Case Reports in Surgery最新文献

{"title":"Giant Mesenteric Lymphangioma in a Young Adult: A Rare Clinical Entity.","authors":"Abdo Imad El Tawil, Leandro Alencar Furtado Machoski, Beatriz Arnaut Mendes, Micheli Fortunato Domingos, João Carlos Chiquetto Filho, Fernando Issamu Tabushi, Eduardo José Brommelstroet Ramos","doi":"10.1155/cris/6779801","DOIUrl":"https://doi.org/10.1155/cris/6779801","url":null,"abstract":"<p><p>Cystic lymphangioma is a rare benign tumor of lymphatic origin, characterized by slow growth and variable clinical presentation. The presence of a peritoneal diverticulum is exceedingly rare in adults and often poses a diagnostic challenge owing to nonspecific symptoms and imaging findings. A 22-year-old previously healthy male presented with abdominal fullness and flatulence without other relevant symptoms. On physical examination, a firm, palpable abdominal mass was identified. Laboratory tests revealed mild elevations in alanine aminotransferase and alkaline phosphatase levels. Abdominal computed tomography (CT) revealed a cystic lesion in the epigastric and right hypochondriac regions adjacent to the liver, pancreas, and stomach. Magnetic resonance imaging (MRI) revealed a cystic mass suggestive of lymphangioma, measuring 21 cm × 20 cm × 16 cm. The patient underwent open retroperitoneal lymphadenectomy with complete excision of the lesion and additional foci located above the superior mesenteric vein. Histopathological examination confirmed the diagnosis of mesenteric cystic lymphangioma. Mesenteric lymphangiomas are rare in adults and present with vague, nonspecific abdominal symptoms. Imaging studies play an essential role in diagnosis, although definitive confirmation requires histopathological evaluation of the tissue. Complete surgical resection remains the treatment of choice and is critical for preventing recurrence and potential complications, such as infection, rupture, or intestinal obstruction. Given the rarity and diagnostic challenges of mesenteric cystic lymphangioma in adults, clinicians should maintain a high index of suspicion when evaluating abdominal cystic lesions in adults. Early surgical intervention is fundamental for achieving optimal outcomes and preventing future complications.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"6779801"},"PeriodicalIF":0.5,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833815","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":"Gallstone Ileus Secondary to Cholecystoduodenal Fistula: A Case Report and Review of Surgical Management.","authors":"Oluwaseun Adeyemi, Mitsu Patel, Elias Shamoun, Cory Cort, Charles Franco","doi":"10.1155/cris/7852699","DOIUrl":"https://doi.org/10.1155/cris/7852699","url":null,"abstract":"<p><p>Gallstone ileus is a rare cause of small bowel obstruction (SBO). It occurs when a gallstone passes through a cholecystoenteric fistula and obstructs the bowel. This case report aims to share our experience in managing an uncommon cause of SBO and to discuss available surgical management options, including the rationale for a staged approach in patients with significant comorbidities. We describe a 63-year-old woman with a history of hypertension, diabetes, gallstones, and uterine cancer treated with hysterectomy and radiation therapy, who presented with right upper quadrant pain and vomiting and subsequently developed signs of SBO. A computerized tomography scan of the abdomen and pelvis revealed a cholecystoduodenal fistula with evidence of a stone in the distal ileum. She subsequently underwent emergency enterolithotomy, successfully removing the stone, and was scheduled for a cholecystectomy at a later date to reduce her surgical risk. We discuss the three approaches to the surgical management of gallstone ileus-enterolithotomy alone, one-stage surgery (enterolithotomy + cholecystectomy with fistula repair), and two-stage surgery (enterolithotomy and delayed cholecystectomy with fistula repair).</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"7852699"},"PeriodicalIF":0.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811198","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":"Laparoscopic Management of Small Bowel Obstruction and Ischemia Caused by Spontaneous Transomental Hernia in a Virgin Abdomen: A Case Report.","authors":"Alaa Mousli","doi":"10.1155/cris/6668120","DOIUrl":"https://doi.org/10.1155/cris/6668120","url":null,"abstract":"<p><p>Transomental hernias (TOHs) are a rare form of internal hernia, accounting for ~1%-4% of all internal hernias and 0.5%-3% of bowel obstructions. Preoperatively diagnosing TOH is challenging owing to nonspecific obstructive symptoms and the absence of a hernia sac. This challenge can lead to delayed interventions and increased risk of bowel ischemia. In this report, we present the case of a 71-year-old female patient with a negative surgical history who presented with small bowel obstruction and a high lactate level. Abdominal computed tomography (CT) showed a closed-loop obstruction with wall thickening and decreased enhancement, raising concerns of ischemia. Laparoscopic exploration revealed spontaneous TOH through the greater omentum, resulting in small bowel obstruction and ischemia, which were successfully managed entirely with laparoscopic resection, anastomosis, and closure of the mesenteric defect. The patient's postoperative course was uneventful. This report discusses diagnostic challenges, surgical approaches, and key intraoperative findings.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"6668120"},"PeriodicalIF":0.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13127347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811185","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":"Evaluation of Rare Hand Injection Injuries With Three Different Substances.","authors":"Hasan Basri Çağlı, Salih Can Sezer, Abdurrahman Ercan Yurttaşer, Ahmet Özdemir, Tahir Babahan, Merve Özger, Mustafa Yılmaz","doi":"10.1155/cris/9941563","DOIUrl":"https://doi.org/10.1155/cris/9941563","url":null,"abstract":"<p><p>Injection injuries to the hand are rare and often underestimated in the initial evaluation due to minor external findings and mild symptoms. However, these injuries can lead to local and systemic complications with mechanical and toxic damage mechanisms. This study presents three cases of hand injection injuries caused by different substances.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"9941563"},"PeriodicalIF":0.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762676","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":"Axial Torsion of a Necrotic Giant Meckel's Diverticulum With Secondary Peritonitis in a 7-Year-Old: A Case Report.","authors":"Maria Daniela Trăilescu, Adrian Ionel Pavel, Adrian Silviu Crișan, Carmen Nicoleta Cindea, Henry Ifeanyi Osakwe, Georgiana Maria Boștinaru","doi":"10.1155/cris/9903442","DOIUrl":"https://doi.org/10.1155/cris/9903442","url":null,"abstract":"<p><p>Axial torsion with subsequent gangrene of Meckel's diverticulum represents an exceptionally rare cause of small bowel obstruction, one of the rarest causes of small bowel obstruction. Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract, and it is often discovered incidentally during abdominal surgery, particularly in pediatric patients. Approximately 4% of individuals with Meckel's diverticulum develop complications, including bleeding, obstruction, inflammation, intussusception, or perforation, with torsion being the rarest. Despite its rarity, symptomatic Meckel's diverticulum poses serious diagnostic and therapeutic challenges due to its nonspecific clinical presentation, which may mimic other intra-abdominal pathologies. Consequently, preoperative diagnosis is difficult, and delayed management may lead to life-threatening complications. We report a case of axial gangrenous torsion of a giant Meckel's diverticulum in a child without a history of previous abdominal surgery. In such cases, prompt decision-making for exploratory laparotomy or laparoscopy is crucial to achieving a favorable outcome. We report a case of axial torsion with gangrene of a giant Meckel's diverticulum in a 7-year-old boy with no prior history of abdominal surgery. This case highlights the importance of early recognition and timely operative management in atypical presentations of acute abdomen in children.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"9903442"},"PeriodicalIF":0.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13122426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762701","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":"Surgical Resection of Fibrolamellar Hepatocellular Carcinoma After Reassessment of Resectability: A Case Report.","authors":"Ruben R Lozano-Salazar, Xavier Rios-Covian-Molina, Andrea Rochel-Perez, Osvaldo Huchim-Mendez, Omar Bermudez Ferro, Nina Mendez-Dominguez","doi":"10.1155/cris/6138539","DOIUrl":"https://doi.org/10.1155/cris/6138539","url":null,"abstract":"<p><strong>Background: </strong>Fibrolamellar hepatocellular carcinoma (FL-HCC) is a rare variant of hepatocellular carcinoma (HCC) that typically arises in non-cirrhotic livers and affects younger individuals compared with conventional HCC. Because patients usually have preserved hepatic function, surgical resection may be feasible even in the presence of large tumors. However, diagnostic uncertainty and concerns regarding extrahepatic disease may limit initial surgical decision-making.</p><p><strong>Case presentation: </strong>We report the case of a 48-year-old male patient who presented with epigastric discomfort, weight loss, and a palpable abdominal mass. Contrast-enhanced imaging demonstrated a large hepatic lesion involving segments II, III, and IV, with additional pulmonary and adrenal findings initially raising concern for metastatic disease. The patient had previously been declined surgical treatment at another institution. Further multidisciplinary evaluation, imaging reassessment, and histological confirmation by percutaneous biopsy supported the diagnosis of FL-HCC without confirmed metastatic disease. An open anatomical left hepatectomy was performed. Histopathology confirmed FL-HCC with negative surgical margins and no lymph node metastases. Follow-up 36 months after surgery demonstrated no evidence of recurrence.</p><p><strong>Conclusion: </strong>This case highlights the importance of comprehensive staging and multidisciplinary reassessment in patients with suspected FL-HCC. Even when surgery has initially been declined, careful evaluation may identify candidates for potentially curative hepatic resection. Long-term surveillance remains essential due to the risk of recurrence following resection. Additionally, this report illustrates that FL-HCC can occur outside the typical age range, emphasizing the need to consider this diagnosis in compatible clinical and radiologic contexts.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"6138539"},"PeriodicalIF":0.5,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763110","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":"Primary Jejunal Melanoma Presenting as Widespread Metastases: Clinicopathological and Embryological Perspectives-A Case Report.","authors":"Mahi Balcı","doi":"10.1155/cris/8003106","DOIUrl":"https://doi.org/10.1155/cris/8003106","url":null,"abstract":"<p><p>Primary malignant melanoma of the small intestine is an exceptionally rare and diagnostically challenging condition, largely due to the predominance of metastatic involvement in the gastrointestinal (GI) tract. We report the case of a 71-year-old male presenting with a large, pigmented jejunal mass accompanied by multiple distant metastases in the liver, adrenal glands, and lungs. Histopathological and immunohistochemical analyses performed on the jejunal mass confirmed the diagnosis of malignant melanoma. Although systemic metastases were present, thorough clinical examination revealed no evidence of cutaneous, ocular, or mucosal primary lesions elsewhere, supporting the jejunum as the primary mucosal site of origin. This report discusses the embryological background, diagnostic challenges, and clinical significance of this rare entity. This case highlights that primary small bowel melanoma, although extremely rare, should be considered in patients presenting with intestinal lesions and disseminated metastases in the absence of an identifiable cutaneous primary lesion.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"8003106"},"PeriodicalIF":0.5,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109621/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763072","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 Large Galenic Dural Arterio-Venous Fistula in an Adult Managed Surgically: A Case Report.","authors":"Soumya Pahari, Paawan Bahadur Bhandari, Purushottam Baniya, Vinayak Dhungana, Nirvik Gurung","doi":"10.1155/cris/6662325","DOIUrl":"https://doi.org/10.1155/cris/6662325","url":null,"abstract":"<p><p>Galenic dural arteriovenous fistulas (GDAVFs) are rare, high-risk vascular malformations within the vein of Galen (VoG), commonly acquired due to factors like venous thrombosis, trauma, or infection and often resulting in severe complications such as hemorrhage or neurological deficits. A 55-year-old female presented with pulsatile tinnitus and headaches, with computed tomography (CT) angiography revealing a Borden type III GDAVF with obstructive hydrocephalus. She underwent microsurgical interruption of the fistula via a posterior interhemispheric approach, achieving significant nidus reduction, though a residual fistula persisted. At 3-month follow-up, the patient remained asymptomatic. This case underscores the challenges of GDAVFs, where their deep anatomical location complicates treatment, often necessitating a combination of endovascular and microsurgical approaches. Moreover, it highlights the impact of socioeconomic factors on healthcare access, particularly in resource-limited settings, and emphasizes the need for tailored, multidisciplinary strategies to optimize outcomes.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"6662325"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147762739","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":"Extensive Odontogenic Deep Neck Infection Complicated by Necrotizing Fasciitis and Bilateral Mastitis: A Rare Case Report.","authors":"Adil Aytaç, Uğur Dönmez, Bahar Yanık Keyik","doi":"10.1155/cris/5614042","DOIUrl":"https://doi.org/10.1155/cris/5614042","url":null,"abstract":"<p><strong>Objectives: </strong>Odontogenic infections are a leading cause of deep neck space infections and may progress rapidly through fascial planes, leading to severe complications such as necrotizing fasciitis, mediastinitis, and sepsis. This case represents an exceptionally rare example of odontogenic deep neck infection complicated by necrotizing fasciitis with bilateral breast involvement, emphasizing its potential for aggressive, life-threatening spread.</p><p><strong>Case report: </strong>We describe a 58-year-old woman with diabetes, hypertension, and coronary artery disease who presented with neck and chest wall swelling, erythema, crepitus, and sepsis after 2 weeks of inadequate treatment for a buccal abscess. Imaging revealed multicompartment spread with subcutaneous emphysema, myositis, abscess formation, and bilateral breast involvement. The patient underwent aggressive resuscitation, broad-spectrum intravenous antibiotics, and serial surgical debridements through extended cervical and anterior chest wall incisions, followed by negative pressure wound therapy (NPWT), resulting in clinical and laboratory improvement.</p><p><strong>Discussion: </strong>This case highlights the potential for odontogenic infections to progress beyond the neck into the thoracic wall and breast tissue, emphasizing the importance of early imaging and comprehensive source control. Diabetes was likely a significant predisposing factor for the rapid and extensive spread observed. Contrast-enhanced CT is critical for mapping disease extent and guiding timely surgical intervention, which is associated with reduced morbidity and mortality.</p><p><strong>Conclusions: </strong>Early recognition, imaging, and a multidisciplinary treatment strategy, including prompt broad-spectrum antibiotic therapy and repeated surgical debridement, are essential to prevent life-threatening complications of odontogenic deep neck infections. Clinicians should maintain a high index of suspicion in patients with systemic symptoms and comorbidities, even when initial dental infections appear minor.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"5614042"},"PeriodicalIF":0.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147763004","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":"Blunt Tracheal Trauma Managed Conservatively and Surgically: Two Case Reports.","authors":"Mohammad Alabdallat, Ahmad Kloub, Basil Younis, Ibrahim Afifi, Ayman El-Menyar, Ruben Peralta, Sandro Rizoli, Hassan Al-Thani","doi":"10.1155/cris/1502104","DOIUrl":"10.1155/cris/1502104","url":null,"abstract":"<p><p>Traumatic tracheobronchial injuries (TTBIs), while rare, are associated with significant morbidity and mortality. The management of these injuries requires a high degree of clinical suspicion, rapid diagnosis, and a multidisciplinary approach. We present two cases of TTBI, managed with varied approaches to achieve prompt, comprehensive, and optimal outcomes. The first case reported a 20-year-old male who presented with a blunt traumatic posterior tracheal wall at the T1/T2 level that was managed conservatively. The second case reported a 25-year-old motorcyclist presented with a tracheal injury at the T1 vertebra level that required surgical repair. The two treatment options were successful. The management of TTBI requires a highly individualized approach, balancing the urgency of surgical intervention with the potential benefits of conservative management.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"1502104"},"PeriodicalIF":0.5,"publicationDate":"2026-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13091006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721695","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}