International Journal of Surgery Case Reports最新文献

{"title":"Nonfunctioning paraganglioma of the bladder mimicking nested variant of urothelial cancer: A case report and clinical management","authors":"Knife Tsehaye Gebregziabher,&nbsp;Bedri Ahmed Kazali,&nbsp;Fadil Nuredin Abrar,&nbsp;Awash Solomon Gebremariam,&nbsp;Abdurrhman Kedir Hamza,&nbsp;Tsiyon Ngusie Alemu","doi":"10.1016/j.ijscr.2025.111169","DOIUrl":"10.1016/j.ijscr.2025.111169","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Non-functioning paraganglioma of the bladder is extremely rare disease. It is important to know the presence of paraganglioma of the bladder as the early and correct diagnosis affects the management and prognosis of the patient. Pathologists may misinterpret it as part of cystitis cystica/glandularis or nested variant urothelial carcinoma, or secondary bladder involvement by prostatic adenocarcinoma.</div><div>This report will contribute to the existing literature and provide valuable insights into the clinical characteristics and treatment options for this rare tumor.</div></div><div><h3>Presentation of case</h3><div>35 years old female patient presented after incidental finding of bladder mass on abdominal ultrasound during routine antenatal follow up. Cystoscope showed 2 × 2 cm single solid bladder mass. Microscopic examination was suggestive of neuroendocrine tumor with paragangliom as a differential diagnosis. Imminohistochemical studies showed positive for synaptophysin, S100, GATA-3 and negative for panCK. The patient was managed with partial cystectomy.</div></div><div><h3>Clinical discussion</h3><div>Non-functioning paragnaglioma of the urinary bladder is a rare extra-adrenal pheochromocystoma. The diagnosis is usually challenging and it may mimic urothelial carcinoma. Histopathology and immunohistochemistry are almost always confirmatory.</div></div><div><h3>Conclusion</h3><div>Urinary bladder paraganglioma may mimic nested variant of the bladder tumor. High clinical suspicion is important. Confirmation is with histopathology and immunohistochemistry. Partial cystectomy is treatment of choice.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111169"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705706","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":"Combined hepatocellular-cholangiocarcinoma in a middle-aged patient: A case report and review of therapeutic approaches","authors":"Chen Guo,&nbsp;Yutao He,&nbsp;Zhitian Shi,&nbsp;Lin Wang","doi":"10.1016/j.ijscr.2025.111165","DOIUrl":"10.1016/j.ijscr.2025.111165","url":null,"abstract":"<div><h3>Introduction</h3><div>Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a rare hepatic malignancy featuring both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) components, often leading to poor prognosis owing to its clinical complexity.</div></div><div><h3>Case presentation</h3><div>A middle-aged man presented with sudden abdominal pain and unexplained weight loss, leading to an initial diagnosis of CCA. The patient underwent laparoscopic left hepatectomy and lymph node dissection, and postoperative pathology confirmed cHCC-CCA with lymph node metastasis. Despite initial recovery, the disease recurred at 2 months and progressed to lung metastasis and multi-organ involvement by 7 months. Immuno-combination targeted therapy was ineffective, and the patient succumbed to the disease eight months after surgery.</div></div><div><h3>Discussion</h3><div>This case highlights the diagnostic and therapeutic challenges of cHCC-CCA, including its histological complexity, high recurrence rate, and limited treatment efficacy. Despite surgical resection, early recurrence and rapid progression to pulmonary metastasis were observed, emphasizing the need for improved treatment strategies for this condition. The failure of immune checkpoint inhibitors and targeted therapy suggests the need for alternative or combined therapeutic approaches.</div></div><div><h3>Conclusion</h3><div>Future research should focus on integrating molecular profiling into treatment selection, optimizing adjuvant therapies, and exploring novel targeted or immunotherapy combinations to improve the long-term outcomes. This report contributes to the growing evidence on cHCC-CCA and underscores the urgency of developing precise diagnostic tools and personalized treatment strategies.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111165"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644908","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":"Recurrent synovial chondromatosis in the hand leading to second ray amputation: A case report","authors":"Mallory Rongstad ,&nbsp;Jarod Moyer ,&nbsp;Rachel Mifflin ,&nbsp;Kevin Condit ,&nbsp;Kurt Rongstad","doi":"10.1016/j.ijscr.2025.111164","DOIUrl":"10.1016/j.ijscr.2025.111164","url":null,"abstract":"<div><h3>Introduction</h3><div>Synovial chondromatosis is a rare, benign metaplasia of the synovium characterized by the formation of cartilaginous nodules. This condition can lead to joint stiffness, pain, and damage. It is most common in the knee but has been described in various joints, including the hand. Due to its low prevalence and nonspecific symptoms, delayed diagnosis may lead to complications such as local invasion, pain, osteoarthritis, and, rarely, malignant transformation. Surgical intervention is often indicated after conservative management fails.</div></div><div><h3>Case report</h3><div>This report describes the complex case of synovial chondromatosis of the second metacarpophalangeal (MCP) joint in an 18-year-old female. Multiple surgical interventions culminated in amputation of her second ray for definitive management.</div></div><div><h3>Discussion</h3><div>This case underscores the complexities of diagnosing and managing synovial chondromatosis, particularly in rare locations like the hand. Despite radiographic and pathological evidence, a definitive diagnosis was delayed, contributing to prolonged morbidity. The aggressive and recurring nature of this case highlights the need to consider synovial chondromatosis in refractory hand and finger joint pain, regardless of patient age or gender. Questions remain about whether earlier aggressive intervention could reduce recurrence or if earlier amputation could improve outcomes.</div></div><div><h3>Conclusion</h3><div>This case highlights the challenges of diagnosing and managing recurrent synovial chondromatosis in the hand. Early recognition and aggressive intervention may prevent prolonged morbidity and functional impairment. Further research is needed to determine whether earlier amputation could improve outcomes in refractory cases.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111164"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637177","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":"Gastrointestinal stromal tumor in patient with neurofibromatosis type 1: A case report","authors":"Ahmed Ibrahimi,&nbsp;Salim Lachkar,&nbsp;Imad Boualaoui,&nbsp;Hachem El Sayegh,&nbsp;Yassine Nouini","doi":"10.1016/j.ijscr.2025.111166","DOIUrl":"10.1016/j.ijscr.2025.111166","url":null,"abstract":"<div><h3>Introduction</h3><div>Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with a 5–15 % risk of gastrointestinal stromal tumors (GISTs), of which 20–30 % may be malignant. Standard treatment includes surgery and adjuvant imatinib for high-risk cases. This case presents a rare large GIST in NF1 without organ invasion.</div></div><div><h3>Presentation of case</h3><div>A 39-year-old male with NF1 presented with a 6-month history of progressive abdominal distension and intermittent pain. Examination revealed typical NF1 signs, including café-au-lait spots, neurofibromas, and Lisch nodules. Imaging showed a large proximal ileal mass, suggestive of GIST. Surgery confirmed a well-circumscribed tumor, and histology revealed high-risk spindle-cell GIST with positive CD117 and DOG1 staining. The patient started adjuvant imatinib therapy for 3 years. Six months postoperatively, he remained asymptomatic with no recurrence on imaging. Regular follow-ups with CT scans and blood tests were scheduled to monitor disease progression and treatment response.</div></div><div><h3>Discussion</h3><div>NF1 is an autosomal dominant disorder with an increased risk of developing GISTs, which occur earlier and are more aggressive than sporadic cases. GIST diagnosis relies on imaging, with CT and MRI providing essential details, and confirmation through histopathology with CD117 and DOG1 markers. Surgical resection remains the primary treatment, with adjuvant imatinib recommended for high-risk cases to reduce recurrence. NF1-related GISTs have higher recurrence rates but respond well to targeted therapy. Regular follow-up with imaging is crucial.</div></div><div><h3>Conclusion</h3><div>Although GISTs are rare in NF1, they pose a significant risk due to their potential for malignancy and recurrence.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111166"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644337","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":"First time use of trans-anal endorectal pull through (Soave procedure) for management of recurrent rectal mucosal prolapse in children not responding to the conventional sclerotherapy interventions: A case series","authors":"A. Tadayon ,&nbsp;H. Hosseini ,&nbsp;O. Azh ,&nbsp;Sh. Yousufzai ,&nbsp;A. Rahmanian ,&nbsp;M. Pourkhosravani","doi":"10.1016/j.ijscr.2025.111176","DOIUrl":"10.1016/j.ijscr.2025.111176","url":null,"abstract":"<div><h3>Introduction</h3><div>Recurrent rectal mucosal prolapse in pediatric patients poses a therapeutic challenge, particularly when conventional treatments like sclerotherapy fail. This case series evaluates the Transanal Endorectal Pull-Through (Soave) procedure as a surgical alternative for children unresponsive to sclerotherapy, emphasizing its ability to preserve sacral plexus integrity.</div></div><div><h3>Case presentation</h3><div>Three pediatric cases (6.5-, 10.5-, and 14-year-old boys) with chronic constipation and recurrent rectal mucosal prolapse, unresponsive to sclerotherapy, underwent the Soave procedure. Hospital stays lasted 7–8 days, with no intra- or postoperative complications. Follow-ups at 6–12 months showed no recurrence, resolution of constipation, and high guardian satisfaction.</div></div><div><h3>Discussion</h3><div>The Soave procedure demonstrated efficacy and safety in treating recurrent rectal mucosal prolapse, with no recurrences or complications over one year. Unlike rectopexy, which risks constipation and incontinence, the Soave procedure preserves rectal integrity, minimizing pelvic trauma. Despite limitations such as small sample size and short follow-up, findings align with literature supporting minimally invasive techniques. Further research, including multicenter studies with larger sample sizes, is needed to confirm long-term outcomes.</div></div><div><h3>Conclusion</h3><div>The Soave procedure is a promising surgical option for recurrent rectal mucosal prolapse in children unresponsive to sclerotherapy, offering reduced recurrence and complications. Larger, long-term studies are essential to validate its efficacy.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111176"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143686770","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 prostatic abscess caused by MRSA in a healthy young male: A case report and literature review","authors":"Hamza A. Abdul-Hafez ,&nbsp;Adel Abu Al Rub ,&nbsp;Abd Alkarim Ali ,&nbsp;Laith B. Nassar ,&nbsp;Mohammed A.M. Rashed ,&nbsp;Mohammed A. Barakat","doi":"10.1016/j.ijscr.2025.111168","DOIUrl":"10.1016/j.ijscr.2025.111168","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Prostatic abscess (PA) is a rare urological condition typically associated with predisposing factors such as diabetes, immunosuppression, or prior instrumentation. It is most commonly caused by gram-negative organisms, with methicillin-resistant <em>Staphylococcus aureus</em> (MRSA) being a rare pathogen, even in immunocompromised individuals. Early diagnosis and prompt treatment are important to prevent severe complications.</div></div><div><h3>Case presentation</h3><div>We report a rare case of a previously healthy 37-year-old male who presented with severe back pain, dysuria, and perineal discomfort persisting for two weeks. Initial evaluation at another facility resulted in a misdiagnosis of urinary tract infection (UTI). At presentation, laboratory tests revealed leukocytosis and elevated C-reactive protein. CT scan showed a large prostatic abscess, measuring of 6 × 7 cm, with necrosis and septations. Blood, urine, and abscess cultures confirmed MRSA. Management involved CT-guided drainage of the abscess and intravenous vancomycin, resulting in complete clinical resolution.</div></div><div><h3>Case discussion</h3><div>While PA is uncommon, it should be considered in patients with persistent urinary symptoms or back pain unresponsive to standard treatment. MRSA as a causative agent is particularly rare in immunocompetent patients. This case highlights the need for early imaging and culture-directed therapy in atypical presentations.</div></div><div><h3>Conclusion</h3><div>This report highlights the importance of recognizing prostatic abscess as a differential diagnosis in young, otherwise healthy males with unresolved symptoms. Early intervention and targeted therapy ensure optimal outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111168"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644907","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":"Pelvic unicentric Castleman's disease mimicking accessory spleen: A rare presentation of Castleman's disease, a case report and literature report","authors":"Zemen Asmare Emiru ,&nbsp;Amsalu Molla Getahun ,&nbsp;Yoseph Gebremedhin Kassie ,&nbsp;Aklog Almaw Yigzaw ,&nbsp;Misganaw Abie Tasew ,&nbsp;Addisu Assfaw Ayen","doi":"10.1016/j.ijscr.2025.111177","DOIUrl":"10.1016/j.ijscr.2025.111177","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Castleman disease, a rare, mostly benign lymphoproliferative disorder, is classified as unicentric or multicentric Castleman disease, with HHV-8 association affecting the latter. Unicentric Castleman disease typically presents as a single enlarged lymph node, most often mediastinal, while multicenter Castleman disease involves multiple lymph nodes. Treatment depends on the type and severity, ranging from surgical resection for unicentric Castleman disease to chemotherapy for multicentric Castleman disease.</div></div><div><h3>Case presentation</h3><div>A 28-year-old Ethiopian man presented with three months of pelvic pain, altered bowel habits, and urinary frequency. The physical examination was unremarkable. Investigations revealed a retroperitoneal pelvic mass, initially suspected to be an accessory spleen. Surgery revealed a 10 × 8 × 4 cm mass. Histopathology showed features consistent with unicentric Castleman disease, confirmed by characteristic “onion skin” and “lollipop” appearances, CD20 positivity, and negative HHV-8 and Bcl-2. The patient recovered well after surgical resection.</div></div><div><h3>Case discussion</h3><div>Pelvic unicentric Castleman disease is a rare presentation of this uncommon disorder, typically affecting the mediastinum. While its pathogenesis is unclear, it's not associated with HHV-8, IL-6 overproduction, or human immunodeficiency virus in all cases (as in this patient). Unicentric Castleman disease is characterized by localized symptoms or may be asymptomatic, unlike multicentric Castleman disease which presents with systemic manifestations. Imaging (ultrasound and CT in this case) guides diagnosis, with histopathology confirming the characteristic “onion skin” and “lollipop” appearances. Surgical excision is the treatment of choice for unicentric Castleman disease, offering excellent outcomes (as seen in the patient). Multicentric Castleman disease requires more extensive treatment, with a less favorable prognosis. Long-term follow-up is crucial due to the risk of malignant transformation.</div></div><div><h3>Conclusion</h3><div>Unicentric pelvic Castleman disease, a rare condition sometimes confused with accessory spleen, requires histopathological diagnosis. While often linked to HIV/AIDS or HHV-8, it can occur without risk factors and usually responds well to surgical excision.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111177"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637680","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":"Retrograde intussusception as a rare complication of giant Meckel's diverticulum in a six-year-old male patient with intestinal obstruction: A case report","authors":"Nek Arthur Jonathan ,&nbsp;Tuhaise Gamukama ,&nbsp;Charles Tumwesige ,&nbsp;Odulusi Daniel ,&nbsp;James Ampumuza ,&nbsp;Arnold Bwambale Asingya","doi":"10.1016/j.ijscr.2025.111170","DOIUrl":"10.1016/j.ijscr.2025.111170","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Intussusception is a common surgical emergency in pediatric populations; however, its association with giant Meckel's diverticulum is exceedingly rare. This case report describes a unique presentation of retrograde ileo-ileal intussusception occurring in conjunction with a giant Meckel's diverticulum in a six-year-old boy.</div></div><div><h3>Case presentation</h3><div>A six-year-old male presented with signs of intestinal obstruction. Abdominal ultrasound revealed classic target signs, and the patient was taken for emergency laparotomy. Intraoperatively, a retrograde ileo-ileal intussusception into a giant Meckel's diverticulum was discovered, necessitating resection and end-to-end ileo-ileal anastomosis.</div></div><div><h3>Clinical discussion</h3><div>The case underscores the diagnostic challenges associated with retrograde intussusception. In the discussion, a comparison is made with a similar report describing Meckel's diverticulum associated with internal hernia and volvulus (Al-Salem et al., 2021), emphasizing the spectrum of complications related to Meckel's diverticulum. This comparison highlights the novelty of our case in the context of pediatric intestinal emergencies.</div></div><div><h3>Conclusion</h3><div>This report highlights the need for a high index of suspicion in pediatric patients with intestinal obstruction and emphasizes that retrograde intussusception complicating giant Meckel's diverticulum, although rare, should be considered in the differential diagnosis.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"130 ","pages":"Article 111170"},"PeriodicalIF":0.6,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143739705","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":"Complete common mesentery revealed by a cecal bascule: Two case reports","authors":"Mohamed Ben Khalifa ,&nbsp;Wajdi Missaoui ,&nbsp;Wassim Elguedr ,&nbsp;Ghassen Hamdi Kbir ,&nbsp;Mohamed Maatouk ,&nbsp;Moez Boudokhane","doi":"10.1016/j.ijscr.2025.111160","DOIUrl":"10.1016/j.ijscr.2025.111160","url":null,"abstract":"<div><h3>Introduction</h3><div>The complete common mesentery (CCM) is due to a midgut malrotation that occurs during embryonic development. Cecal volvulus (CV) is an uncommon cause of acute intestinal obstruction in this circumstance. The bascule subtype is the rarest form and happens when the cecum folds anteriorly over the ascending colon.</div></div><div><h3>Cases presentation</h3><div>We present two cases of acute intestinal obstruction caused by Cecal Bascule (CB) due to complete common mesentery. Notably, one patient was initially admitted wrongly for a strangulated umbilical hernia and underwent surgery without prior imaging. Both patients had open surgery consisting of a right colectomy with primary intestinal anastomosis with an uneventful recovery.</div></div><div><h3>Discussion</h3><div>During fetal development, the intestine rotates counterclockwise around the superior mesenteric artery. The disruption of this process leads to an anomaly called the complete common mesentery, associated with an abnormal fixation and an excessively mobile right colon positioned on the left of the abdomen. This abnormality can be revealed via a cecal volvulus with a bascule subtype, accounting for less than 10 % of all cecal volvulus. Right hemicolectomy with ileocolic anastomosis is the main treatment.</div></div><div><h3>Conclusion</h3><div>Complete common mesentery is a rare anomaly that can lead to serious complications, including cecal volvulus. Diagnosing this condition via abdominal CT scan can be challenging due to the modified radiological anatomy. Surgeons and radiologists must recognize this pathology. Even less experienced visceral surgeons must be aware and should remain vigilant, as one emergency can hide another.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111160"},"PeriodicalIF":0.6,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644906","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":"Management of a complex multiligament knee injury: Simultaneous reconstruction of ACL, PCL, and both meniscal roots","authors":"Mohamed Muath Adi,&nbsp;Ahmed Mohamed Yousif Mohamed,&nbsp;Mohanad Abdulgadir,&nbsp;Muhammad Rafat Meda,&nbsp;Nujud AbdelMoneim Sayed Mohamed,&nbsp;Jaber AlKhyeli","doi":"10.1016/j.ijscr.2025.111150","DOIUrl":"10.1016/j.ijscr.2025.111150","url":null,"abstract":"<div><h3>Introduction</h3><div>Multiligament knee injuries (MLKIs) can lead to severe complications like early osteoarthritis and functional loss. Meniscal root tears further increase these risks. This study reports the first documented case of simultaneous anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and dual meniscal root injuries, emphasizing the unique surgical and rehabilitative challenges involved.</div></div><div><h3>Presentation of case</h3><div>A 19-year-old male presented with persistent knee pain and instability seven months after a traumatic injury from a major fall. Examination revealed a range of motion of 0–120 degrees, no swelling or tenderness, but a positive recurvatum over 10 degrees, indicating significant instability. Lachman's, McMurray's, pivot shift, and both anterior and posterior drawer tests were positive.</div></div><div><h3>Discussion</h3><div>The radiography of the right knee revealed no fractures. The MRI confirmed injuries to the ACL, PCL, and the posterior roots of both the lateral and medial menisci. The patient received surgical intervention. Grafts were obtained: the peroneus longus tendon autograft for posterior cruciate ligament reconstruction and a hamstring autograft for anterior cruciate ligament reconstruction. The ACL and PCL reconstructions were subsequently performed utilizing an all-inside technique, and both posterior roots of the lateral and medial menisci were repaired. Postoperative care included knee immobilization and a progressive rehabilitation program.</div></div><div><h3>Conclusion</h3><div>Effective management of multiple ligament knee injuries necessitates a comprehensive approach, including precise identification and treatment of all torn ligaments, accurate graft placement, and robust fixation. Simultaneous reconstruction reduces hospital stays, anaesthesia exposure, and surgical risks while streamlining rehabilitation, enabling quicker patient recovery and improved outcomes.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"129 ","pages":"Article 111150"},"PeriodicalIF":0.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143644335","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}