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Case Reports in Surgery

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https://www.readbyqxmd.com/read/28326219/a-case-of-spontaneous-transdiaphragmatic-intercostal-hernia-with-contralateral-injury-and-review-of-the-literature
#1
Alexander A Chapman, Steven B Duff
This case report discusses the diagnosis and management of a 67-year-old male presenting with a spontaneous transdiaphragmatic intercostal hernia with contralateral intercostal hernia. The patient had a history of chronic obstructive pulmonary disease (COPD) exacerbations requiring multiple prolonged courses of steroids. The patient was ultimately diagnosed with computed tomography (CT) and underwent surgical repair via thoracotomy with primary repair of the diaphragmatic defect. The patient's postoperative course was uncomplicated...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28321356/island-posterior-thigh-flap-revisited-in-covering-extensive-sacral-wounds-our-experience-with-two-patients
#2
F Nangole Wanjala, Ajujo Martin
Deep sacral wounds are best covered by flaps. Posterior thigh flaps have routinely been used to cover such wounds. The flap can however be modified as an island flap. Two patients with extensive sacral wounds were managed with island posterior thigh flaps. Both patients were admitted secondary to road traffic accident with subsequent soft tissue loss of the sacral area. The sacral defects in both patients were approximately 17 cm by 23 cm in dimensions. Unilateral island posterior thigh flap was raised and used to cover the wounds...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28316858/spontaneous-intramural-oesophageal-haematoma-in-a-patient-with-uncontrolled-hypertension-an-unusual-chest-pain-aetiology
#3
Samantha Cooray, Dionysios Dellaportas, Clifford Caruana, Andrew R Davies
Introduction. Spontaneous intramural oesophageal haematoma is a rare condition that usually occurs secondary to an acute or chronic coagulation disorder. The presenting complaint is often with retrosternal chest pain and most patients are initially investigated to exclude more common causes in the differential diagnosis, such as acute coronary syndromes. Severe life-threatening bleeding or perforation seldom, if ever, arises. Case Presentation. We present a case of spontaneous oesophageal haematoma which appears to have developed gradually in a 69-year-old female with uncontrolled hypertension and antiplatelet medication use...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28299230/reconstruction-of-chest-wall-by-cryopreserved-sternal-allograft-after-resection-of-aneurysmal-bone-cyst-of-sternum
#4
Kambiz Sheikhy, Azizollah Abbasi Dezfouli, Farahnaz Sadegh Beigee
A 20-year-old female was referred to our hospital due to deformity and bulging in anterior aspect of chest wall in sternal area. Chest X-ray and CT scan confirmed a large mass with destruction of sternum. Pathologic diagnosis after incisional biopsy was compatible with aneurysmal bone cyst. We resected sternum completely and reconstructed large anterior defect by a cryopreserved sternal allograft. In follow-up of patient there was no unstability of chest wall with good cosmetic result.
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28299229/a-giant-brunneroma-causing-gastrointestinal-bleeding-and-severe-anemia-requiring-transfusion-and-surgery
#5
Nicola C Frenkel, Miangela M Laclé, Inne H M Borel Rinkes, Izaak Q Molenaar, Jeroen Hagendoorn
Brunner's gland hamartoma, also called hyperplasia, adenoma, and Brunneroma, is an extremely rare benign proliferative lesion of Brunner's glands in the duodenum. While being mostly small and asymptomatic, they can result in gastrointestinal bleeding and obstruction. We report the case of a 54-year-old man presenting with melena and severe anemia requiring blood transfusion. CT scans showed a large mass of 8 cm in diameter, presumably arising in the duodenum. Endoscopic biopsies were not conclusive. As we were unable to determine the nature of the mass preoperatively and due to the severe symptoms, its size, and the uncertain malignant potential, a classic Whipple procedure was performed...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28299228/surgical-management-of-unusual-biangular-mandibular-fractures
#6
Stefan Cocis, Umberto Autorino, Fabio Roccia, Chiara Corio
Bilateral mandibular angle fractures, while representing a rarity among mandibular fractures, are a huge challenge of complex management for the maxillofacial surgeon. There are still many open questions regarding the ideal management of such fractures, including the following: the removal of the third molar in the fracture line, the best surgical approach, and the fixation methods. In this report the authors present the case of 40-year-old man presenting with a bilateral mandibular angle fracture referred to the Maxillofacial Surgery Department of Turin...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28299227/resection-of-the-gastric-tube-reconstructed-through-the-retrosternal-route-without-sternotomy
#7
Masahiro Kimura, Yasuyuki Shibata, Kotaro Mizuno, Hironori Tanaka, Motoki Hato, Satoshi Taniwaki, Yoichiro Mori, Nobuo Ochi, Takaya Nagasaki, Shuhei Ueno, Yuki Eguchi
With advances of combined modality therapy, prognoses in esophageal cancer have been improving. After resection of esophageal cancer, the development of gastric tube cancer is a risk. While such cancer in an early stage can be cured endoscopically, total gastric tube resection is indicated in advanced stages. A 68-year-old man underwent subtotal esophagectomy reconstructed with a gastric tube through the retrosternal route. Gastric cancer was found one and a half years postoperatively. The gastric tube was resected without sternotomy...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28299226/dental-implant-placement-with-simultaneous-anterior-maxillary-reconstruction-with-block-and-particulate-fresh-frozen-allograft-bone-a-case-report-with-24-month-follow-up-data
#8
J S Vieira, E M Brandão-Filho, F R Deliberador, J C Zielak, A F Giovanini, T M Deliberador
Fresh frozen allograft bone is routinely used in orthopedic surgery for the reconstruction of large bone defects, and its use in oral and maxillofacial surgery is increasing. The purpose of this case was to demonstrate the installation of dental implants and the use of fresh frozen bone for reconstruction of anterior maxilla in the same surgery. This case report presents the insertion of dental implants followed immediately by a placement of fresh frozen allograft in block and particle for a reconstruction of atrophic anterior maxillary in the same surgery...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28280645/stewart-treves-syndrome-involving-chronic-lymphedema-after-mastectomy-of-breast-cancer
#9
Smain Nabil Mesli, Amin Khayreddine Ghouali, Fouad Benamara, Fouzi Ahmed Taleb, Hicham Tahraoui, Chakib Abi-Ayad
Steward-Treves syndrome is a cutaneous angiosarcoma that usually appears after long evolution of a lymphoedema after mastectomy for mammary neoplasia associated with an axillary dissection. This is a rare disease develop most of the time in upper arm and often confounded with cutaneous metastasis. Only the biopsy and immunohistochemical study confirm the diagnosis. The treatment is surgical and consists of large cutaneous excision, an amputation of the limb or even its disarticulation and will be followed by chemotherapy...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28261515/demanding-diagnosis-of-splenic-angiosarcoma-as-cause-of-delayed-treatment-of-spontaneous-splenic-rupture-a-case-report-and-literature-review
#10
Sara Coppola, Andrea Leva, Fabio Pagni, Simone Famularo, Luca Gianotti
Background. Primary splenic angiosarcoma is a very rare mesenchymal malignant tumor associated with a poor prognosis due to its high metastatic potential. This disease can be easily neglected and spontaneous splenic rupture is a frequent manifestation at the time of diagnosis leading to a poor outcome because of peritoneal dissemination. Case Presentation. We describe the case of a 49-year-old man who presented with asthenia, left upper quadrant abdominal pain, and anemia. Computerized tomography scan showed an enlarged spleen with no nodules and a nontraumatic rupture of the splenic capsule...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28255494/juvenile-breast-hypertrophy-a-successful-breast-reduction-of-14-9-body-weight-without-recurrence-in-a-5-year-follow-up
#11
Akmal Hisham, Marzida Abd Latib, Normala Basiron
Juvenile hypertrophy of the breast (JHB) is a rare and relentless disease affecting women in the peripubertal period. We present a 13-year-old girl with massive bilateral JHB, successfully treated with a breast reduction and free nipple graft technique. A total of 7300 grams of breast tissue had been removed, accounting for 14.9% of the patient's total body weight. Prophylactic hormonal therapy was not commenced. During the 5-year follow-up period, there was no recurrence and the patient remains satisfied with the aesthetic outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28255493/treatment-of-complete-anal-stricture-after-diverting-colostomy-for-fournier-s-gangrene
#12
Kenji Okumura, Tadao Kubota, Kazuhiro Nishida, Alan Kawarai Lefor, Ken Mizokami
Background. Anal stenosis is a rare but serious complication of anorectal surgery. Severe anal stenosis is a challenging condition. Case Presentation. A 70-year-old Japanese man presented with a ten-hour history of continuous anal pain due to incarcerated hemorrhoids. He had a history of reducible internal hemorrhoids and was followed for 10 years. He had a fever and nonreducible internal hemorrhoids surrounding necrotic soft tissues. He was diagnosed as Fournier's gangrene and treated with debridement and diverting colostomy...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28251014/primary-pure-squamous-cell-carcinoma-of-the-gallbladder-locally-invading-the-liver-duodenum-and-stomach-a-case-report-and-literature-review
#13
Aldrin C Alpuerto, Maximo E Mora, R Jonathan Robitsek, Sebastian D Schubl
Primary pure squamous cell carcinoma (SCC) of the gallbladder is an exceptionally rare type of tumor that comprises only 1% of all gallbladder cancer. SCC of the gallbladder portends a worse prognosis than the more common adenocarcinoma variant because of its aggressive invasion to local structures and because it is often diagnosed at an advanced stage. Owing to its rarity, diagnosis and management can be challenging. Herein, we present the case of a 75-year-old female complaining of abdominal pain, nausea, and vomiting...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28246569/acute-thrombotic-occlusion-of-the-popliteal-artery-following-knee-dislocation-a-case-report-of-management-local-unit-practice-and-a-review-of-the-literature
#14
Anthony Dean Godfrey, Fadi Hindi, Callum Ettles, Mark Pemberton, Perbinder Grewal
Arterial complications following traumatic knee injury are relatively rare but mandate timely recognition and treatment to avoid significant comorbidity and medicolegal ramifications. In this report we describe a case of acute thrombotic occlusion of the popliteal artery occurring after knee dislocation, successfully repaired by intimal fixation and a limited venous patch reconstruction. We present a review of local practice in screening vascular injuries following knee dislocation, aligned with a review of the literature and considerations for practice...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28246568/unusual-complication-following-a-myomectomy-colic-migration-of-a-forgotten-abdominal-swab
#15
Boyodi Tchangai, Fousseni Alassani, Mazamesso Tchaou
Surgical sponges are the most common retained foreign bodies following surgery. The morbidity of this condition is illustrated herein with the case of a 36-year-old female patient with a history of myomectomy 5 months before her admission into our unit for enterocutaneous fistula. Although imaging and etiological investigations were made, diagnosis was carried out only by laparotomy. The foreign body found was an abdominal swab that migrated from abdominal cavity to the colon causing several intestinal injuries...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28203474/unexpected-radiation-induced-aortic-wall-thickening-requiring-composite-graft-technique-during-off-pump-coronary-artery-bypass-grafting
#16
Paola Redaelli, Amando Gamba, Antonello Stefano Martino, Michele Triggiani
Mediastinal radiation is commonly used to treat Hodgkin's and non-Hodgkin's lymphoma, lung and breast cancer. Cardiac complications after radiation therapy are well described, although rare. A large spectrum of injuries can occur, causing long term morbidity among survivors. We describe a case of post-actinic ascending aortic wall thickening that prevented saphenous vein proximal anastomosis and was successfully managed with aortic no-touch off-pump coronary artery bypass grafting (OPCAB), 25 years after radiation therapy for Hodgkin's lymphoma...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28197356/acute-pseudoischemic-ecg-abnormalities-after-right-pneumonectomy
#17
Nada Vasic, Sanja Dimic-Janjic, Ruza Stevic, Branislava Milenkovic, Verica Djukanovic
New onset of electrocardiographic (ECG) abnormalities can occur after lung surgery due to the changes in the position of structures and organs in the chest cavity. The most common heart rhythm disorder is atrial fibrillation. So-called "pseudoischemic" ECG changes that mimic classic ECG signs of acute myocardial ischemia are also often noticed. We report the case of a 68-year-old male, with no prior cardiovascular disease, who underwent extensive surgical resection for lung cancer. On a second postoperative day, clinical and electrocardiographic signs of acute myocardial ischemia occurred...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28197355/a-case-of-crossed-left-renal-ectopia-identified-during-colostomy-reversal
#18
Rachel NeMoyer, Sumana Narayanan, Nell Maloney-Patel
Unilateral crossed renal ectopia without fusion is an uncommon anatomic anomaly, which often goes undiagnosed. We report a case of this renal variant discovered incidentally during colostomy reversal after Hartmann's procedure for diverticular stricture.
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28194294/pedicle-temporalis-fascial-flap-with-axial-scalp-flap-obviates-need-of-free-flap-in-extensive-scalp-wound
#19
F W Nangole, S O Khainga
Extensive scalp defect with exposed bone is best reconstructed with flaps. Majority of these wounds are now routinely reconstructed with free flaps in many centers. Free flaps however require lengthy operative time and may not be available to all patients, where possible less extensive options should thus be encouraged. A sixty-eight-year-old patient presented to us with a Marjolin's ulcer on the vertex of the scalp. After wide local excision a defect of about 17 cm and 12 cm was left. The defect was successfully covered with a combination of an ipsilateral pedicle temporalis fascial flap and an axial supraorbital scalp flap with good outcome...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28182093/utility-of-the-ct-scan-in-diagnosing-midgut-volvulus-in-patients-with-chronic-abdominal-pain
#20
Ehsan Shahverdi, Mehdi Morshedi, Maryam Allahverdi Khani, Mohammad Baradaran Jamili, Fatemeh Shafizadeh Barmi
Symptomatic intestinal malrotation first presenting in the adults is rare. Midgut volvulus is the most common complication of malrotation in the adults. Because of more differential diagnosis, Computed Tomography (CT) scan can play an important role in the evaluation of patients with this abnormality. The whirl pattern around the superior mesenteric artery found on CT scan in patients with midgut volvulus is pathognomonic and diagnostic. We describe a case of intestinal malrotation complicated by midgut volvulus in an adult patient...
2017: Case Reports in Surgery
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