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Case Reports in Surgery

Oscar Kivike, Israel Soko, David Mgaya, Frank Sandi
Pica among psychiatric patients has been well documented. We report a 25-year-old female patient who presented with abdominal distension for one week. She is a known psychiatric patient for 5 years. Through history taking, physical examination, and investigations, the patient was found to have psychotic features and features of intestinal obstruction. Surgery was done by opening the abdomen and then the stomach. The stomach, together with the proximal intestine, was found to be filled with metallic instruments weighing 780 mg...
2018: Case Reports in Surgery
Tomoko Takagishi, Yuta Niimi, Goshi Matsuki, Shinta Nagano, Junsuke Hinami, Masaaki Kajiwara, Kiyoshi Kaneko, Yoshihiro Kubota, Osamu Nakai
A 56-year-old Japanese female presented with vomiting, nausea, and abdominal pain after excessive drinking and eating. Abdominal computed tomography showed an encapsulated circumscribed cluster of jejunal loops in the right upper quadrant. She was diagnosed with a strangulated intestinal obstruction caused by right paraduodenal hernia (PDH) and underwent an emergency laparoscopic repair. A view through the endoscope showed the right PDH, which was encapsulated under the mesocolon. Most of the small bowel was entrapped and adhered inside the sac, requiring careful adhesiolysis...
2018: Case Reports in Surgery
Lofty-John C Anyanwu, Aminu M Mohammad, Lawal B Abdullahi, Mustapha U Ibrahim, Aliyu U Farinyaro, Mohammed S Aliyu, Stephen K Obaro
Intestinal perforation is a life-threatening complication of typhoid fever commonly seen in developing countries, but extraintestinal complications are infrequently reported. We report herein two cases of gangrene seen in children managed for typhoid intestinal perforation, highlighting the challenges faced in their management.
2018: Case Reports in Surgery
Rafael Correia Cavalcante, Isabela Polesi Bergamaschi, Aline Monise Sebastiani, Fabiano Galina, Marina Fanderuff, Delson João da Costa, Nelson Luis Barbosa Rebellato, Rafaela Scariot, Leandro Eduardo Klüppel
Introduction: Class II division I malocclusions are the most common dentofacial deformities seen in clinical practice. Severe cases or cases in which growth has ceased may require full correction combining orthodontic and surgical treatment. We report a case of a total mandibular subapical alveolar osteotomy, performed to correct a class II division I dentofacial deformity. Case Report: A 19-year-old female patient was referred to the oral and maxillofacial surgery department at the Federal University of Paraná with chin aesthetic complaints as well as class II malocclusion...
2018: Case Reports in Surgery
Scarlett Hao, Roberta Lilly, Hugo J R Bonatti
Background: Acute appendicitis may be treated with antibiotics, but most surgeons offer laparoscopic appendectomy (LA). Appendiceal mucocele (AMC) is a rare disorder. Surgical removal is recommended due to the risk of pseudomyxoma peritonei. LA has been suggested for this condition. Although rare, breast cancer (BC) may metastasize to the appendix. An appendiceal mass in a breast cancer patient should be approached as a possible metastatic focus until proven otherwise. Case Presentation: A 45-year-old Caucasian woman with invasive lobular BC underwent bilateral mastectomy...
2018: Case Reports in Surgery
Michela De Angelis, Guido Mantovani, Francesco Di Lecce, Luigi Boccia
Background: Inguinoscrotal herniation of the bladder is a rare clinical entity, with a frequency between 0.5% and 4% of all inguinal hernias. The bladder can partially or entirely herniate into the inguinal canal; when the whole bladder and ureters migrate into the scrotum, it may cause urinary disorders. Case Presentation: A 62-year-old male patient presented with urinary disorders and right-sided inguinoscrotal hernia. Under clinical suspicion of bladder involvement in the inguinal canal, abdominal and pelvic computed tomography (CT) scan with endovenous contrast was performed, revealing a right inguinoscrotal hernia, containing the whole urinary bladder and the right pelvic ureter...
2018: Case Reports in Surgery
Abdalla Mohamed, Youssef Botros, Paul Hanna, Sang Lee, Walid Baddoura, Jamshed Zuberi, Tanuja Damani
Gastrointestinal stromal tumors are uncommon when compared to all gastrointestinal neoplasms but are the most common mesenchymal tumors of the gastrointestinal tract. The largest gastrointestinal stromal tumor ever recorded in literature weighed approximately 6.1 kg and measured 39 cm × 27 cm × 14 cm. About two-thirds of GISTs are malignant. The tumor size, mitotic rate, cellularity, and nuclear pleomorphism are the most important parameters when considering prognosis and recurrence. The definitive treatment for these tumors is resection...
2018: Case Reports in Surgery
Laurie Adams, Theodore M Friedman, Timothy R Shaver, George Younan
Introduction: Duodenal gangliocytic paragangliomas (GPs) are a subclass of duodenal neuroendocrine neoplasms and are exceedingly rare. They have been associated with an indolent behavior; however, they can rarely metastasize. Radical resection like a pancreaticoduodenectomy is sometimes indicated. We hereby present a case requiring major surgery and perform a literature search about this disease. Presentation of Case: A 49-year-old Caucasian female, who presented with an upper gastrointestinal bleed, was found to have a hypodense mass in the second/third portion of the duodenum...
2018: Case Reports in Surgery
Francesca Chiara Surace, Federica Iezzi, Massimo Colaneri, Marco Pozzi
Idiopathic enlargement of the right atrium (IERA) is a very rare abnormality. Approximately one-half (48%) of the patients with a congenital enlargement of the right atrium have no symptoms. When they occur, symptoms include shortness of breath (28% of cases), palpitations (17%), arrhythmias (12%), and in rare cases, right heart failure and extreme tiredness. We report one such case of a young man with a disproportionally enlarged right atrium. The basal transthoracic echocardiogram demonstrated a huge right atrium with a thick smoke pattern and mild tricuspid regurgitation in the absence of congenital heart disease...
2018: Case Reports in Surgery
Christos Plataras, Efstratios Christianakis, Florentia Fostira, George Bourikis, Maria Chorti, Dimitrios Bourikas, Nikolaos Fotopoulos, Konstantinos Damalas, Khalil Eirekat
We describe an asymptomatic case of PJS in a six-year-old boy with café au lait spots in several parts of his body, a large gastroduodenal polyp, two polyps near the ampulla of Vater, and another in the jejunum. This patient shows some unique aspects of PJS. No other such large gastric polyp in a Peutz-Jeghers child is reported in the literature. The large size of the gastric polyp with lack of symptoms is unusual and poses a unique challenge in terms of management and surgical resection.
2018: Case Reports in Surgery
Jun-Ichiro Harada, Takeshi Matsutani, Nobutoshi Hagiwara, Yoichi Kawano, Akihisa Matsuda, Nobuhiko Taniai, Tsutomu Nomura, Eiji Uchida
A follow-up endoscopy in a 71-year-old Japanese man who had undergone a left lateral segmentectomy for HCC two years ago revealed an approximately 2 cm in diameter pedunculated polypoid mass in the middle part of the thoracic esophagus. Immunohistochemical staining of the endoscopic biopsy revealed a metastatic HCC esophageal tumor. As the patient's disease could be radically removed by preoperative examinations, we resected the metastatic esophageal tumor via right thoracotomy and esophagogastrostomy reconstruction...
2018: Case Reports in Surgery
Tze Huat Chong, Mohd Zuki Asyraf, Firdaus Hayati, Nornazirah Azizan, Nik Amin Sahid, Jesse Ron Swire Ting, Andee Dzulkarnaen Zakaria
Preputial calculus is a relative surgical rarity. It usually happens in elderly men with poor hygiene and uncircumcised penis complicated with phimosis. In the paediatric group, it is usually secondary to phimosis and other urologic and/or neurologic anomalies. Surgical treatment is the mainstay of treatment. Herein, we report a 27-year-old gentleman with preputial stone presented with obstructive uropathy and was successfully treated with surgical intervention. To the best of our knowledge, this is the first reported case of the largest preputial stone in Malaysia...
2018: Case Reports in Surgery
Anthony Nagib, Chauniqua Kiffin, Eddy H Carrillo, Andrew A Rosenthal, Rachele J Solomon, Dafney L Davare
One of the most feared complications in colorectal surgery is an anastomotic leak (AL) following a colorectal resection. While various recommendations have been proposed to prevent this potentially fatal complication, anastomotic leaks still occur. We present a case of an AL resulting in a complicated and fatal outcome. This case demonstrates the importance of high clinical suspicion, early recognition, and immediate management.
2018: Case Reports in Surgery
Enrico Erdas, Gian Luigi Canu, Luca Gordini, Paolo Mura, Giulia Laconi, Giuseppe Pisano, Fabio Medas, Pietro Giorgio Calò
Postoperative diaphragmatic hernia (PDH) is an increasingly reported complication of esophageal cancer surgery. PDH occurs more frequently when minimally invasive techniques are employed, but very little is known about its pathogenesis. Currently, no consensus exists concerning preventive measures and its management. A 71-year-old man underwent minimally invasive esophagectomy for esophageal cancer. Three months later, he developed a giant PDH, which was repaired by direct suture via laparoscopic approach. A hypertensive pneumothorax occurred during surgery...
2018: Case Reports in Surgery
Francesca D'Auria, Vincenzo Consalvo, Antonio Canero, Maria Russo, Carmela Rescigno, Domenico Lombardi
Introduction: Ingestion of foreign bodies including dentures, fishbone, screw, and/or surgical devices can be a cause of morbidity, and it rarely could be fatal. Presentation of Case: We present the first hitherto reported case of mussel shell ingestion, which caused acute abdominal pain in a 55-year-old woman. The shell pierced ileal loops, and it was found in the abdominal cavity. Discussion: The accidental or voluntary ingestion of a foreign body is an uncommon event compared to the other causes of bowel perforation...
2018: Case Reports in Surgery
Keisuke Nonoyama, Hidehiko Kitagami, Akira Yasuda, Shiro Fujihata, Minoru Yamamoto, Yasunobu Shimizu, Moritsugu Tanaka
Background: Although 18F-fluorodeoxyglucose positron emission tomography (FDG-PET/CT) is now widely used in their differential diagnosis, it is sometimes difficult to distinguish between benign and malignant diseases. Case Presentation: A 44-year-old woman was found to have abnormalities on health screening. Magnetic resonance imaging for detailed examination showed an intra-abdominal tumor measuring 12 cm in the major axis near the cranial end of the uterus. Upper gastrointestinal tract endoscopy showed a tumor with an ulcer in the third part of the duodenum, involving half the circumference...
2018: Case Reports in Surgery
Samantha Seitter, Zachary D Goodman, Theodore M Friedman, Timothy R Shaver, George Younan
Introduction: Reactive lymphoid hyperplasia (RLH) is a rare and benign lesion found in organs of the gastrointestinal tract, skin, lung, orbit, and more rarely in the liver. Due to its similar appearance on imaging, it is hard to differentiate from primary liver malignancies. The following is a case report of a patient presenting with a suspicious liver lesion found to be RLH associated with primary biliary cirrhosis (PBC), after surgical resection. Presentation of Case: A 54-year-old woman presented with nonspecific abdominal pain, and her workup included axial imaging of the abdomen that showed a suspicious lesion in her liver...
2018: Case Reports in Surgery
Noritoshi Mizuta, Kozo Tsunemi
Desmoid tumors are rare, monoclonal myofibroblastic neoplasms that occur in the extremities, the trunk, and the abdominal cavity. We present a case that is significant for its rarity and for consideration of its treatment plan. A 17-year-old male reported swelling of his abdomen and abdominal pain. He was referred to our hospital with no history of surgery, trauma, or familial adenomatous polyposis. A large tumor in the abdominal cavity was detected by computed tomography, and surgical resection was performed...
2018: Case Reports in Surgery
Gloria Pelizzo, Eloisa Arbustini, Noemi Pasqua, Patrizia Morbini, Valeria Calcaterra
Introduction: In selected patients, the absorbable fibrin patch TachoSil® is superior to standard surgical treatment in reducing air leakage after pulmonary lobectomy. Pulmonary involvement is not considered a main feature of Marfan syndrome (MFS); however, spontaneous pneumothorax (SP) with a high rate of recurrence is frequently reported. We describe the use of TachoSil® in the supportive treatment of recurrent pneumothorax in a girl with MFS. Case Report: A 12-year-old girl with a previous diagnosis of MFS and recurrent history of left spontaneous pneumothorax was submitted to thoracoscopic atypical lung resection...
2018: Case Reports in Surgery
Luke L Wang, Zachary M Bauman
Hemosuccus pancreaticus is a very rare cause of gastrointestinal bleeding and can be life-threatening if not managed appropriately. Still thought to be a surgical problem, advances in medical therapy now afford these patients the opportunity to undergo less-invasive angiography techniques to manage this illness when it occurs. Here, we present a case of hemosuccus pancreaticus safely managed with liquid N-butyl-2-cyanoacrylate embolization.
2018: Case Reports in Surgery
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