American Journal of Case Reports最新文献

{"title":"Two Cases of Primary Melanoma of the Uterine Cervix.","authors":"Jung Yuan, I-Te Wang, Yun-Ho Lin, J-Timothy Qiu, Wei-Min Liu, Yen-Hsieh Chiu","doi":"10.12659/AJCR.948101","DOIUrl":"10.12659/AJCR.948101","url":null,"abstract":"<p><p>BACKGROUND This study reports on 2 cases of cervical melanoma with similar presentations but at different stages, and the treatment strategy varied accordingly, and we review the literature on the characteristics, diagnosis, and management of cervical melanoma. CASE REPORT Case 1: A 69-year-old woman with abnormal vaginal bleeding was diagnosed with advanced cervical melanoma, staged as International Federation of Gynecology and Obstetrics (FIGO) Stage IVB, involving multiple metastases. Despite chemoradiotherapy and immunotherapy (nivolumab), the disease progressed rapidly, and the patient died 4 months after diagnosis. Case 2: A 75-year-old woman with cervical melanoma, staged as FIGO Stage IIIc, underwent concurrent chemoradiotherapy, surgery, and adjuvant brachytherapy. After initial stability, recurrence occurred 17 months later, followed by metastases. Palliative care was started after treatment intolerance, and the patient died 7 years after the diagnosis. CONCLUSIONS Cervical melanoma is an exceptionally rare and highly aggressive malignancy with a poor prognosis, often characterized by nonspecific symptoms. Diagnosis is based on pathological findings and immunohistochemical markers such as HMB-45, Melan-A, and S-100. The FIGO staging system is used for staging, and radical hysterectomy remains the primary treatment for achieving clear margins. Adjuvant therapies, including chemotherapy, radiation, and immunotherapy, are essential for managing advanced and metastatic cases. However, challenges persist regarding standardized treatment protocols, and further research into emerging therapies is necessary. Increasing awareness and improving diagnostic methods are vital for improving survival and quality of life for patients with this disease.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948101"},"PeriodicalIF":0.7,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12433177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030773","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":"Adolescent Morel-Lavallée Lesions: A Case Report of Challenges in Diagnosis and Management in Atypical Locations.","authors":"Brendon C Chou, Jason M Reiter, Myron M Georgei, Peter C Wei, Mariam W Fahim","doi":"10.12659/AJCR.948545","DOIUrl":"10.12659/AJCR.948545","url":null,"abstract":"<p><p>BACKGROUND Morel-Lavallee lesions (MLLs) are uncommon, closed soft-tissue degloving injuries caused by high-energy trauma that are often missed due to their rarity and delayed presentation, resulting in serious complications. MLLs are particularly missed and underreported in pediatric and adolescent patients. We describe the case of an adolescent MLL occurring in an atypical lesion site at the calf to increase awareness of this diagnosis and associated presentation in this patient group, which can differ from adult presentation and contribute to diagnostic uncertainty that consequently impacts clinical decision-making. CASE REPORT An 18-year-old male presented with pain and worsening swelling in the right lateral calf after sliding into a wall while playing basketball. Magnetic resonance imaging (MRI) demonstrated a fluid collection initially suspected to be a hematoma. Following failed conservative management, a multidisciplinary collaborative approach confirmed a MLL diagnosis and drained the lesion via ultrasound-guided aspiration. While the patient has resumed all normal physical activities, residual swelling and deformity remain under surveillance. CONCLUSIONS Our case highlights the diagnostic and treatment challenges associated with an atypical clinical presentation of a MLL in an adolescent patient with a sports injury to the calf, highlighting the role of imaging and multidisciplinary consultation in timely intervention. Consistent with the limited existing literature on MLLs, early minimally invasive ultrasound-guided aspiration may be beneficial to guide subsequent treatment, but further study and consensus via establishment of standardized pediatric and adolescent management guidelines are necessary to achieve optimal clinical outcomes for this vulnerable patient population.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948545"},"PeriodicalIF":0.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016440","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":"Invasive Gastrointestinal Mucormycosis Presenting as Neutropenic Enterocolitis: A Case Report.","authors":"Hamad J AlBassam, Wael Alanazi, Faisal Al Rashid, Zainab I Alruwaii, Zainab Almusa","doi":"10.12659/AJCR.948878","DOIUrl":"10.12659/AJCR.948878","url":null,"abstract":"<p><p>BACKGROUND Gastrointestinal mucormycosis is an underrecognized and underreported fungal infection with a high mortality rate. Diagnosis is often confounded by a non-specific constellation of signs and symptoms. We present a case of neutropenic colitis and ileocecal perforation secondary to gastrointestinal mucormycosis. CASE REPORT The patient was a 19-year-old man recently diagnosed with B-cell acute lymphoblastic leukemia, on active chemotherapy. He presented with abdominal pain and tenderness, and a contrast-enhanced CT revealed neutropenic colitis. Despite broad-spectrum antibiotics, his condition worsened, prompting reassessment. Follow-up CT showed bowel ischemia and a pelvic collection. He underwent an emergency laparotomy, which revealed destruction of the anterior cecal wall and detachment from the terminal ileum and ascending colon. Ileocecal resection was performed and histopathologic examination demonstrated angioinvasive fungal elements consistent with Mucor spp. He was diagnosed with gastrointestinal mucormycosis and promptly started on amphotericin intravenously. He improved over the next 2 weeks and was discharged with a plan to continue his 6-week course as an outpatient, followed by oral posaconazole maintenance therapy. Several weeks later, his infection relapsed secondary to non-compliance. He underwent repeat surgical debridement and antimicrobial therapy was restarted with intravenous amphotericin and Isavuconazole. He successfully completed 6 weeks of treatment and was transitioned to oral Isavuconazole prophylaxis. He remained stable and relapse-free at 6 months following his second procedure. CONCLUSIONS The case highlights the importance of early recognition of patients at risk for this infection, maintaining a high index of suspicion, and employing aggressive medical and surgical management strategies to avoid mortality.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948878"},"PeriodicalIF":0.7,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12427590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024363","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":"Retrospective Study of Pediatric Sinonasal Tumors in a Tertiary Hospital Setting.","authors":"Dinah A AlNoaimi, Shaykhah AlNaimi, Maria Alabdulaal, Ali Almomen","doi":"10.12659/AJCR.948494","DOIUrl":"10.12659/AJCR.948494","url":null,"abstract":"<p><p>BACKGROUND Pediatric sinonasal tumors are rare, accounting for about 4% of all pediatric head and neck neoplasms. Due to their nonspecific symptoms such as nasal obstruction, epistaxis, and facial pain, these tumors often present diagnostic challenges and lead to delays in managment. Early and accurate diagnosis is crucial to optimize clinical outcomes. CASE REPORT This is a retrospective review of 4 pediatric patients with diagnosis of sinonasal tumors at a tertiary hospital in Saudi Arabia. The series includes 2 benign tumors, osteoma and juvenile nasopharyngeal angiofibroma, and 2 malignant tumors, NK/T-cell lymphoma and rhabdomyosarcoma. Diagnostic workups included nasal endoscopy, CT, MRI, and PET-CT imaging, followed by histopathological confirmation. Benign tumors were successfully treated with image-guided endoscopic excision, with no evidence of recurrence during follow-up periods of 2 and 5 years, respectively, while malignant tumors required a multimodal approach, combining chemotherapy and radiotherapy under multidisciplinary care, and showed stabilization after treatment with continued surveillance. The variety in presentation and complexity of management underscore the diagnostic and therapeutic challenges in this population. CONCLUSIONS This case series highlights the importance of early suspicion, comprehensive imaging, and individualized treatment plans in managing pediatric sinonasal tumors. The use of minimally invasive surgical techniques and preoperative embolization was effective in selected cases. The findings emphasize the role of multidisciplinary collaboration in optimizing outcomes for benign and malignant tumors. Future research should aim to develop standardized diagnostic algorithms and explore advanced diagnostic tools, such as molecular imaging, to facilitate earlier detection and improve treatment precision in pediatric sinonasal oncology.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948494"},"PeriodicalIF":0.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424476/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008488","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":"Combining Plate and Ilizarov Fixation for Tibial Fracture in a 95-Year-Old Woman: A Case Report.","authors":"Shunsuke Sato, Satoshi Hatashita, Michiyuki Hakozaki, Yoichi Kaneuchi, Takuya Kameda, Yoshifumi Kawamae, Masayuki Ito, Yoshihiro Matsumoto","doi":"10.12659/AJCR.949273","DOIUrl":"10.12659/AJCR.949273","url":null,"abstract":"<p><p>BACKGROUND Periprosthetic tibial fractures following total knee arthroplasty (TKA) are increasingly encountered in very elderly patients, where multiple comorbidities and osteoporosis compromise early mobilization and elevate the risk of complications. Maintaining pre-injury activities of daily living (ADL) while ensuring safe surgical management is challenging. We present a case of a 95-year-old woman with a periprosthetic tibial shaft fracture managed with open reduction, additional plate fixation, and Ilizarov external fixation, enabling immediate postoperative weight-bearing. CASE REPORT A 95-year-old woman who sustained a periprosthetic tibial shaft fracture after a fall had been independently ambulatory indoors and used a cane outdoors. On admission, radiographs showed a Felix Type III tibial fracture. Six days after the injury, the fracture was stabilized using Ilizarov external fixator with additional internal fixation using a small locking plate. This combined approach allowed immediate full weight-bearing from the day after surgery. She had no major complications; a minor pin-site infection was managed conservatively. Bone union was confirmed on computed tomography (CT) at 4 months, and the external fixator was removed. At 1 year, radiographs showed good alignment, and she walked independently without a cane. CONCLUSIONS This case demonstrates that combining Ilizarov external fixation with internal plate fixation can enable immediate postoperative weight-bearing and functional recovery, even in very elderly patients with periprosthetic tibial shaft fractures and severe osteoporosis.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949273"},"PeriodicalIF":0.7,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016474","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":"Stereotactic Body Radiation Therapy Facilitating Debulking Surgery in Metastatic VIPoma with Severe Diarrhea and Hypovolemic Shock.","authors":"Ahsan Wahab, Puneet Raman, Matthew Koshy, Yolande Chen","doi":"10.12659/AJCR.949041","DOIUrl":"10.12659/AJCR.949041","url":null,"abstract":"<p><p>BACKGROUND Treatment of metastatic vasoactive intestinal peptide tumors (VIPoma) is challenging and requires a careful multidisciplinary approach to achieve optimal disease control. We present a case of metastatic VIPoma with recurring episodes of life-threatening diarrhea necessitating multiple intensive care unit (ICU) admissions. CASE REPORT A 54-year-old man presented with severe watery diarrhea and metabolic acidosis with MRI showing a necrotic pancreatic body mass, and multiple liver lesions. Histopathologic and biochemical findings were consistent with VIPoma. Due to the multifocal liver lesions, he was deemed unsuitable for curative surgical intervention, shifting focus to other therapies. Initial treatments over 7 months included octreotide, transarterial chemoembolization, yttrium-90 radioembolization, and systemic therapy with everolimus, with decreases in serum vasoactive intestinal peptide (VIP) levels from a peak of 3180 pg/mL to undetectable levels corresponding to temporary relief of diarrhea. However, the temporary relief was followed by a rapid increase in VIP levels into the 200s and 300s and recurrence of 3-11 liters of diarrhea per day. He had multiple ICU admissions due to severe diarrhea/hypovolemic shock until he was treated with stereotactic body radiation therapy (SBRT). SBRT of the pancreatic site immediately yielded long-term hemodynamic stability, prevented further ICU admissions, and enabled the patient to receive debulking surgery. CONCLUSIONS Although radiation is not typically a primary treatment modality for VIPoma, in this case, the high dose per fraction delivered with stereotactic technique to a pancreatic mass played a crucial role in alleviating his catastrophic volume loss through intravenous octreotide-refractory diarrhea, making the patient a suitable candidate for debulking surgery. This case highlights the importance of considering all available treatment options, even those not traditionally employed, when managing complex cases with refractory symptoms.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e949041"},"PeriodicalIF":0.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145008454","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":"Salvage Masquelet Technique for Insufficient Bone Regeneration Following Chipping and Lengthening in Tibial Nonunion: A Case Report.","authors":"Jun Takagaki, Yohei Kumabe, Tomoaki Fukui, Ryosuke Kuroda, Keisuke Oe","doi":"10.12659/AJCR.948871","DOIUrl":"10.12659/AJCR.948871","url":null,"abstract":"<p><p>BACKGROUND The treatment of nonunion with deformity and shortening remains a significant challenge in orthopedic surgery. The chipping and lengthening technique is used for bone reconstruction and new bone formation, without the need for bone grafting. However, inadequate bone regeneration can require additional treatment. The Masquelet technique, a 2-stage procedure involving an induced membrane, has been reported to be effective in managing large bone defects and nonunion cases. CASE REPORT We present a case of a 21-year-old man with tibial nonunion associated with deformity and shortening. The patient underwent the chipping and lengthening technique using an external fixator, followed by conversion to internal fixation. However, bone regeneration at the distraction site was insufficient, necessitating salvage surgery using the Masquelet technique. The first-stage procedure involved debridement of the immature regenerate and placement of a cement spacer to induce membrane formation. In the second stage, the cement spacer was removed and replaced with an autologous bone graft. As a result, successful bone union was achieved, enabling the patient to regain full weight-bearing ability without complications. CONCLUSIONS This case highlights the effectiveness of the Masquelet technique as a salvage procedure for inadequate bone regeneration following the chipping and lengthening technique. The combination of these techniques is a viable treatment approach for nonunion cases with deformity and shortening.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948871"},"PeriodicalIF":0.7,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006687","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":"Postoperative Residual Pleural Space: A Risk Factor for Chest Wall Hernia After Thoracoscopic Surgery.","authors":"Arpad Hasenauer, Anna Dambrosio, Sebastian Happ, Michel Christodoulou","doi":"10.12659/AJCR.947322","DOIUrl":"10.12659/AJCR.947322","url":null,"abstract":"<p><p>BACKGROUND Chest wall hernia and residual pleural space are known complications after thoracoscopic anatomical lung resection. Some risk factors for chest wall hernia have been described; however, residual pleural space has never been described as one of them. We present 2 cases suggesting that postoperative residual air space can represent a newly identified risk factor for chest wall hernia. CASE REPORT Case 1: A 71-year-old man developed a postoperative chest wall hernia at the fourth intercostal incision level 1 week after a 3-port thoracoscopic left lower lobectomy for early-stage non-small cell lung carcinoma. He was not known to have any described risk factors for postoperative chest wall hernia, but his postoperative course was complicated by a residual pleural space. Case 2: A 60-year-old man developed a postoperative chest wall hernia at the fourth intercostal incision level, diagnosed 5 months after a right apical upper lobe segmentectomy by 3-port thoracoscopy for early-stage non-small cell lung carcinoma. She was not known to have any risk factors for postoperative chest wall hernia; however, her postoperative course was also complicated by a residual pleural space. CONCLUSIONS We suggest that air flow through the thoracoscopic incision, due to residual pleural air, could impede wound healing and favor chest wall hernia. Adaptation of the closure technique for video-assisted thoracic surgery incisions in patients at risk may help prevent postoperative chest wall hernias. These cases highlight the possibility that residual pleural space could be a newly identified risk factor for postoperative chest wall hernia and propose potential preventive measures.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947322"},"PeriodicalIF":0.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006703","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":"Management of Unilateral Hearing Loss in a 14-Year-Old with Internal Auditory Canal Duplication Using a Bonebridge Bone Conduction Implant.","authors":"Anna K Piecuch, Katarzyna B Cywka, Piotr H Skarżyński, Henryk Skarżyński","doi":"10.12659/AJCR.947791","DOIUrl":"10.12659/AJCR.947791","url":null,"abstract":"<p><p>BACKGROUND Duplicated internal auditory canal (dIAC) is a rare congenital temporal bone anomaly associated with ipsilateral sensorineural hearing loss (SNHL). The Bonebridge bone conduction implant has a magnet, an internal transducer, and an external audio processor. This report is of a 14-year-old girl with unilateral SNHL and vestibulocochlear nerve (VIII cranial nerve) aplasia due to dIAC who was treated with a Bonebridge bone conduction implant. CASE REPORT A 14-year-old girl was diagnosed with unilateral hearing loss during a school health check. Her hearing screening at birth was normal. Pure-tone audiometry revealed unilateral deafness in the right ear. CT scan showed a separate canal for the facial and vestibulocochlear nerves. MRI suggested unilateral aplasia of the right nerve VIII. The patient was implanted with a Bonebridge 602 implant in the right ear as a CROS (contralateral routing of signal). During implant activation in the Matrix test with the Bonebridge implant (in SSD configuration), the patient achieved SRT=-10.3 dB SNR. The results of the APHAB questionnaire indicated improvements in hearing. CONCLUSIONS Duplication of the internal auditory canal is pathognomonic for severe cochlear nerve hypoplasia or aplasia. It is important to perform an imaging study before deciding on implantation, as a hearing screening test at birth may not detect congenital hearing loss (embryogenesis of the inner ear and the internal auditory canal occurs independently). In the case of a unilateral anomaly with no hearing impairment on the opposite side, bone conduction implantation should be considered as a CROS.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e947791"},"PeriodicalIF":0.7,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001507","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":"Innovative Use of Atrial Septal Defect Occluders for Gastric Leak Management After Sleeve Gastrectomy: A Case Report.","authors":"Saud Alsairy, Nawaf N Almutairi","doi":"10.12659/AJCR.948515","DOIUrl":"10.12659/AJCR.948515","url":null,"abstract":"<p><p>BACKGROUND Atrial septal defect (ASD) occluder devices present a novel approach for managing persistent gastric leaks following sleeve gastrectomy. While sleeve gastrectomy is effective, postoperative leak rates reach up to 3% in primary surgeries and exceed 10% in revisions, with management remaining complex and non-standardized. CASE REPORT This case report describes a 20-year-old Saudi woman who developed a gastric leak after laparoscopic sleeve gastrectomy. After a failed initial treatment with a self-expandable mega stent that migrated, she presented with severe symptoms and a significant sub-capsular splenic collection. Despite ultrasound-guided drainage and endoscopic interventions, leakage persisted. An ASD occluder device was deployed using endoscopic and fluoroscopic guidance following failed repairs. While post-application imaging initially showed no leaks and the patient's condition improved, she later experienced recurrent symptoms with persistent leakage. The case was ultimately resolved through a Roux-en-Y gastric bypass. CONCLUSIONS This case highlights the potential of ASD occluders in treating complex gastric leaks, particularly for patients reluctant to undergo repeated surgeries. The device's flexibility for repositioning and retrieval, combined with endoscopic compatibility, makes it a valuable tool for managing postoperative bariatric complications. While initial results are promising, further research is needed to validate this approach's efficacy and safety. Future studies should focus on larger cohorts to establish guidelines for ASD device use in gastrointestinal applications.</p>","PeriodicalId":39064,"journal":{"name":"American Journal of Case Reports","volume":"26 ","pages":"e948515"},"PeriodicalIF":0.7,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001518","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}