International Journal of Surgery Case Reports最新文献

{"title":"Locked patellar dislocation due to osteophytes: two case reports with a focused literature review.","authors":"Ngoc Quyen Le, Trong Xuan Cuong Tran","doi":"10.1097/RC9.0000000000000936","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000936","url":null,"abstract":"<p><strong>Introduction: </strong>Locked patellar dislocation is a rare injury in which the patella becomes irreducible due to mechanical obstruction. Osteophytes have been increasingly recognized as a cause of irreducibility, but the mechanisms remain incompletely characterized.</p><p><strong>Case presentation: </strong>Case 1: A 41-year-old female sustained a locked lateral, vertical, intra-articular patellar dislocation following a motorcycle collision. An inferomedial patellar osteophyte was impacted against the medial femoral condyle and entrapped within soft tissue, requiring open reduction. Case 2: A 57-year-old female presented with a superior patellar dislocation during massage. An inferior patellar osteophyte was entrapped against the femoral intercondylar notch, successfully reduced using a modified disengagement-first maneuver.</p><p><strong>Clinical discussion: </strong>Both cases demonstrate distinct osteophyte-mediated pathomechanisms of irreducibility. In both patients, imaging before definitive treatment identified the mechanical block and guided the choice between closed and open reduction. Both patients achieved excellent functional outcomes.</p><p><strong>Conclusion: </strong>Osteophytes can transform a simple patellar dislocation into an irreducible locked injury. Imaging, particularly computed tomography when indicated, can identify the mechanical block and guide safe reduction.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4262-4269"},"PeriodicalIF":0.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652475/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168036","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":"Giant ectopic splenic volvulus: a rare surgical emergency.","authors":"Amine Chaabouni, Nizar Kardoun, Wassim Hentati, Rahma Daoud, Salah Boujelben","doi":"10.1097/RC9.0000000000000990","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000990","url":null,"abstract":"<p><strong>Background: </strong>Splenic volvulus is a rare condition most often associated with a wandering spleen (WS) due to congenital or acquired ligamentous laxity. A giant ectopic splenic volvulus in adults without identifiable risk factors is exceptionally rare.</p><p><strong>Case presentation: </strong>We report the case of a 46-year-old woman with no significant past medical history who presented with acute abdominal pain. Computed tomography (CT) revealed a giant ectopic spleen measuring approximately 20 cm, with torsion of the splenic pedicle, consistent with splenic volvulus. Emergency surgery was performed. Intraoperatively, the spleen was found to be massively enlarged, ectopic, and nonviable due to vascular compromise. A splenectomy was therefore carried out. The postoperative course was uneventful.</p><p><strong>Clinical discussion: </strong>This case underscores the diagnostic challenge of giant ectopic splenic volvulus in an atypical patient profile. The extreme size of the spleen likely exacerbated the torsion due to increased gravitational pull on an otherwise normal pedicle. While detorsion and splenopexy are preferred in pediatric or early-presenting cases to preserve immune function, the massive enlargement and established vascular compromise in this adult necessitated emergency splenectomy to prevent necrosis and life-threatening peritonitis. This case adds to the scarce literature on giant WSs in adults, reinforcing that the \"whirl sign\" on CT is pathognomonic and that delayed intervention invariably leads to splenic infarction.</p><p><strong>Conclusion: </strong>Giant ectopic splenic volvulus is a rare but potentially life-threatening condition. Early diagnosis based on imaging and prompt surgical management are crucial. Splenectomy remains the treatment of choice when splenic viability cannot be preserved.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4512-4516"},"PeriodicalIF":0.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170353","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":"Heterotopic pancreas as a rare lead point of ileal intussusception mimicking acute appendicitis in a child: a case report and review of the literature.","authors":"Taha Negahdari, Sohrab Sharifi, Mahdokht Azizi, Sepehr Moradi, Ava Khalili, Ardavan Shahbazi","doi":"10.1097/RC9.0000000000000930","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000930","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Heterotopic pancreas is an uncommon developmental anomaly characterized by pancreatic tissue located outside the normal pancreas without anatomical or vascular continuity. Although it is most frequently identified in the stomach and duodenum, involvement of the ileum is rare, particularly in children. When present in the small intestine, it may act as a pathological lead point for intussusception, posing a considerable diagnostic challenge because the underlying lesion is often not identified by preoperative imaging.</p><p><strong>Presentation of case: </strong>We report the case of a 6-year-old Iranian boy who presented with clinical features highly suggestive of acute appendicitis. Initial ultrasonography and contrast-enhanced computed tomography did not demonstrate appendicitis, intussusception, or a definite pathological lead point. Despite negative imaging, persistent right lower quadrant tenderness, fever, leukocytosis, and progressive clinical findings prompted an exploratory laparotomy. Intraoperatively, a normal appendix and an ileo-ileal intussusception approximately 30 cm proximal to the ileocecal valve were identified. Manual reduction was unsuccessful, necessitating segmental ileal resection with primary anastomosis. Gross examination demonstrated a 3.6 × 4.0 × 5.5 cm submucosal mass protruding into the intestinal lumen and acting as the pathological lead point. Histopathological evaluation confirmed Heinrich type II heterotopic pancreas composed of pancreatic acini and ducts without identifiable islets of Langerhans, dysplasia, or malignancy, accompanied by transmural ischemic changes secondary to intussusception. The postoperative course was uneventful, and the patient remained asymptomatic throughout follow-up.</p><p><strong>Clinical discussion: </strong>Heterotopic pancreas is an exceptionally rare pathological lead point for pediatric ileo-ileal intussusception and may clinically mimic more common surgical conditions, such as acute appendicitis. Although ultrasonography is highly sensitive for detecting intussusception, characterization of the underlying lead point remains challenging, and histopathological examination is essential for definitive diagnosis. Early surgical exploration should be considered when persistent clinical suspicion outweighs nondiagnostic imaging findings.</p><p><strong>Conclusion: </strong>Ileal heterotopic pancreas should be considered in the differential diagnosis of older children presenting with atypical or recurrent intussusception, particularly when clinical findings are discordant with imaging studies. Prompt surgical management and histopathological evaluation are crucial for establishing the diagnosis and achieving excellent clinical outcomes.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4288-4296"},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149166703","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":"Isolated supernumerary nipple along embryonic milk line in an adult male patient successfully treated by surgical excision: a case report.","authors":"Pratisma Wagle, Bishowdeep Timilsina, Nameeka S Hada, Prakash T Chhetri, Ranjan Barnawal, Ishma Ghimire","doi":"10.1097/RC9.0000000000000972","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000972","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Supernumerary nipples are the most common congenital anomaly of the mammary ridge, resulting from incomplete regression of the embryonic milk line. Most cases are asymptomatic and managed conservatively; surgical excision is reserved for cosmetic concerns, psychological distress, symptomatic lesions, or diagnostic uncertainty.</p><p><strong>Case presentation: </strong>A 19-year-old Nepali male presented with an accessory nipple-areolar complex on the right chest, which had been present since childhood. Although asymptomatic, it caused significant cosmetic dissatisfaction and self-consciousness. Examination revealed a well-circumscribed, non-tender lesion measuring 5 × 5 mm² located 5 cm inferior to the right nipple along the embryonic milk line. Ultrasound showed no underlying glandular tissue or abnormalities. Surgical excision was performed under intravenous anesthesia with primary wound closure. Recovery was uneventful, with satisfactory healing and minimal scarring. Histopathology confirmed a supernumerary nipple without atypia or malignancy. The patient reported high satisfaction with the cosmetic outcome at follow-up.</p><p><strong>Clinical discussion: </strong>A supernumerary nipple is generally benign and managed conservatively; however, cosmetic and psychosocial concerns may significantly impair quality of life, particularly in young patients. Although rare, supernumerary tissue can undergo the same benign and malignant changes as normal breast tissue, highlighting the importance of clinical evaluation and histopathological examination after excision.</p><p><strong>Conclusion: </strong>Surgical excision is a safe, effective, and definitive treatment for symptomatic or cosmetically concerning supernumerary nipples, providing excellent esthetic outcomes and histopathological confirmation.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4446-4450"},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172343","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":"A rare sequela of open cholecystectomy: gossypiboma presenting as a subhepatic mass with duodenal sinus - a case report.","authors":"Sabin Kumar Ghimire, Niliza Shakya, Suresh Maharjan, Rabin Kumar Ghimire, Rishika Prasad, Rahul Jha","doi":"10.1097/RC9.0000000000000975","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000975","url":null,"abstract":"<p><strong>Introduction: </strong>Gossypiboma refers to a retained surgical sponge or gauze left inadvertently after surgery, which is a rare yet serious complication that is often underreported due to medicolegal concerns. Intra-abdominal gossypiboma frequently occurs after cholecystectomy. This case is reportable, as it emphasizes the importance of maintaining a high index of suspicion for gossypiboma in postoperative patients presenting with abdominal pain, as early diagnosis and timely surgical management can help reduce associated morbidity and complications.</p><p><strong>Case presentation: </strong>A 39-year-old man, who had undergone an open cholecystectomy 4 months earlier, presented with right-upper-quadrant pain for 2 months. Imaging studies demonstrated a gossypiboma in the subhepatic region, with a duodenal sinus draining pus. Exploratory laparotomy revealed two retained surgical sponges, an abscess, and a duodenal perforation. Surgical removal, duodenal repair, and peritoneal lavage were performed, and the patient recovered uneventfully.</p><p><strong>Discussion: </strong>Retained surgical sponges trigger a foreign-body reaction with two patterns: an acute exudative inflammatory response causing sepsis or abscess, and a chronic aseptic fibrous response with encapsulation and granuloma formation, leading to mass effect, adhesions, bowel erosion, and fistula formation. Because the clinical presentation is often nonspecific and may occur months or years after surgery, diagnosis requires a high index of suspicion. Imaging plays a crucial role, with contrast-enhanced computed tomography being the most useful modality. Definitive management involves surgical removal through endoscopic, laparoscopic, or open approaches, thereby reducing complications.</p><p><strong>Conclusion: </strong>This case highlights the importance of strict adherence to surgical safety checklist protocols, particularly meticulous sponge counting during surgery.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4424-4429"},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171302","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":"Isolated left-lobe metastatic hepatic abscess due to portal pyemia from microperforated ascending colon carcinoma: a rare case report.","authors":"Suman Supratik, Manaswi Acharya, Rajani Neupane, Abhijeet Kumar","doi":"10.1097/RC9.0000000000000971","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000971","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction and importance: &lt;/strong&gt;Liver abscess-like lesions are commonly managed as primary hepatobiliary infections; however, colorectal cancer can be an occult source, particularly when portal pyemia follows a microperforated tumor. Diagnostic complexity increases when right-sided colon cancer presents with an apparently isolated left-lobe hepatic collection mimicking foregut disease, especially in settings where anaerobic culture and immunohistochemistry are limited.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Case presentation: &lt;/strong&gt;A middle-aged woman in her fifth decade with an 8-month history of intermittent right iliac fossa pain and recurrent loose stools represented with sepsis after deferring surgery for a colonoscopically detected ascending-colon mass. She had previously been advised surgical resection but left against medical advice and pursued traditional treatments, resulting in an 8-month diagnostic-to-intervention delay. Contrast-enhanced computed tomography showed a large ascending-colon tumor with suspected microperforation, pericolic lymphadenopathy, ileocolic vein thrombosis, an appendiceal mucocele, and a left-lobe subcapsular hepatic collection with peripheral enhancement and internal gas. A presumed gastric mass was later explained intraoperatively by extrinsic compression from the ruptured collection. Laparotomy with drainage and right hemicolectomy was performed. Histopathology confirmed moderately differentiated ascending-colon adenocarcinoma, pT3N1a, R0, with 1 of 18 nodes positive, and a low-grade appendiceal mucinous neoplasm. A hepatic core biopsy demonstrated metastatic well-differentiated adenocarcinoma within an abscessed, necrotic inflammatory background, confirming a metastatic hepatic abscess.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical discussion: &lt;/strong&gt;Pyogenic liver abscess (PLA) may rarely represent the first clinically overt manifestation of occult colorectal carcinoma, though in this case, right iliac fossa pain was the earliest symptom, with the hepatic abscess emerging as the complication that precipitated the final presentation. Imaging and limited biopsy sampling created uncertainty as to whether the lesion was an abscess or a necrotic metastasis. Cryptogenic PLA warrants evaluation for underlying colorectal malignancy. Early antibiotics and surgical source control are essential. The postoperative course was complicated by a superficial surgical site infection (Clavien-Dindo Grade I) due to methicillin-resistant &lt;i&gt;Staphylococcus aureus&lt;/i&gt;, managed with wound care and targeted antimicrobials.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Right-sided colon cancer complicated by microperforation and portal pyemia can culminate in a ruptured left-lobe metastatic hepatic abscess that mimics foregut pathology, creating a multilayered diagnostic challenge. This case underscores the importance of early cross-sectional imaging, prompt oncologic source control, and integrated pathology-oncology collaboration. Clinicians should maintain a low thre","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4376-4382"},"PeriodicalIF":0.6,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168348","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":"External iliac artery dissection associated with resuscitative endovascular balloon occlusion of the aorta (REBOA) removal: a case report.","authors":"Motoyasu Nakamura, Akihito Kato, Gen Inoue, Masaharu Yagi, Kenji Dohi","doi":"10.1097/RC9.0000000000000979","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000979","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Resuscitative endovascular balloon occlusion of the aorta (REBOA) is used as an initial treatment for hemorrhagic shock.</p><p><strong>Case presentation: </strong>The patient was a man in his 70s with a history of alcohol use. He was brought to the hospital with high-energy trauma and hemorrhagic shock. REBOA was performed for a pubic-ischial fracture with pelvic contrast extravasation. Arterial embolization was performed using an interventional radiology, and partial occlusion was achieved. On the second day of hospitalization, the patient's general condition improved, and the REBOA was removed with the stylet wire left in place. On the third day of hospitalization, contrast-enhanced computed tomography (CT) showed an antegrade dissection of the external iliac artery on the REBOA insertion side. No worsening of the dissected cavity was observed after conservative treatment.</p><p><strong>Clinical discussion: </strong>Previous reports have described vascular damage due to blind REBOA insertion and ischemic injury to lower-body organs due to prolonged occlusion. In this case, CT performed at the time of insertion did not reveal an external iliac artery dissection; therefore, it was suspected that the dissection occurred during insertion of the stylet wire for REBOA removal.</p><p><strong>Conclusion: </strong>This case suggests that serious vascular complications may be associated with REBOA, including during the period after device removal, and that careful procedures are required.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4389-4393"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167557","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":"Safe robotic resection of a rare low-grade pelvic presacral mesenchymal tumor - case report.","authors":"Zofia Mik, Jakub Nowacki, Katarzyna Dzika, Michał Mik","doi":"10.1097/RC9.0000000000000959","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000959","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Solitary fibrous tumor (SFT) is an uncommon mesenchymal neoplasm that may reach considerable size in the lesser pelvis before becoming symptomatic. Surgical treatment is challenging because of the deep pelvic location, its proximity to major vessels and autonomic nerves, and frequent tumor hypervascularity.</p><p><strong>Presentation of case: </strong>We report the case of a 32-year-old woman presenting with persistent gluteal pain. Imaging studies revealed a hypervascularized presacral mass measuring 58 × 46 × 78 mm, adherent to the posterior rectal wall without evidence of infiltration. The patient underwent robotic radical resection using the da Vinci Xi system with 50 mL blood loss. Pathological analysis confirmed a low-grade SFT with characteristic immunohistochemical profile (CD34 and STAT6 strongly positive) and negative surgical margins (R0). The postoperative course was uneventful. After 6-month follow-up, no evidence of recurrence was observed.</p><p><strong>Clinical discussion: </strong>In hypervascularized presacral SFT, the aim is to minimize intraoperative bleeding and achieve R0 resection. Robotic surgery allows for precise visualization of the tumor margins and of the vascular and neural structures in the lesser pelvis. In such procedures, the surgical stages must be planned correctly, based on imaging studies and the main sources of vascularization.</p><p><strong>Conclusion: </strong>The robotic abdominal approach may be a safe and effective option for the resection of presacral SFT, offering precise dissection and effective hemostasis. Further studies are required to confirm long-term oncological outcomes in robotic SFT resection.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4346-4349"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168448","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":"Neglected Busch-Hoffa fracture following the patellar dislocation: a rare case report.","authors":"Ali Alahgholiei, Ali Maavaeian, Ahmad B Rasikh, Mahdi Mohammaditabar, Seyed M Kazemi","doi":"10.1097/RC9.0000000000000127","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000127","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Busch-Hoffa fractures are rare intra-articular coronal plane fractures of the femoral condyle that often remain unnoticed, particularly when complications develop. Due to their instability and risk of long-term problems, these fractures require immediate anatomical reduction and stable fixation. The occurrence of a Busch-Hoffa fracture in conjunction with patellar dislocation is extremely rare and has been rarely reported in the current literature.</p><p><strong>Case presentation: </strong>We report a case involving a 21-year-old male who experienced a Bagaria type 2 Hoffa fracture of the lateral femoral condyle due to a twisting knee injury during exercise, which was associated with an acute lateral patellar dislocation. Imaging studies revealed a displaced osteochondral fragment from the posterior-inferior lateral femoral condyle, along with a fracture of the medial patellar facet. The patient underwent an open reduction using a lateral parapatellar approach. We achieved anatomical reduction of the condylar fragment, which was then secured with four Herbert screws. The torn medial patellofemoral ligament was repaired and reefed, and any loose bodies were excised. At an 18-month follow-up, the patient exhibited full knee range of motion, with no evidence of pain, instability, or degenerative changes.</p><p><strong>Clinical discussion: </strong>The distinct fracture pattern, coupled with the patellar entrapment in the fracture line, presented diagnostic and surgical difficulties. This case highlights the need for heightened clinical suspicion, prompt computed tomography (CT) imaging, and careful surgical planning. The current literature is deficient in providing a definitive treatment protocol, and there is limited biomechanical data available on these types of injuries.</p><p><strong>Conclusion: </strong>This unusual instance presents a complex case of Busch-Hoffa fracture, accompanied by patellar dislocation. Prompt open reduction and internal fixation are crucial for avoiding complications and restoring joint function.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4011-4016"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170148","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":"Splenic hematoma following ERCP for obstructive jaundice requiring splenectomy: a case report and literature review.","authors":"Branislav Oluic, Dragan Vasin","doi":"10.1097/RC9.0000000000000958","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000958","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Splenic injury following endoscopic retrograde cholangiopancreatography (ERCP) is an exceptionally rare but potentially life-threatening complication.</p><p><strong>Case presentation: </strong>We report the case of a female patient admitted with obstructive jaundice and suspected periampullary malignancy associated with markedly elevated CA 19-9 levels. Following ERCP, abdominal computed tomography demonstrated a large subcapsular splenic hematoma. The patient underwent splenectomy, cholecystectomy, hepaticojejunostomy, and Roux-en-Y reconstruction. Histopathological examination confirmed traumatic splenic injury without evidence of malignancy. The postoperative course was complicated by pancreatic fistula, which was successfully managed conservatively.</p><p><strong>Clinical discussion: </strong>ERCP-related splenic injury remains a rare complication with nonspecific clinical manifestations that may delay diagnosis. A review of the literature demonstrates substantial variability in clinical presentation and management, ranging from conservative treatment to splenectomy.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenge of ERCP-related splenic hematoma in patients undergoing evaluation for suspected pancreatic head malignancy. Early recognition, prompt cross-sectional imaging, and individualized multidisciplinary management are essential for achieving favorable outcomes. In selected patients, modification of the operative strategy according to intraoperative findings may be lifesaving.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4332-4336"},"PeriodicalIF":0.6,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652398/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171300","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}