surgery three times. First, she underwent a laparotomy for peritonitis after trauma from a traffic accident. During the procedure, pelvic empyema, severe intestinal adhesions, and damage to the serous layer of the rectum were found, but no significant intestinal rupture and perforation were found. As a precaution, she underwent a prophylactic ileostomy after a flush in her abdomen. The second and third surgeries were for treatment of recurrent stoma obstruction. The patient's condition was complicated for a long period, but after comprehensive treatment by our department, the patient was successfully discharged from the hospital and is currently recovering well.</p><p><strong>Conclusion: </strong>Currently, abdominal contrast-enhanced computed tomography is the best imaging modality for preoperative evaluation of AC, but most patients are diagnosed only after intraoperative exploration. For the treatment of typical or severe ACs, the primary method of removal and healing of ACs is complete removal of the abdominal fibrous membrane. Finding a breakthrough in the anatomy is the key to the success of the surgery.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"98608"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of brush rinse on the diagnostic accuracy of biliary stricture evaluation: A multicenter trial.","authors":"Hoonsub So, Sung Ill Jang, Sung Woo Ko, Seung Bae Yoon, Young Sub Lee, SungJo Bang, Misung Kim, Hye-Jeong Choi","doi":"10.12998/wjcc.v13.i15.99212","DOIUrl":"10.12998/wjcc.v13.i15.99212","url":null,"abstract":"<p><strong>Background: </strong>Brush cytology is the most commonly used technique for tissue acquisition during endoscopic retrograde cholangiopancreatography for the evaluation of biliary strictures. Nonetheless, brush cytology is limited by its low sensitivity due to insufficient cellular yield.</p><p><strong>Aim: </strong>To evaluate the impact of the sheath-rinse technique on improving the cellularity yield.</p><p><strong>Methods: </strong>A total of 112 patients with suspected malignant biliary strictures were enrolled at two tertiary centers in South Korea. The sample cellularity and diagnostic accuracy of brush-wash and sheath-rinse specimens were compared.</p><p><strong>Results: </strong>A significantly increased number of total cell clusters per representative 20 × field was recorded in the sheath-rinse compared with the brush-wash specimens (median: 12 <i>vs</i> 3, <i>P</i> < 0.001). This trend persisted when large (> 50 cells) clusters (median: 8 <i>vs</i> 3, <i>P</i> < 0.001), medium (6-49 cells) (median: 7 <i>vs</i> 3, <i>P</i> < 0.001), and small (2-5 cells) clusters (median: 9 <i>vs</i> 3, <i>P</i> < 0.001) were evaluated. Diagnostic accuracy and sensitivity for differentiating malignancy were superior with sheath-rinsing than with the brush-wash method (72.3% <i>vs</i> 62.5%, <i>P</i> < 0.001 and 69.9% <i>vs</i> 59.2%, <i>P</i> < 0.001, respectively).</p><p><strong>Conclusion: </strong>Incorporating sheath-rinse specimens significantly improved the yield and diagnostic accuracy of biliary brush cytology. Sheath-rinsing should be integrated into routine clinical practice to improve diagnostic performance for biliary strictures.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"99212"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755213/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference diagnosis and treatment process of juvenile hemochromatosis patients.","authors":"Yan-Chun He, Nan-Xue Wang, Tao Zhong","doi":"10.12998/wjcc.v13.i15.99198","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i15.99198","url":null,"abstract":"<p><p>The compelling case report by Xie <i>et al</i>, published in a renowned medical journal, is an excellent example of meticulous clinical evaluation, comprehensive laboratory testing, advanced imaging, and genetic analysis. The authors identified novel compound heterozygous mutations in the hemojuvelin gene of a patient diagnosed with juvenile hemochromatosis. They suggested that long-term, strategic phlebotomy might offer a novel therapeutic strategy for severe juvenile hemochromatosis, challenging the traditional treatment paradigms.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"99198"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Granulomatosis with polyangiitis induced by the anti-programmed cell death-1 inhibitor tislelizumab: A case report.","authors":"Jian-Hui Zhao, Jing-Jiao Wang, Yi-Wen Li","doi":"10.12998/wjcc.v13.i15.103239","DOIUrl":"10.12998/wjcc.v13.i15.103239","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) are a new class of antitumor agents. They enhance antitumor effects by blocking inhibitory receptors and related ligands expressed on T cells. ICIs also modulate regular immune cell activity, affecting the immune system and causing immune-related adverse events. The renal system is sometimes affected by these adverse events. Currently, the literature on ICIs-related glomerular injuries is scarce.</p><p><strong>Case summary: </strong>We present a patient who developed granulomatosis with polyangiitis (GPA) 3 weeks after treatment with the anti-programmed cell death-1 inhibitor, tislelizumab. The patient experienced proteinuria, hematuria, and acute kidney injury without pulmonary hemorrhage and tested positive for anti-neutrophil cytoplasmic antibody (ANCA)-cytoplasmic type. Renal biopsy confirmed ANCA-associated vasculitis, and GPA was finally diagnosed. The patient received pulse treatment with glucocorticoids and cyclophosphamide, and renal function improved. After self-discontinuation of the drug, the disease recurred, and the original treatment regimen was continued. However, the patient's renal function continued to deteriorate.</p><p><strong>Conclusion: </strong>Glucocorticoids plus cyclophosphamide are effective for treating GPA induced by tislelizumab. However, follow-up and patient education are needed.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"103239"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151346","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>MYH7</i> mutation in a pedigree with familial dilated hypertrophic cardiomyopathy: A case report and review of literature.","authors":"Ying Hong, Zhen Fan, Yi Guo, Hui-Hui Ma, Sheng-Zhi Zeng, Hu-Tao Xi, Jing Yang, Kai Luo, Rong Luo, Xiao-Ping Li","doi":"10.12998/wjcc.v13.i15.101272","DOIUrl":"10.12998/wjcc.v13.i15.101272","url":null,"abstract":"<p><strong>Background: </strong>Hypertrophic cardiomyopathy (HCM) is one of the most prevalent inherited myocardial disorders and is characterized by considerable genetic and phenotypic heterogeneity. A subset of patients with HCM progress to a dilated phase of HCM (DPHCM), which is associated with a poor prognosis; however, the underlying pathogenesis remains inadequately understood.</p><p><strong>Case summary: </strong>In this study, we present a case involving a pedigree with familial DPHCM and conduct a retrospective review of patients with DPHCM with identified gene mutations. Through panel sequencing targeting the coding regions of 312 genes associated with inherited cardiomyopathy, a heterozygous missense mutation (c.746G>A, p.Arg249Glu) in the <i>MYH7</i> gene was identified in the proband (III-5). Sanger sequencing subsequently confirmed this pathogenic mutation in three additional family members (II-4, III-4, and IV-3). A total of 26 well-documented patients with DPHCM were identified in the literature. Patients with DPHCM are commonly middle-aged and male. The mean age of patients with DPHCM was 53.43 ± 12.79 years. Heart failure, dyspnoea, and atrial fibrillation were the most prevalent symptoms observed, accompanied by an average left ventricular end-diastolic size of 58.62 mm.</p><p><strong>Conclusion: </strong>Our findings corroborate the pathogenicity of the <i>MYH7</i> (c.746G>A, p.Arg249Glu) mutation for DPHCM and suggest that the Arg249Gln mutation may be responsible for high mortality.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"101272"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mitochondrial myopathy revealed postoperative acute respiratory failure: A case report.","authors":"Seon Yeong Park, Sung Min Hong, Ho Young Lee, Mi-Yeong Kim, Hyun-Kyung Lee, Ji-Yeon Han, Hwa Jin Cho, Seong-Il Oh, Hongyeul Lee","doi":"10.12998/wjcc.v13.i15.102691","DOIUrl":"10.12998/wjcc.v13.i15.102691","url":null,"abstract":"<p><strong>Background: </strong>Mitochondrial myopathies are characterized by primary dysfunction of the mitochondrial respiratory chain; they typically present as chronic muscle weakness. Clinically visible acute respiratory dysfunctions associated with mitochondrial myopathies occur rarely.</p><p><strong>Case summary: </strong>In this report, we present the case of a patient who developed postoperative hypoventilation after undergoing an uneventful administration of general anesthesia. A 34-year-old woman with no family history of myopathy underwent laparoscopic removal of a right-sided ureteric stone. Two days postoperatively, her oxygen saturation decreased rapidly, and blood gas analysis revealed hypercapnia. We promptly intubated and initiated the patient and initiated her on mechanical ventilation as she remained awake. Clinical examination findings were unremarkable; the results of laboratory investigations, including those for thyroid, hepatic, renal, and neuromuscular functions, were within normal limits. Muscle biopsy revealed muscle fibers of varying sizes as well as several degenerating and regenerating myofibers. Modified Gomori trichrome staining of the cross-sections revealed ragged red fibers. Based on these findings, we diagnosed the patient with mitochondrial myopathy. The patient's condition gradually improved, and she was discharged on a home ventilator 73 days postoperatively.</p><p><strong>Conclusion: </strong>Our case highlights that mitochondrial myopathy should be considered in the differential diagnosis of patients with postoperative respiratory failure.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"102691"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation combined with intra-aortic balloon counterpulsation for pheochromocytoma: A case report.","authors":"Shu-Ying Zeng, Hai-Hui Wu, Zhi-Hong Yu, Qing-Qian Zhang","doi":"10.12998/wjcc.v13.i15.102343","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i15.102343","url":null,"abstract":"<p><strong>Background: </strong>Pheochromocytoma (PHEO) is a type of tumor that originates from chromaffin cells in the adrenal medulla and is classified as an adrenal paraganglioma. PHEOs can secrete catecholamines, leading to a variety of symptoms. Accurate diagnosis and appropriate treatment selection are crucial for favorable outcomes in these cases.</p><p><strong>Case summary: </strong>The patient presented with unexplained chest tightness, palpitations, and pink sputum. Upon examination and analysis of laboratory results, a diagnosis of adrenal PHEO was established. The PHEO secreted high levels of catecholamines, causing sudden fluctuations in blood pressure and heart rate, leading to extremely unstable hemodynamics. Treatment with extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation helped stabilize the patient's vital signs, allowing for timely surgical intervention.</p><p><strong>Conclusion: </strong>The combination of extracorporeal membrane oxygenation and intra-aortic balloon counterpulsation can enhance tissue perfusion, thus providing a solid foundation for the accurate diagnosis and effective surgical treatment of PHEO.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"102343"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improved super-elastic Ti-Ni alloy wire for the angle class III patient with anterior open bite: A case report.","authors":"Yu Fan, Jian-Hong Yu, Yuan-Hou Chen","doi":"10.12998/wjcc.v13.i15.101884","DOIUrl":"https://doi.org/10.12998/wjcc.v13.i15.101884","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic treatment for open bite and crossbite cases is always challenging. In this paper, we demonstrate a skeletal class III patient with anterior open bite and crossbite whose problem was successfully corrected with improved super-elastic Ti-Ni alloy wire (ISW).</p><p><strong>Case summary: </strong>A 19 years old male came to our clinic with a chief complaint of anterior open bite and crossbite and not able to chew food well. Clinical examination revealed an angle class III malocclusion with anterior open bite, crossbite and spaced arch. Radiographic and clinical examination showed a skeletal class III pattern. We used ISW to level the upper and lower arch and to correct the anterior open bite and crossbite. Intermaxillary elastics were also used to achieve a better interdigitation. Finally, adequate overbite, overjet and a desirable occlusion were achieved. The active treatment time took 2 years and 2 months.</p><p><strong>Conclusion: </strong>In a case of class III angular malocclusion with open bite and crossbite in the anterior teeth, ideal results were achieved using the ISW technique and the patient was satisfied with the outcome.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"101884"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revitalizing upper blepharoplasty: Preserving volume.","authors":"Rana Farsakoury, Abdulqadir J Nashwan","doi":"10.12998/wjcc.v13.i15.100563","DOIUrl":"10.12998/wjcc.v13.i15.100563","url":null,"abstract":"<p><p>Blepharoplasty is a frequently performed aesthetic surgery today aimed at enhancing eyelid appearance and correcting age-related changes. The traditional method of subtraction blepharoplasty, which involved removing fat and excess skin, is now considered outdated. This letter explores Gorgy <i>et al</i>'s commentary on Miotti <i>et al</i>'s study, highlighting a shift in upper eyelid blepharoplasty towards a more conservative, volume-preserving approach. The study systematically reviewed 10 publications, including three retrospective studies, five comparative studies, and two clinical trials. It emphasizes the trend towards preserving the patient's natural anatomy and focusing on enhancement rather than alteration. However, the study's limitations, such as the lack of long-term comparative research, a relatively small sample size, and a single-center design, indicate that further research with extended follow-up is necessary to validate the safety and effectiveness of these techniques. The focus is increasingly on preserving and augmenting volume in upper blepharoplasty rather than removing tissue.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"100563"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence and the impact of multiomics on the reporting of case reports.","authors":"Aishwarya Boini, Vincent Grasso, Heba Taher, Andrew A Gumbs","doi":"10.12998/wjcc.v13.i15.101188","DOIUrl":"10.12998/wjcc.v13.i15.101188","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) and multiomics has transformed clinical and life sciences, enabling precision medicine and redefining disease understanding. Scientific publications grew significantly from 2.1 million in 2012 to 3.3 million in 2022, with AI research tripling during this period. Multiomics fields, including genomics and proteomics, also advanced, exemplified by the Human Proteome Project achieving a 90% complete blueprint by 2021. This growth highlights opportunities and challenges in integrating AI and multiomics into clinical reporting. A review of studies and case reports was conducted to evaluate AI and multiomics integration. Key areas analyzed included diagnostic accuracy, predictive modeling, and personalized treatment approaches driven by AI tools. Case examples were studied to assess impacts on clinical decision-making. AI and multiomics enhanced data integration, predictive insights, and treatment personalization. Fields like radiomics, genomics, and proteomics improved diagnostics and guided therapy. For instance, the \"AI radiomics, genomics, oncopathomics, and surgomics project\" combined radiomics and genomics for surgical decision-making, enabling preoperative, intraoperative, and postoperative interventions. AI applications in case reports predicted conditions like postoperative delirium and monitored cancer progression using genomic and imaging data. AI and multiomics enable standardized data analysis, dynamic updates, and predictive modeling in case reports. Traditional reports often lack objectivity, but AI enhances reproducibility and decision-making by processing large datasets. Challenges include data standardization, biases, and ethical concerns. Overcoming these barriers is vital for optimizing AI applications and advancing personalized medicine. AI and multiomics integration is revolutionizing clinical research and practice. Standardizing data reporting and addressing challenges in ethics and data quality will unlock their full potential. Emphasizing collaboration and transparency is essential for leveraging these tools to improve patient care and scientific communication.</p>","PeriodicalId":23912,"journal":{"name":"World Journal of Clinical Cases","volume":"13 15","pages":"101188"},"PeriodicalIF":1.0,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144152063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}