International Journal of Surgery Case Reports最新文献

{"title":"Isolated jejunal amyloidosis presenting as acute mechanical small bowel obstruction: a rare diagnostic challenge - a case report.","authors":"Philippe Attieh, Rim Moubayed, Lamia Azizi, Karam Karam, Kim Charro","doi":"10.1097/RC9.0000000000000928","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000928","url":null,"abstract":"<p><strong>Introduction: </strong>Gastrointestinal (GI) involvement in amyloidosis is uncommon and usually occurs as part of systemic disease. Localized jejunal amyloidosis is exceptionally rare and may mimic neoplastic or inflammatory disorders because of its nonspecific presentation.</p><p><strong>Case presentation: </strong>A 77-year-old man with no significant medical history presented with acute abdominal pain, distension, and bilious vomiting. Contrast-enhanced CT demonstrated jejunal obstruction associated with circumferential wall thickening and multiple intraluminal polypoid lesions. Enteric magnetic resonance imaging confirmed these findings, suggesting an infiltrative lesion. Enteroscopy revealed multiple jejunal polypoid lesions, and biopsies demonstrated Congo red-positive amyloid deposition. Extensive investigations excluded systemic amyloidosis, establishing localized jejunal amyloidosis. Owing to symptomatic mechanical obstruction, the patient underwent segmental jejunal resection with primary anastomosis. Histopathology confirmed localized amyloid infiltration. Recovery was uneventful, and at 6-month follow-up the patient remained asymptomatic without recurrence.</p><p><strong>Discussion: </strong>Localized jejunal amyloidosis causing true mechanical bowel obstruction is exceedingly rare. This case highlights the diagnostic challenge posed by nonspecific imaging and endoscopic findings and emphasizes the importance of histopathological confirmation.</p><p><strong>Conclusion: </strong>Amyloidosis should be considered in the differential diagnosis of unexplained small bowel obstruction. Surgical resection provides both definitive diagnosis and effective treatment in obstructive localized disease.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4284-4287"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167568","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":"Retroperitoneal necrotizing fasciitis masquerading as perforated viscus: a rare case report.","authors":"Binyam Mulatu Habte, Yoseph Mulatu Habte, Abel Tariku Agoje, Makida Mulatu Habte, Helina Takele, Dagmawi Dagne Gelaye","doi":"10.1097/RC9.0000000000000946","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000946","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Necrotizing fasciitis is a rapidly progressive, life-threatening soft-tissue infection associated with high mortality, particularly when diagnosis is delayed. While most cases involve the extremities or perineum, retroperitoneal necrotizing fasciitis is exceedingly rare. Its deep anatomical location often results in vague clinical presentations, allowing extensive infection before overt signs develop, which poses significant diagnostic and therapeutic challenges. Early recognition and timely intervention are critical to improving outcomes.</p><p><strong>Presentation of case: </strong>We report the case of a 40-year-old male who presented with nonspecific abdominal and flank pain, and low-grade fever of 2 days duration. Imaging revealed extensive retroperitoneal gas and fascial involvement. Urgent exploratory laparotomy confirmed necrosis of the bilateral abdominal wall fascia and retroperitoneal involvement. Initial surgical debridement was performed along with broad-spectrum antimicrobial therapy. Postoperatively, the patient underwent repeat surgical drainage. Despite initial stabilization, he progressed to acute kidney injury, hyperbilirubinemia, and biochemical evidence of pancreatitis, necessitating intensive care. The patient ultimately succumbed to uncontrolled sepsis with multiorgan failure on the sixth postoperative day.</p><p><strong>Discussion: </strong>Retroperitoneal necrotizing fasciitis is difficult to diagnose due to nonspecific symptoms and deep anatomical location. Imaging, particularly contrast-enhanced computed tomography, is essential for detecting fascial necrosis and retroperitoneal gas. Even with prompt surgical debridement and broad-spectrum antibiotics, the infection can progress rapidly along fascial planes, causing secondary abscesses and multiorgan dysfunction.</p><p><strong>Conclusion: </strong>Retroperitoneal necrotizing fasciitis can progress silently and rapidly, leading to multiorgan failure. Heightened clinical suspicion, early imaging, and prompt surgical management are crucial for improving patient outcomes.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4156-4160"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168359","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":"Fibrocystic disease within an axillary accessory breast (Kajava class IV): a case report.","authors":"Rawan Al-Ahmar, Osama Haj Osman, Lina Ghabreau, Kusay Ayoub","doi":"10.1097/RC9.0000000000000937","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000937","url":null,"abstract":"<p><strong>Introduction: </strong>Accessory breast tissue is a congenital anomaly occurring in 0.4-6% of the population, most commonly in the axilla. While this tissue is subject to the same physiological and pathological changes as orthotopic breast tissue, fibrocystic disease presenting as a large axillary mass is rare, representing a diagnostic challenge that mimics lipomas and other conditions common in the axillary region.</p><p><strong>Case presentation: </strong>We report a case of 33-year-old female who presented with a chronic painful mass in the left axilla that have been present for 10 years. Clinical examination revealed a soft, mobile mass without associated nipple or areola (Kajava Class IV). Initially suspected to be a lipoma, ultrasonography suggested ectopic breast tissue. Excisional biopsy was performed, revealing a mass of size 9 × 8.5 x 3.5 cm. Histopathological analysis confirmed benign mammary parenchyma with prominent fibrocystic changes, including ductal ectasia and apocrine metaplasia. The patient showed satisfactory recovery with no recurrence at the 1-month follow-up.</p><p><strong>Discussion: </strong>This case emphasizes the importance of including accessory breast tissue in the differential diagnosis of axillary swellings, even when clinical features suggest more common benign lesions like lipomas.</p><p><strong>Conclusion: </strong>Early recognition through clinical suspicion, imaging, and histopathological confirmation is crucial, particularly in low-resource settings, to ensure appropriate management and monitor for potential neoplastic transformation.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4280-4283"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652454/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168796","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":"Aggressive mediastinal amyloidosis mimicking malignancy: a case report.","authors":"Sergio Andres Siado Guerrero, Jorge Ramírez Pereira, María Paula Motta Aguirre, Yeni Alexandra Arroyave-Guerrero","doi":"10.1097/RC9.0000000000000925","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000925","url":null,"abstract":"<p><strong>Introduction: </strong>Amyloidosis is characterized by extracellular protein fibril deposition. Light-chain (AL) amyloidosis may be associated with plasma cell dyscrasias. Isolated mediastinal involvement is exceptionally rare and may mimic malignant tumors.</p><p><strong>Case presentation: </strong>A 69-year-old woman presented with a progressively enlarging anterior chest wall mass caused by an invasive mediastinal lesion. Biopsy revealed amyloid deposition. She underwent bilateral thoracotomy, sternectomy, <i>en-bloc</i> chest wall resection, and reconstruction. Final pathology confirmed AL amyloidosis associated with a kappa-restricted plasma cell neoplasm. Subsequent hematologic evaluation demonstrated active multiple myeloma.</p><p><strong>Clinical discussion: </strong>Mediastinal amyloidosis may present as a locally aggressive pseudotumoral mass mimicking malignancy. Histopathological confirmation is essential for diagnosis. The association between AL amyloidosis and plasma cell neoplasms may create additional diagnostic challenges and should be considered even in apparently localized thoracic presentations.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic and therapeutic challenges of mediastinal AL amyloidosis with aggressive pseudotumoral behavior. Comprehensive hematologic evaluation should be performed early in all patients with localized thoracic AL amyloidosis to exclude occult plasma cell dyscrasia. Radical surgical resection may be justified in selected patients presenting with extensive local invasion and suspicion of primary thoracic malignancy. Long-term multidisciplinary surveillance remains essential because systemic progression may occur despite apparently localized initial disease.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4161-4166"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169826","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":"Idiopathic sclerosing encapsulating peritonitis (abdominal cocoon) presenting with abdominal pain and palpable mass: a case report.","authors":"Mikiyass Cherinet Kifetew, Robel Tibebu Kasaye, Nina Adaiah Berr, Kalkidan Abera Dinku, Michael Akalu Geleta, Patrick Elie Imanishimwe","doi":"10.1097/RC9.0000000000000935","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000935","url":null,"abstract":"<p><strong>Introduction: </strong>Sclerosing encapsulating peritonitis (SEP), also known as abdominal cocoon, is a rare condition characterized by a fibrocollagenous membrane encasing the bowel, leading to symptoms ranging from vague abdominal discomfort to intestinal obstruction. It may be primary (idiopathic) or secondary, most commonly associated with prior peritoneal dialysis.</p><p><strong>Case presentation: </strong>A 45-year-old Ethiopian man presented with acute periumbilical abdominal pain, nausea, and a palpable abdominal mass, with a background of chronic intermittent abdominal symptoms for 5 years. Exploratory laparotomy revealed small bowel loops encased in a thick fibrocollagenous membrane consistent with abdominal cocoon. Complete membrane excision was performed, with preservation of bowel viability. Histopathology confirmed fibrocollagenous tissue with sclerosis and inflammatory infiltrates. The postoperative course was uneventful.</p><p><strong>Discussion: </strong>The pathogenesis of primary SEP remains unclear but is thought to involve chronic peritoneal inflammation. Due to its nonspecific presentation, diagnosis is often made intraoperatively, particularly in resource-limited settings. Surgical excision of the encapsulating membrane remains the mainstay of treatment.</p><p><strong>Conclusion: </strong>This case highlights the diagnostic challenges of abdominal cocoon and emphasizes the importance of maintaining a high index of suspicion, especially in patients from resource-limited settings presenting with unexplained intestinal obstruction.</p><p><strong>Graphical abstract available at: </strong>https://links.lww.com/IJSCR/A143.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4258-4261"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169937","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":"Neuropathic symptoms after sleeve gastrectomy: two cases illustrating diagnostic pitfalls and discordant nerve conduction findings - a case report.","authors":"Ahmad E Al-Mulla, Abdulla E Sultan, Obaid Al-Harbi, Nour A Jibara","doi":"10.1097/RC9.0000000000000924","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000924","url":null,"abstract":"<p><strong>Introduction: </strong>Peripheral neuropathy is a recognized but often underappreciated complication after sleeve gastrectomy, particularly in patients with rapid weight loss, recurrent vomiting, poor oral intake, and inadequate adherence to postoperative supplementation.</p><p><strong>Presentation of case: </strong>We describe two young women who developed neuropathic symptoms within 3-4 months of laparoscopic sleeve gastrectomy. Both experienced substantial early weight loss, poor oral intake, recurrent vomiting or regurgitation, and poor adherence to prescribed supplements. Serum vitamin B12 and thiamine levels were elevated in both cases. In the first case, nerve conduction studies demonstrated mild axonal sensorimotor polyneuropathy. In the second, symptoms were neuropathic in character, but lower-limb electrophysiological studies were normal, and interpretation was complicated by spinal imaging abnormalities and interrupted treatment adherence.</p><p><strong>Clinical discussion: </strong>These cases underscore the limitations of routine serum vitamin measurements in excluding clinically relevant nutritional neuropathy and highlight the importance of considering alternative neurological or musculoskeletal explanations while initiating prompt empirical treatment in high-risk patients.</p><p><strong>Conclusion: </strong>Early nutritional reassessment and empirical vitamin replacement should be considered in symptomatic patients after sleeve gastrectomy, particularly when poor intake and rapid postoperative weight loss are present.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4243-4246"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652481/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149172292","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":"Duodenal atresia associated with apple-peel configuration of distal small bowel in a late preterm neonate: a rare case report and literature review.","authors":"Minale Menberu Kebede, Jejaw Endale Mihretie, Mesfin Tesera Wassie, Asratu Getnet Amare, Temesgen Agegnehu Abebe","doi":"10.1097/RC9.0000000000000912","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000912","url":null,"abstract":"<p><strong>Introduction: </strong>The association of duodenal atresia with apple-peel (Christmas tree) configuration of the distal small bowel is exceptionally rare, with only a few cases reported in the literature. This unusual combination is of particular interest because it may provide evidence supporting a vascular etiology for selected cases of duodenal atresia. We report a neonate with type III duodenal atresia associated with apple-peel bowel and absent proximal superior mesenteric artery anatomy.</p><p><strong>Case presentation: </strong>A late-preterm (35 + 5 weeks) female neonate with antenatal suspicion of jejunal atresia presented on the second day of life with bilious vomiting and mild abdominal distension. Plain abdominal radiography demonstrated a double-bubble sign suggestive of duodenal obstruction. Exploratory laparotomy revealed type III duodenal atresia immediately distal to the ampulla of Vater. The third and fourth portions of the duodenum, the ligament of Treitz, and the proximal superior mesenteric artery were absent. The distal small bowel exhibited an apple-peel configuration, with a long segment of jejunum and ileum spiraling around a single vascular pedicle in the absence of normal mesentery.</p><p><strong>Diagnosis therapeutic intervention and outcomes: </strong>A diagnosis of duodenal atresia associated with apple-peel small bowel was established intraoperatively. Duodenojejunostomy was performed with preservation of maximal bowel length. The postoperative course was uneventful, with successful establishment of enteral feeding and discharge in stable condition.</p><p><strong>Conclusion: </strong>This rare association supports an intrauterine vascular etiology for both duodenal atresia and apple-peel bowel. Awareness of this variant is essential for careful surgical planning and bowel preservation, while trans-anastomotic feeding offers a crucial alternative for early enteral nutrition in total parenteral nutrition-limited settings.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4185-4188"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170112","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":"Feasibility of primary repair in extensive gunshot-induced colon injuries with severe fecal contamination: a case series of six patients and review of literature.","authors":"Taha Negahdari, Aidin Darbeh, Mahdokht Azizi, Reza Valiandoost, Raha Rahmani, Mohammadamin Kashefi","doi":"10.1097/RC9.0000000000000926","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000926","url":null,"abstract":"<p><strong>Background: </strong>The optimal management of penetrating colon injuries, particularly in the presence of high-risk features such as severe fecal contamination, hemodynamic instability, and extensive tissue damage, remains controversial. Although primary repair has gained increasing acceptance, fecal diversion is still frequently performed in complex cases due to concerns regarding anastomotic failure and septic complications. Evidence specifically addressing the feasibility of primary repair in patients with extensive destructive injuries is limited.</p><p><strong>Case presentation: </strong>We report a case series of six patients with shotgun-induced colon injuries characterized by multiple perforations and varying degrees of fecal contamination. All patients met at least one traditionally accepted indication for fecal diversion, including hemodynamic instability, delayed presentation, or extensive injury. Despite these high-risk features, all patients underwent primary repair or resection with primary anastomosis. Postoperative morbidity was limited, with one surgical site infection and one anastomotic leak requiring reoperation. No mortality was observed.</p><p><strong>Discussion: </strong>Our findings are consistent with an evolving body of literature supporting primary repair in penetrating colon trauma. While prior studies have demonstrated favorable outcomes in selected patients, many have excluded those with extensive destructive injuries or severe contamination. In contrast, this series focuses on a high-risk subgroup, suggesting that traditional contraindications may not independently predict adverse outcomes when contemporary trauma care principles and careful patient selection are applied. These findings support a more individualized, physiology-based approach rather than strict adherence to protocol-driven decision-making.</p><p><strong>Conclusion: </strong>Primary repair or resection with primary anastomosis may be a feasible and safe option in carefully selected patients with complex, shotgun-induced colon injuries, even in the presence of traditional high-risk features. Further multicenter studies are warranted to better define selection criteria and validate these findings.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"3990-3995"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170808","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":"Focal laser photocoagulation for circumscribed choroidal hemangioma: a case report.","authors":"Badr Alahmadi, Alaa Almuzaini, Razan Alawaz, Esraa Alshareef, Ali Almalki","doi":"10.1097/RC9.0000000000000907","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000907","url":null,"abstract":"<p><strong>Background: </strong>Circumscribed choroidal hemangioma (CCH) is a benign vascular tumor that may cause visual loss due to chronic subretinal fluid and macular involvement. Various treatment modalities have been described, including photodynamic therapy, laser photocoagulation, and anti-vascular endothelial growth factor (VEGF) therapy. We report a case of symptomatic CCH successfully treated with focal laser photocoagulation after an inadequate response to intravitreal aflibercept.</p><p><strong>Methods: </strong>A 59-year-old male presented with progressive visual decline in the left eye. Clinical examination and multimodal imaging, including fundus photography, optical coherence tomography (OCT), and fluorescein angiography (FA), were performed. The patient initially received three monthly intravitreal aflibercept injections without significant anatomical or functional improvement. Focal laser photocoagulation was subsequently applied directly over the extrafoveal lesion.</p><p><strong>Results: </strong>Fundus examination revealed an orange choroidal lesion nasal to the optic disc, with associated subretinal fluid extending to the macula. OCT demonstrated subretinal and intraretinal fluid, while FA showed progressive hyperfluorescence consistent with CCH. Following two sessions of focal laser photocoagulation, complete resolution of subretinal fluid was achieved. Best-corrected visual acuity improved from 6/120 to 6/15 and remained stable throughout 18 months of follow-up without recurrence.</p><p><strong>Conclusion: </strong>Focal laser photocoagulation can provide favorable anatomical and visual outcomes in selected patients with extrafoveal CCH, particularly when anti-VEGF therapy is ineffective and photodynamic therapy is unavailable.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4141-4144"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168756","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":"The concurrence of osteochondromatosis and bone infarction in a patient with anterior cruciate ligament rupture: a rare case report.","authors":"Tai Duc Tran, Duc Hoang Tran, Vuong Ngoc Vu, Toan Nguyen Thanh, Tri Quang Le","doi":"10.1097/RC9.0000000000000932","DOIUrl":"https://doi.org/10.1097/RC9.0000000000000932","url":null,"abstract":"<p><strong>Introduction: </strong>Synovial osteochondromatosis and bone infarction are two uncommon conditions that typically present independently and are frequently misdiagnosed due to their nonspecific symptoms. This case highlights an exceptionally rare clinical scenario, underscoring the importance of meticulous imaging evaluation and integrated surgical management.</p><p><strong>Presentation of case: </strong>A 38-year-old male diver with a history of heavy smoking presented with knee instability, pain, and swelling following trauma. Examination revealed anterior cruciate ligament (ACL) rupture with concomitant meniscal tears. Imaging demonstrated multiple intra-articular calcified loose bodies, synovial proliferation consistent with synovial osteochondromatosis, and bone infarctions of the distal femur and proximal tibia. Arthroscopic management included loose body removal, synovectomy, meniscal repair, tibial drilling for infarct revascularization, and all-inside ACL reconstruction. Histopathology confirmed chronic synovitis and osteochondromatosis. At the 12-month follow-up, the patient demonstrated significant functional improvement, as assessed by clinical outcome scores.</p><p><strong>Discussion: </strong>The patient's occupation and smoking habit may have contributed to vascular compromise, repetitive microtrauma, and synovial metaplasia. Arthroscopy offers a minimally invasive approach, enabling the simultaneous treatment of all lesions. Persistent mild pain was likely related to underlying bone infarction.</p><p><strong>Conclusion: </strong>To the best of our knowledge, this is an extremely rare case involving the concurrence of synovial osteochondromatosis, bone infarction, and ACL rupture in a single patient. Arthroscopic management was feasible and was associated with satisfactory short-term clinical and functional improvement in this patient.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"138 10","pages":"4247-4252"},"PeriodicalIF":0.6,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170002","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}