American Journal of Case Reports最新文献_第2页

Wilkie's Syndrome with Successful Nonsurgical Conservative Treatment in a Young Man: A Case Report. 一名年轻男子的威尔基综合征非手术保守治疗获得成功：病例报告

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American Journal of Case Reports Pub Date : 2024-10-29 DOI: 10.12659/AJCR.943238

Robert Karitnig, Doris Wagner, Robert Sucher, Peter Kornprat

{"title":"Wilkie's Syndrome with Successful Nonsurgical Conservative Treatment in a Young Man: A Case Report.","authors":"Robert Karitnig, Doris Wagner, Robert Sucher, Peter Kornprat","doi":"10.12659/AJCR.943238","DOIUrl":"10.12659/AJCR.943238","url":null,"abstract":"BACKGROUND Superior mesenteric artery syndrome, also known as Wilkie's syndrome, is a rare etiology of obstruction of the lower duodenum between the superior mesenteric artery and aorta. It often presents with unspecific abdominal pain and laboratory findings, resulting in difficult diagnosis and treatment. CASE REPORT A 21-year-old male patient was admitted to our clinic with a 13-month history of coughing, ill feeling, night sweats, vomiting, unintentional weight loss, and epigastric pain. Despite recurrent referral, the diagnostic panels, including a full abdominal laboratory workup, were unremarkable, with the following results: pancreatic amylase: 34.6 U/L, pancreatic lipase: 22 U/L, bilirubin: 0.66 mg/dL, aspartate aminotransferase: 21 U/L, alanine aminotransferase: 40 U/L, white blood cells: 12.59×10⁹/L, plasma total protein: 8.4 g/dL, and hemoglobin: 14.7 g/dL. An abdominal computed tomography scan revealed a paucity of the mesenteric artery and subcutaneous fat, the dilation of the stomach and compression of the duodenum between the superior mesenteric artery and aorta, and an aorto-mesenteric distance of 5.1 mm, resembling superior mesenteric artery syndrome (Wilkie's syndrome). Conservative therapy, including high caloric nutritional support, was administered. A gastroscopy was performed to dilate the distal portion of the duodenum, to enable a physiological passage. The patient was discharged 5 days after diagnosis in good condition, with weight gain, and continued to receive regular follow-up with our outpatient department. CONCLUSIONS This case underlines the importance of considering rare etiologies of abdominal symptoms for concise diagnosis, along with the importance of considering nonsurgical treatment, especially in young patients.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11537275/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523292","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}

引用次数: 0

Encapsulating Peritoneal Sclerosis Leading to Small Bowel Obstruction in a Young Woman with End-Stage Renal Disease: A Case Report. 一名患有终末期肾病的年轻女性因包裹性腹膜硬化症导致小肠阻塞：病例报告。

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American Journal of Case Reports Pub Date : 2024-10-28 DOI: 10.12659/AJCR.945398

Sahil M Patel, Vashistha M Patel, Shreya V Patel, Samarth M Patel, Lauren L Pacheco

{"title":"Encapsulating Peritoneal Sclerosis Leading to Small Bowel Obstruction in a Young Woman with End-Stage Renal Disease: A Case Report.","authors":"Sahil M Patel, Vashistha M Patel, Shreya V Patel, Samarth M Patel, Lauren L Pacheco","doi":"10.12659/AJCR.945398","DOIUrl":"10.12659/AJCR.945398","url":null,"abstract":"BACKGROUND Encapsulating peritoneal sclerosis (EPS) is a life-threatening complication of peritoneal dialysis (PD). It is characterized by a fibrous membrane partially or totally encasing the small bowel and is a rare cause of small bowel obstruction (SBO). Here we present a case of a young woman with a history of PD presenting with SBO due to EPS. CASE REPORT A 37-year-old woman with end-stage renal disease secondary to uncontrolled hypertension previously on PD presented to the emergency department for evaluation of 1 week of intractable nausea and vomiting associated with diffuse abdominal pain. Computed tomography of the abdomen showed findings consistent with a fibrous membrane encapsulating the small bowel and a small bowel follow-through revealed an SBO. She was diagnosed with secondary stage 3 EPS due to PD. She was started on prednisone and tamoxifen with quick resolution of her symptoms. Unfortunately, due to numerous recurrent SBOs, she is now being evaluated for surgical treatment options. CONCLUSIONS This report has presented a case of EPS, a rare complication of PD, which requires early diagnosis and management to prevent potentially fatal consequences. Management should focus on treating the underlying condition, optimizing nutrition, and using corticosteroids or tamoxifen (alone or in combination) depending on disease state and contraindications, with the aim of reducing recurrent SBOs. Failure of conservative management may require surgical evaluation.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509793","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}

引用次数: 0

Intra-Articular Osteochondroma in the Elbow: Diagnosis and Surgical Treatment in an 8-Year-Old Boy. 肘关节内骨软骨瘤：一名 8 岁男孩的诊断和手术治疗。

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American Journal of Case Reports Pub Date : 2024-10-27 DOI: 10.12659/AJCR.943927

Ibrahim Almoftery, Abdulrhman Hassan, Yousef Alshumrani, Abdulaziz Mesfer A Alqahtani

{"title":"Intra-Articular Osteochondroma in the Elbow: Diagnosis and Surgical Treatment in an 8-Year-Old Boy.","authors":"Ibrahim Almoftery, Abdulrhman Hassan, Yousef Alshumrani, Abdulaziz Mesfer A Alqahtani","doi":"10.12659/AJCR.943927","DOIUrl":"10.12659/AJCR.943927","url":null,"abstract":"BACKGROUND Osteochondroma is the most common bone tumor and is a surface bone lesion that includes cortical and medullary bone with a hyaline cartilage cap. Benign osteochondroma is a common tumor in children that may be asymptomatic but can cause pain and limit joint movement when arising in a joint. This report describes the presentation, diagnosis, and management of an intra-articular osteochondroma of the right elbow joint in an 8-year-old boy. CASE REPORT An 8-year-old boy experienced persistent right elbow pain and limited motion, which were unresponsive to conservative measures. Examination revealed a firm swelling in the right cubital fossa. Radiographic and advanced imaging confirmed an osteochondroma originating from the capitellum and trochlea. Surgical exploration via a lateral approach and capsulotomy excised a lobulated intra-articular mass (5×2×1.5 cm). Histopathology showed a hyaline cartilage cap with typical chondrocytes and endochondral ossification, and normal fatty marrow and hematopoietic elements in the stroma. The procedure restored normal elbow function. This case is the first documented instance of an elbow joint intra-articular osteochondroma. CONCLUSIONS This report has highlighted the importance of surgical removal and histopathology in the diagnosis of this common bone lesion to exclude the differential diagnoses of intra-articular masses that include a foreign body, enchondroma, chondroblastoma, periosteal chondroma, chondromyxoid fibroma, or malignant chondrosarcoma.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509795","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}

引用次数: 0

Multifocal Renal Infarction and Diabetic Ketoacidosis: Diagnostic Challenges and Anticoagulation Management in a Complex Case. 多灶性肾梗死和糖尿病酮症酸中毒：一个复杂病例的诊断挑战和抗凝管理。

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American Journal of Case Reports Pub Date : 2024-10-26 DOI: 10.12659/AJCR.945456

Levi Miles, Brandon Shin, Hyein Ji, Shadeh Ghaffari-Rafi, Morteza Chitsazan, Daniel I Kim

{"title":"Multifocal Renal Infarction and Diabetic Ketoacidosis: Diagnostic Challenges and Anticoagulation Management in a Complex Case.","authors":"Levi Miles, Brandon Shin, Hyein Ji, Shadeh Ghaffari-Rafi, Morteza Chitsazan, Daniel I Kim","doi":"10.12659/AJCR.945456","DOIUrl":"10.12659/AJCR.945456","url":null,"abstract":"BACKGROUND Incidental findings of renal infarct secondary to thrombosis in acutely ill patients present a unique challenge in diagnosis. We present a case of idiopathic renal infarct to highlight its workup and management and encourage further investigation of renal infarctions. CASE REPORT A 68-year-old woman with a past medical history of diet-controlled diabetes, hypertension, and hyperlipidemia presented to the Emergency Department (ED) for abdominal pain. She was found to be in diabetic ketoacidosis with pyelonephritis, so she was admitted to the Intensive Care Unit (ICU) for insulin and dextrose drip. Due to her abdominal pain, she underwent computed tomography (CT) of her abdomen and pelvis with contrast. This revealed multifocal infarcts of her right kidney with noncalcified thrombus at the proximal right renal artery. Subsequent CT angiography confirmed a right renal artery thrombus. She was started on subcutaneous enoxaparin and downgraded to basic level of care. Her history was negative for prior thrombosis, hypercoagulable state, and abdominal trauma. Echocardiogram and limited hypercoagulable workup were largely unremarkable. A multidisciplinary team evaluated the patient and recommended no surgical intervention. Following downgrade from the ICU, the patient was transitioned from enoxaparin to apixaban. She was discharged with plans for anticoagulation for 6 months, aspirin daily, and repeat CT angiogram abdomen/pelvis in 1 month. CONCLUSIONS This case illustrates the difficulties in elucidating the cause of incidental renal thrombosis in an acutely ill patient. Diagnostic workup is limited in the inpatient setting, but therapeutic anticoagulation remains the standard of treatment regardless of etiology.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509796","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}

引用次数: 0

Implications of Associated Atrial Fibrillation in Brugada Syndrome for Sudden Cardiac Death ‒ A Case Series Analysis. Brugada 综合征伴发心房颤动对心脏性猝死的影响--病例系列分析。

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American Journal of Case Reports Pub Date : 2024-10-25 DOI: 10.12659/AJCR.945005

Mohammad Iqbal, Michael Aditya Lesmana, Iwan Cahyo Santosa Putra, Giky Karwiky, Chaerul Achmad, Hanna Goenawan, Mohammad Rizki Akbar, Arief Sjamsulaksan Kartasasmita

{"title":"Implications of Associated Atrial Fibrillation in Brugada Syndrome for Sudden Cardiac Death ‒ A Case Series Analysis.","authors":"Mohammad Iqbal, Michael Aditya Lesmana, Iwan Cahyo Santosa Putra, Giky Karwiky, Chaerul Achmad, Hanna Goenawan, Mohammad Rizki Akbar, Arief Sjamsulaksan Kartasasmita","doi":"10.12659/AJCR.945005","DOIUrl":"10.12659/AJCR.945005","url":null,"abstract":"BACKGROUND Brugada syndrome (BrS) is a cardiac arrhythmia disorder characterized by ventricular arrhythmias, which can lead to sudden cardiac death (SCD). BrS is also associated with atrial arrhythmias, particularly atrial fibrillation (AF). There is ongoing debate regarding whether treated AF can still precipitate ventricular arrhythmias in patients with BrS. This case series aims to elucidate the prognostic significance of treated AF in BrS patients who experienced SCD. CASE REPORT We report on 2 patients diagnosed with Brugada syndrome (BrS) who presented with atrial fibrillation (AF). Both patients exhibited type I Brugada electrocardiographic patterns, and echocardiographic assessments revealed normal cardiac structure and function. Thyroid function tests and electrolyte levels were within normal ranges. An electrophysiology study (EPS) performed on the first patient demonstrated the induction and termination of AF, but no inducible ventricular arrhythmia was observed. Both patients declined the ablation procedure for AF treatment, opting instead for pharmacologic rhythm control with amiodarone. During follow-up visits every 3 months, neither patient reported palpitations or syncope, and electrocardiography consistently indicated sinus rhythm. Despite this, sudden cardiac death (SCD) occurred in the first patient during the first year of follow-up and in the second patient during the second year of follow-up. CONCLUSIONS Patients with BrS who have treated AF remain at a high risk of SCD. The presence of AF in BrS patients may indicate a specific variant of the SCN5A mutation, which can heighten the risk of ventricular arrhythmias and consequent SCD.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509794","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}

引用次数: 0

Simultaneous Bilateral Primary Choroidal Melanoma Linked to Bilateral Ocular Melanocytosis: A Rare Case Study. 同时发生的双侧原发性脉络膜黑色素瘤与双侧眼部黑色素细胞增多症有关：罕见病例研究。

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American Journal of Case Reports Pub Date : 2024-10-24 DOI: 10.12659/AJCR.946129

Constantine D Angelidis, Petros Petrou, Stylianos A Kandarakis, Eleni Georgopoulou, Ilias Georgalas

{"title":"Simultaneous Bilateral Primary Choroidal Melanoma Linked to Bilateral Ocular Melanocytosis: A Rare Case Study.","authors":"Constantine D Angelidis, Petros Petrou, Stylianos A Kandarakis, Eleni Georgopoulou, Ilias Georgalas","doi":"10.12659/AJCR.946129","DOIUrl":"10.12659/AJCR.946129","url":null,"abstract":"BACKGROUND Choroidal melanoma is the most common primary intraocular tumor in adults. Most primary choroidal melanomas are unilateral and unifocal. Bilateral primary choroidal melanomas are considered to be a rare occurrence. Ocular melanocytosis, especially when it is bilateral, increases the incidence of bilateral primary choroidal melanoma. CASE REPORT Our patient was a 78-year-old man who presented to the Emergency Department with floaters and a reduction in visual acuity in his left eye, with an onset 7 days prior. Upon macroscopic examination, the patient displayed bilateral pigmentation on the sclera, which was consistent with ocular melanocytosis. Fundoscopy revealed a large choroidal melanoma, situated superior and nasally of the posterior pole of the left eye, and a smaller choroidal melanoma, located inferonasally, in the right eye. Ultrasonography, optical coherence tomography, fundus autofluorescence, fundus fluorescein, and indocyanine green angiographies were performed, confirming the diagnosis of simultaneous bilateral primary choroidal melanomas. CONCLUSIONS This was a rare case of bilateral ocular melanocytosis, which increased the probability of bilateral primary choroidal melanoma. To the best of our knowledge, this is the first case in Greece to be reported. This case illustrates the necessity of always examining the fellow eye on initial presentation and over a long follow-up. We should always bear in mind that choroidal melanoma can be a bilateral disease, albeit very rarely.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11520808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509813","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}

引用次数: 0

Postpartum Hemorrhage Management with Bakri Balloon: Investigating Retained Placenta Risk. 使用 Bakri 球囊处理产后出血：调查胎盘滞留风险。

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American Journal of Case Reports Pub Date : 2024-10-23 DOI: 10.12659/AJCR.945672

Shohei Tanabe, Yutoku Shi

{"title":"Postpartum Hemorrhage Management with Bakri Balloon: Investigating Retained Placenta Risk.","authors":"Shohei Tanabe, Yutoku Shi","doi":"10.12659/AJCR.945672","DOIUrl":"10.12659/AJCR.945672","url":null,"abstract":"BACKGROUND Retained products of conception (RPOC) is a rare complication following second-trimester delivery or pregnancy termination, often leading to significant hemorrhage. Diagnosed via ultrasound or CT, RPOC requires surgical intervention based on endometrial thickness. Risk factors include second-trimester abortion and use of placental forceps. We report a case of RPOC diagnosed 1 month postpartum after using a Bakri balloon for atonic hemorrhage during full-term delivery. CASE REPORT The patient, a 32-year-old woman with a history of 4 pregnancies and 3 births, conceived via frozen embryo transfer, which was her first infertility treatment. At 36 weeks of gestation, blood tests revealed a hemoglobin level of 10.4 g/dl. She delivered vaginally at 38 weeks 2 days, but postpartum uterine contractions were poor, leading to significant bleeding. Oxytocin administration and uterine massage failed to improve contractions, so a Bakri balloon was inserted. The total blood loss was 2263 cc, and 6 units of RBCs were transfused. The next day, the Bakri balloon was removed, and ultrasonography confirmed the absence of retained placenta before discharge on postpartum day 5. However, at her 1-month checkup, a retained placenta was diagnosed, requiring further intervention. The patient declined follow-up. CONCLUSIONS We encountered a case of RPOC 1 month after using a Bakri balloon. Although the relationship between the 2 remains unclear, it may be preferable to avoid such treatment in the future.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142509812","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}

引用次数: 0

Splenic Rupture Following Extracorporeal Shockwave Lithotripsy: A Case Requiring Emergency Splenectomy. 体外冲击波碎石术后脾破裂：需要紧急脾切除术的病例。

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American Journal of Case Reports Pub Date : 2024-10-22 DOI: 10.12659/AJCR.944890

Dzhevdet Chakarov, Dimitar Hadzhiev, Elena Hadzhieva

{"title":"Splenic Rupture Following Extracorporeal Shockwave Lithotripsy: A Case Requiring Emergency Splenectomy.","authors":"Dzhevdet Chakarov, Dimitar Hadzhiev, Elena Hadzhieva","doi":"10.12659/AJCR.944890","DOIUrl":"10.12659/AJCR.944890","url":null,"abstract":"BACKGROUND Extracorporeal shockwave lithotripsy (ESWL) is a common procedure, and splenic rupture is a rare complication of ESWL. Depending on the stage of injury and patient's condition, treatment options include non-operative management (NOM) and emergency splenectomy. Diagnosis is not difficult with symptoms such as deteriorating hemodynamic and hematologic indices, localized physical signs of peritoneal irritation in the left hypochondriac region, and confirmation provided by signs of free fluid (hemoperitoneum) seen on ultrasound or computed tomography (CT). Prompt diagnosis and treatment are essential for patient survival. If NOM is not feasible, emergency laparotomy with splenectomy is standard procedure. CASE REPORT A 72-year-old man with a medical history of arterial hypertension and cardiac arrhythmia was emergently admitted 1 day after undergoing ESWL for bilateral nephrolithiasis. He presented with abdominal pain, nausea, vomiting, and anemia. Urgent CT confirmed a splenic rupture, with intraperitoneal fluid. He underwent emergency splenectomy 24 h after ESWL. Complete splenic rupture (grade IV) was identified, accompanied by significant blood loss of 2000 mL. The postoperative course was uneventful, and he was discharged on postoperative day 7, with primary wound healing. CONCLUSIONS Splenic injury following ESWL is a rare but serious complication. Our case underscores the importance of monitoring for splenic injury following ESWL. Management should be multidisciplinary, considering physiological, anatomical, and immunological aspects. While splenectomy is the standard treatment, NOM can be considered for hemodynamically stable patients to avoid complications following splenectomy. Recent treatment protocols have improved stone breakage and reduced tissue damage, suggesting long-term adverse effects can be minimized or eliminated.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476963","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}

引用次数: 0

Surgical Outcomes of Spiral Vein Wrapping Flaps for Painful Neuromas: A Case Series Analysis. 螺旋静脉包裹皮瓣治疗疼痛性神经瘤的手术效果：病例系列分析。

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American Journal of Case Reports Pub Date : 2024-10-21 DOI: 10.12659/AJCR.945014

Meirizal Meirizal, Karisa Kartika Sukotjo, A Faiz Huwaidi, Agung Susilo Lo

{"title":"Surgical Outcomes of Spiral Vein Wrapping Flaps for Painful Neuromas: A Case Series Analysis.","authors":"Meirizal Meirizal, Karisa Kartika Sukotjo, A Faiz Huwaidi, Agung Susilo Lo","doi":"10.12659/AJCR.945014","DOIUrl":"10.12659/AJCR.945014","url":null,"abstract":"BACKGROUND Neuropathic pain symptoms caused by neuromas impose physical burdens and affect patients mentally and socioeconomically. Surgical intervention offers more promising outcomes than do conservative approaches. An accessible and cost-effective surgical treatments is neuroma excision, coupled with nerve wrapping flaps. However, few reports have detailed the outcomes of this approach. In this study, we report 4 patients who underwent neuroma excision and nerve wrapping with vein autographs. CASE REPORT We present 4 patients who experienced persistent neuropathic pain and did not respond to conservative treatment for more than 6 months. Three patients had upper limb neuromas in continuity and 1 patient had a stump femoral neuroma. Surgical intervention involved neuroma excision, nerve grafting, and the application of nerve wrapping flaps at the site of anastomosis. Evaluation of our patients included neuroma pain scores and the Weber 2-point discrimination test. Follow-up assessments demonstrated significant clinical improvement, with all patients showing up to 60% reduction in pain and an average improvement of 5 mm in 2-point discrimination. No recurrence or need for further surgery was observed. CONCLUSIONS Surgical intervention was superior to conservative treatment in patients with painful neuromas. Nerve wrapping flaps, one of the surgical procedures for neuroma management, represents an effective surgical option for neuromas in continuity and stump neuromas. This is related to the more physiological nerve regeneration process when nerve ends are closed. The use of autograft veins as one of the materials for closing nerve ends is advantageous owing to its affordability and versatility in accommodating nerves of varying sizes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476964","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}

引用次数: 0

Resolved Chronic Non-Healing Ulcer After Distal Radius Giant Cell Tumor Resection: Nursing Experience and Wound Care. 桡骨远端巨细胞瘤切除术后的慢性不愈合溃疡：护理经验与伤口护理。

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American Journal of Case Reports Pub Date : 2024-10-20 DOI: 10.12659/AJCR.944971

Yiming Lin, Huiling Li, Jun Zhao

{"title":"Resolved Chronic Non-Healing Ulcer After Distal Radius Giant Cell Tumor Resection: Nursing Experience and Wound Care.","authors":"Yiming Lin, Huiling Li, Jun Zhao","doi":"10.12659/AJCR.944971","DOIUrl":"10.12659/AJCR.944971","url":null,"abstract":"BACKGROUND Giant cell tumors of bone typically occur in early adulthood, when the growth plate has closed. The distal radius is the second most common location affected, accounting for 10% to 12% of cases. Complications of poor soft tissue healing are rare in the distal radius, owing to its rich blood supply. However, the curettage procedure and use of bone cement and external fixation can affect the local blood supply. CASE REPORT We present a rare case of a 24-year-old woman with no significant medical history who underwent surgery at a local hospital to treat a giant cell tumor of the radius. During postoperative wound dressing changes, a 4×3-cm area of flushed skin color with a small blister and reduced local sensation was found on the dorsal side of the wrist. The skin condition worsened despite treatment at the surgical outpatient clinic, leading to referral to scar specialist outpatient treatment. Examination revealed a well-healed surgical scar on the palmar side of the wrist, but a skin defect with necrotic tissue and tendon exposure on the dorsal side. The diagnosis was postoperative soft tissue necrosis of the skin with a giant cell tumor of the bone. CONCLUSIONS This case report discusses the management of chronic non-healing postoperative wounds in giant cell tumors of the distal radius. It emphasizes the importance of appropriate dressing changes, selecting suitable dressings, nutritional support, and effective nurse-patient communication. The case serves as an example of best practices for managing these types of wounds.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":null,"pages":null},"PeriodicalIF":1.0,"publicationDate":"2024-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11502519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142476961","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}

引用次数: 0