Case Reports in Surgery最新文献

{"title":"Asymptomatic Multiple Bilateral Segmental Pulmonary Embolisms Caused by Cement After Multilevel Vertebroplasty: A Case Report and Literature Review.","authors":"Elie Mokled, Anthony Sadek, Maher Ghandour, Fatima Farhat, Amer Abdallah","doi":"10.1155/cris/7151548","DOIUrl":"10.1155/cris/7151548","url":null,"abstract":"<p><p>Pulmonary cement embolization (PCE) is a recognized, often asymptomatic complication of percutaneous vertebroplasty (PVP), a procedure commonly used to stabilize vertebral compression fractures. Here, we report the case of a 58-year-old male who, after vertebroplasty for multiple acute thoracic and lumbar fractures, exhibited segmental, peripheral PCE on postoperative imaging. Despite cement leakage into the pulmonary vasculature, the patient remained asymptomatic, stable, and was discharged following brief observation. A review of the literature reveals varied management approaches for asymptomatic PCE, from conservative monitoring to anticoagulation therapy, with outcomes generally favorable regardless of intervention. Our case supports the safety of conservative management in asymptomatic PCE, highlighting the need for standardized guidelines to aid clinical decision-making. Early detection through postoperative imaging, combined with tailored patient management, may improve outcomes while minimizing unnecessary interventions for asymptomatic PCE. Emergency physicians should be aware of PCE as a potential postoperative complication of vertebroplasty, even in asymptomatic patients, to ensure timely recognition, appropriate monitoring, and avoid unnecessary interventions.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"7151548"},"PeriodicalIF":0.6,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13530869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873048","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":"Familial Juvenile Polyposis Syndrome: A Case Report of a Cosegregation of SMAD4 Germline Pathogenic Variant c.403C>T and Review of the Literature.","authors":"Carlos Augusto Real Martinez, Giovanna Savoy Pazin, Rayama Moreira Siqueira, Rita Barboza de Carvalho, Michel Gardere Camargo, Lívia Moreira Genaro, Pedro Henrique Leite Bonfitto, Maria de Lourdes Setsuko Ayrizono, Raquel Franco Leal, Cláudio Saddy Rodrigues Coy","doi":"10.1155/cris/8105440","DOIUrl":"10.1155/cris/8105440","url":null,"abstract":"<p><p>Juvenile polyposis syndrome (JPS) is an inherited autosomal dominant disease that is distinguished by the emergence of numerous juvenile polyps within the gastrointestinal (GI) tract and has an increased risk of cancer. JPS is associated with germline mutations of the <i>BMPR1A</i> or <i>SMAD4</i> genes. We aim to describe a case of familial occurrence of the SMAD4 germline pathogenic variant c.403C>T in a Brazilian family. We present a case of an 18-year-old female with rectal bleeding and chronic anemia who had a family history of colorectal issues-her mother had a total colectomy due to multiple polyps, and her maternal grandfather died from colorectal cancer (CRC). Despite a negative physical examination for attenuated familial adenomatous polyposis (AFAP) signs, a colonoscopy revealed around 30 proximal colon polyps of juvenile nature. These were systematically removed through multiple sessions, and an upper digestive endoscopy uncovered a few sessile inflammatory polyps. Notably, no polyps were found in the small intestine via double-balloon enteroscopy. After polyp removal, her bleeding episodes ceased, and her anemia resolved. She now maintains her health through biennial colonoscopies, upper digestive endoscopies, and endoscopic capsule procedures. Genetic testing identified a pathogenic mutation in exon 3 of the SMAD4 gene (c.403C>T), resulting in a truncated SMAD4 protein (p.Arg135 ^∗). While previously documented in international databases, this represents the first report of a Brazilian family carrying this variant. Additionally, no mutations were found in the BMPR1A gene during genetic testing. In conclusion, molecular analysis confirmed the familial occurrence of the SMAD4 germline pathogenic variant c.403C>T within this Brazilian family.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"8105440"},"PeriodicalIF":0.6,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863681","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":"Right Ventricular Lipoma With an Aneurysm-Like Appearance: A Case Report of Successful Surgical Resection.","authors":"Yuta Inoue, Takayoshi Kato, Ryo Fujii, Mizuki Kadota, Natsuko Suzui, Masayuki Sato, Hiroki Ogura, Etsuji Umeda, Osamu Sakai, Kiyoshi Doi","doi":"10.1155/cris/4331944","DOIUrl":"10.1155/cris/4331944","url":null,"abstract":"<p><p>Cardiac lipomas are rare benign tumors, comprising ~8.4% of all benign primary cardiac tumors. They can arise in various cardiac chambers, though right ventricular (RV) involvement is uncommon. While most cardiac lipomas are asymptomatic and detected incidentally, those originating in the RV may present with unusual features, including pseudoaneurysmal appearances. Such anomalous structural changes can increase right atrial and ventricular pressures, placing the patient at risk of progressive hemodynamic compromise and rupture. We report a case of an RV lipoma initially diagnosed as a pseudoaneurysm that was successfully resected. An 81-year-old man with an incidentally detected RV mass was admitted to our hospital. Contrast-enhanced computed tomography (CT) showed that the mass contained a large amount of fatty tissue with a pseudoaneurysmal appearance, suggesting it to be an RV lipoma. Transthoracic echocardiography revealed to-and-fro blood flow between the RV and the aneurysm through the slits. Although the patient was asymptomatic, considering that the right atrial pressure and RV end-diastolic pressure (RVEDP) were 12 and 25 mmHg, respectively, based on right heart catheterization, we decided to perform surgical resection to avoid the risk of future enlargement or rupture. A fat-covered mass was found in the anterior aspect of the RV and resected. The residual RV and slits were closed using a patch. The patient had a good postoperative course with normalized right heart pressure and was discharged on the postoperative day 14. While the indications for surgery in asymptomatic patients remain unclear due to the rarity of this condition, these findings suggest that early surgical intervention may be considered in cases presenting with structural compromise and elevated right-sided pressures.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"4331944"},"PeriodicalIF":0.6,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863671","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 and Histopathologic Insights Into Mid-Aortic Syndrome: A Case Report.","authors":"Bernhard Hruschka, Panagiotis Doukas, Alexander Gombert","doi":"10.1155/cris/3337193","DOIUrl":"10.1155/cris/3337193","url":null,"abstract":"<p><p>Mid-aortic syndrome (MAS) is a rare condition marked by narrowing of the thoraco-abdominal aorta, often causing severe hypertension. We present a 17-year-old male with refractory hypertension due to high-grade aortic coarctation at the viscero-renal segment. After failed endovascular interventions, open thoracoabdominal aortic repair was performed. The celiac trunk, superior mesenteric artery (SMA), and right renal artery were initially implanted into the tubegraft as a patch, but limited blood flow required revision including separate bypasses for the visceral arteries and both renal arteries. The patient was discharged with normalized blood pressure. Histopathology revealed adventitial necrosis, smooth muscle disorganization, and severe intimal thickening, suggesting intimal hyperplasia and fibrosis reduced blood flow. Separate bypasses might have been more effective than a patch for long-term patency. At a 4-year follow-up, the patient remains stable, though the right renal bypass is occluded. This case report provides unique insights into the histopathological features of MAS and their potential impact on surgical decision-making, contributing to our understanding of this rare condition.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"3337193"},"PeriodicalIF":0.6,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148856983","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":"Robotic-Assisted Extended Thymus Carcinoma Resection With Unilateral Total Pleurectomy and Hyperthermic Intrathoracic Chemotherapy (HITOC).","authors":"Maria Andrea Kröplin, Peter Keller, Nicolas Eckstein, Hruy Menghesha, Philipp Feodorovici, Jens Buermann, Joachim Schmidt, Donatas Zalepugas","doi":"10.1155/cris/5591698","DOIUrl":"10.1155/cris/5591698","url":null,"abstract":"<p><p>Thymic squamous cell carcinoma (SCC) is an aggressive form of thymic cancer that is often diagnosed at an advanced stage. Hyperthermic intrathoracic chemotherapy (HITOC) is a treatment option for advanced thoracic and especially pleural malignancies, though it is not yet the standard of care. However, the success of treating pleural cancers with HITOC protocols has been well documented in selected cases. Robotic-assisted thoracoscopic surgery (RATS) has become the standard procedure for thymectomy, even for locally advanced tumors. In this report, we describe the treatment of a 53-year-old patient with a locally advanced Masaoka-Koga stage IVa thymic SCC and concomitant limited pleural carcinomatosis who was successfully treated by RATS thymectomy and HITOC. The report highlights the diagnostic challenges, therapeutic approach, and postoperative care, emphasizing the advantages of minimally invasive, robot-assisted surgery even in advanced cases. RATS with HITOC can be a safe and effective method for the treatment of advanced thymic carcinoma. This case report demonstrates that this procedure enables rapid postoperative recovery and can be performed with minimal morbidity.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"5591698"},"PeriodicalIF":0.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13508577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148824869","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":"Retention of Small Bowel Capsule in a Patient With Remote Small Bowel Resection With a Normal CT Enterography and Patency Capsule Examination.","authors":"Jennifer E Geller, Arthur J Geller","doi":"10.1155/cris/5246805","DOIUrl":"10.1155/cris/5246805","url":null,"abstract":"<p><p>Wireless capsule endoscopy (WCE) uses an electronic small bowel capsule to transmit images of the small bowel to diagnose pathology. In patients at risk for capsule retention, the patency capsule, a radiopaque dissolvable capsule of the same size, may be used to predict that the small bowel capsule will pass through the patient. An abdominal radiograph or scanner is used to confirm passage of the patency capsule, predicting future passage with the small bowel capsule. If the patency capsule is retained in the small bowel, it will dissolve over time, relieving a potential obstruction. Patency capsules have been noted to be highly sensitive for detecting potential obstructing lesions and have a high negative predictive value for small bowel capsule retention. However, we describe a case and management of small bowel capsule retention occurring in a patient with a remote history of bowel resection for intussusception and normal small bowel demonstrated on CT enterography and a normal patency capsule examination.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"5246805"},"PeriodicalIF":0.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788589","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":"Segmental Distal Duodenectomy With Duodenojejunostomy and Gastrojejunostomy Reconstruction for Duodenal Gastrointestinal Stromal Tumor.","authors":"Yusuke Hosoyamada, Shuhei Niki, Yoshiyuki Chiba, Yuzuru Ito, Yu Gyoda, Hiroyuki Sugo","doi":"10.1155/cris/5367811","DOIUrl":"10.1155/cris/5367811","url":null,"abstract":"<p><p>An 83-year-old man was admitted to the emergency department of our hospital with a chief complaint of melena. A computed tomography revealed a hypervascular tumor approximately 3 cm in size near the duodenojejunal flexure. On diagnosis of bleeding from the gastrointestinal stromal tumor (GST), emergency surgery was performed. At laparotomy, a whitish tumor measuring approximately 3 cm in diameter was identified on the serosal surface along the mesenteric border of the duodenojejunal flexure. Considering the need for secure hemostasis, a segmental duodenectomy including resection of the feeding vessels to the affected bowel segment was performed. For reconstruction, considering that anastomosis posterior to the superior mesenteric artery (SMA) was avoided and instead performed primary closure of the duodenal stump. To provide duodenal drainage, a Roux-en-Y jejunal limb was constructed and anastomosed to the 2^nd part of the duodenum. Additionally, a gastrojejunostomy in the Billroth II configuration was performed. The patient was discharged on postoperative day 15, with no complications.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"5367811"},"PeriodicalIF":0.6,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757408","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":"Bailout Intravascular Lithotripsy for Calcium-Mediated Underexpansion of a Peripheral Covered Stent in an Emergency Setting: A Case Report.","authors":"Andrea Esposito, Danilo Menna, Mario Malangone, Rocco Pasqua, Nunzio Montelione","doi":"10.1155/cris/4893296","DOIUrl":"10.1155/cris/4893296","url":null,"abstract":"<p><p>Severe iliofemoral calcification can compromise emergency endovascular control of access-site bleeding by preventing full covered-stent expansion at the landing zone. A 78-year-old man developed hemodynamic instability, right-flank pain, and severe anemia 6 h after ultrasound-guided right transfemoral primary percutaneous coronary intervention for anterior ST-segment elevation myocardial infarction. Contrast-enhanced computed tomography demonstrated a large right retroperitoneal hematoma with active extravasation from the distal external iliac artery, immediately proximal to a bulky calcified plaque involving the proximal common femoral artery (CFA). Through ultrasound-guided contralateral femoral access, an 8 mm × 60 mm self-expanding covered stent achieved immediate sealing of the external iliac artery injury but remained markedly underexpanded distally at the calcified CFA landing zone. Conventional 8-mm balloon post-dilation was attempted, but residual underexpansion persisted; further high-pressure dilation was avoided because of concern for rupture or perforation of the calcified iliofemoral segment and loss of the newly achieved seal. Bailout intravascular lithotripsy (IVL) with an 8 mm × 60 mm balloon consisted of 150 pulses delivered at 4 atm in repeated sequences, each followed by nominal-pressure post-dilation of the same balloon at 6 atm. Final angiography showed improved covered-stent expansion with approximately 30% residual stenosis and no recurrent extravasation, dissection, perforation, or distal embolization. The patient was discharged on postoperative day 8. At 12-month follow-up, duplex ultrasound confirmed covered-stent patency without edge stenosis, pseudoaneurysm, or hemodynamically significant restenosis. This case illustrates that IVL may provide a low-pressure bailout option for calcium-mediated peripheral covered-stent underexpansion during emergency vascular access-site repair; however, this off-label use requires careful device sizing, attention to covered-stent integrity, and structured imaging surveillance.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"4893296"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148720418","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":"Finding of a Urachal Cyst in a Patient Presenting With an Acute Abdomen due to Appendicitis.","authors":"Jairo Harim Rodriguez-Perez, Emilio Israel Wong-Valenzuela, Maria Jose Diaz-Amaya, Daniela Sanchez-Rodriguez, Nallely Garate-Retamoza, Agustin Cervantes-Orozco","doi":"10.1155/cris/3813358","DOIUrl":"10.1155/cris/3813358","url":null,"abstract":"<p><p>Urachal cysts are rare congenital anomalies in adults and are often identified incidentally during imaging studies or surgery because most remain asymptomatic. They represent the most frequent subtype of urachal anomaly. The simultaneous occurrence of acute appendicitis and a urachal cyst is exceptionally rare, with only a handful of cases reported in the literature. We describe the case of a 49-year-old man with a history of heart failure and substance use who presented with acute abdominal pain. Computed tomography (CT) demonstrated acute appendicitis and incidentally revealed a large cystic lesion adherent to the bladder dome, suggestive of a urachal cyst. Exploratory laparotomy confirmed suppurative appendicitis and a noncommunicating urachal cyst measuring 11 × 10 × 8 cm. Complete cyst excision and appendectomy were performed during the same procedure. Histopathological examination confirmed benign urachal tissue lined by transitional epithelium without dysplastic changes, together with transmural acute appendicitis. The postoperative course was uneventful, and the patient was discharged on the third postoperative day. This case emphasizes that urachal anomalies may be encountered as incidental findings during the evaluation of acute abdomen. Although infection is the most common clinical manifestation, urachal cysts may also be identified unexpectedly during surgery for unrelated conditions. Complete surgical excision provides definitive treatment while reducing the risk of recurrence and potential malignant transformation.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"3813358"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13463726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721357","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":"Postoperative Knee Squeaking Following Arthroscopic Meniscal Repair: A Case-Based Report and Literature Review.","authors":"Amer Abdallah, Anthony Sadek, Elie Mokled, Maher Ghandour","doi":"10.1155/cris/3599063","DOIUrl":"10.1155/cris/3599063","url":null,"abstract":"<p><p>Postoperative knee squeaking is a rare phenomenon in native knees, with prior reports limited to ligament reconstructions. This case-based report describes the first documented instances of transient knee squeaking following arthroscopic meniscal repair. We present two cases of male patients who developed audible squeaking within 1 month postoperatively using the Meniscal Cinch II (MCII) Implant Delivery System (Arthrex). Both cases demonstrated squeaking between 60° and 120° of knee motion without swelling or mechanical symptoms. Magnetic resonance imaging (MRI) findings did not reveal displaced sutures or loose bodies. Symptoms resolved spontaneously within 8 weeks without intervention. A literature review shows that previously reported cases of postoperative knee squeaking typically required arthroscopic suture removal due to intra-articular migration. Our findings suggest that in select cases, knee squeaking may be benign and self-limiting, supporting a conservative approach. Further studies are warranted to explore the etiology and guide management strategies for this unusual postoperative symptom.</p>","PeriodicalId":9600,"journal":{"name":"Case Reports in Surgery","volume":"2026 ","pages":"3599063"},"PeriodicalIF":0.6,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13469320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758709","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}