Case Reports in Surgery最新文献

{"title":"Surgical Management of Atraumatic Rupture of Splenic Artery Aneurysm with Spleen Preservation in a Regional Australian Hospital.","authors":"Emma Jane Hamilton,&nbsp;Samuel Ngugi,&nbsp;Rasika Kotakadeniya","doi":"10.1155/2023/5738806","DOIUrl":"https://doi.org/10.1155/2023/5738806","url":null,"abstract":"<p><p>A 41-year-old male presented to the emergency department of a regional Australian hospital with chest and abdominal pain. He became rapidly haemodynamically unstable and was diagnosed with a ruptured splenic artery aneurysm and large volume hemoperitoneum. Due to the regional location of our small hospital, endovascular services are not available and the patient required emergency laparotomy. At laparotomy, a 2 L hemoperitoneum was evacuated, and the bleeding splenic artery aneurysm was identified and controlled. The aneurysm was approached with a unique technique via division of the gastro colic omentum to enter the lesser sac. This allowed adequate exposure of the splenic artery and proximal and distal control of the vessel was achieved. Adequate perfusion to the spleen was preserved by this surgical technique and splenectomy was therefore not required. This study details the management of this patient, details of the interoperative technique, and a discussion regarding splenic artery aneurysms. Splenic artery control and ligation without splenectomy may be considered in appropriate patients and splenectomy is therefore not always required in cases of hemodynamic instability where open surgical management is performed.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2023 ","pages":"5738806"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10010872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9129375","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":"Delayed Diagnosis of Blunt Ureteral Injury following Motor Vehicle Collision.","authors":"Alexander Canales,&nbsp;Harsh Desai","doi":"10.1155/2023/8869634","DOIUrl":"https://doi.org/10.1155/2023/8869634","url":null,"abstract":"<p><strong>Background: </strong>A 19-year-old male requiring emergency surgery after presenting to the emergency department (ED) as a trauma activation status post-motor vehicle collision. <i>Summary.</i> The patient presented to the ED after a motor vehicle collision. He was taken emergently to the operating room after finding hemoperitoneum on computerized tomography scan without evidence of solid organ injury. Significant small and large bowel injuries were discovered requiring resection and anastomosis. The patient had an uneventful post-operative recovery and was discharged home. He was later re-admitted to the hospital with a large pelvic abscess and a left mid-ureteral stricture causing hydronephrosis. The abscess was treated with antibiotics, and the left ureteral injury was treated with a nephrostomy tube and stent placement. He made a full recovery after hospital re-admission and a delay in diagnosis of blunt ureteral injury.</p><p><strong>Conclusion: </strong>Patients involved in motor vehicle collisions are at risk of multi-system trauma including genito-urinary injuries. A small percentage of these patients may present with blunt ureteral injuries. A high index of suspicion is required to make an early diagnosis. Earlier diagnosis may help to prevent morbidity.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2023 ","pages":"8869634"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10181907/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9468660","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":"Two Sites of Obstruction with Gallstones: A Case Report of Bouveret Syndrome with a Concurrent Biliary Ileus.","authors":"Eric Bergeron,&nbsp;Maude Pichette","doi":"10.1155/2023/9664165","DOIUrl":"https://doi.org/10.1155/2023/9664165","url":null,"abstract":"<p><p>Bouveret syndrome is a gastric outlet obstruction, and biliary ileus is an obstruction of the small bowel, and both are caused by a gallstone that escaped the gallbladder through a bilio-enteric fistula. The concurrent occurrence of obstruction at both sites is encountered very rarely, and only two such cases associated with Bouveret syndrome were reported before. We now present a case involving a 78-year-old female with simultaneous obstruction at both the duodenum and jejunum. The literature is reviewed to evaluate the incidence of such a situation and to discuss the management of the case.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2023 ","pages":"9664165"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10361827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9864207","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":"Cecal Perforation Induced by Migrated Biliary Stent as a Rare Complication of ERCP: A Case Report and Literature Review.","authors":"Arash Mohammadi Tofigh,&nbsp;Hamed Tahmasbi,&nbsp;Majid Iranshahi,&nbsp;Alireza Haghbin Toutounchi,&nbsp;Hojatolah Khoshnoudi,&nbsp;Seyed Pedram Kouchak Hosseini","doi":"10.1155/2023/9493333","DOIUrl":"https://doi.org/10.1155/2023/9493333","url":null,"abstract":"<p><p><i>Introduction and Importance.</i> Endoscopic retrograde cholangiopancreatography (ERCP) is a non-surgical method utilized to manage biliary tract obstruction, but the complication of biliary stent migration occurs in 5-10% of patients. Though migrated stents are commonly passed through the gastrointestinal tract without harm, intestinal perforation is a rare but severe complication, affecting less than 1% of cases. <i>Case Presentation.</i> We report a case of a 65-year-old woman who presented to the emergency department with symptoms of abdominal pain, nausea, and loss of appetite. According to clinical examination and evidence, the patient underwent surgery with high suspicion of appendicitis, which unexpectedly uncovered a perforated cecum with a protruding biliary stent. <i>Clinical Discussion.</i> Our report describes a unique and unexpected finding of cecal perforation caused by a migrated biliary stent in a patient. We also conducted a review of current literature on ERCP complications, including risk factors for stent migration, relevant statistics, and appropriate interventions. <i>Conclusion.</i> Surgeons should be aware of the risk of stent migration and complications in patients with a history of ERCP. Removal of migrated biliary stents is recommended, regardless of the presence of complications. Additional assessments for alternative diagnoses are recommended for older patients with abdominal pain complaints. Flexible plastic stents should be used for patients at risk of stent passage.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2023 ","pages":"9493333"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10438969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040822","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":"Occult Perforation of the Esophagus during Removal of an Enteral Feeding Tube: A Case Report and Literature Review.","authors":"Mohammad Alabdallat,&nbsp;Gustav Strandvik,&nbsp;Ibrahim Afifi,&nbsp;Ruben Peralta,&nbsp;Ashok Parchani,&nbsp;Ayman El-Menyar,&nbsp;Sandro Rizoli,&nbsp;Hassan Al-Thani","doi":"10.1155/2023/4230158","DOIUrl":"https://doi.org/10.1155/2023/4230158","url":null,"abstract":"<p><p><i>Background</i>. The use of oral or nasal route for enteral feeding is a standard practice in intensive care patients with a safe profile in general. However, complications associated with the insertion of a nasogastric (NGT) or orogastric tube (OGT) are common in the medical literature compared to the removal of such tubes. <i>Case presentation</i>. We presented a 38-year-old male who was involved in a motor-vehicle collision and found with low Glasgow Coma Scale outside his vehicle. He had polytrauma and was intubated-and commenced on enteral feeding via an OGT. Esophageal bezoar developed within a few days around the feeding tube, resulting in significant force being required to remove it, which was complicated by esophageal perforation. The esophageal injury was treated conservatively with uneventful recovery. <i>Discussion and conclusions</i>. Although limited case reports of esophageal enteral feeding bezoar formation do exist in the literature, we believe that this is the first case report of esophageal perforation due to the forceful removal of a wedged OGT secondary to esophageal bezoar formation. Morbidity associated with OGT/NGT is not common and may require a high index of suspicion to be identified. This is especially true if resistance is appreciated while removing the NGT/OGT. Gastroenterology consultation is recommended as early as possible to detect and manage any complications, however, their role was very limited in such stable case. In addition, early computed tomography (CT) can be considered for timely recognition of esophageal perforation. Non-operative management may be considered in stable patients, especially if the leak is in the cervical portion of the esophagus. Finally, prevention is better than cure, so being diligent in confirming NGT/OGT position, both radiologically and by measuring the tube length at the nostril/mouth, is the key to avoid misplacement and complication. This case raises the awareness of physician for such preventable iatrogenic event.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2023 ","pages":"4230158"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9273552","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":"Extensively Invasive Gallbladder Cancer from Intracholecystic Papillary Neoplasm Treated with Pylorus-Preserving Pancreaticoduodenectomy and Extended Cholecystectomy: A Case Report and Literature Review.","authors":"Hideki Kumagai,&nbsp;Akira Umemura,&nbsp;Hiroyuki Nitta,&nbsp;Hirokatsu Katagiri,&nbsp;Masao Nishiya,&nbsp;Noriyuki Uesugi,&nbsp;Tamotsu Sugai,&nbsp;Akira Sasaki","doi":"10.1155/2023/5825045","DOIUrl":"https://doi.org/10.1155/2023/5825045","url":null,"abstract":"<p><strong>Background: </strong>Intracholecystic papillary neoplasm (ICPN) is a rare tumor first classified by the World Health Organization in 2010. ICPN is a counterpart of the intraductal papillary mucinous neoplasm of the pancreas and intraductal papillary neoplasm of the bile duct. Previous reports on ICPN are limited; thus, the diagnosis, surgical intervention, and prognosis are controversial. Here, we report an extensively invasive gallbladder cancer arising in ICPN treated with pylorus-preserving pancreaticoduodenectomy (PPPD) and extended cholecystectomy. <i>Case Presentation</i>. A 75-year-old man presented to another hospital with jaundice for 1 month. Laboratory findings showed elevated total bilirubin, 10.6 mg/dL and carbohydrate antigen 19-9, 54.8 U/mL. Computed tomography showed a well-enhanced tumor located in the distal bile duct and dilated hepatic bile duct. The gallbladder wall was thickened and homogeneously enhanced. Endoscopic retrograde cholangiopancreatography revealed a filling defect in the distal common bile duct, and intraductal ultrasonography showed a papillary tumor in the common bile duct, indicating tumor invasion of the bile duct subserosa. Subsequent bile duct brush cytology revealed adenocarcinoma. The patient was referred to our hospital for surgical treatment and underwent an open PPPD. Intraoperative findings showed a thickened and indurated gallbladder wall, suggesting concurrent gallbladder cancer; thus, the patient subsequently underwent PPPD and extended cholecystectomy. Histopathological findings confirmed gallbladder carcinoma originating from ICPN, which extensively invaded the liver, common bile duct, and pancreas. The patient started adjuvant chemotherapy (tegafur/gimeracil/oteracil) 1 month after surgery and had no recurrence at follow-up after 1 year.</p><p><strong>Conclusions: </strong>Accurate preoperative diagnosis of ICPN, including the extent of tumor invasion is challenging. To ensure complete curability, the development of an optimal surgical strategy considering preoperative examinations and intraoperative findings is essential.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2023 ","pages":"5825045"},"PeriodicalIF":0.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10314817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10104103","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":"Splenic Artery Infarct Requiring Surgery: A Rare Complication of COVID-19 Infection.","authors":"Ioannis Dimitriou, Nikolaos Christodoulou, Kleanthis Chatzimargaritis, Aristidis Kaikis, Eirini Kasti, Georgios Triantos","doi":"10.1155/2022/3391405","DOIUrl":"10.1155/2022/3391405","url":null,"abstract":"<p><p><i>Introduction</i>. Coronavirus disease (COVID-19) from SARS-CoV-2 infection is linked to a hypercoagulable state, leading to arterial and venous thrombotic events, of which pulmonary embolism is the most frequent. However, arterial thromboembolisms may also occur as visceral infracts in unusual sites, such as the renal, splenic, and intestinal arteries. <i>Case Report</i>. A 46-year-old unvaccinated male with a COVID-19 infection was admitted to the COVID-19 isolation ward with symptoms of respiratory infection. He complained of epigastric pain and fever for several days; radiological imaging of the abdomen revealed complete splenic arterial occlusion due to a large infarct. He was treated with low molecular weight heparin (enoxaparin) in therapeutic doses, resulting in minimal improvement. However, the pain worsened, and eventually, a laparotomy and splenectomy were performed. He was hospitalized for another 36 days before he was discharged in good condition. A second surgery was performed to remove a noninfected encapsulated hematoma from the subdiaphragmatic space. The patient remained healthy afterward, with no relapses. <i>Discussion</i>. Although rare, the number of cases of visceral infarcts in COVID-19 patients has increased. Splenic artery infarct is an exceptional case of acute abdominal pain that can be treated successfully with anticoagulant medication. Splenectomy may be required to manage refractory pain after failure of conservative management.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2022 ","pages":"3391405"},"PeriodicalIF":0.6,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9729033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10330868","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 Ectopic Parathyroid Adenoma Arising in the Posterior Mediastinum. Report of Case and a Review.","authors":"Yousef S Amr,&nbsp;Mousa M Saleh,&nbsp;Samir S Amr","doi":"10.1155/2022/6473197","DOIUrl":"https://doi.org/10.1155/2022/6473197","url":null,"abstract":"We present a case of a greatly enlarged giant ectopic parathyroid adenoma that weighed 43 grams, which was located in the posterior mediastinum of a 74-year-old man. The patient presented with generalized weakness and decreased level of consciousness. He was found to have elevated level of serum calcium (19.9 mg/dl), and a subsequent assay of parathyroid hormone (PTH) was greatly elevated (2234 pg/ml). We report the course of management and outcome of the patient and present a review of the literature on giant ectopic parathyroid adenomas in the posterior mediastinum.","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":" ","pages":"6473197"},"PeriodicalIF":0.6,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9668461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40487227","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 Curious Case of Lip Tongue Fusion: A Consequence of Suboptimal Oral Care.","authors":"Jimmy Xu,&nbsp;Prateek Biyani,&nbsp;Andrew Rajkumar,&nbsp;Robert Orr","doi":"10.1155/2022/3113886","DOIUrl":"https://doi.org/10.1155/2022/3113886","url":null,"abstract":"<p><p>Oral care is an often difficult and an unappreciated part of hospital life. Patients who are unable to provide their own care rely on assistance from hospital personnel. Most sequelae from suboptimal oral care often present over months if not years, in the form of dental caries and periodontal disease. We present an exception, where a 66-year-old patient who experienced widespread ulceration and necrosis from <i>Capnocytophaga</i>-related sepsis received suboptimal oral care, resulting in their tongue being fused to their lip. This was later divided by the oral and maxillofacial team resulting in restoration of full function. Future cases can be avoided in patients with similar symptoms, such as Stevens-Johnson syndrome or erythema multiforme, if rigorous oral care can be provided.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":" ","pages":"3113886"},"PeriodicalIF":0.6,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9666028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40483819","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":"Adenocarcinoma Metastasis from Colon to the Thyroid.","authors":"Parviz Mardani,&nbsp;Nazanin Ayareh,&nbsp;Hooman Kamran,&nbsp;Reza Shahriarirad,&nbsp;Masoud Vafabin,&nbsp;Neda Soleimani","doi":"10.1155/2022/8705143","DOIUrl":"https://doi.org/10.1155/2022/8705143","url":null,"abstract":"<p><strong>Background: </strong>Colorectal cancer metastasis to the thyroid is extremely rare and happens in the late course of the disease. <i>Case Description.</i> Here is the report of a 55-year-old female patient who came to us with the chief complaint of cough, diagnosed with colon metastasize to the lung. Surgical resection of the mass was performed. However, a thyroid mass was found incidentally in her postoperative follow-up. Fine needle aspiration of thyroid mass showed papillary thyroid carcinoma. But, after thyroidectomy, the origin of the mass was reported to be adenocarcinoma metastasis from colon cancer.</p><p><strong>Conclusion: </strong>Although thyroid metastasis from colorectal cancer rarely occurs, it should be considered in a patient with a solitary thyroid nodule and a past medical history of colon cancer. Surgical treatment is the preferred choice of treatment in these cases.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":" ","pages":"8705143"},"PeriodicalIF":0.6,"publicationDate":"2022-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9663209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40688877","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}