International Journal of Surgery Case Reports最新文献

{"title":"Strangulated right obturator hernia in an elderly patient: A case report","authors":"Jasser Yaakoubi,&nbsp;Aziz Atallah,&nbsp;Mohamed Guelbi,&nbsp;Mohamed Mehdi Kamoun,&nbsp;Hafedh Mestiri,&nbsp;Sahir Omrani","doi":"10.1016/j.ijscr.2025.111398","DOIUrl":"10.1016/j.ijscr.2025.111398","url":null,"abstract":"<div><h3>Introduction</h3><div>An obturator hernia is a rare condition representing less than 1 % of abdominal hernias and responsible for 0.05 to 1.4 % of cases of mechanical obstruction of the small intestine [<span><span>1</span></span>] typically affecting elderly, emaciated, multiparous women. Strangulation is a frequent complication and is generally the main clinical presentation. The positive diagnosis is often difficult because of the low specificity, hence the importance of sectional imaging. Surgical management must be initiated urgently to reduce the rate of morbidity and mortality.</div></div><div><h3>Presentation of case</h3><div>A 79-year-old woman with a history of achalasia and esophageal squamous cell carcinoma undergoing radiotherapy presented with a five-day history of acute abdominal pain, vomiting, and abdominal distension. Clinical examination revealed diffuse tenderness with no palpable hernial orifices. Laboratory tests indicated an inflammatory response, and an abdominal CT scan demonstrated bowel distension with an ileal loop incarcerated in the right obturator foramen. Following brief resuscitation, she underwent midline laparotomy. Intraoperative findings confirmed a strangulated ileal loop with preserved vitality, along with an incidental left obturator hernia. Both obturator foramina were repaired using sutures and reinforcement with adjacent tissue.</div></div><div><h3>Discussion</h3><div>The non-specific nature of symptoms often delays diagnosis, making CT imaging the gold standard for early detection. Prompt surgical intervention is vital to reduce the high morbidity and mortality associated with obturator hernias.</div></div><div><h3>Conclusion</h3><div>Although rare, obturator hernias require high clinical suspicion in high-risk populations. Early diagnosis through CT imaging and immediate surgical management are essential for improving patient outcomes and reducing complications.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111398"},"PeriodicalIF":0.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gastric bronchogenic cyst mimicking adrenal Phaeochromocytoma: a case report","authors":"Fan-Fan Li ,&nbsp;Xiao-Ping Li ,&nbsp;Yong-Shun Li ,&nbsp;Xiao-Ping Wang ,&nbsp;Xiao-Chun Yang","doi":"10.1016/j.ijscr.2025.111397","DOIUrl":"10.1016/j.ijscr.2025.111397","url":null,"abstract":"<div><h3>Background</h3><div>Bronchogenic cysts (BCs) are rare foregut-derived cystic malformations that can develop within the respiratory tract. While they are commonly found in the mediastinum or lungs, their occurrence at ectopic sites, such as the stomach, is extremely rare. This case report highlights the challenges in diagnosing a gastric bronchogenic cyst and the potential for misdiagnosis a pheochromocytoma, especially when associated with hypertension.</div></div><div><h3>Case presentation</h3><div>A 47-year-old male presented with a 6-day history of headache and nausea, and was found to have elevated blood pressure. Imaging studies, including computed tomography (CT) scans, suggested the possibility of a pheochromocytoma located near the left adrenal gland. However, subsequent surgical exploration revealed a cystic lesion near the posterior gastric wall, contiguous with the posterior gastric fundus. Pathological examination confirmed the diagnosis of a bronchogenic cyst in the gastric fundus.</div></div><div><h3>Discussion</h3><div>Bronchogenic cysts are congenital malformations that can present diagnostic challenges, especially when located in atypical sites like the stomach or when associated with hypertension, potentially mimicking pheochromocytoma. Accurate diagnosis relies on imaging, laboratory tests for metanephrines, and careful clinical assessment to differentiate from other tumors.</div></div><div><h3>Conclusions</h3><div>Correct differentiation between gastric bronchogenic cysts and pheochromocytoma is crucial, emphasizing the need for thorough diagnostic workup and considerate surgical approach.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111397"},"PeriodicalIF":0.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid rotational atherectomy and shockwave-assisted complex left main PCI with mechanical support in a high-bleeding risk patient, a rare case report","authors":"Rima Chaddad ,&nbsp;Jamil Nasrallah ,&nbsp;Waseem Sajjad ,&nbsp;Eran Sim Wen Jun ,&nbsp;Bharat Khialani","doi":"10.1016/j.ijscr.2025.111386","DOIUrl":"10.1016/j.ijscr.2025.111386","url":null,"abstract":"<div><h3>Introduction</h3><div>High-risk percutaneous coronary intervention (PCI) with mechanical circulatory support has emerged as an alternative to coronary artery bypass grafting (CABG) for patients with complex left main coronary artery disease who are at high surgical risk.</div></div><div><h3>Case presentation</h3><div>A 69-year-old woman with diabetes mellitus, hypertension, hyperlipidemia, and a prior stroke presented with non-ST-segment elevation myocardial infarction. Echocardiography revealed a left ventricular ejection fraction of 25 %. Coronary angiography showed heavily calcified distal left main disease with critical ostial stenosis of the left anterior descending (LAD) and left circumflex (LCX) arteries. Deemed unsuitable for CABG, she underwent high-risk PCI with Impella mechanical support. Rotational atherectomy and intravascular lithotripsy were employed to address extensive calcification. A drug-coated balloon angioplasty was performed from the left main to the LCX, and a drug-eluting stent was placed from the left main into the mid-LAD. Post-dilation ensured optimal stent apposition and vessel patency.</div></div><div><h3>Discussion</h3><div>Mechanical circulatory support provided essential hemodynamic stability during the complex PCI procedure. Advanced lesion modification techniques, including rotational atherectomy and intravascular lithotripsy, were crucial for treating the heavily calcified lesions, facilitating optimal stent deployment, and minimizing procedural risks.</div></div><div><h3>Conclusion</h3><div>The hybrid PCI approach combining mechanical support and advanced interventional techniques was effective in managing complex coronary artery disease in a high-risk patient contraindicated for CABG. This strategy offers a viable alternative for patients with significant anatomical and clinical challenges, emphasizing the importance of tailored therapeutic interventions in contemporary interventional cardiology.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111386"},"PeriodicalIF":0.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary bladder mucosal graft harvesting methods for urethral reconstruction","authors":"Ramazan Ugur,&nbsp;Akif Erbin,&nbsp;Abdullah Zilan,&nbsp;Halil Lutfi Canat","doi":"10.1016/j.ijscr.2025.111387","DOIUrl":"10.1016/j.ijscr.2025.111387","url":null,"abstract":"","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111387"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143891577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A successful surgical management of spinal cord herniation in a patient with old thoracic spine fracture: a case report from Syria","authors":"Mostafa Jaber Hassan ,&nbsp;Iyas Salman ,&nbsp;Rama Ahmad ,&nbsp;Issam Salman ,&nbsp;Eman Ali","doi":"10.1016/j.ijscr.2025.111394","DOIUrl":"10.1016/j.ijscr.2025.111394","url":null,"abstract":"<div><h3>Introduction</h3><div>Idiopathic spinal cord herniation is a very uncommon condition marked by the spinal cord protruding through a defect in the front part of the dura mater. Because there is limited clinical evidence available, the treatment options and outcomes for idiopathic spinal cord herniation remain unclear. We report this first case of idiopathic spinal cord herniation at the T5 level in Syria.</div></div><div><h3>Case presentation</h3><div>A 31-year-old Syrian man presented with a 4-year history of numbness and weakness in the right lower limb. Magnetic resonance imaging (MRI) revealed that his spinal cord was displaced ventrally at the T5 level. A surgical procedure was performed through a posterior midline approach. During the operation, a tear in the ventral dura was discovered. After the herniated tissue was repositioned, the defect was closed with sutures. After a 3-month follow-up, the lower-extremity weakness was improved, and there was no recurrence. The patient remained stable after nine months.</div></div><div><h3>Discussion</h3><div>Spinal cord herniation is a rare and challenging condition for medical practitioners because it is poorly understood. Several pathological mechanisms have been proposed, yet the term “idiopathic spinal cord herniation” remains the most common. Trauma and mechanical mechanisms are more convincing and generally accepted.</div></div><div><h3>Conclusion</h3><div>Surgery's main goal is to prevent the worsening of the condition, we identify trauma as a key cause and highlight suture therapy as an effective treatment. More studies are needed to clarify the pathology and treatment options for this disease.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111394"},"PeriodicalIF":0.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Concurrent pancreatic ductal adenocarcinoma and poorly differentiated neuroendocrine carcinoma: A case report and review of the literature","authors":"Alireza Negahi ,&nbsp;Ali Zare-Mirzaie ,&nbsp;Hossein Negahban ,&nbsp;Sepideh Soleymani ,&nbsp;Ali Jaliliyan ,&nbsp;Shahram Agah","doi":"10.1016/j.ijscr.2025.111320","DOIUrl":"10.1016/j.ijscr.2025.111320","url":null,"abstract":"<div><h3>Introduction</h3><div>Concurrent pancreatic ductal adenocarcinoma (PDAC) and poorly differentiated neuroendocrine carcinoma (NEC) is a rare condition. This simultaneous occurrence poses significant diagnostic and therapeutic challenges due to the unique characteristics and treatment protocols of each cancer. An accurate diagnosis is crucial to optimizing treatment outcomes and prognosis.</div></div><div><h3>Presentation of case</h3><div>We present a case of a 55-year-old male with type 2 diabetes and psoriatic arthritis, referred for an elevated serum CA 19–9 level found during a check-up. Imaging studies, including CT and EUS, revealed a 6 cm mass in the pancreatic head. EUS-guided biopsy confirmed PDAC. After a Whipple procedure, pathology showed concurrent poorly differentiated NEC with a 30 % neuroendocrine component. After surgery, the patient received gemcitabine-based chemotherapy and was disease-free at six months post-surgery.</div></div><div><h3>Discussion</h3><div>This case illustrates the diagnostic intricacy of simultaneous PDAC and poorly differentiated NEC. Effective management in such scenarios benefits from a collaborative approach among surgeons, oncologists, and pathologists. Due to the limited number of documented cases, there is insufficient evidence to inform the best treatment strategies, particularly concerning the most effective chemotherapy options. This case adds to the growing body of literature on rare concurrent pancreatic tumors and highlights the need for further research to enhance understanding and develop comprehensive clinical guidelines.</div></div><div><h3>Conclusion</h3><div>The combination of PDAC and poorly differentiated NEC poses unique diagnostic and treatment challenges. This case underscores the importance of a multidisciplinary approach and calls for further research to develop evidence-based management protocols for these rare malignancies.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111320"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transverse colonic atresia with rectal atresia in a neonate – A rare case of double-site intestinal atresia","authors":"Mathayo Shadrack ,&nbsp;Salma Juma Ali ,&nbsp;Mohammed Sultan Salim ,&nbsp;Victor Ngotta ,&nbsp;Petronilla Ngiloi ,&nbsp;Zaituni Bokhary","doi":"10.1016/j.ijscr.2025.111385","DOIUrl":"10.1016/j.ijscr.2025.111385","url":null,"abstract":"<div><h3>Background</h3><div>Colonic atresia is among uncommon and extremely rare congenital anomalies, accounting for less than 15 % of all intestinal atresias, with an estimated incidence of 1 in 20,000 live births. Even rarer is the coexistence of colonic atresia with rectal atresia, which has been reported in only a few cases globally. These dual conditions lead to neonatal intestinal obstruction, requiring early diagnosis and surgical intervention to prevent life-threatening complications.</div></div><div><h3>Case presentation</h3><div>Herein a 2-day-old neonate presented with a grossly distended, tense abdomen and bilious vomiting. Digital rectal examination (DRE) revealed that the examiner's finger could not pass beyond 2 cm from the anal verge. Saline irrigation and enema catheter insertion failed, leading to a preoperative diagnosis of rectal atresia. Intraoperative findings revealed a dilated small intestine and grossly dilated colon up to the level of the distal transverse colon, with the ascending and sigmoid colon replaced by fibrous-like tissue. The affected segments were excised, necessitating a future coloanal anastomosis. A double-barrel ileostomy was performed, and a biopsy was taken from the dilated transverse colon.</div></div><div><h3>Discussion</h3><div>The rarity of combined distal transverse colonic atresia and rectal atresia presents significant diagnostic and surgical challenges. The condition likely results from intrauterine vascular disruptions. Early surgical intervention offers favorable outcomes, though long-term bowel function remains a concern.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of early diagnosis and tailored surgical management in complex intestinal atresias to improve survival and long-term outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111385"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical removal of cesarean-related textiloma: A case report","authors":"Mohammad Al-Jawad,&nbsp;Nour Abdulazize Lbabidi,&nbsp;Mohammad Aldaher,&nbsp;Reema Khateeb,&nbsp;Aya Hamze,&nbsp;Aghyad Kurda Danial","doi":"10.1016/j.ijscr.2025.111388","DOIUrl":"10.1016/j.ijscr.2025.111388","url":null,"abstract":"<div><h3>Introduction</h3><div>Gossypiboma, a rare complication of surgery, involves retained surgical items like sponges, posing serious health risks and legal challenges. Though incidence rates have declined, the condition remains difficult to diagnose, often presenting with nonspecific symptoms and significant medicolegal implications.</div></div><div><h3>Case presentation</h3><div>A 30-year-old female with persistent gastrointestinal symptoms post-cesarean section was diagnosed with a retained stitch after 1.5 years, leading to surgical intervention. Following the removal of the foreign body, her symptoms improved significantly, highlighting the importance of thorough evaluation in post-surgical patients.</div></div><div><h3>Discussion</h3><div>Despite preventive measures, gossypibomas remain a significant issue, occurring in approximately 1 in 100 to 3000 surgical cases, particularly in emergency situations. Clinical manifestations can vary widely, and CT imaging is crucial for diagnosis, revealing characteristic patterns that guide surgical intervention for effective treatment.</div></div><div><h3>Conclusion</h3><div>This case highlights the seriousness of gossypiboma and the need for increased medical awareness to prevent its occurrence. Early diagnosis and appropriate management are essential to avoid severe complications, emphasizing the importance of educating healthcare professionals about gossypibomas as a differential diagnosis.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111388"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A painful twist: Wandering spleen with torsion and infarction: A case report","authors":"Abdelrahman S. Elnour ,&nbsp;Adam Yagoub ,&nbsp;Ahmed Saeed ,&nbsp;Faisal Nugud ,&nbsp;Ahmed A. Alshaikh","doi":"10.1016/j.ijscr.2025.111391","DOIUrl":"10.1016/j.ijscr.2025.111391","url":null,"abstract":"<div><h3>Introduction</h3><div>Wandering spleen is a rare condition characterized by abnormal spleen mobility due to defects in its supporting ligaments. Delayed management can lead to severe complications such as torsion and infarction, making early diagnosis and surgical intervention crucial for preventing adverse outcomes.</div></div><div><h3>Case presentation</h3><div>A 16-year-old girl presented with recurrent episodes of severe left hypochondrial pain, which worsened over six months, accompanied by occasional vomiting. Physical examination revealed a tender, palpable spleen extending from the left hypochondrium to the left iliac fossa. Imaging studies, including abdominal ultrasound and contrast-enhanced CT scan, revealed an enlarged spleen with signs of pedicle torsion and infarction, confirming a diagnosis of wandering spleen with vascular compromise. An emergency splenectomy was performed, revealing significant splenic enlargement with torsion and infarction, with no ligamentous attachments. The patient recovered uneventfully and received a pneumococcal vaccine along with long-term antibiotic prophylaxis prior to discharge.</div></div><div><h3>Discussion</h3><div>Wandering spleen often presents with nonspecific symptoms, leading to misdiagnosis or delayed treatment. Diagnostic imaging is essential for accurate identification. Management typically involves surgery, with splenopexy preferred when feasible and splenectomy reserved for cases with complications.</div></div><div><h3>Conclusion</h3><div>Wandering spleen, though rare, requires prompt recognition and management to prevent complications like torsion and infarction.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111391"},"PeriodicalIF":0.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cavernoma in the pineal region: A case report","authors":"Nischal Neupane ,&nbsp;Sujan Paudel ,&nbsp;Prajjwol Luitel ,&nbsp;Sagar Khadka ,&nbsp;Bikas Thapa ,&nbsp;Gopal Sedain","doi":"10.1016/j.ijscr.2025.111381","DOIUrl":"10.1016/j.ijscr.2025.111381","url":null,"abstract":"<div><h3>Introduction</h3><div>Pineal region cavernoma is a rare diagnosis comprising &lt;1 % of all cerebral cavernous malformations with female preponderance. These vascular malformations are benign and curable compared to other lesions in the region.</div></div><div><h3>Case presentation</h3><div>A 40-year female presented with bilateral temporal headache and multiple episodes of vomiting and was diagnosed as pineal cavernoma. She was managed effectively with a ventriculoperitoneal shunt for hydrocephalus.</div></div><div><h3>Discussion</h3><div>MRI provides an effective and accurate diagnosis in cavernous lesions of pineal region. Pineal cavernoma has higher risk of rebleeding and can cause acute obstructive hydrocephalus. Treatment of hydrocephalus is necessary if the surgical treatment is not possible.</div></div><div><h3>Conclusion</h3><div>This case report highlights the importance of early diagnosis and an option for palliative approach of management of pineal cavernoma.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"131 ","pages":"Article 111381"},"PeriodicalIF":0.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143878847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}