International Journal of Surgery Case Reports最新文献

{"title":"Substantial medial para-meniscal cyst with a complex meniscal tear: A case report","authors":"","doi":"10.1016/j.ijscr.2024.110533","DOIUrl":"10.1016/j.ijscr.2024.110533","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Meniscal cysts, while infrequent with a prevalence of 1 %–8 %, may result in considerable knee discomfort and functional limitations. The cysts are categorized according to their position in relation through the meniscus, labeled as either intrameniscal or parameniscal. Although parameniscal cysts are often small and asymptomatic, they may expand and become painful with time. This case report describes an uncommon instance of a medial parameniscal cyst.</div></div><div><h3>Case presentation</h3><div>A 28-year-old male presented with persistent pain and swelling in the medial aspect of his left knee, lasting for 8 months. His symptoms were exacerbated by activities such as stair climbing and general mobility. On physical examination, a firm, fluctuating mass measuring 5 × 3 cm was noted. MRI revealed a complex tear in the posterior horn of the medial meniscus, along with a cyst measuring 4.9 × 3.2 × 2.0 cm. Arthroscopy identified a degenerative medial meniscus tear, and the cyst was excised through open surgery. The patient's recovery was uneventful, with full restoration of knee function within three months.</div></div><div><h3>Clinical discussion</h3><div>Parameniscal cysts often coexist with horizontal meniscal tears, influenced by factors like knee laxity, trauma, and degeneration. MRI is the preferred diagnostic tool, but high-resolution ultrasound can be beneficial. Treatment options include conservative management and surgical interventions like partial meniscectomy, emphasizing the need for comprehensive diagnosis and appropriate management.</div></div><div><h3>Conclusion</h3><div>This unique case of a medial parameniscal cyst highlights the critical need for timely diagnosis and intervention. Surgical treatment, including meniscectomy or meniscal repair, offers significant pain relief and functional improvement, demonstrating its effectiveness in managing such cases.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548338","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":"Atypical respiratory symptoms due to hepatic hydatid cyst: A case report of emergency surgery","authors":"","doi":"10.1016/j.ijscr.2024.110530","DOIUrl":"10.1016/j.ijscr.2024.110530","url":null,"abstract":"<div><h3>Introduction</h3><div>Cystic Echinococcosis (CE), caused by Echinococcus granulosus, primarily affects the liver and lungs, particularly in endemic regions. While commonly associated with gastrointestinal manifestations, CE can lead to severe complications that necessitate surgical intervention.</div></div><div><h3>Case presentation</h3><div>A 53-year-old female was referred due to a prolonged history of exertional dyspnea that recently worsened. Imaging studies indicated a large hydatid cyst in the right lobe of the liver and significant pleural effusion. Surgical management was conducted via thoracotomy, facilitating the excision of multiple cysts and drainage of the pleural fluid.</div></div><div><h3>Discussion</h3><div>This case illustrates the potential for respiratory symptoms to emerge from hydatid cyst infections, which often present with digestive issues. Effective diagnostic techniques are crucial for identifying the cysts and assessing their impact on surrounding structures. The surgical intervention not only relieved the patient's symptoms but also mitigated the risk of further complications associated with untreated cysts.</div></div><div><h3>Conclusion</h3><div>The findings underscore the importance of recognizing atypical presentations of hepatic hydatid cysts. Timely surgical intervention was essential in managing the patient's condition, highlighting the critical role of prompt diagnosis and treatment in preventing serious complications.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548329","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":"Paradoxical brain herniation following decompressive craniectomy: A case series and systematic review of literature","authors":"","doi":"10.1016/j.ijscr.2024.110477","DOIUrl":"10.1016/j.ijscr.2024.110477","url":null,"abstract":"<div><h3>Introduction</h3><div>Paradoxical brain herniation (PBH) represents a rare and potentially life-threatening complication observed in individuals following decompressive craniectomy. Its diagnosis necessitates a high level of suspicion, combined with clinical and imaging evidence, such as midline shift, herniation, and a decreased Glasgow Coma Scale (GCS). Given the rarity and severity of this condition, we conduct a comprehensive literature review to identify all documented predisposing factors, clinical presentations, and appropriate clinical management. This review will serve as a guide for effective treatment strategies.</div></div><div><h3>Case presentation</h3><div>In this report, we document three cases of post-traumatic PBH following decompressive craniectomy. The patient's predisposing factor was a lumbar puncture, with two cases resolving after Terendlenburg repositioning, hydration, and elective cranioplasty. The third case developed PBH after external ventricular drainage (EVD) insertion. Although the patient's GCS improved after clamping the EVD and hydration, the patient ultimately succumbed to meningitis.</div></div><div><h3>Clinical discussion</h3><div>The primary clinical manifestations of PBH often encompass a diminished GCS alongside radiographic evidence of midline shift and brain herniation. Various precipitating factors have been associated with PBH after decompressive craniectomy, including CSF drainage, dehydration, and upright positioning, although instances of spontaneous PBH have been documented. Reported therapeutic strategies encompass rehydration, Trendelenburg positioning, temporary cessation of CSF drainage, and cranioplasty.</div></div><div><h3>Conclusion</h3><div>Given the infrequency of PBH and the potential for misdiagnosis with brain edema, it is imperative to consider this condition in every patient who experiences a decreased level of consciousness following decompressive craniectomy.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568793","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 cystic Intradural extramedullary tumor of the lumbar spine mimicking arachnoid cyst: A case report","authors":"","doi":"10.1016/j.ijscr.2024.110535","DOIUrl":"10.1016/j.ijscr.2024.110535","url":null,"abstract":"<div><h3>Introduction</h3><div>Schwannoma, also known as neurilemmoma, is a benign tumor commonly found around the spinal nerve roots. Large, solitary cases of cystic degeneration within the extramedullary intradural compartment (IDEM) can be challenging for preoperative diagnosis. Furthermore, these cases are not extensively documented in the medical literature.</div></div><div><h3>Case presentation</h3><div>We report a case of giant invasive IDEM schwannoma in a 28-year-old man who presented with intermittent pain radiating to the left thigh without numbness. Magnetic resonance imaging (MRI) showed a complex cystic lesion within the spinal canal from the inferior end plate of L4 to the mid-body of S1.</div></div><div><h3>Clinical discussion</h3><div>The patient underwent a series of surgical procedures, including laminectomy and decompression at the L4-L5 level for resection of the tumor. Histopathological examination confirmed the diagnosis of schwannoma. The patient had a favorable postoperative recovery and experienced a resolution of symptoms.</div></div><div><h3>Conclusion</h3><div>The giant cystic lumbar schwannoma, although rare, necessitates careful diagnosis and management. The utilization of contrast-enhanced MRI aids in distinguishing it from other lesions. In cases of cystic spinal schwannoma, the lesion walls tend to be thicker and more irregular compared to other cysts, including arachnoid cysts. Histopathological examination should be utilized to identify these lesions intraoperatively. Surgical excision is the primary treatment, and complete excision should be attempted whenever feasible.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564611","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":"Cervical thymic cysts in children: A case report","authors":"","doi":"10.1016/j.ijscr.2024.110483","DOIUrl":"10.1016/j.ijscr.2024.110483","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Cervical thymic cysts are rare benign lesions that rarely considered in the differential diagnosis of neck cysts in children. The correct diagnosis is often made after surgical excision and though determination of the specific histopathological findings of the thymic cyst.</div></div><div><h3>Case presentation</h3><div>We report an observation of a cervical thymic cyst erroneously diagnosed preoperatively respectively as a cystic lymphangioma.</div></div><div><h3>Clinical discussion</h3><div>The diagnosis is generally rectified after surgery by identifying the specific histopathological findings of the thymic cyst. Treatment is surgical.</div></div><div><h3>Conclusion</h3><div>This diagnosis should be considered in front of any indolent lateral cervical mass.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142553569","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":"Case report: HPV related pelvic retroperitoneal squamous cell cancer of unknown primary presenting as ovary neoplasm","authors":"","doi":"10.1016/j.ijscr.2024.110528","DOIUrl":"10.1016/j.ijscr.2024.110528","url":null,"abstract":"<div><h3>Introduction</h3><div>Retroperitoneal tumors (RPTs) of the pelvis are rare and often present asymptomatically. We report a rare case of human papillomavirus (HPV)-related primary retroperitoneal squamous cell carcinoma (PRSCC) that was preoperatively misdiagnosed as adnexal cancer.</div></div><div><h3>Case presentation</h3><div>A menopausal 59-year-old woman presented with right leg pain persisting for two months. Imaging revealed a heterogeneous lesion in the right adnexal area; however, the uterus and left ovary appeared normal. Laboratory tests showed slightly elevated levels of cancer 125 (CA 125) and squamous cell carcinoma (SCC) antigens. The patient underwent surgical staging for the suspected ovarian cancer. Intraoperatively, the bilateral adnexa and uterus appeared normal. A lesion identified in the right pelvic retroperitoneal cavity was resected and its pathological analysis revealed SCC and cervical intraepithelial neoplasia III (CIN III) and immunohistochemical expression of cyclin-dependent kinase inhibitor 2A (p16) in the cervix. HPV 16 was identified by a polymerase chain reaction (PCR). The patient chose not to undergo any additional postoperative treatment. Her leg pain disappeared the day after the procedure but recurred a year later. A new tumor was detected on computed tomography (CT) in the same area.</div></div><div><h3>Discussion</h3><div>PRSCC is rare and can be misdiagnosed as a gynaecological neoplasm. HPV can migrate to the retroperitoneal space and act as a carcinogen in this location.</div></div><div><h3>Conclusions</h3><div>HPV infection may contribute to the development of PRSCC. Complete surgical resection, with adjuvant radiotherapy and chemotherapy, is a viable treatment approach.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548331","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":"Chronic bacterial osteomyelitis of the clavicle secondary to pectoralis major pyomyositis in a child: A case report","authors":"","doi":"10.1016/j.ijscr.2024.110525","DOIUrl":"10.1016/j.ijscr.2024.110525","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Chronic bacterial osteomyelitis of the clavicle is rare in children. It mainly results from hematogenous spread of the infection and exceptionally from a non-hematogenous origin.</div></div><div><h3>Case presentation</h3><div>A 11-year-old boy was admitted for two wounds in right clavicular and pectoral regions, evolving for weeks. He had history of right pectoralis major pyomyositis debridement 6 months ago. Initial X-rays did not identify any bone anomaly. After initial antibiotic treatment, he discontinued his follow-up and came up 3 months later, with a pus discharging fistula in the right pectoral region, with X-ray identifying a sequestrum over the right clavicle. After pus culture, a <em>Pseudomonas aeruginosa</em>-sensitive antibiotic treatment was conducted, with surgical treatment (fistulectomy and sequestrectomy). The postoperative course was unremarkable.</div></div><div><h3>Clinical discussion</h3><div>In children, osteomyelitis affects usually long bones. Its location on the clavicle is rare, but mainly due to a hematogenous spread. Infection from previous pectoralis major pyomyositis can occur due to its clavicular head, it is an exceptional mechanism.</div></div><div><h3>Conclusion</h3><div>Bacterial chronic osteomyelitis of the clavicle is rare, its origin from pectoralis major pyomyositis is even exceptional. However rarely reported, infection may be linked to <em>Pseudomonas aeruginosa</em>.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548332","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":"Fasttrack intubation with the head rotated 30° following a cervical stab wound. A case report","authors":"","doi":"10.1016/j.ijscr.2024.110498","DOIUrl":"10.1016/j.ijscr.2024.110498","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Airway management in patient with cervical trauma is often challenging, especially when it involves intubation.</div></div><div><h3>Case presentation</h3><div>An uncommon case of posterolateral blunt traumatic cervical spine injury was seen in our emergency department following an assault on a 19-year-old young man.</div><div>The only point of impact was cervical, the initial examination found a GCS = 15/15, no motor or sensory deficit.</div><div>The head was slightly rotated 30° to the left, the patient was hemodynamically and respiratorily stable, he was fasting.</div><div>The patient was directly transported to the neurosurgery operating room for exploration. Positioning could only be achieved with assistance; the patient was placed in the supine position, head turned 30° to the left, secured in a horseshoe-shaped headrest.</div><div>We chose the LMA Factrach for intubation to ensure optimal ventilation for the patient. The result was satisfactory, with successful intubation achieved on the first attempt.</div></div><div><h3>Clinical discussion</h3><div>Airway management in patient with cervical trauma is often challenging, especially when it involves intubation; maintaining the head in neutral position is not always feasible in cases of stab wounds, as the entry point of the sharp object often determines the head's position.</div><div>Intubating in non-standard positions is more challenging and often leads to poorer laryngoscopic visibility. This can create a disconnect between the quality of the laryngoscopic view and the ease of performing endotracheal intubation.</div><div>Awake fiberoptic nasotracheal intubation remains the gold standard in cases of difficult intubation with difficult ventilation criteria and nonstandard positioning.</div><div>Several scientific societies recommend videolaryngoscopy as the first-line approach for difficult intubations in the absence of difficult ventilation criteria. Nonetheless, the absence of such criteria does not guarantee effective ventilation following anesthetic induction, which necessitates the use of the laryngeal mask as a secondary measure to ensure oxygenation. The LMA Fastrach can facilitate the subsequent intubation process, particularly in situations where the stomach is not full.</div><div>We chose the LMA Fastrach to ensure optimal ventilation for the patient. The result was satisfactory, with successful intubation achieved on the first attempt.</div></div><div><h3>Conclusion</h3><div>The LMA Fastrach appears to be a very useful mean for air way management when the head cannot be kept in a neutral position.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548334","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":"Invasive mucinous urachal adenocarcinoma: A case report of surgical management and insights from the literature","authors":"","doi":"10.1016/j.ijscr.2024.110524","DOIUrl":"10.1016/j.ijscr.2024.110524","url":null,"abstract":"<div><h3>Introduction and Importance</h3><div>Urachal carcinoma (UrC) is a rare bladder malignancy originating from the urachus. Comprising around 90 % adenocarcinomas, most cases are invasive. Urachal adenocarcinoma is less common than its non-urachal counterpart and is recognized for its aggressive nature, often diagnosed at advanced stages with a poor prognosis. Early stages typically present as asymptomatic, making timely diagnosis challenging.</div></div><div><h3>Case Presentation</h3><div>We present the case of a 58-year-old female who exhibited painless hematuria, leading to further investigation. The definitive diagnosis of invasive mucinous urachal adenocarcinoma was established through cystoscopy and transurethral resection of bladder tumor (TURBT). Surgical intervention was undertaken to manage the condition.</div></div><div><h3>Clinical Discussion</h3><div>The gold standard treatment for muscle-invasive UrC is radical cystectomy. This case underscores the importance of recognizing urinary symptoms and utilizing appropriate diagnostic procedures to identify this rare malignancy early. The surgical approach is crucial in improving patient outcomes, especially in advanced cases.</div></div><div><h3>Conclusion</h3><div>Invasive mucinous urachal adenocarcinoma is a rare but aggressive cancer that requires prompt diagnosis and intervention. Surgical management proved effective in this case, emphasizing the need for awareness and regular follow-up in patients to monitor for recurrence.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548337","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 look at Zancolli-Lasso indications and surgical technique with a unique case","authors":"","doi":"10.1016/j.ijscr.2024.110499","DOIUrl":"10.1016/j.ijscr.2024.110499","url":null,"abstract":"<div><h3>Introduction</h3><div>Forearm lacerations could lead to disastrous disabilities, nerve injuries led by the ulna nerve cause severe hand deformity and disfunction with little options to repair.</div></div><div><h3>Case presentation</h3><div>A young male suffered a distal ulna nerve injury and underwent multiple surgeries over two years. Zancolli-Lasso procedure was done, and major improvement was obtained.</div></div><div><h3>Discussion</h3><div>A comprehensive approach for claw hand is essential, supple mobile joints and the Bouvier maneuver are the most decisive factors, literature shows that the right procedure will work for the right patient.</div></div><div><h3>Conclusion</h3><div>The Zancolli procedure could be a simple viable treatment for a compliant patient who suffers from hand clawing and adapted to a weaker pinch.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":null,"pages":null},"PeriodicalIF":0.6,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142548326","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}