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

Leukemoid Reactions in Pancreatic Cancer: A Case Series. 胰腺癌的类白血病反应：一个病例系列。

IF 0.7

American Journal of Case Reports Pub Date : 2025-07-22 DOI: 10.12659/AJCR.948491

Teng Huang, Tangchun Liu, Siqi Liu, Zhengfei Yang

{"title":"Leukemoid Reactions in Pancreatic Cancer: A Case Series.","authors":"Teng Huang, Tangchun Liu, Siqi Liu, Zhengfei Yang","doi":"10.12659/AJCR.948491","DOIUrl":"10.12659/AJCR.948491","url":null,"abstract":"BACKGROUND This article presents a rare case of pancreatic cancer complicated by a leukemoid reaction, alongside 4 similar cases treated at our hospital between 2016 and 2024. Leukemoid reactions are uncommon paraneoplastic manifestations, and their optimal management remains undefined. Herein, we systematically analyze the clinical characteristics and potential molecular mechanisms involved in the development and progression of tumor-associated leukemoid reactions, and summarize our diagnostic and therapeutic approaches. CASE REPORT We reviewed the records of 5 patients at our hospital who had malignancies complicated by leukemoid reactions. Medical histories, laboratory tests, imaging findings, bone marrow biopsy results, and treatment details were collected and analyzed. We explored the pathogenesis, diagnostic strategies, and treatment modalities for leukemoid reactions. A 52-year-old man with advanced pancreatic adenocarcinoma and a KRAS p.G12D mutation, developed extreme leukocytosis (96.22×10⁹ white blood cells/L) in the context of hepatic metastases. Despite broad-spectrum antimicrobial coverage, cytoreductive therapies, and supportive measures (bilirubin adsorption and plasma exchange, continuous veno-venous hemofiltration), his condition rapidly deteriorated, culminating in multi-organ failure. The 4 additional patients - 1 each with metastatic breast cancer, colon cancer, cholangiocarcinoma, and recurrent pancreatic cancer - exhibited similarly aggressive courses, with only transient stabilization observed in the breast cancer case. CONCLUSIONS Patients with malignancies complicated by leukemoid reaction generally have a poor prognosis. Clinicians should be alert to markedly elevated white blood cell counts, promptly investigate underlying causes, and initiate individualized treatments. Future research should focus on the molecular mechanisms driving the development and progression of leukemoid reactions and therapeutic interventions to enhance patient survival and clinical outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948491"},"PeriodicalIF":0.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683338","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

Diagnosing Disseminated Peritoneal Leiomyomatosis: Malignancy-Like Presentation in a 59-Year-Old Woman. 弥散性腹膜平滑肌瘤病的诊断：一位59岁女性的恶性样表现。

IF 0.7

American Journal of Case Reports Pub Date : 2025-07-21 DOI: 10.12659/AJCR.947246

Changchao Xiao, Haixing Ju, Jun Cao

{"title":"Diagnosing Disseminated Peritoneal Leiomyomatosis: Malignancy-Like Presentation in a 59-Year-Old Woman.","authors":"Changchao Xiao, Haixing Ju, Jun Cao","doi":"10.12659/AJCR.947246","DOIUrl":"10.12659/AJCR.947246","url":null,"abstract":"BACKGROUND Disseminated peritoneal leiomyomatosis (DPL), or leiomyomatosis peritoneal disseminata, is a benign condition that presents with multiple lower abdominal peritoneal nodules consisting of smooth muscle cells, which can slowly increase in size. The risk of malignant transformation is 2% to 5%. The mechanisms underlying the pathogenesis and malignancy of DPL are unclear and can be associated with a variety of factors. This report describes a 59-year-old woman presenting with multiple abdominal masses and a diagnosis of DPL. CASE REPORT This report describes a 59-year-old female patient who experienced abdominal pain and difficulty defecating. Proctoscopy showed intestinal stenosis and inflammatory changes. She may have had renal dysfunction. The medical history showed that the patient had uterine fibroids in the past and had undergone hysterectomy surgery. We cannot confirm whether the patient received hormone therapy before admission. Based on the results of histopathology and immunohistochemistry, it was considered to be a DPL. The patient died 6 months after surgery. CONCLUSIONS DPL is a rare disease that is difficult to diagnose and traditionally considered a benign condition. This report emphasizes the importance of understanding the presentation and distribution of DPL, as it can mimic the deposition of malignant tumors. This case also emphasizes the importance of diagnosing benign tumors through histopathology. The mechanism of malignant transformation of DPL is currently unclear, and it is of great significance to combine multiple detection methods in clinical practice to determine its malignancy.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947246"},"PeriodicalIF":0.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12291607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676015","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 Approach to Littre's Hernia: A Rare Presentation of Meckel's Diverticulum. 利特氏疝的手术入路：一例罕见的梅克尔憩室。

IF 1

American Journal of Case Reports Pub Date : 2025-07-20 DOI: 10.12659/AJCR.947174

João Maria Regueiras Mendes, Dimitrios Chatziisaak, Pascal Burri

{"title":"Surgical Approach to Littre's Hernia: A Rare Presentation of Meckel's Diverticulum.","authors":"João Maria Regueiras Mendes, Dimitrios Chatziisaak, Pascal Burri","doi":"10.12659/AJCR.947174","DOIUrl":"10.12659/AJCR.947174","url":null,"abstract":"BACKGROUND Littre's hernia is a rare entity defined as the herniation of a Meckel's diverticulum through a defect in the abdominal wall. Although Meckel's diverticulum occurs in up to 2% of the population, its manifestation within a hernia is extremely rare, comprising around 1% of Meckel's cases. This report describes the case of a 32-year-old man presenting as an emergency with lower abdominal pain and a diagnosis of Littre's hernia. CASE REPORT A 32-year-old man presented with a 3-day history of lower abdominal pain and periumbilical erythema. Clinical examination revealed an irreducible umbilical hernia. Laboratory tests showed leukocytosis and elevated CRP. A CT scan suggested an incarcerated hernia with signs of ischemia, but no clear identification of Meckel's diverticulum. Diagnostic laparoscopy followed by mini-laparotomy revealed a necrotic Meckel's diverticulum 110 cm proximal to the ileo-cecal valve. A stapled diverticulectomy was performed without mesh repair due to contamination. The wound was managed with a vacuum-assisted closure (VAC) system. The postoperative course was uneventful, and histopathology confirmed necrotizing inflammation without malignancy. CONCLUSIONS Littre's hernia is a rare but important differential diagnosis in abdominal wall hernias and can present symptomatically as an acute abdomen. This case highlights the presentation, diagnosis, and surgical management of an atypical umbilical Littre's hernia and reinforces the value of prompt surgical exploration and intraoperative assessment to avoid ischemic complications.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947174"},"PeriodicalIF":1.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668633","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

Adult Hemophagocytic Lymphohistiocytosis (HLH) with Neurological Involvement: Diagnostic Complexities - A Case Report and Literature Review. 成人嗜血球性淋巴组织细胞增多症（HLH）累及神经系统：诊断的复杂性-一个病例报告和文献回顾。

IF 1

American Journal of Case Reports Pub Date : 2025-07-19 DOI: 10.12659/AJCR.947694

Michał J Sekuła, Anna Jamroz-Wiśniewska, Urszula Chyrchel-Paszkiewicz, Aleksandra Pietruczuk, Aleksandra Dembowska, Maciej Dubaj, Karol Bigosiński, Konrad Rejdak

{"title":"Adult Hemophagocytic Lymphohistiocytosis (HLH) with Neurological Involvement: Diagnostic Complexities - A Case Report and Literature Review.","authors":"Michał J Sekuła, Anna Jamroz-Wiśniewska, Urszula Chyrchel-Paszkiewicz, Aleksandra Pietruczuk, Aleksandra Dembowska, Maciej Dubaj, Karol Bigosiński, Konrad Rejdak","doi":"10.12659/AJCR.947694","DOIUrl":"10.12659/AJCR.947694","url":null,"abstract":"BACKGROUND Hemophagocytic lymphohistiocytosis (HLH) is a potentially fatal disease that is uncommon among adults. It is characterized by proinflammatory overactivity of the immune system. In infants it is usually hereditary, whereas in adults it is secondary to infection, malignancies, or autoimmune diseases. Clinical features include fever, hepatosplenomegaly, pancytopenia, lymphadenopathy, hypertriglyceridemia, hyperferritinemia, hemophagocytosis, and, rarely in adults, CNS involvement. CASE REPORT We report the case of a 54-year-old man, in whom HLH has been diagnosed, manifesting mainly as neurological signs - increasing spastic paraparesis with sphincter disorder. He had a fever of unestablished etiology for about 1 year. On brain and thoracic spinal cord MRI there were multiple disseminated focal lesions suspected of being demyelination. Neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis were excluded. Treatment with dexamethasone, etoposide, cyclosporine A, and intrathecal methotrexate was used. After a temporary significant improvement in his clinical condition, the patient died 18 months after diagnosis. Our literature review found 37 cases of HLH with neurological symptoms. Only 3 of these cases (and only 1 of them similar to our case) involved clinical and imaging features of demyelinating disease, as in the present case. CONCLUSIONS HLH mimicking demyelinating disorders is rarely encountered clinically. In such a situation, making a diagnosis is extremely difficult and the initiation of appropriate treatment may be delayed, which significantly worsens the prognosis for patients. Increased clinical awareness of HLH should be present in the non-specific course of various diseases, including those with neurological symptoms of unclear origin.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947694"},"PeriodicalIF":1.0,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12285541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668632","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

An 88-Year-Old Woman with a 33-Year History of Idiopathic Portal Hypertension Presenting with Hepatocellular Carcinoma Treated with Carbon-Ion Radiotherapy. 一位有33年特发性门静脉高压症病史的88岁女性，以碳离子放射治疗肝细胞癌。

IF 1

American Journal of Case Reports Pub Date : 2025-07-18 DOI: 10.12659/AJCR.947725

Akira Sato, Reiko Kumano, Yasushi Ariizumi, Nobuyuki Matsumoto

{"title":"An 88-Year-Old Woman with a 33-Year History of Idiopathic Portal Hypertension Presenting with Hepatocellular Carcinoma Treated with Carbon-Ion Radiotherapy.","authors":"Akira Sato, Reiko Kumano, Yasushi Ariizumi, Nobuyuki Matsumoto","doi":"10.12659/AJCR.947725","DOIUrl":"10.12659/AJCR.947725","url":null,"abstract":"BACKGROUND Idiopathic portal hypertension (IPH) is a rare disease of unknown etiology that causes hypersplenism, splenomegaly, and portal hypertension. There have been rare reports of hepatocellular carcinoma (HCC) in patients with IPH, but no causal relationship has been confirmed. This report details the case of an 88-year-old Japanese woman who developed HCC after a 30-year history of IPH and was treated with carbon-ion radiotherapy. CASE REPORT An 88-year-old Japanese woman had presented to our hospital 33 years earlier with bleeding from esophageal varices. Liver function test results were normal. Computed tomography (CT) showed marked splenomegaly. She had no known causative factors for liver disease, and IPH was suspected. Endoscopic injection sclerotherapy was performed repeatedly for episodes of bleeding from esophageal varices until 4 years after presentation, when she underwent Hassab's procedure. A liver biopsy showed preserved lobular architecture and moderate fibrous enlargement of the portal area without necro-inflammatory reaction. She had a stroke 18 years later and was started on clopidogrel. Nine years later, CT revealed a 24-mm HCC in S8, and portal vein thrombosis (PVT). Carbon-ion radiotherapy was administered, followed by edoxaban. Three months later, CT showed shrinkage of the HCC and complete resolution of the PVT. Almost 3 years later, CT showed no recurrence of HCC or PVT. CONCLUSIONS We report a rare case of IPH and HCC co-existing in a patient followed up for more than 30 years. Although there is no recognized association between IPH and HCC, this report highlights the importance of continued clinical follow-up of patients with chronic liver disease.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947725"},"PeriodicalIF":1.0,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660691","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

Recognizing Exocrine Pancreatic Insufficiency in Patients with Diabetes: A Case Study. 识别糖尿病患者的外分泌胰腺功能不全：一个案例研究。

IF 1

American Journal of Case Reports Pub Date : 2025-07-17 DOI: 10.12659/AJCR.948283

Victoria Kusztos, Mariya Pogorelova

{"title":"Recognizing Exocrine Pancreatic Insufficiency in Patients with Diabetes: A Case Study.","authors":"Victoria Kusztos, Mariya Pogorelova","doi":"10.12659/AJCR.948283","DOIUrl":"10.12659/AJCR.948283","url":null,"abstract":"BACKGROUND Exocrine pancreatic insufficiency (EPI) is characterized by inadequate delivery of pancreatic digestive enzymes to the small intestine, and can result in steatorrhea, weight loss, and fat-soluble vitamin deficiencies without treatment. We present a case of EPI attributed to longstanding type 2 diabetes mellitus. CASE REPORT A 71-year-old man with type 2 diabetes mellitus and remote history of Roux-en-Y bypass surgery 35 years ago and cholecystectomy 50 years ago presented with an 8-month history of steatorrhea and 41-kg weight loss despite increased caloric intake. Workup was notable for fecal elastase less than 40 µg/g and significant steatorrhea with total fat 277 g over 24 hours. Computed tomography (CT) enterography revealed marked pancreatic atrophy without any sign of pancreatic tumor. He was diagnosed with EPI, and with initiation of pancreatic enzyme replacement therapy (PERT), his diarrhea improved, allowing him to regain weight to his prior baseline and to reduce caloric intake. CONCLUSIONS Although exocrine pancreatic insufficiency affects close to one-third of patients with type 2 diabetes mellitus, it remains under-recognized due to the nonspecific nature of presenting symptoms and their frequent attribution to the effects of diabetes mellitus itself or diabetes medications. EPI can lead to marked malabsorption, reduced quality of life, and increased morbidity and mortality, and therefore should be included in the differential diagnosis for steatorrhea, weight loss, and vitamin deficiencies in patients with diabetes during initial assessment by internal medicine providers. A high index of suspicion and assessment with fecal elastase testing can allow for early recognition and timely initiation of PERT, helping mitigate long-term complications.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948283"},"PeriodicalIF":1.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12282292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650870","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

Endovascular Embolization in Acquired Hemophilia A: A Case Study Highlighting Diagnostic and Therapeutic Strategies. 获得性血友病A的血管内栓塞：一个强调诊断和治疗策略的案例研究。

IF 1

American Journal of Case Reports Pub Date : 2025-07-16 DOI: 10.12659/AJCR.948268

Michail Makris, Stavroula Bountola, Vasileios Patriarcheas, Anastasia Adamou, Panagiota Tsiatsiou, Vasileios Perifanis, Christos Savopoulos, Georgia Kaiafa

{"title":"Endovascular Embolization in Acquired Hemophilia A: A Case Study Highlighting Diagnostic and Therapeutic Strategies.","authors":"Michail Makris, Stavroula Bountola, Vasileios Patriarcheas, Anastasia Adamou, Panagiota Tsiatsiou, Vasileios Perifanis, Christos Savopoulos, Georgia Kaiafa","doi":"10.12659/AJCR.948268","DOIUrl":"10.12659/AJCR.948268","url":null,"abstract":"BACKGROUND Acquired hemophilia A (AHA) is a rare and potentially life-threatening bleeding disorder characterized by the formation of autoantibodies targeting coagulation factor VIII (FVIII). This condition poses considerable diagnostic and therapeutic challenges, requiring a multidisciplinary approach. Despite advancements in treatment, literature on the management of bleeding episodes in patients with hemophilia undergoing endovascular procedures remains limited. It is essential to acknowledge the significance of timely diagnosis and customized intervention for enhancing outcomes. CASE REPORT We report the case of an 82-year-old woman presenting with a large hematoma on the anterior surface of the left thigh due to AHA. The patient was initially treated with immunosuppression combined with administration of recombinant activated FVII, but there was no observed response. The patient's condition worsened, leading to hemodynamic instability. Consequently, CT angiography was performed, which identified extravasation from a branch of the left superficial femoral artery. Following this, the patient underwent successful endovascular embolization of the bleeding vessel, leading to effective hemorrhage control without complications. The whole procedure was performed under hemostasis expert supervision and administration of recombinant activated human FVII. CONCLUSIONS This case highlights that endovascular embolization can be a safe and effective option for controlling bleeding in selected patients, particularly when traditional strategies are insufficient. Its success depends on a multidisciplinary approach and collaboration among various medical specialists under the supervision of hemostasis experts, due to the high periprocedural risks.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948268"},"PeriodicalIF":1.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643680","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

Diffuse Large B-Cell Lymphoma with Cardiac Metastasis: A Case Report. 弥漫性大b细胞淋巴瘤合并心脏转移1例。

IF 1

American Journal of Case Reports Pub Date : 2025-07-15 DOI: 10.12659/AJCR.947386

Shuyue Yin, Dezhuan Da, Shuping Li

{"title":"Diffuse Large B-Cell Lymphoma with Cardiac Metastasis: A Case Report.","authors":"Shuyue Yin, Dezhuan Da, Shuping Li","doi":"10.12659/AJCR.947386","DOIUrl":"10.12659/AJCR.947386","url":null,"abstract":"BACKGROUND Diffuse large B-cell lymphoma (DLBCL) is an aggressive tumor derived from mature B cells and is the most common type of non-Hodgkin's lymphoma (NHL). Cardiac invasion is rare and heart rupture or cardiac arrest can cause increased risk. Patients with DLBCL progress rapidly and are prone to recurrence, although its 5-year survival rate is high. The clinical manifestations of these patients lack specificity and this can delay diagnosis. Herein, we present a rare case of DLBCL with cardiac and multiorgan metastases and discuss the diagnostic and therapeutic challenges. CASE REPORT A 63-year-old woman was admitted to the hospital due to abdominal distension and abdominal pain. A chest computed tomography (CT) scan indicated no abnormal changes in her heart. She was diagnosed with DLBCL with cardiac metastasis and multiple systemic metastases by contrast-enhanced CT and pathology biopsy. She was started on the standard R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone). However, she developed severe bradycardia, necessitating regimen modification to R-CEOD (rituximab, cyclophosphamide, pirarubicin, etoposide). Following 3 cycles of treatment with R-CEOD, the overall efficacy was assessed as partial response (PR). CONCLUSIONS For patients with DLBCL combined with cardiac metastasis, treatment regimens containing anthracyclines are preferred whenever possible. Cardiac function was assessed by echocardiography and electrocardiogram and by assessing the levels of brain natriuretic peptide prior to treatment. During the process of treatment, the toxic effects of chemotherapeutic drugs, notably cardiac adverse reactions, were closely monitored and quickly treated.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947386"},"PeriodicalIF":1.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12275492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638349","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

Innovative Reconstruction of Depressed Abdominal Scars Using Adipofascial Flaps and W-Plasty. 应用脂肪筋膜瓣和w -成形术创新重建腹部凹陷疤痕。

IF 1

American Journal of Case Reports Pub Date : 2025-07-14 DOI: 10.12659/AJCR.948731

Ruoshui Liu, Yimin Liang, Danru Wang, Renpeng Zhou

{"title":"Innovative Reconstruction of Depressed Abdominal Scars Using Adipofascial Flaps and W-Plasty.","authors":"Ruoshui Liu, Yimin Liang, Danru Wang, Renpeng Zhou","doi":"10.12659/AJCR.948731","DOIUrl":"10.12659/AJCR.948731","url":null,"abstract":"BACKGROUND Depressed abdominal scars resulting from childhood surgical interventions, such as appendectomies, often result in aesthetic and functional impairments due to dermal tissue deficiencies and adhesions to the anterior rectus sheath. Traditional methods, including subcision and fat grafting, have limitations in addressing extensive, adherent scars. This report describes a 22-year-old woman with a post-appendectomy depressed scar and outlines an innovative reconstructive approach involving scar tissue release, abdominal wall reinforcement, bilayered adipofascial flaps, and a W-plasty suturing. CASE REPORT A 22-year-old woman presented to our institution with an 8×2 cm depressed abdominal scar resulting from a childhood appendectomy complicated by postoperative infection. Preoperative imaging confirmed adipose deficiency, muscular disruption, and fibrotic adhesions. Under general anesthesia, the scarred epidermis was completely excised, and adhesions were released. The de-epithelialized scar tissue was anchored to the medial and lateral borders of the released anterior rectus sheath using interrupted sutures for reinforcement. Bilayered adipofascial flaps, comprising Scarpa and Camper fascia, were transposed to restore volumetric deficit, followed by W-plasty closure to minimize tension. Postoperative evaluations at 2 weeks and 1 year revealed no evidence of scar contracture, hypertrophy, or depression recurrence. CONCLUSIONS This report demonstrates that bilayered adipofascial flap reconstruction, combined with tension-distributing sutures, provides an effective solution for complex abdominal scars with deep adhesions and tissue deficiency. The technique overcomes key limitations of conventional approaches - including fat resorption and incomplete adhesion release - to achieve durable functional and aesthetic restoration.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948731"},"PeriodicalIF":1.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12273522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627363","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

Adult Acute Appendicitis Complicated by Intestinal Malrotation: A Case Analysis. 成人急性阑尾炎并发肠道旋转不良1例分析。

IF 1

American Journal of Case Reports Pub Date : 2025-07-13 DOI: 10.12659/AJCR.949194

Daniel Krstic, Dimitrios Chatziisaak, Strahinja Konstantinović, Luca Benigno, Christopher Soll, Magdalena Biraima

{"title":"Adult Acute Appendicitis Complicated by Intestinal Malrotation: A Case Analysis.","authors":"Daniel Krstic, Dimitrios Chatziisaak, Strahinja Konstantinović, Luca Benigno, Christopher Soll, Magdalena Biraima","doi":"10.12659/AJCR.949194","DOIUrl":"10.12659/AJCR.949194","url":null,"abstract":"BACKGROUND Intestinal malrotation (IM) is a rare congenital anomaly resulting from incomplete midgut rotation during embryonic development. Typically, it is diagnosed in infancy due to symptoms such as bilious vomiting, failure to thrive, or signs of bowel obstruction. However, in some cases, it remains undetected until adulthood, when it can present either incidentally or with complications, including volvulus, chronic abdominal pain, or acute bowel obstruction. Although its exact incidence in adults is unclear, studies estimate it to be approximately 0.2% to 0.5%, underscoring its rarity in this age group. As such, adult cases of IM pose a diagnostic challenge and are often discovered unexpectedly during imaging or surgery for unrelated conditions. CASE REPORT A 20-year-old woman with no medical history was admitted to our hospital with persistent mid-abdominal pain. Clinical and sonographic findings suggested acute appendicitis; however, intraoperative exploration revealed an unexpected intestinal malrotation of the non-rotation type. The cecum was in the midline, and the colon was entirely positioned in the left hemi-abdomen, which rendered laparoscopic appendectomy technically challenging. The operation was successfully completed without the need for an additional procedure to correct the malrotation. The postoperative course was uneventful, and the patient was discharged on the second postoperative day in good condition. CONCLUSIONS This case highlights the importance of considering congenital anomalies such as IM in cases of atypically located abdominal structures. Awareness of such anatomical variations is crucial for surgeons so they can adapt intraoperative strategies accordingly and ensure optimal patient outcomes.","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949194"},"PeriodicalIF":1.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620758","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