American Journal of Case Reports最新文献

{"title":"When Neurological Symptoms Hide a Life-Threatening Hemorrhage: A Case Report of Diagnostic Challenges and Management of Hemorrhagic Shock From an Aberrant Radial Artery.","authors":"Arnaud Robert, Thibaud T'kind, Sammy Tawk, Patrick M Honoré, Pierre Bulpa","doi":"10.12659/AJCR.948021","DOIUrl":"10.12659/AJCR.948021","url":null,"abstract":"<p><p>BACKGROUND Anatomical variations of the radial artery are present in 10-20% of individuals. Such variations can impact management and clinical outcomes in vascular interventions, trauma, or surgeries. These abnormalities can pose diagnostic and therapeutic challenges, especially in cases of vascular trauma requiring prompt intervention. CASE REPORT We present the case of a 66-year-old woman with a history of bilateral lung transplantation, atrial fibrillation on anticoagulation, and prior breast cancer, who developed hemorrhagic shock following a fall. Initially presenting with neurological symptoms, her condition rapidly worsened, leading to unresponsiveness and coma. Initial imaging excluded intracranial pathology, but repeated imaging then revealed a large right chest wall hematoma with active bleeding from an aberrant radial artery originating from the axillary artery. The patient was managed with aggressive fluid resuscitation, blood transfusion, anticoagulation reversal, and ultimately interventional radiology. Radio-embolization allowed successful embolization of the bleeding vessel with preservation of hand perfusion. Further questioning revealed that the bleeding was caused by nursing management and by her complex medical history of steroid intake, lymph node dissection, and radiotherapy. CONCLUSIONS To the best of our knowledge this is the first description of hemorrhagic shock due to an aberrant radial artery originating from the axillary artery. The case underscores the diagnostic complexity of hemorrhagic shock in patients with abnormal vascular anatomy and significant comorbidities. It highlights the critical role of interventional radiology in managing such cases and the importance of multidisciplinary collaboration to ensure timely diagnosis, effective treatment, and prevention of ischemic complications. We discuss the current literature and management of complex upper-limb vascular trauma.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948021"},"PeriodicalIF":0.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092618","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":"Gestational Gigantomastia in Multiparity: Successful Management with Bilateral Reduction and Free Nipple Grafts.","authors":"Ebtesam Almajed, Rana Alkhelaif, Saud Alrasheedi, Mishal D Alshammari","doi":"10.12659/AJCR.948337","DOIUrl":"10.12659/AJCR.948337","url":null,"abstract":"<p><p>BACKGROUND Gestational gigantomastia is a rare but benign diffuse enlargement of one or both breasts during pregnancy. This report describes the case of a 36-year-old woman with a history of previous pregnancies who presented with back pain associated with bilateral massive breast enlargement that was managed with breast reduction surgery. CASE REPORT A 36-year-old woman, gravida 4 para 3+1, presented 6 months postpartum with significant bilateral breast enlargement, shoulder numbness, and back pain. She was not breastfeeding, and her symptoms began in the second trimester of her fourth pregnancy. There was no evidence of overlying skin changes. Breast length from the sternal notch to the nipple was measured on the right breast at 50 cm and the left at 52 cm. A multidisciplinary team was involved, and the patient underwent bilateral breast reduction with free nipple grafts. A total of 5.150 kg of right breast tissue was excised, measuring 38.0×32.0×8.0 cm. Similarly, 5.530 kg of left breast tissue was excised, measuring 36.0×30.0×9.0 cm, for a total of 10.68 kg of breast tissue. Histopathological investigation confirmed benign breast tissue with fibrocystic changes, with no signs of malignancy. Her postoperative recovery was uneventful, with complete resolution of musculoskeletal symptoms and satisfactory aesthetic outcomes. CONCLUSIONS Gestational gigantomastia requires a multidisciplinary approach. This case highlights its potential to occur in later pregnancies, even without prior history, and demonstrates that bilateral breast reduction with free nipple grafts can offer effective symptom relief and favorable cosmetic outcomes. Preoperative counseling and individualized treatment planning are essential to optimize patient outcomes.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948337"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087590","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":"Alveolar Bone Augmentation Using Octacalcium Phosphate and Collagen Composite with Custom-Made Titanium Mesh: A Case Report.","authors":"Tadashi Kawai, Atsushi Ogawa, Yunosuke Ikeda, Akihiro Fukutoku, Noriaki Takahashi, Kazuhiro Kon, Mitsuru Izumisawa, Hiroyuki Yamada","doi":"10.12659/AJCR.948537","DOIUrl":"10.12659/AJCR.948537","url":null,"abstract":"<p><p>BACKGROUND Extensive bone augmentation using artificial bone substitutes is difficult because of their inferior bone regeneration ability compared with that of autologous bone. However, octacalcium phosphate (OCP) and OCP collagen composite (OCP/Col) are better bone substitutes than other materials. Herein, we report a case of extensive alveolar-bone augmentation using OCP/Col and a titanium mesh for restoration of the occlusion and aesthetics using dental implants. CASE REPORT An 18-year-old man with maxillary anterior alveolar-bone deficiency due to a traffic accident was referred to our hospital for dental implant treatment. The bilateral maxillary central incisors were missing, and the labial alveolar-bone volume was insufficient. Radiographic examination and preoperative simulations revealed that the alveolar bone was insufficient for dental implant placement. Bone augmentation was performed using OCP/Col and a custom-made titanium mesh according to the ideal shape determined through simulation. The periosteum was incised to expand the mucosa, and the wound was then sutured. The patient was required to eat soft foods for several days, and movement around the upper lip was restricted using taping. Six months after bone augmentation, reconstruction of the ideal alveolar morphology was confirmed, and dental implants were placed. After the final prosthesis was inserted, the occlusion and esthetics were restored, and the patient's quality of life significantly improved. CONCLUSIONS In this patient, an extensive alveolar-bone defect was reconstructed with an ideal alveolar shape using OCP/Col and a titanium mesh. This case report presents the first clinical application of OCP/Col combined with a custom titanium mesh for repairing large alveolar bone defects in the maxillary anterior teeth.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948537"},"PeriodicalIF":0.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12456092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081993","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":"Constipation as an Atypical Presentation of Hyperparathyroidism: A Case Report.","authors":"Ioannis Xefteris, Argyrios Periferakis, Loredana Goran","doi":"10.12659/AJCR.949359","DOIUrl":"10.12659/AJCR.949359","url":null,"abstract":"<p><p>BACKGROUND Hyperparathyroidism is a relatively rare endocrine disorder, albeit with increasing prevalence in the last years. While oftentimes clinically silent, it can lead to severe hypercalcemia, which is life-threatening and a medical emergency. Therefore, prompt diagnosis and treatment are essential, even in cases presenting with atypical symptoms. CASE REPORT We present a case of a patient with hyperparathyroidism presenting in the Emergency Department with only gastrointestinal symptoms. A 77-year-old woman presented with progressively more severe constipation and involuntary weight loss in the past 3 months. A computed tomography scan revealed calcified and non-calcified plaques in the lumen of the celiac trunk and superior mesenteric artery, along with diffusely distributed microcalcifications of the liver parenchyma. Colonoscopy could not be performed, due to increased and intractable fecal loading. After a laboratory examination revealed normochromic normocytic anemia and elevated ferritin and creatinine, further tests were ordered, and severe hypercalcemia, with serum calcium levels over 15 mg/dL, and parathormone levels over 1000 pg/mL were detected. Therefore, the diagnosis of primary hyperparathyroidism was established, attributed to a parathyroid gland adenoma visualized on computed tomography. The patient was subsequently referred to the Endocrinology Department. CONCLUSIONS With clinical awareness, patients presenting with unexplained gastrointestinal symptoms can be screened for and receive a diagnosis of hyperparathyroidism, by a prompt laboratory checkup of calcium and parathormone levels.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949359"},"PeriodicalIF":0.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076193","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":"Rare Posterior Dislocation of Mobi-C Cervical Disc: A Case Report and Surgical Resolution.","authors":"Marcin Łapiński, Jurij Kseniuk, Krzysztof Modzelewski, Monika Wyszyńska, Olga Adamska, Atanas Atanasov, Artur Stolarczyk","doi":"10.12659/AJCR.947721","DOIUrl":"10.12659/AJCR.947721","url":null,"abstract":"<p><p>BACKGROUND Cervical disc prosthesis (CDP) is a well-established treatment for cervical degenerative disc disease. It provides motion preservation and decreases adjacent segment degeneration associated with ACDF. It is highly effective, with a low failure rate, but rare complications, including prosthesis migration, can occur. The posterior migration of a CDP is extremely rare, and only a few cases have been described in the literature. This report describes a unique case of posterior intraprosthetic dislocation of a Mobi-C prosthesis and adds valuable knowledge about this rare complication. CASE REPORT A 50-year-old female non-smoker underwent C6-C7 discectomy with implantation of the Mobi-C prosthesis for cervical disc herniation causing radicular pain and paresthesia. The initial postoperative results were good, with remission of neurological symptoms and no complications. However, after 2.5 years, she presented with neck pain and numbness of the right upper limb after routine physical activity. Imaging studies, including computed tomography (CT), revealed a posterior migration of the polyethylene insert with compression of the spinal cord. Revision surgery was undertaken comprising removal of the dislocated prosthesis and conversion to ACDF using the Anchor C system. Complete symptom resolution was achieved, and implants were properly aligned without complication in this procedure. CONCLUSIONS Posterior intraprosthetic dislocation of the Mobi-C prosthesis is an extremely rare complication. This case report with long-term follow-up shows ACDF is an effective method of salvage. Further investigation is necessary for understanding failure mechanisms, and development of CDP design is needed to avoid such complications.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947721"},"PeriodicalIF":0.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12452201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081965","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 Aortic Valve Replacement After Transcatheter Aortic Valve Implantation (TAVI) Following Initial Surgical Aortic Valve Replacement (SAVR): A Case Report.","authors":"Majed Tolah, Osama A Abdulrahman, Ahmed Mohamed Shaban, Amna M Qawalh, Hasan I Sandogji","doi":"10.12659/AJCR.949438","DOIUrl":"10.12659/AJCR.949438","url":null,"abstract":"<p><p>BACKGROUND The management of degenerated bioprosthetic aortic valves poses a significant clinical challenge, particularly in younger patients with a history of rheumatic heart disease. While transcatheter aortic valve replacement (TAVR) has emerged as a less invasive alternative to redo surgical aortic valve replacement (SAVR), its long-term durability and the potential need for subsequent interventions remain areas of concern. This report describes a unique case of a young patient who underwent SAVR after TAVR, following an initial SAVR, highlighting the complexities and therapeutic considerations in managing such cases. CASE REPORT A 39-year-old woman with a history of rheumatic heart disease and severe aortic stenosis underwent bioprosthetic aortic valve replacement in 2014. She subsequently required TAVR in 2023 due to valve degeneration. Despite TAVR, she developed recurrent severe aortic stenosis, necessitating a redo SAVR with a mechanical valve in 2024. This report outlines the patient's clinical course, diagnostic findings, and surgical management. CONCLUSIONS This case underscores the importance of careful patient selection and long-term follow-up in individuals undergoing aortic valve interventions. It highlights the potential need for subsequent surgical intervention even after TAVR, particularly in younger patients. The successful redo SAVR following TAVR demonstrates the feasibility of this approach in carefully selected cases, despite increased surgical complexity.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949438"},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076238","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":"Nasopharyngeal Giant Carcinoma Mimicking Intracranial Lesions: A Case Report and Literature Review.","authors":"Ying Zilan, Zhimin Ye","doi":"10.12659/AJCR.947790","DOIUrl":"10.12659/AJCR.947790","url":null,"abstract":"<p><p>BACKGROUND Nasopharyngeal carcinoma can directly invade the intracranial cavity through skull base foramina in advanced-stage patients. Due to both the multiple cranial nerve injuries associated with nasopharyngeal base invasion and the proximity of the pituitary gland, it is challenging to differentiate this condition from intracranial space-occupying lesions, such as meningiomas and pituitary adenomas, in the early stages. This report describes a 37-year-old woman with bilateral nasal congestion, diplopia, hearing loss, and headache diagnosed with a large nasopharyngeal carcinoma invading the cerebellum, pons, medulla oblongata, and cervical spinal cord. CASE REPORT A 37-year-old woman with nasopharyngeal carcinoma (NPC) exhibiting extensive intracranial invasion - involving the mesencephalon, cerebellum, pons, medulla oblongata, and cervical spinal cord - was, with difficulty, diagnosed as having intracranial space-occupying lesions (meningiomas/pituitary tumors) by some renowned neurosurgical centers. She came to our hospital using a wheelchair, exhibiting vague pronunciation, decreased bilateral hearing, headache, facial numbness, diplopia, and coughing when drinking water. Following definitive diagnosis through nasopharyngeal biopsy confirming non-keratinizing carcinoma, we quickly proceeded with treatment. After receiving 6 cycles of chemotherapy with anti-PD-1 immunotherapy, followed by tomotherapy with concurrent nivolumab, the lesion was dynamically reduced, and efficacy was assessed as a complete response (CR). Therapy significantly improved her symptoms, with the holocranial headache resolving, intelligible speech restored, and facial sensation recovered. CONCLUSIONS This case highlights the importance of routinely integrating nasopharyngeal MRI and biopsy when evaluating patients with atypical cranial neuropathies. Furthermore, multidisciplinary team (MDT) collaboration is essential to avoid delayed diagnosis in NPC cases with extensive skull base invasion.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947790"},"PeriodicalIF":0.7,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070726","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":"Extracorporeal Blood Purification with CytoSorb® Hemoadsorption in Valve Surgery for Infective Endocarditis: A Case Series.","authors":"Živojin S Jonjev, Anđela Božić, Ilija Bjeljac, Jan Hrubik, Novica Kalinić","doi":"10.12659/AJCR.948318","DOIUrl":"10.12659/AJCR.948318","url":null,"abstract":"<p><p>BACKGROUND Infective endocarditis (IE) is a life-threatening condition characterized by endocardial infection, systemic inflammation, and potential multi-organ dysfunction. Despite advances in surgical techniques and antimicrobial therapy, outcomes remain suboptimal in high-risk patients. Hemoadsorption using the CytoSorb® device has emerged as a potential adjunctive therapy to mitigate systemic inflammation during cardiopulmonary bypass (CPB) surgery, but its clinical benefit in IE remains under evaluation. CASE REPORT We describe a series of 4 adult patients with confirmed bacterial IE involving the aortic or tricuspid valve, all requiring urgent cardiac surgery. Each patient exhibited clinical signs of sepsis, persistent fever, elevated inflammatory markers, and vegetation on echocardiography. Intraoperatively, CytoSorb hemoadsorption was integrated into the CPB circuit. In all cases, a significant reduction in inflammatory markers (C-reactive protein, procalcitonin), lactate, and vasopressor requirements was observed within 24 hours postoperatively. Mechanical ventilation duration was below institutional averages. No patients required re-operation, mechanical circulatory support, or postoperative hemoadsorption. All were discharged between postoperative days 7 and 17, and follow-up at 6 months revealed no complications or relapses. CONCLUSIONS This case series suggests that intraoperative hemoadsorption using CytoSorb may be a beneficial adjunct in the surgical management of severe IE, particularly in patients with high inflammatory burden. Improvements in hemodynamic stability, inflammatory response, and postoperative recovery were consistently observed. These findings support the need for randomized controlled trials to evaluate patient selection criteria and confirm therapeutic efficacy.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948318"},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070717","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":"Vertebral Artery Dissection Induced by Fitness Video Game Exercise: A Case Report.","authors":"Hiroyuki Tokue, Azusa Tokue, Yoshito Tsushima","doi":"10.12659/AJCR.950188","DOIUrl":"10.12659/AJCR.950188","url":null,"abstract":"<p><p>BACKGROUND Vertebral artery dissection (VAD) is an important cause of ischemic stroke in young adults and is often associated with mechanical stressors such as trauma, sudden neck movements, or intense physical activity. While video games are not traditionally recognized as a risk factor, the increasing popularity of interactive fitness games calls for attention to their potential health implications. CASE REPORT We present the case of a 25-year-old sedentary woman with no vascular risk factors who developed acute left-sided neck pain while performing repetitive overhead pushing and pulling movements using a resistance-based controller during gameplay with Ring Fit Adventure (Nintendo Co., Ltd.), a home fitness video game. Two days later, she experienced sudden-onset left-sided numbness and visual disturbance. Neurological examination revealed left homonymous hemianopia and hemisensory deficits. Brain MRI revealed an acute infarct in the right occipital lobe, and magnetic resonance angiography showed right posterior cerebral artery occlusion and dissection of the left vertebral artery with intramural thrombus. She underwent successful endovascular thrombectomy and intra-arterial thrombolysis, followed by dual antiplatelet therapy. Her symptoms improved markedly, and she was discharged with only mild visual field defect. Imaging at follow-up demonstrated vascular remodeling. No underlying vasculopathy or prothrombotic condition was identified. CONCLUSIONS This case highlights that even a seemingly benign fitness video game may exert sufficient mechanical stress to trigger VAD, particularly in untrained individuals. While the temporal association suggests a potential link, causality cannot be definitively established. As home fitness gaming becomes increasingly popular, it is important for both clinicians and the general public to be aware of rare but serious vascular complications that may arise from sudden, strenuous activity in previously sedentary individuals.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e950188"},"PeriodicalIF":0.7,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065556","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":"Right Hepatic Lobe Hypoplasia and Gangrenous Cholecystitis: Surgical Implications and Case Report.","authors":"Mohamad Ayham Muqresh, Sandrella I Zebian, Abdulkarim M Alkadrou, Osama Al-Shoaib, Thamer Bin Traiki","doi":"10.12659/AJCR.948437","DOIUrl":"10.12659/AJCR.948437","url":null,"abstract":"<p><p>BACKGROUND Hypoplasia of the right hepatic lobe is a rare congenital anomaly often discovered incidentally during imaging or surgery. This anomaly can be challenging during surgery, leading to intraoperative complications. Patient with right hepatic hypoplasia usually live normally without symptoms, but it can be associated with liver cirrhosis, portal hypertension, and gallstones. While the exact pathophysiological relationship between congenital hepatic hypoplasia and cholecystitis remains unclear, a few contributing factors have been proposed. These include mutations in the hepatocyte nuclear factor 1B (HNF1B) transcription, impaired gallbladder function, and gallbladder ischemia due to malposition. CASE REPORT A 70-year-old man presented with gangrenous cholecystitis and concurrent hypoplasia of the right hepatic lobe; a combination not previously documented. The patient, initially asymptomatic, presented with sharp epigastric pain and was diagnosed with acute cholecystitis through abdominal ultrasound. However, computed tomography (CT) imaging showed severe hypoplasia of the right liver lobe with associated compensatory hypertrophy of the left lobe in addition to stones in the gallbladder. Despite normal laboratory results, we think that the anomaly delayed the diagnosis until the development of cholecystitis as a complication. The patient underwent a successful laparoscopic cholecystectomy without converting to open surgery. CONCLUSIONS This case underscores the importance of recognizing anatomical variations when planning surgery. Awareness of right hepatic lobe hypoplasia can aid in timely diagnosis and appropriate management, ultimately reducing surgical risks and complications. Furthermore, we recommend performing CT in case of vague or atypical symptoms of acute cholecystitis, as well as when the gallbladder shows malposition on abdominal ultrasound (US). However, we recommend identifying the anatomical structure during the surgery to avoid complications.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948437"},"PeriodicalIF":0.7,"publicationDate":"2025-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12445154/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065239","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}