International Journal of Surgery Case Reports最新文献

{"title":"Diagnosis and management challenges of spontaneous pneumoperitoneum associated with infectious pneumonia: case report and literature review","authors":"Guillaume Tcheutchoua Soh ,&nbsp;Aïcha Ndichout-Gbetnkom ,&nbsp;Marilyn Okpeyemi Senami Houndekon ,&nbsp;Thierno Amadou Telly Diallo ,&nbsp;Papa Mamadou Faye ,&nbsp;Mamadou Cisse","doi":"10.1016/j.ijscr.2025.111995","DOIUrl":"10.1016/j.ijscr.2025.111995","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Spontaneous pneumoperitoneum is rare and can be treated without surgery. There are no clear criteria for determining which patient with pneumoperitoneum does not require surgery. We present a patient admitted to our centre for the management of infectious pneumonitis associated with spontaneous pneumoperitoneum.</div></div><div><h3>Presentation of case</h3><div>A 76-year-old white male was admitted with dyspnoea, cough and diarrhoea for three days. The patient had heart rate of 117 beats per minute, oxygen saturation of 84 % and Glasgow scale of 13/15. Pulmonary embolism was suspected. The chest CT scan showed interstitial syndrome, bronchial dilatation, emphysema and pneumoperitoneum. He was assessed by the surgical team. The abdomen was distended with tympanism and bowel sounds present. An exploratory laparotomy was proposed, but the patient refused with an improvement in his state two days later. We suspected that the patient had a sealed perforation. An abdominal CT showed pneumoperitoneum with no signs of hollow organ perforation. We concluded to spontaneous peritoneum.</div></div><div><h3>Clinical discussion</h3><div>Spontaneous pneumoperitoneum has many causes dominated by mechanical ventilation and recently COVID-19 infection. It remains poorly understood, this limits the development of a decision-making algorithm. It must be differentiated from hollow organ perforation, which has a high mortality rate. This requires careful clinical evaluation, monitoring of the disease progression and thorough analysis of the abdominal CT scan.</div></div><div><h3>Conclusion</h3><div>Spontaneous pneumoperitoneum is poorly understood and its causes are numerous. Deciding on conservative treatment requires rigorous clinical analysis. Despite advances in medical imaging, surgery is the best option in cases of doubt.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 111995"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222518","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":"Perforator identification for propeller flap harvest: Technical insights from a case serie.","authors":"Elise Lupon","doi":"10.1016/j.ijscr.2025.111921","DOIUrl":"10.1016/j.ijscr.2025.111921","url":null,"abstract":"","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111921"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058826","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":"Multimodal approach in the treatment of recurrent keloids: Surgery, triamcinolone and 5-FU injections, and PLT, a case-report.","authors":"Mahshid Sabetghadam, Zahra Farahani Nik","doi":"10.1016/j.ijscr.2025.111931","DOIUrl":"10.1016/j.ijscr.2025.111931","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Keloids are benign fibroproliferative lesions with high recurrence rates and resistance to monotherapies. Their management remains challenging, especially in high-tension anatomical regions. This case report describes a successful multimodal approach combining surgery, intralesional injections, and polarized light therapy (PLT) for recurrent large keloids.</p><p><strong>Case presentation: </strong>A 27-year-old male with a 10-year history of multiple keloids secondary to acne presented with three large recurrent lesions on the posterior trunk. He had undergone previous treatments including surgery, corticosteroid injections, cryotherapy, and CO₂ laser, with unsatisfactory outcomes. Surgical excision of all three keloids was performed, followed by layered closure using tension-adapted sutures. Postoperatively, intralesional injections of triamcinolone (40 mg/mL) and 5-fluorouracil (50 mg/mL) in a 1:1 ratio were administered in three monthly courses. Four sessions of PLT (400-3400 nm) were performed the day after each injection. The patient was followed for 9 months.</p><p><strong>Clinical discussion: </strong>The combination therapy led to complete resolution of lesions with no recurrence. The patient reported high satisfaction, improved mobility, and cosmetic outcomes. Only mild depression at the injection site was observed. PLT may have contributed to tissue regeneration and inflammation reduction. Proper suture selection based on anatomical tension zones likely minimized mechanical recurrence risk.</p><p><strong>Conclusion: </strong>This multimodal treatment combining surgery, pharmacological injection, and PLT offers an effective, safe approach to managing large, recurrent keloids. Further studies with extended follow-up and larger cohorts are needed to validate these findings.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111931"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058801","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":"Chronic abdominal pain secondary to portosystemic collateral vessels: A case report and review of etiologies.","authors":"Zahra Mohammadimanesh, Soheil Mirzaei, Reza Naseri, Maryam Haghighi-Morad, Afsaneh Safarian","doi":"10.1016/j.ijscr.2025.111878","DOIUrl":"10.1016/j.ijscr.2025.111878","url":null,"abstract":"<p><strong>Introduction: </strong>Portosystemic collateral veins (PSCVs) are rare venous anomalies that arise due to portal hypertension and can closely resemble primary sclerosing cholangitis (PSC) or cholangiocarcinoma (CCA) on imaging studies. Their presence around the common bile duct (CBD) may lead to diagnostic confusion and inappropriate management.</p><p><strong>Case presentation: </strong>We report the case of a 52-year-old woman with a history of cholecystectomy and post-ERCP pancreatitis who presented with chronic right upper quadrant abdominal pain. MRCP revealed beading and wall thickening of the CBD, raising suspicion for PSC or periductal CCA. Three-phase CT imaging demonstrated dilated paracholedochal collateral veins encasing the CBD. Laboratory investigations showed elevated AST, ALT, ALP, and CA 19-9, with declining hemoglobin and platelets during her latest admission.</p><p><strong>Clinical discussion: </strong>PSCVs can produce external compression and irregularity of the bile duct, mimicking the imaging features of malignant or inflammatory biliary conditions. Recognizing this vascular anomaly requires correlation of imaging findings with clinical and laboratory data to prevent misdiagnosis.</p><p><strong>Conclusion: </strong>In patients with persistent abdominal symptoms and a history of biliary procedures or portal vein thrombosis, PSCVs should be included in the differential diagnosis. Accurate and timely identification via CT and MRCP can guide appropriate clinical management and avoid unnecessary interventions.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111878"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058819","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":"Tunica vaginalis graft use for repair of testicular rupture after blunt trauma: A report of two cases and literature review.","authors":"Xiangxiang Zhang, Fanfan Li, Mao Zhang, Hengping Li","doi":"10.1016/j.ijscr.2025.111754","DOIUrl":"10.1016/j.ijscr.2025.111754","url":null,"abstract":"<p><strong>Background: </strong>Testicular rupture caused by blunt scrotal trauma can be repaired routinely, but for severe testicular rupture often accompanied by a large area of tunica albuginea defect, it is impossible to suture the tunica albuginea without tension unless excess normal testicular tissue is removed. This case report highlights the surgical challenge of using a pedicled tunica vaginalis in the case of severe tunica albuginea defect in testicular rupture.</p><p><strong>Case presentation: </strong>Two underage boys both experienced severe pain in the scrotum due to trauma, and ultrasound examination showed testicular rupture. Emergency surgical exploration was performed, and severe testicular rupture was observed during the operation, with a large area of tunica albuginea defect that could not be repaired routinely. After trimming the necrotic testicular tissue, a pedicled testicular sheath was sutured to the residual tunica albuginea. After one year of postoperative follow-up, the recovery was good and hormone levels were normal.</p><p><strong>Discussion: </strong>Surgical repair of testicular rupture presents certain challenges, especially for severe tunica albuginea defects. The use of a pedicled testicular tunica vaginalis can more easily solve this problem, but the location and size of the tunica vaginalis need to be designed during surgery, especially to ensure blood supply to the tunica vaginalis.</p><p><strong>Conclusion: </strong>For severe testicular rupture, the use of pedicle testicular sheath repair is a recommended option, but it requires certain surgical techniques.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111754"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081844","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":"Letter to the editor in response to \"Management of a challenging open urethral defect in a patient with Fournier's gangrene: A case report\" Int. J. Surg. Case Rep.","authors":"Radhika Salpekar, Vikram Satav, Radhika Salpekar","doi":"10.1016/j.ijscr.2025.111922","DOIUrl":"10.1016/j.ijscr.2025.111922","url":null,"abstract":"","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111922"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145041817","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":"Occult breast cancer management with axillary lymph node dissection versus sentinel lymph node biopsy: Case reports and literature review.","authors":"Aishah A AlGhuneem, Noora Y AlMoosa, Mohammed B Awadh","doi":"10.1016/j.ijscr.2025.111896","DOIUrl":"10.1016/j.ijscr.2025.111896","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most common cancer worldwide. In patients with occult breast cancer, sentinel lymph node biopsy (SLNB) has been shown to reduce complications, shorter hospital stay, and improved quality of life compared to axillary lymph node dissection (ALND). This study presents two case reports comparing outcomes of ALND versus SLNB in the management of occult breast cancer. CASE 1: A 52-year-old female presented with a left axillary tail mass which showed invasive ductal carcinoma. Underwent left axillary lymph node dissection. She developed postoperative drain seroma. The patient was managed conservatively. CASE 2: A 65-year-old female known case of diabetes mellitus type 2, hypertension, and dyslipidemia presented with a right axillary tail mass which showed features suggestive of metastatic carcinoma, most arising from breast origin. The patient underwent uneventful right sentinel lymph node biopsy without any postoperative complications.</p><p><strong>Discussion: </strong>While ALND is associated with more complications including, seroma, lymphedema, paresthesia, infection, and nerve injury, SLNB offers a less invasive approach with favorable outcome.</p><p><strong>Conclusion: </strong>SLNB is an effective and less morbid approach for managing occult breast cancer and warrants further study in larger cohorts.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111896"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066148","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":"Case report: An unusual case of sliding para peritoneal inguinal bladder hernia: A diagnostic challenge.","authors":"Kalkidan Kibret Mekoya, Mukasa Mohammed, Shabbir Murtaza Adamjee, Justus Kamara Anacleth, Berhane Weldegergis Yohannes","doi":"10.1016/j.ijscr.2025.111910","DOIUrl":"10.1016/j.ijscr.2025.111910","url":null,"abstract":"<p><strong>Introduction: </strong>Inguinal bladder hernia is a rare and often underdiagnosed condition. Due to its non-specific presentation, it is frequently identified only during surgery.</p><p><strong>Case presentation: </strong>We report the case of a 54-year-old man who presented with a longstanding right inguinoscrotal swelling. He had no urinary symptoms and no identifiable risk factors for hernia. Preoperative ultrasonography did not reveal bladder involvement. The diagnosis was made intraoperatively when the bladder was identified as part of the hernia sac.</p><p><strong>Discussion: </strong>Inguinal bladder hernia is typically misdiagnosed preoperatively due to its rarity and subtle clinical presentation. Most cases are diagnosed intraoperatively, which increases the risk of accidental bladder injury and associated postoperative morbidity.</p><p><strong>Conclusion: </strong>This case highlights the importance of maintaining a high index of suspicion for bladder involvement in inguinal hernias, particularly in at-risk patients. Preoperative imaging can aid in diagnosis and help prevent intraoperative complications.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111910"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076476","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":"Clinical and angiographic characteristics of below-the-knee arterial disease: A case series study from Vietnam.","authors":"Nguyen Minh Tan, Lam Thao Cuong, Le Phi Long, Tran Minh Bao Luan, Tran Thanh Vy, Nguyen Hoai Nam","doi":"10.1016/j.ijscr.2025.111936","DOIUrl":"10.1016/j.ijscr.2025.111936","url":null,"abstract":"<p><strong>Background: </strong>Below-the-knee peripheral arterial disease (BTKPAD) is a major cause of chronic limb-threatening ischemia (CLTI), yet data on its clinical and angiographic presentation in resource-limited settings remain scarce. This study aimed to characterize the clinical staging and angiographic features of patients with BTKPAD at the time of hospital admission.</p><p><strong>Methods: </strong>A retrospective consecutive case series study was conducted at the University Medical Center Ho Chi Minh City from January 2022 to September 2024. A total of 127 patients diagnosed with BTKPAD were included. A standardized diagnostic work-up was performed for all patients. Clinical staging was assessed using the Rutherford and Fontaine classifications. Diagnostic angiography (DSA) was performed to evaluate lesion morphology, number, length, and runoff scores. Ischemia severity and lesion complexity were assessed using the ankle-brachial index (ABI) and TASC II classification, respectively.</p><p><strong>Results: </strong>Most patients presented with advanced CLTI: 96.1 % were classified as Rutherford category 5-6 and Fontaine stage IV. The median ABI was 0.55, with over 70 % having ABI < 0.90. Tissue loss or gangrene was the primary cause of admission in 93.7 % of cases. DSA revealed multisegmental disease, with 77.2 % of patients having two to three lesion sites and a median lesion length of 14 cm. TASC classification showed 68.5 % had type C and 25.2 % had type D lesions. The median runoff score was 8.0, indicating severe distal hypoperfusion.</p><p><strong>Conclusions: </strong>Patients with BTKPAD in this cohort predominantly presented with late-stage disease and complex vascular lesions. These findings underscore the need for earlier diagnosis and timely revascularization strategies to improve limb salvage in similar healthcare settings.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111936"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12475568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082062","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":"Pediatric nodular fasciitis of the orofacial region: A rare case report and literature review.","authors":"Maryam Salah, Mouna Rimani, Laïla Benjelloun, Bouchra Taleb","doi":"10.1016/j.ijscr.2025.111929","DOIUrl":"10.1016/j.ijscr.2025.111929","url":null,"abstract":"<p><strong>Introduction: </strong>Nodular fasciitis is a rare, benign, rapidly growing, self-limited myofibroblastic/fibroblastic pseudotumor that often mimics sarcomas, making its diagnosis particularly challenging. While it typically occurs in the subcutaneous tissues of the trunk and extremities, intraoral presentation is extremely uncommon.</p><p><strong>Case presentation: </strong>We report a rare case of oral nodular fasciitis in a 10-year-old patient who presented with delayed eruption of the right lower premolars and a firm, rapidly enlarging, painless swelling in the corresponding region. An excisional biopsy was performed, followed by immunohistochemical analysis, which confirmed the diagnosis of nodular fasciitis.</p><p><strong>Clinical discussion: </strong>Due to its clinical and histopathological resemblance to malignant lesions, nodular fasciitis can easily be misdiagnosed, potentially leading to overtreatment. Recognizing its key features is essential to avoid unnecessary and invasive procedures, especially in pediatric patients.</p><p><strong>Conclusion: </strong>This case highlights the importance of considering nodular fasciitis in the differential diagnosis of rapidly growing soft tissue masses in the oral cavity, particularly in children.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"135 ","pages":"111929"},"PeriodicalIF":0.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087846","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}