International Journal of Surgery Case Reports最新文献

{"title":"A case report of intestinal intussusception secondary to endometriosis of the last ileal loop","authors":"Faiez Boughanmi,&nbsp;Mohamed Ali Chaouch,&nbsp;Midani Touati,&nbsp;Mohamed Zayati,&nbsp;Hiba Ben Hassine,&nbsp;Faouzi Noomen","doi":"10.1016/j.ijscr.2025.111221","DOIUrl":"10.1016/j.ijscr.2025.111221","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Acute intestinal intussusception secondary to intestinal endometriosis is a rare entity, but it can be life-threatening. Improving diagnostic and therapeutic investigations through multidisciplinary collaboration improves its management and prognosis.</div></div><div><h3>Case presentation</h3><div>Reporting the clinical case of a 37-year-old patient admitted for treatment of intestinal intussusception secondary to intestinal endometriosis. She underwent a resection of the invaginated segment without disinvagination and a manual end-to-end ileo-ileal anastomosis. Pathological examination concluded that there was intestinal endometriosis with simple surgical suites.</div></div><div><h3>Clinical discussion</h3><div>Several studies have addressed the subject of intestinal intussusception secondary to intestinal endometriosis. However, the studies are mainly case reports. It is certainly rare, but potentially serious, and all studies converge on the importance of diagnosis and rapid multidisciplinary care.</div></div><div><h3>Conclusions</h3><div>Due to its rarity and the non-specificity of its symptoms, digestive endometriosis is poorly understood and is often diagnosed late. Intussusception secondary to endometriosis is rare and generally requires surgery.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111221"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725617","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":"Spontaneous uterine rupture in the second trimester with fetal Cyclopia at a resource-limited setting: A case report","authors":"Mohamed Ahmed Abdillahi ,&nbsp;Ahmed Abdi Aw Egge ,&nbsp;Chaltu Resassa Shashe ,&nbsp;Kenzu Bedru Hussen ,&nbsp;Abdisalam Aden Dahir ,&nbsp;Abdisalam Hassan Muse","doi":"10.1016/j.ijscr.2025.111228","DOIUrl":"10.1016/j.ijscr.2025.111228","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Spontaneous uterine rupture in the second trimester is a rare and life-threatening obstetric emergency, typically associated with pre-existing risk factors. This case presents a unique instance of spontaneous uterine rupture in a multiparous woman without typical risk factors, highlighting the challenges of diagnosis and management in a resource-limited setting. The associated fetal cyclopia adds to the rarity of the case and contributes to the existing literature on uterine rupture. This report demonstrates the need for high clinical suspicion and prompt intervention, even in the absence of usual risk factors.</div></div><div><h3>Case presentation</h3><div>A 30-year-old, gravida 7, para 6 female presented with a two-day history of abdominal pain, vomiting, and subjective fever. The patient progressed to hemodynamic instability, vaginal bleeding, and loss of consciousness within a few hours of admission.</div></div><div><h3>Clinical discussion</h3><div>The main diagnosis was spontaneous uterine rupture with hemoperitoneum and a non-viable fetus with cyclopia. The therapeutic interventions included emergency exploratory laparotomy, evacuation of the hemoperitoneum, and subtotal hysterectomy. The patient recovered well and was discharged on postoperative day five.</div></div><div><h3>Conclusion</h3><div>This case underscores the unpredictable nature of uterine rupture and the importance of maintaining a high index of suspicion for this diagnosis, even in the absence of typical risk factors, particularly in resource-limited settings. Prompt surgical intervention and appropriate postoperative care are essential for favorable maternal outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111228"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783191","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":"Retroduodenal lymphangiomyoma: A rare cause of abdominal pain – A case report","authors":"Rana Ibrahim ,&nbsp;Abdallah Hazimeh ,&nbsp;Jamil Nasrallah ,&nbsp;Khodor Fahda ,&nbsp;Houssein Haidar Ahmad","doi":"10.1016/j.ijscr.2025.111220","DOIUrl":"10.1016/j.ijscr.2025.111220","url":null,"abstract":"<div><h3>Background</h3><div>Lymphangiomyomas are rare benign tumors arising from the lymphatic system, most commonly found in the retroperitoneum. Retroduodenal lymphangiomyomas are exceedingly rare and present significant diagnostic challenges due to their nonspecific symptoms and overlapping features with other retroperitoneal and gastrointestinal pathologies.</div></div><div><h3>Case presentation</h3><div>We report a 48-year-old man with persistent abdominal pain lasting several weeks. Clinical examination and laboratory investigations were unremarkable. Gastroscopy revealed no abnormalities. Contrast-enhanced computed tomography (CT) identified a well-demarcated, non-enhancing retroduodenal soft tissue lesion measuring 36 mm × 30 mm with punctate calcifications, suggestive of a benign process. Endosonography confirmed the lesion's location between the aorta and inferior vena cava. A fine-needle biopsy was avoided due to the lesion's vascular nature. Surgical excision was performed, and histopathological analysis revealed anastomosing vascular channels with smooth muscle proliferation, confirming the diagnosis of lymphangiomyoma. Postoperative recovery was uneventful, and follow-up imaging showed no recurrence.</div></div><div><h3>Discussion</h3><div>This case underscores the importance of a multidisciplinary approach involving radiology, surgery, and pathology in the diagnosis and management of retroduodenal lymphangiomyomas. Contrast-enhanced CT and histopathology are critical in distinguishing lymphangiomyomas from other retroperitoneal masses. Complete surgical excision remains the definitive treatment to prevent recurrence.</div></div><div><h3>Conclusion</h3><div>Although rare, retroduodenal lymphangiomyomas should be considered in the differential diagnosis of retroperitoneal masses with nonspecific symptoms.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111220"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143724704","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 case report of dyspnea that revealed a congenital left cardiac diverticulum of discovery in adulthood with a fatal course","authors":"Fethi Jebali ,&nbsp;Asma Ladib ,&nbsp;Mohamed Ali Chaouch ,&nbsp;Saida Hidouri ,&nbsp;Hafedh Daly ,&nbsp;Rachid Ben Soussia","doi":"10.1016/j.ijscr.2025.111223","DOIUrl":"10.1016/j.ijscr.2025.111223","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Congenital cardiac diverticula are rare malformations involving the myocardium, the endocardium, and occasionally the pericardium. They have variable presentations and are often incidental findings.</div></div><div><h3>Case presentation</h3><div>A 61-year-old man with no significant history presented worsening exertional dyspnea. Examination revealed obesity but was otherwise unremarkable. Initial tests were normal, but chest radiography showed cardiomegaly and ECG indicated diffuse microvoltage. Echocardiography revealed a large left ventricular diverticulum (7 × 8 cm) with a wide neck (4 cm) and severe dysfunction (EF 30 %). Coronary angiography confirmed normal coronary arteries. Despite intensive care, his condition deteriorated and required mechanical ventilation and vasoactive support. He underwent emergency surgery but succumbed intraoperatively.</div></div><div><h3>Clinical discussion</h3><div>Although rare, congenital cardiac diverticula can cause severe complications, including heart failure and sudden death. Echocardiography is the key to diagnosis, with CT or MRI providing further characterization. Surgery is the preferred treatment for symptomatic cases, while asymptomatic patients require close follow-up.</div></div><div><h3>Conclusion</h3><div>This case highlights the need for early diagnosis and timely intervention in congenital cardiac diverticula to prevent fatal outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111223"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725584","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":"Pancreatic panniculitis of the breast following post-ERCP pancreatitis: A case report","authors":"Diyaree Nihad Ismael ,&nbsp;Mohammed H. Ali AlBarznji ,&nbsp;Hakim Mahmud Ahmad ,&nbsp;Lusan Abdulhameed Arkawazi ,&nbsp;Araz Latif Rahim ,&nbsp;Sirwan Khalid Ahmed","doi":"10.1016/j.ijscr.2025.111226","DOIUrl":"10.1016/j.ijscr.2025.111226","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Pancreatic panniculitis (PP) is a rare dermatological manifestation of pancreatic disease, typically affecting the lower extremities. Breast involvement is exceedingly rare, posing diagnostic challenges as it can mimic inflammatory and neoplastic breast conditions. Recognizing this unusual presentation is crucial to avoid unnecessary interventions.</div></div><div><h3>Case presentation</h3><div>A 45-year-old woman with a history of laparoscopic surgery for hepatic hydatid cysts, gallbladder disease, and total thyroidectomy developed acute pancreatitis following an endoscopic retrograde cholangiopancreatography (ERCP) procedure for bile leak management. Within hours, she experienced progressive bilateral breast pain, erythema, and peau d'orange changes, initially suspected as mastitis. Imaging revealed inflammatory changes, and histopathological examination confirmed lobular panniculitis with adipocyte necrosis and ghost cells, diagnostic of pancreatic panniculitis. The patient was managed conservatively with intravenous fluids, analgesics, and supportive care, leading to complete symptom resolution.</div></div><div><h3>Clinical discussion</h3><div>Our findings align with prior reports highlighting the rarity of breast involvement in pancreatic panniculitis despite abundant breast adipose tissue. Histopathology showing lobular panniculitis with ghost cells matched established diagnostic criteria. Unlike previous variable timelines, our case showed a clear temporal link with post-ERCP pancreatitis. Consistent with existing literature, conservative management of pancreatitis successfully resolved skin manifestations, confirming the importance of treating the underlying condition.</div></div><div><h3>Conclusion</h3><div>Early recognition of pancreatic panniculitis in unusual sites can prevent unnecessary interventions. Conservative treatment of the underlying pancreatic disease remains the cornerstone of management, leading to symptom resolution.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111226"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725615","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":"Neonatal total gastrectomy as treatment for gastric rupture: Case report","authors":"Arturo Javier Cavazos Castro ,&nbsp;Castro Anaya Harold ,&nbsp;José Asz Sigall ,&nbsp;María Elena Ortega Ramírez ,&nbsp;Claudia Elitania Espinosa Guerrero ,&nbsp;Horacio G. Carvajal","doi":"10.1016/j.ijscr.2025.111217","DOIUrl":"10.1016/j.ijscr.2025.111217","url":null,"abstract":"<div><h3>Introduction</h3><div>Neonatal gastric perforation is an uncommon but life-threatening condition, rarely requiring gastrectomy. We report the case of a neonate requiring total gastrectomy secondary to suspected barotrauma leading to gastric perforation.</div></div><div><h3>Case presentation</h3><div>A 2-day-old term male was referred to our institution in extremis following attempted resuscitation with makeshift positive airway pressure ventilation in the setting of respiratory distress. Exam was notable for a distended, peritonitic abdomen, and abdominal radiograph showed massive pneumoperitoneum. Exploratory laparotomy revealed an extensive anterior gastric perforation extending from the pylorus to the esophagogastric junction, along with gross ischemia of the posterior gastric wall. The patient underwent gastrectomy with pouchless retrocolic Roux-en-Y esophagojejunostomy reconstruction. He was kept NPO (nil per os) on total parenteral nutrition for seven days. Esophagram on postoperative day 7 demonstrated patency of the esophagojejunal anastomosis without leaks, and he was transitioned to formula via nasojejunal tube feeds supplemented with vitamins and pancreatic enzymes. He was discharged home on postoperative day 45. At latest follow-up 2.9 years after surgery, his height and weight were in the 10th percentile for his age.</div></div><div><h3>Clinical discussion</h3><div>This report showcases the successful management of an extensive gastric perforation with gastrectomy and pouchless Roux-en-Y esophagojejunostomy. Multidisciplinary postoperative and outpatient care was essential to ensure a positive outcome.</div></div><div><h3>Conclusion</h3><div>Neonatal gastric perforation is a rare condition with high morbidity and mortality, particularly in those born prematurely or low birthweight. This patient suffered from an extensive gastric perforation secondary to suspected barotrauma, undergoing gastrectomy and esophagojejunostomy without a pouch, achieving adequate nutritional status for his age.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111217"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725616","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 case of low-grade fibromyxoid sarcoma of the thigh: Diagnostic and therapeutic challenges in a resource-limited setting","authors":"Mujaheed Suleman ,&nbsp;Jay Lodhia ,&nbsp;Alex Mremi ,&nbsp;Elizabeth Wampembe ,&nbsp;Felister Uisso ,&nbsp;Kondo Chilonga","doi":"10.1016/j.ijscr.2025.111218","DOIUrl":"10.1016/j.ijscr.2025.111218","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Low-grade fibromyxoid sarcoma is a rare, indolent soft tissue tumor with a deceptively benign histological appearance, high recurrence rates, and potential for late metastasis. It typically arises in the deep soft tissues of the extremities or trunk in young adults, but reports of unusual locations exist.</div></div><div><h3>Case presentation</h3><div>We report a 43-year-old African male with a 2-year history of a progressively enlarging left thigh mass. Initial attempts at traditional remedies delayed medical intervention. Examination revealed a large ulcerated mass, and imaging showed a well-circumscribed soft tissue tumor without bone involvement. The biopsy confirmed Low-grade fibromyxoid sarcoma, and the patient underwent hip disarticulation surgery. Histopathology showed typical Low-grade fibromyxoid sarcoma features with no lymph node involvement. Postoperative recovery was satisfactory, and the patient is undergoing rehabilitation.</div></div><div><h3>Clinical discussion</h3><div>Low-grade fibromyxoid sarcoma diagnosis is challenging due to its morphological heterogeneity. Ancillary studies, including MUC4 immunostaining, are critical but often unavailable in resource-limited settings. Wide surgical excision remains the primary treatment, as the tumor is less responsive to chemotherapy and radiotherapy. This case underscores the need for early medical intervention, clinician-led community education, and long-term follow-up.</div></div><div><h3>Conclusion</h3><div>This report highlights the rarity of Low-grade fibromyxoid sarcoma and its challenges in resource-limited settings. Future efforts should focus on establishing standardized management protocols and identifying prognostic biomarkers to improve patient outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111218"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725620","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":"Carotid body tumor associated with complete heart block: A rare case report with long-term follow-up","authors":"Ahmad Hoseinzadeh ,&nbsp;Hamed Nozari ,&nbsp;Ebrahim Zeraatpisheh ,&nbsp;Ali Tajaddini ,&nbsp;Mohsen Mohebbiniya ,&nbsp;Hamid Zaferani Arani","doi":"10.1016/j.ijscr.2025.111216","DOIUrl":"10.1016/j.ijscr.2025.111216","url":null,"abstract":"<div><h3>Introduction</h3><div>Carotid body tumor (CBT) is one of the most common paragangliomas in the head and neck region, accounting for only 0.6 % of tumors in this area. Here, we present a rare case of CBT associated with congenital complete heart block (CHB).</div></div><div><h3>Case presentation</h3><div>We report the case of a 47-year-old female with a history of left neck and ear pain, accompanied by a gradually enlarging neck mass over 2.5 years. Following initial evaluations and multiple differential diagnoses, CT angiography revealed an oval-shaped mass measuring 30 × 50 mm at the left carotid bifurcation, confirming a Shamblin type II CBT. Preoperative assessments demonstrated congenital CHB on electrocardiogram and echocardiography. The patient underwent complete tumor resection with all necessary precautions, including temporary pacemaker placement and careful monitoring.</div></div><div><h3>Clinical discussion</h3><div>CBTs are considered rare neoplasms, comprising only 0.6 % of head and neck tumors and approximately 0.03 % of all neoplasms. The surgical outcomes demonstrated that despite the coexistence of a CBT with CHB, safe and successful surgery is possible with careful planning and comprehensive management.</div></div><div><h3>Conclusion</h3><div>This case highlights the importance of precise diagnosis and management in rare combination cases and emphasizes the crucial role of collaboration between vascular surgery and anesthesiology specialists in minimizing surgical risks and improving patient quality of life.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111216"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777125","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":"Dandy-Walker malformation associated with hydrocephalus in a 15-month-old child: A case report with literature review","authors":"Turyalai Hakimi ,&nbsp;Hasibullah Baha Nijrabi ,&nbsp;Mohammad Yusuf Yadgari ,&nbsp;Khalid Mohammad Qasem ,&nbsp;Mohammad Anwar Jawed","doi":"10.1016/j.ijscr.2025.111229","DOIUrl":"10.1016/j.ijscr.2025.111229","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Dandy-Walker malformation is a posterior cranial fossa anomaly, characterized by the absence or hypoplasia of the vermis and cystic dilatation of the fourth ventricle, resulting in elevation of the tentorium and torcula. This condition can present with a broad range of neurological and developmental symptoms, highlighting the importance of early recognition and intervention to improve patient outcomes.</div></div><div><h3>Case presentation</h3><div>This case describes a 15-month-old male presenting with head enlargement and motor dysfunction. A computerized tomography scan identified absence of the cerebellar vermis and ventriculomegaly. The patient underwent ventriculoperitoneal shunt placement, leading to significant improvement (head size, motor function) and complete recovery from convulsion over a six-month follow-up.</div></div><div><h3>Clinical discussion</h3><div>The clinical presentation primarily originates from cerebellar dysfunction, impacting balance, coordination, vision, motor skills, cognition, and behavior. This condition occurs sporadically and is frequently associated with hydrocephalus. Treatment is centered on managing symptoms and related comorbidities.</div></div><div><h3>Conclusion</h3><div>Dandy-Walker malformation is a congenital anomaly of the posterior fossa that causes a wide range of neurological and developmental challenges, primarily hydrocephalus. Effective management requires a multidisciplinary team, including pediatric surgeons and pediatricians, with timely consultation with a pediatric neurosurgeon and neurologist being essential.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111229"},"PeriodicalIF":0.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143747527","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":"Acute peritonitis caused by a giant appendicolith: A rare case report and a literature review","authors":"Maryam Maghbool ,&nbsp;Babak Samizadeh ,&nbsp;Sepehr Ramezanipour","doi":"10.1016/j.ijscr.2025.111198","DOIUrl":"10.1016/j.ijscr.2025.111198","url":null,"abstract":"<div><h3>Introduction</h3><div>Giant appendicoliths, which are calcified deposits larger than 2 cm found in the appendix, are uncommon and often linked to appendicitis, as well as complications like perforation or abscess formation. The occurrence of a giant appendicolith leading to peritonitis without accompanying appendicitis is rare, presenting a distinct diagnostic and therapeutic challenge.</div></div><div><h3>Presentation of case</h3><div>A 77-year-old male with beta-thalassemia minor came in with acute pain in the right lower quadrant, along with nausea and vomiting. Upon examination, he showed signs of peritoneal irritation, including rebound tenderness and guarding. Laboratory tests indicated mild leukopenia and normal inflammatory markers. Imaging studies identified a 5 cm appendicolith and localized free fluid suggestive of perforation, along with signs of superimposed peritonitis. Surgical intervention revealed a distended appendix containing the giant appendicolith and an ileocecal perforation, but histopathological analysis showed no evidence of acute appendicitis. The patient underwent an appendectomy and repair of the perforation, resulting in an uneventful recovery.</div></div><div><h3>Discussion</h3><div>Giant appendicoliths can lead to significant mechanical irritation and complications such as perforation, even in the absence of the typical inflammatory response associated with appendicitis. The diagnostic difficulty arises from the lack of fever and elevated inflammatory markers, which are usually present in cases of acute appendicitis.</div></div><div><h3>Conclusion</h3><div>Giant appendicoliths should be included in the differential diagnosis for acute abdominal pain, even when appendicitis is not evident. This case highlights the necessity of thorough approaches for accurate diagnosis and effective treatment.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111198"},"PeriodicalIF":0.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725621","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}