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Case Reports in Surgery

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https://www.readbyqxmd.com/read/28203474/unexpected-radiation-induced-aortic-wall-thickening-requiring-composite-graft-technique-during-off-pump-coronary-artery-bypass-grafting
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28163949/anterior-to-posterior-migration-of-a-lumbar-disc-sequestration-surgical-remarks-and-technical-notes-about-a-tailored-microsurgical-discectomy
#6
Alessandro Frati, Alessandro Pesce, Mauro Palmieri, Tommaso Vangelista, Riccardo Caruso, Maurizio Salvati, Antonino Raco
Extrusion of disc material within the spinal canal complicates up to 28.6% of lumbar disc herniations. Due to the anatomical "corridors" created by the anterior midline septum and lateral membranes, relocation occurs with an anterior and anterolateral axial topography. Posterior migration is an extremely rare condition and anterior-to-posterior circumferential migration is an even rarer condition. Its radiological feature can be enigmatic and since, in more than 50% of cases, clinical onset is a hyperacute cauda equina syndrome, it may imply a difficult surgical decision in emergency settings...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28133561/thoracoscopic-surgery-for-glomus-tumor-an-uncommon-mediastinal-neoplasm-and-iatrogenic-tracheal-rupture
#7
Zhongjie Fang, Dehua Ma, Baofu Chen, Huarong Luo
Mediastinal glomus tumors are rarely recognized, and only seven cases have been reported in the literature. Here, we describe a rare mediastinal glomus tumor and review the characteristics of this rare clinical case. The patient was a 50-year-old female who presented with coughing for 3 months. Her chest computed tomography scan demonstrated a localized tumor in the posterior superior mediastinum. Intraoperatively, we found a longitudinal rupture of the membranous trachea above the carina. We completely resected the tumor and repaired the tracheal rupture under a thoracoscopy using a pedicled muscle flap...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28127490/rare-type-cranial-postauricular-pilonidal-sinus-a-case-report-and-brief-review-of-literature
#8
Sebahattin Destek, Vahit Onur Gul, Serkan Ahioglu
A pilonidal sinus is a chronic inflammatory process, the etiology of which is still not fully elucidated. It frequently presents at the sacrococcygeal region (typical) and rarely at extrasacrococcygeal (atypical) locations, including the interdigital, axillary, inguinal, and umbilical regions, as well as the neck, face, and scalp. A 46-year-old man presented with a thirty-year history of a slowly growing nodule on the postauricular area of the scalp. The lesion was excised and diagnosed as a pilonidal sinus based on the clinical and histological findings...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28116210/colorectal-cancer-metastasis-to-the-thymus-gland-rare-presentation-of-colorectal-cancer-as-anterior-mediastinal-mass
#9
H Charles Peters, Xiuli Liu, Atif Iqbal, Lisa A Cunningham, Sanda A Tan
Despite improved screening modalities, 15-25% of newly diagnosed colorectal cancers are metastatic at the time of diagnosis. The vast majority of these cases present as hepatic metastasis; however, 22% present with concomitant extrahepatic disease. The thymus gland is an uncommon site of metastasis for any primary malignancy, particularly, colorectal cancer given its vascular and lymphatic drainage. This case report details our experience with a rare case of colorectal cancer metastasis to the thymus gland presenting as a symptomatic mediastinal mass...
2017: Case Reports in Surgery
https://www.readbyqxmd.com/read/28116209/laparoendoscopic-rendezvous-for-concomitant-cholecystocholedocholithiasis-a-successful-modality-even-in-the-most-difficult-presentations-including-pregnancy
#10
Bader Hamza Shirah, Zaher Abdulaziz Mikwar, Akram Neyaz Ahmad, Yaser Mohammed Dahlan
Background. Laparoendoscopic rendezvous (LERV) technique is emerging as an attractive treatment option for concomitant cholecystocholedocholithiasis. In this paper, we report our experience in performing the LERV technique in patients with unusual presentations in terms of anatomical difficulty, pregnancy, multiple comorbid diseases, and postlaparotomy. We aim to highlight the effectiveness of the LERV technique in some clinical situations where conventional methods would fail or carry high risks in adequately managing concomitant cholecystocholedocholithiasis...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28116208/skeletal-muscle-metastasis-of-a-gist-a-case-report-and-review-of-the-literature
#11
Olga D Savvidou, George D Chloros, Georgios D Agrogiannis, Penelope Korkolopoulou, Georgios N Panagopoulos, Panayiotis J Papagelopoulos
Gastrointestinal stromal tumors (GISTs) are the most common malignant mesenchymal tumors of the gastrointestinal tract. The most common sites of metastasis are the liver and the peritoneum, whereas metastasis to soft tissue is rare. The authors present the case of a 78-year-old male with a soft tissue metastasis of a GIST and the current literature is reviewed.
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28101394/ancient-schwannoma-of-the-cauda-equina-our-experience-and-review-of-the-literature
#12
Venceslao Wierzbicki, Alessandro Pesce, Luigi Marrocco, Emanuele Piccione, Alessandro Frati, Riccardo Caruso
Ancient schwannomas (AS) are exceedingly rare variant of common schwannomas (CS). Only two cases involving the cauda equina region have been previously reported in literature. AS are typically associated with a higher histological degree of degenerative changes (Antoni B areas). It is of peculiar importance, according to our opinion, to outline that, because of their extremely slow growth (which explains the increase of the degenerative changes in respect to the CS) and their typical soft consistency in respect to their standard counterparts, AS usually imply an even better prognosis...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28101393/unusual-presentation-of-tuberculous-thyroid-abscess-in-a-background-of-hashimoto-s-thyroiditis-in-a-chronic-hepatitis-b-carrier
#13
Sakthivel Chinnakkulam Kandhasamy, Sunil Kumar, Anubhav Sangwan, Neelam Sahani, Gopalakrishnan Gunasekaran, Sunil Kumar Meena, Swapnil Singh Kushwaha
Tuberculosis of thyroid gland is a very rare disease. It has variable presentations and may be sometimes associated with autoimmune thyroiditis. We report a case of 45-year-old male, with left sided painless neck swelling, with a purulent discharging sinus over it associated with night sweats and loss of appetite. Thyroid imaging disclosed heterogeneous enhancement of left lobe of thyroid gland with internal vascularity and coarse calcifications. Core needle biopsy revealed caseous necrosis and AFB positivity...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28097035/flare-up-diverticulitis-in-the-terminal-ileum-in-short-interval-after-conservative-therapy-report-of-a-case
#14
Kensuke Nakatani, Takaharu Kato, Shinichiro Okada, Risa Matsumoto, Kazuhiro Nishida, Hiroyasu Komuro, Maki Iida, Shiro Tsujimoto, Toshiyuki Suganuma
Diverticulitis in the terminal ileum is uncommon. Past reports suggested that conservative therapy may be feasible to treat terminal ileum diverticulitis without perforation; however, there is no consensus on the therapeutic strategy for small bowel diverticulitis. We present a 37-year-old man who was referred to our hospital for sudden onset of abdominal pain and nausea. He was diagnosed with diverticulitis in the terminal ileum by computed tomography (CT). Tazobactam/piperacillin hydrate (18 g/day) was administered...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28097034/blowhole-colostomy-for-clostridium-difficile-associated-toxic-megacolon
#15
Jeroen Kerstens, Ian Diebels, Charles de Gheldere, Patrick Vanclooster
We present the case of a 58-year-old man who underwent urgent blowhole colostomy for toxic megacolon (TM) secondary to Clostridium difficile infection (CDI). This infection occurred under antibiotic coverage with amoxicillin-clavulanic acid, four days after laparoscopic sigmoidectomy in our hospital. Although prospective clinical research regarding the surgical management of TM is lacking, decompressive procedures like blowhole colostomy are reported to carry a high risk of postoperative morbidity and mortality and are widely regarded as obsolete...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28097033/a-case-report-of-bilateral-adrenal-sarcomatoid-carcinoma
#16
Ozlem Turhan Iyidir, Ethem Turgay Cerit, Çiğdem Özkan, Eroğlu Altınova, Ali Rıza Çimen, Sinan Sözen, Mustafa Kerem, Müjde Aktürk, Leyla Memiş, Baloş Törüner, Nuri Çakır, Metin Arslan
Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy. Sarcomatoid adrenal carcinoma is even more aggressive type of ACC. Bilateral malignant adrenal tumors are extremely rare except for those that represent metastasis from an extra-adrenal organ. Here we report a 53-year-old woman who presented with abdominal pain and weight loss. Abdominal computed tomography revealed bilateral adrenal masses and a mass in her liver. Surgical specimens showed pleomorphic tumor cells with epithelial and spindle cell morphology and immunohistochemical staining was compatible with sarcomatoid carcinoma...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28097032/abdominal-pain-in-the-female-patient-a-case-of-concurrent-acute-appendicitis-and-ruptured-endometrioma
#17
Martine A Louis, Amanda R Doubleday, Elizabeth Lin, Ji Yoon Baek, Alda Andoni, Xiao Hui Wang
General surgeons are often asked to evaluate acute abdominal pain which has an expanded differential diagnosis in women of childbearing age. Acute appendicitis accounts for many surgical emergencies as a common cause of nongynecologic pelvic pain. In some rare instances, acute appendicitis has been shown to occur simultaneously with a variety of gynecologic diseases. We report a case of concurrent acute appendicitis and ruptured ovarian endometrioma.
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28074168/reconstruction-of-abdominal-wall-defects-using-a-pedicled-anterolateral-thigh-flap-including-the-vastus-lateralis-muscle-a-report-of-two-cases
#18
Kiyoko Fukui, Masaki Fujioka, Satoko Ishiyama
The purpose of abdominal wall reconstruction is to prevent hernias and protect the abdominal viscera. In cases involving full-thickness defects of the rectus abdominis muscle, the muscle layer should be repaired. We present 2 cases in which full-thickness lower rectus abdominis muscle defects were reconstructed using vastus lateralis-anterolateral thigh flaps. The pedicled vastus lateralis-anterolateral thigh flap provides skin, fascia, and muscle tissue. Furthermore, it has a long neurovascular pedicle and can reach up to the periumbilical area and cover large defects...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28074167/delayed-tension-pneumocephalus-following-gunshot-wound-to-the-head-a-case-report-and-review-of-the-literature
#19
Arthur Wang, Elena Solli, Nathan Carberry, Virany Hillard, Adesh Tandon
Tension pneumocephalus is a rare complication of head trauma and neurosurgical procedures, amongst other causes. It is defined by the combination of intracranial air, increased intracranial pressure, and mass effect. Although it often presents soon after surgery, it can also rarely present in a delayed fashion. We present a case of delayed tension pneumocephalus, occurring approximately 16 weeks after bifrontal craniectomy for a self-inflicted gunshot wound. Following a month of rhinorrhea, postnasal drip, and cough, the patient presented with a sensation of expansion in the area of the right forehead...
2016: Case Reports in Surgery
https://www.readbyqxmd.com/read/28070440/a-rare-subcutaneous-manifestation-of-metastatic-renal-cell-carcinoma
#20
Darren Yak Leong Chan, Wei Jin Chua
We report a rare case of advanced metastatic renal cell carcinoma which initially presented to the clinic with back and forehead lumps. Ultrasound imaging of the lumps and later of the abdomen picked up a right renal tumour which led to further computed tomography and bone scans. The bone scan confirmed that the forehead lump was a calvarial metastasis and such a presentation for metastatic RCC is very rare which bears a significantly poorer prognosis.
2016: Case Reports in Surgery
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