International Journal of Surgery Case Reports最新文献

{"title":"An atypical metastatic pathway: Bilateral inguinal lymphadenopathy as the initial presentation of papillary thyroid carcinoma.","authors":"Alsadig Suliman, Rawan Mohamedosman, Mohamed Soud, Hiba Suliman, Alsadig Suliman","doi":"10.1016/j.ijscr.2025.111189","DOIUrl":"10.1016/j.ijscr.2025.111189","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Papillary thyroid carcinoma (PTC) is known to primarily manifest as a thyroid nodule with regional lymph node metastasis. Distant metastasis in PTC is rare, making its diagnosis challenging when presenting atypically.</p><p><strong>Case presentation: </strong>A 47-year-old Sudanese female was evaluated for bilateral inguinal lymphadenopathy and significant weight loss. Extensive diagnostic efforts, including abdominal imaging and thyroid function tests, showed no abnormalities and no palpable thyroid nodules. However, a biopsy of the inguinal lymph nodes (ILNs) revealed psammoma bodies, confirming PTC. Further evaluation detected a 1 cm thyroid nodule.</p><p><strong>Clinical discussion: </strong>This case highlights the unusual presentation of PTC with distant metastasis to the ILNs without the typical presence of a thyroid nodule or cervical lymphadenopathy. The discovery underscores the importance of considering PTC in differential diagnoses for unexplained inguinal lymphadenopathy, emphasizing the need for thorough evaluation in atypical presentations.</p><p><strong>Conclusion: </strong>The rarity of inguinal lymphadenopathy as an initial presentation of PTC demonstrates significant diagnostic challenges. This case emphasizes the necessity of including PTC in the differential diagnosis for inguinal lymphadenopathy, advocating for comprehensive diagnostic strategies to manage and improve outcomes in such atypical cases. The patient's refusal of surgery and subsequent loss to follow-up culminating in undocumented death further complicate management in such rare presentations.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"111189"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755095","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":"Penetrating cardiac injury with non-coronary cusp aortic valve rupture and ventricular septal injury: A case report.","authors":"Desalegn Fekadu Wadaja, Shibikom Tamirat, Fikreyohanis Shewa, Natinael Muluneh, Abraham Ariaya, Wondu Reta Demissie","doi":"10.1016/j.ijscr.2025.111214","DOIUrl":"10.1016/j.ijscr.2025.111214","url":null,"abstract":"<p><strong>Background and importance: </strong>Penetrating cardiac trauma is a highly lethal injury, with an overall mortality approaching 80 % for those who survive to reach the hospital. Factors influencing survival following penetrating cardiac injury (PCI) include age, mechanism of injury, anatomic site, and injury grade. Stab wounds account for 77.8 % of such injuries, while gunshot wounds account for 22.2 %. The right ventricle is the most frequently injured chamber (34.7 %), followed by the left ventricle (29.3 %).</p><p><strong>Case presentation: </strong>This article presents a case of a 21-year-old male who presented 18 h after sustaining a stab injury to his anterior chest. The patient exhibited borderline blood pressure, severe bradycardia, and a focused assessment with sonography in trauma (FAST) revealed pericardial effusion with tamponade physiology. Immediate surgical intervention addressed the right ventricle injury. On the fourth postoperative day, echocardiography revealed ventricular septum and aortic injuries. The patient underwent prompt surgical repair of the septal injury, application of a prosthetic valve, and insertion of a permanent pacemaker, and was discharged in an improved condition.</p><p><strong>Clinical discussion: </strong>Managing penetrating cardiac injury (PCI) in resource-limited areas presents significant challenges. In our case, the time between injury and intervention was notably prolonged at 18 h, contrasting with the reported 60-minute median in larger cohorts. Timely recognition and referral, especially for patients with precordial stabs, are critical in the management. Median sternotomy is the preferred incision for patients with penetrating precordial wounds; however, left thoracotomy, emergency room thoracotomy, and clamshell thoracotomy are alternative options. Following survival to the intensive care unit, echocardiography is imperative before discharge to rule out valvular, papillary, and interventricular injuries.</p><p><strong>Conclusion: </strong>Timely intervention is imperative to improve outcomes and mitigate the impact of limited resources in low-income setting.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"111214"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755102","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":"Early CT scan prevents airway obstruction in a thyroidectomy case complicated by postoperative hematoma: A case report.","authors":"Yutaka Tateda, Takahiro Suzuki, Teruyuki Sato, Akiko Yoshida, Nobuo Ohta","doi":"10.1016/j.ijscr.2025.111227","DOIUrl":"10.1016/j.ijscr.2025.111227","url":null,"abstract":"<p><strong>Introduction: </strong>Among patients undergoing thyroid or head and neck surgery, the incidence of postoperative hemorrhage is reported to range between 0.36 % and 4.2 %. Postoperative bleeding in the neck can lead to severe complications if not promptly addressed.</p><p><strong>Presentation of case: </strong>The patient in this case was a man in his 50s, who was being treated for T3-dominant Basedow's disease with medication at the endocrinology department of our hospital. However, owing to the ineffectiveness of drug therapy in controlling the condition, the patient was referred to our department for surgery. Approximately 18 h after undergoing a thyroidectomy, the patient suddenly complained of dyspnea. Laryngeal fiberoptic examination showed no signs of laryngeal edema or recurrent nerve palsy. However, a neck CT scan revealed a hematoma at the surgical site, necessitating emergency surgery. During the operation, hematomas were found in both the superficial and deep layers of the surgical area. Arterial bleeding from the left side of the thyroid cartilage was confirmed, and the branches of the superior laryngeal artery were ligated to stop the bleeding.</p><p><strong>Discussion: </strong>Hematoma formation in a narrow space, particularly in the neck, can obstruct large vessels such as the internal jugular veins, compromising venous return. This may result in laryngeal edema, asphyxia, and, in the worst-case scenario, death.</p><p><strong>Conclusion: </strong>An early neck CT scan revealed a subcutaneous neck hematoma caused by postoperative bleeding, leading to emergency hematoma removal, hemostasis, and tracheotomy, which successfully prevented airway obstruction.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"111227"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755043","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":"Inflammatory myofibroblastic tumor of the bladder treated with partial cystectomy: Case report.","authors":"Chale Yohannes Tegegne, Mekuanint Asfaw Yitayew, Chalachew Tenna Alemu, Samuel Fekadu Shiferaw, Admassu Melaku Mikru, Abdiqadir Omer Rabile","doi":"10.1016/j.ijscr.2025.111225","DOIUrl":"10.1016/j.ijscr.2025.111225","url":null,"abstract":"<p><strong>Introduction: </strong>Inflammatory myofibroblastic tumor (IMT) is a rare form of tumor which is composed of fibroblastic and myofibroblastic spindle cells, with an inflammatory infiltrate of lymphocytes, plasma cells, and eosinophils. IMT may arise from different organs, but it is infrequent in the urinary bladder and usually manifests as haematuria.</p><p><strong>Case presentation: </strong>Here we report a 20 years old male patient with no previous history of trauma or surgery presented with gross hematuria and severe anaemia. Further workup with transurethral resection biopsy and immunohistochemistry are supportive of IMT and we did partial cystectomy. Follow up cystoscopy after 3 months showed normal bladder wall.</p><p><strong>Clinical discussion: </strong>An inflammatory myofibroblastic tumor (IMT) is a rare mesenchymal tumor. It comprises differentiated myofibroblastic spindle cells with numerous plasma cells and/or lymphocyte infiltrate. According to the World Health Organisation (WHO) classification, IMT is a low grade or borderline mesenchymal tumor. The commonest site for IMT is the lung, but it rarely occur in the genitourinary tract. Hematuria is the commonest manifestation of bladder IMT. Transurethral resection of bladder tumor (TURBT) and partial cystectomy are treatment modalities.</p><p><strong>Conclusion: </strong>IMT of the bladder is a rare tumor which manifests mainly with hematuria. Although TURBT is the standard treatment for IMT, partial cystectomy has lower recurrence rate.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"111225"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755098","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":"Laparoscopic Level II thrombectomy for renal cell carcinoma: An index case report from a national tertiary hospital","authors":"Binod Babu Gharti ,&nbsp;Umesh Nepal ,&nbsp;Ajit Khadga ,&nbsp;Bharat Mani Pokharel ,&nbsp;Mahesh Mani Adhikari","doi":"10.1016/j.ijscr.2025.111246","DOIUrl":"10.1016/j.ijscr.2025.111246","url":null,"abstract":"<div><h3>Introduction</h3><div>Renal cell carcinoma (RCC) with inferior vena cava (IVC) thrombosis is a rare and complex condition. Most cases have been managed through open surgery, particularly in premier institutes in Nepal. However, no published literature currently exists regarding laparoscopic management of such cases in this region.</div></div><div><h3>Presentation of case</h3><div>We present an index case of right RCC with IVC thrombosis managed laparoscopically at a tertiary cancer center in Nepal. The patient had a history of prior abdominal surgery, which led to dense adhesions complicating the laparoscopic procedure. Despite these challenges, the laparoscopic approach was successfully performed, offering a minimally invasive alternative to traditional open surgery.</div></div><div><h3>Discussion</h3><div>The major challenges in this case included managing the dense adhesions from the previous surgery, which significantly hindered the laparoscopic dissection and exposure of the IVC. Additionally, the complexity of tumor removal and IVC thrombectomy posed a significant technical challenge.</div></div><div><h3>Conclusion</h3><div>Surgical treatment for RCC with IVC thrombus is highly complex, carrying significant risk of peri-operative mortality, and is best performed in a high-volume centre.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111246"},"PeriodicalIF":0.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143790212","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":"Commentary on “Interstitial ectopic pregnancy: A rare challenging case report” by Essebbagh et al., 2025","authors":"Hamidreza Zivarifar ,&nbsp;Tahereh Ahrari Roodi","doi":"10.1016/j.ijscr.2025.111241","DOIUrl":"10.1016/j.ijscr.2025.111241","url":null,"abstract":"","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111241"},"PeriodicalIF":0.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739709","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 pipkin type IV injury treated with acetabular reconstruction and primary total hip replacement surgery: A case report","authors":"Godlisten S. Kawiche ,&nbsp;Abel Nelson ,&nbsp;Mussa Mahsein ,&nbsp;John Kazwika ,&nbsp;Peter Magembe Mrimba ,&nbsp;Faiton N. Mandari","doi":"10.1016/j.ijscr.2025.111240","DOIUrl":"10.1016/j.ijscr.2025.111240","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Acetabular fractures are uncommon and serious injuries to the hip joint occurring in 3 out of 100,000 individuals annually, commonly affects young people. In young individuals usually occurs from high-energy trauma and usually accompanied with associated injuries.</div></div><div><h3>Case presentation</h3><div>54 years old male involved in a motor traffic crash as a driver who had head-to-head collision with a tractor and sustained right hip injury and loss of consciousness for an unknown period of time. On admission pelvis X-ray and CT scan were done, he was diagnosed with 1. mild traumatic brain injury, 2. posterior hip dislocation with comminuted posterior wall acetabular fracture, and 3. femoral head fracture pipkin IV. E-fast was negative, chest X-ray revealed cardiomegaly, echocardiogram and electrocardiogram were unremarkable. He was kept on right distal femur skeletal traction temporarily, definitively acetabular reconstruction and total hip replacement were done.</div></div><div><h3>Discussion</h3><div>Posterior wall acetabular fracture with posterior column fracture if treated with ORIF results into failed fixation in 31.8 %, osteoarthritis in 63.6 %. 46 % of patients above 50 yrs treated with ORIF will end up requiring a late total hip replacement. Early treatment with total hip replacement results into better outcome compared to total hip done secondary to posttraumatic arthritis and failed fixation.</div></div><div><h3>Conclusion</h3><div>Primary total hip replacement is a best treatment modality in patients with severely comminuted posterior wall acetabular fracture due to the fact that open reduction and internal fixation is associated with more complications and inferior outcome compared to early total hip replacement.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111240"},"PeriodicalIF":0.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracorporeal membrane oxygenation in patient with dilated cardiomyopathy: A case report","authors":"W. Ragmoun,&nbsp;H. Massoudi,&nbsp;M. Lajmi,&nbsp;M. Ziadi,&nbsp;M.S. Shenik","doi":"10.1016/j.ijscr.2025.111242","DOIUrl":"10.1016/j.ijscr.2025.111242","url":null,"abstract":"<div><h3>Introduction</h3><div>Extracorporeal membrane oxygenation (ECMO) became a technique of respiratory and cardio respiratory assistance ensuring the oxygenation and the perfusion of the organs while waiting for the restoration of their functions. Critical care physicians should recognize early pathologies likely to progress rapidly to refractory cardiogenic shock and asystole.</div></div><div><h3>Case presentation</h3><div>A 29-year-old man known carrier of idiopathic dilated cardiomyopathy since 2017 presented with refractory cardiogenic shock after spinal anaesthesia for surgical treatment of a coccygeal fistula. The diagnosis of acute fulminant myocarditis toxic to anaesthetic products was suspected and he was supported after 24 h with an extracorporeal membrane oxygenation (ECMO) for cardiopulmonary support for 14 days with gradual improvement and successful weaning, the patient was extubated in three days and discharged from hospital after recovery from reanimation injuries.</div></div><div><h3>Discussion</h3><div>The occurrence of refractory cardiogenic shock in patients with dilated cardio myopathy may require the establishment of temporary ECMO for circulatory support as a bridge to long-term assistance, transplantation or recovery. In these emergency situations, ECMO is now the first circulatory assistance line and the patient must be referred as quickly as possible to a medical and surgical centre with the mastery of the implementation and monitoring of this complex technology. A refractory cardiogenic shock even in patients with dilated cardiomyopathy may require the establishment of temporary ECMO for circulatory support as a bridge to long-term assistance, transplantation or recovery.</div></div><div><h3>Conclusion</h3><div>The long-term prognosis of these patients who received an ECMO is not known. However, without circulatory support, the survival rate is almost nil.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111242"},"PeriodicalIF":0.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143799362","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":"Loss of a limb: A consequence of traditional bone setting","authors":"Dennis Machaku ,&nbsp;Jay Lodhia ,&nbsp;Amani Nangole ,&nbsp;Kondo Chilonga ,&nbsp;Honest Massawe","doi":"10.1016/j.ijscr.2025.111237","DOIUrl":"10.1016/j.ijscr.2025.111237","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Traditional bone setting (TBS) is commonly practiced in many communities worldwide, especially in developing countries in Asia, South America, and Africa, where healthcare resources are less developed. It plays an important role in healthcare delivery systems and remains a widely used alternative to modern medical care for limb fractures. This practice involves using wooden straps and casts to immobilize and stretch the injured limb, often leading to complications such as non-union, malunion, infections, compartment syndrome, and even limb amputations.</div></div><div><h3>Case presentation</h3><div>We discuss a case of a 30-year-old male patient who arrived at our facility with infected and gangrenous forearm with compartment syndrome following a week after traditional bone-setting intervention. The patient required an urgent fasciotomy and extensive surgical debridement of necrotized tissues. Due to extensive tissue loss, ischemia, gangrene, and persistent limb hypoesthesia and paresis, a forearm amputation was ultimately performed.</div></div><div><h3>Clinical discussion</h3><div>The traditional bone setter is a lay practitioner of joint manipulation, often lacking formal medical training. Despite the availability of modern healthcare systems, traditional bone setting continues to be widely used in many communities, leading to severe complications when improperly performed. In rural areas, traditional healers may not have the necessary knowledge to manage limb fractures appropriately, resulting in inflammation, infections, and delayed treatment. Strengthening healthcare delivery requires additional training for traditional healers and increasing public awareness about trauma care and early hospital referrals.</div></div><div><h3>Conclusion</h3><div>While traditional bone setting holds cultural significance, it poses serious risks, including infection, gangrene, and limb amputation, as demonstrated in this case. This report highlights the urgent need for community education, improved trauma awareness, and enhanced integration of safe, evidence-based fracture management in rural settings to prevent such complications and improve patient outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111237"},"PeriodicalIF":0.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739703","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":"Low-grade duodenal neuroendocrine tumor in a 72-year-old man: A case report","authors":"Mohammad Al-Jawad,&nbsp;Dania Hashemagha,&nbsp;Abdalrahman Salem,&nbsp;Nour Seijari,&nbsp;Shereen Hussein,&nbsp;Ammar Niazi","doi":"10.1016/j.ijscr.2025.111232","DOIUrl":"10.1016/j.ijscr.2025.111232","url":null,"abstract":"<div><h3>Introduction</h3><div>The neuroendocrine system includes various endocrine glands, with neuroendocrine neoplasms (NENs) primarily found in the lungs and gastrointestinal tract. This report presents a rare case of a duodenal NEN in a 72-year-old male, highlighting diagnostic and management challenges.</div></div><div><h3>Case presentation</h3><div>A 72-year-old male presented with melena and hypotension, revealing anemia and thrombocytopenia. Imaging and biopsy confirmed a low-grade neuroendocrine tumor, leading to surgical resection and a diagnosis of a well-differentiated tumor measuring 1.7 cm.</div></div><div><h3>Discussion</h3><div>This case underscores the complexities of diagnosing duodenal neuroendocrine tumors, with surgical resection necessary due to the tumor's invasive nature. Timely intervention and interdisciplinary collaboration are vital for effective management and monitoring.</div></div><div><h3>Conclusion</h3><div>This report highlights successful management of a duodenal neuroendocrine tumor in a 72-year-old male, emphasizing timely surgical intervention. Continued follow-up is essential for monitoring recurrence and ensuring optimal patient care.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111232"},"PeriodicalIF":0.6,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740101","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}