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Case Reports in Surgery

Toru Imagami, Satoru Takayama, Yohei Maeda, Ryohei Matsui, Masaki Sakamoto, Hisanori Kani
Background: Schwannoma arises from Schwann's cell of the neural sheath. Schwannoma of the large intestine, particularly of the appendix, is rare. We report a case of appendiceal schwannoma resected using laparoscopic surgery. Case Presentation: A 75-year-old man was referred to our hospital for abdominal fullness and nausea since 2 months. Abdominal CT revealed a well-demarcated oval mass of 25 mm at the tip of the appendix. Contrast-enhanced CT revealed a lesion with gradually enhanced contrast from the arterial phase to the equilibrium phase...
2018: Case Reports in Surgery
Nisar A Chowdri, Asif Mehraj, Fazl Q Parray, Mudassir A Khan, Masood A Laharwal, Rauf A Wani
Endometrial stromal sarcomas of uterus are quite rare. Most of the recurrences in these tumors are seen in the pelvis. However, extrapelvic recurrences and metastases to other parts are quite unusual. Here, we are reporting a rare case of caecal recurrence of endometrial stromal sarcoma. Case Report . A 52-year-old female presented to us with pain and lump in the right lower abdomen. The patient was earlier subjected to total abdominal hysterectomy with bilateral salpingo-oophorectomy (TAHBSO) for low-grade endometrial stromal sarcoma...
2018: Case Reports in Surgery
Eric J Vick, Christopher T Clark, James M Lewis
Radiation exposure for the average coronary stent placement varies based on a number of factors but typically amounts to 6-11 mSv per patient (compared to 3 mSv background). As with all procedures which utilize radiation, there is an inherent risk of genetic mutation and the possible development of malignancy. Here, we present the case of a 75-year-old male who presented with an exophytic mass on his back following prolonged coronary catheterization with a radiation burn seven years prior. Biopsy of the lesion revealed the mass was consistent with an undifferentiated pleomorphic sarcoma emanating from the site of the radiation burn...
2018: Case Reports in Surgery
Yohei Kawatani, Hirotsugu Kurobe, Yoshitsugu Nakamura, Yuji Suda, Takaki Hori
Introduction: Blunt thoracic aortic injury (BTAI) is a critical condition. Thoracic endovascular aortic repair (TEVAR) is considered a surgical treatment for BTAI. Reports reveal that some patients benefit from conservative and delayed operation rather than emergency operative therapy. Here, we present three BTAI cases that were treated with TEVAR using different timings. Case Presentation: Case 1 involved a 49-year-old man injured in a car accident and who went into shock...
2018: Case Reports in Surgery
Khuram Khan, Saqib Saeed, Haytham Maria, Mohammed Sbeih, Farhana Iqbal, Alexius Ramcharan, Brian Donaldson
Introduction: Duodenal diverticulum is a rare disease that can be easily missed. The incidence of duodenal diverticulum diagnosed by upper GI study is approximately 5%. Autopsy results show that 22% of the population have duodenum diverticulum. Most patients with duodenal diverticulum are asymptomatic. However, complications like inflammation, perforation with retroperitoneal abscess, sepsis, pancreatitis, bile duct obstruction, and bleeding can occur. Approximately 162 cases of perforated duodenal diverticulum have been reported in the literature...
2018: Case Reports in Surgery
Sameep S Shetty, Premalatha Shetty, Prit Kiran Shah, Jayanth Nambiar, Nancy Agarwal
A striking feature of the skull base is the pterygoid hamulus known for its bizarre morphology and biomechanical location. Pterygoid hamular bursitis is an inflammation of bursae located between the tendon, muscle, and bony prominences. The minimal objective finding in an apparently normal orofacial apparatus and dependence on the subjective symptoms experienced by the patient with widespread referral pattern often perplexes the clinician. Bursitis should be considered in the differential diagnosis of craniofacial neuralgia, temporomandibular joint dysfunction, and chronic craniofacial pain...
2018: Case Reports in Surgery
Paddy Ssentongo, Mark Egan, Temitope E Arkorful, Theodore Dorvlo, Oneka Scott, John S Oh, Forster Amponsah-Manu
We present a rare case of gastrogastric intussusception due to gastrointestinal stromal tumor (GIST) and the largest comprehensive literature review of published case reports on gastrointestinal (GI) intussusception due to GIST in the past three decades. We found that the common presenting symptoms were features of gastrointestinal obstruction and melena. We highlight the diagnostic challenges faced in low-resource countries. Our findings emphasize the importance of early clinical diagnosis in low-resource settings in order to guide timely management...
2018: Case Reports in Surgery
Gian Luigi Canu, Fabio Medas, Giulio Columbano, Luca Gordini, Luca Saba, Enrico Erdas, Pietro Giorgio Calò
Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past medical history included a previous unilateral nephrectomy for Wilms' tumor and the previous incidental finding of some intra-abdominal cystic formations at the level of the mesentery. After performing a CT scan, an exploratory laparotomy was done and a voluminous cystic mesenteric mass, composed of 3 confluent formations, was observed...
2018: Case Reports in Surgery
Gael Kuhn, Jean Bruno Lekeufack, Michael Chilcott, Zacharia Mbaidjol
The onset of colon diverticular disease is a frequent event, with a prevalence that increases with age. Amongst possible complications, free peritoneal perforation with abscess formation may occur. We herein describe two rare presentations of an extraperitoneal sigmoid diverticulum perforation. Our first patient, an 89-year-old female with no signs of distress, developed a subcutaneous abscess and emphysema in an incisional hernia following an appendectomy through a McBurney incision. The second patient, an 82-year-old female, was in general distress at the time of her admission and had a more advanced infection following the occurrence of a sigmoid perforation in a hernial sac...
2018: Case Reports in Surgery
Jun Takahashi, Shingo Tsujinaka, Nao Kakizawa, Noriya Takayama, Erika Machida, Kazuki Iseya, Fumi Hasegawa, Rina Kikugawa, Yasuyuki Miyakura, Koichi Suzuki, Toshiki Rikiyama
Recent advancements in multimodal therapy can provide oncologic benefits for patients with recurrent colorectal cancer. This report presents a case of locoregionally recurrent appendiceal cancer treated with neoadjuvant chemotherapy followed by surgical resection with vascular reconstruction. A 68-year-old Japanese woman was diagnosed with appendiceal cancer and underwent ileocecal resection. The pathological evaluation revealed KRAS-mutant adenocarcinoma with the final stage of T4bN1M0. She received oral fluorouracil-based adjuvant chemotherapy...
2018: Case Reports in Surgery
Tarek Aridi, Mohamad Fawwaz, Ahmad Kassab, Marwan Bahmad, Faisal Houcheimi, Mohamad Mshiek, Fouad Boulos, Ali Kanj, Ghassan Ramadan, Hisham F Bahmad, Najla Fakhruddin
Lymphoepithelioma-like carcinoma (LELC) of the breast is an extremely rare tumor type. Histologically, it mimics undifferentiated nasopharyngeal carcinoma by demonstrating nests of neoplastic epithelial cells in a background of lymphoplasmacytic infiltrates. This paper reports a 62-year-old female patient with a 3 × 1.5 cm BI-RADS type IV breast mass diagnosed on excisional biopsy as LELC. The tumor is negative for estrogen and progesterone receptors and did not overexpress HER2/neu. Routine tests for clearance before surgery were performed, and patient was managed by a modified radical mastectomy with axillary lymph node dissection showing no residual tumor...
2018: Case Reports in Surgery
Maria Francesca Secchi, Carlo Torre, Giovanni Dui, Francesco Virdis, Mauro Podda
Colonoscopic perforation is a serious and potentially life-threatening complication of colonoscopy. Its incidence varies in frequency from 0.016% to 0.21% for diagnostic procedures, but may be seen in up to 5% of therapeutic colonoscopies. In case of extraperitoneal perforation, atypical signs and symptoms may develop. The aim of this report is to raise the awareness on the likelihood of rare clinical features of colonoscopic perforation. A 72-year-old male patient with a past medical history of myocardial infarction presented to the emergency department four hours after a screening colonoscopy with polypectomy, complaining of neck pain, retrosternal oppressive chest pain, dyspnea, and rhinolalia...
2018: Case Reports in Surgery
Jayan George, Michael Peirson, Samuel Birks, Paul Skinner
We describe the case of a 37-year-old gentleman with Crohn's disease and a complex surgical history including a giant incisional hernia with no abdominal wall. He presented on a Sunday to the general surgical on-call with a four-day history of generalised abdominal pain, nausea, and decreased stoma output following colonoscopy. After CT imaging, he was diagnosed with a large colonic perforation. Initially, he was worked up for theatre but following early senior input, a conservative approach with antibiotics was adopted...
2018: Case Reports in Surgery
Kevin L Chow, Eduardo Smith-Singares, James Doherty
Introduction: Pelvic fractures usually involve a high-energy traumatic mechanism and account for approximately 3% of all blunt traumatic skeletal injuries. Additional musculoskeletal injuries are found in over 80% of unstable pelvic fractures. Traumatic abdominal wall hernias (TAWHs) are a rare entity, and traumatic inguinal hernias (TIHs) associated with open-book pelvic fractures have not been described previously. Case Presentation: We present the case of a 45-year-old male motorcyclist involved in a collision resulting in a traumatic direct inguinal hernia due to abdominal wall disruption from an open-book pelvic fracture...
2018: Case Reports in Surgery
Alyssa Goldbach, Partha Hota, Andrew Czulewicz, Christine Burgert-Lon, Omar Agosto
The de Garengeot hernia is an uncommon and potentially confounding pathologic process in which the appendix is contained within a femoral hernia. While typically a benign incidental finding, superimposed acute appendicitis is a rare but serious complication. Identification of this entity is crucial to patient management and ultimately outcome with imaging playing a critical role. Cross-sectional imaging, with either CT or MRI, should be performed in all cases of suspected incarcerated de Garengeot hernia to facilitate the appropriate diagnosis and surgical intervention...
2018: Case Reports in Surgery
Yuji Kamei, Ai Miyoshi, Nao Wakui, Takeya Hara, Serika Kanao, Hirokazu Naoi, Hirofumi Otsuka, Takeshi Yokoi
Women in the reproductive age group diagnosed with cervical cancer can receive radical trachelectomy in case they wish to preserve fertility. However, the indication for this procedure in infertile women with cervical cancer is controversial depending on the underlying cause of infertility. Here, we present a case of a successful pregnancy following myomectomy accompanied with abdominal radical trachelectomy for an infertile woman with early cervical cancer. The patient was a 38-year-old nulliparous woman with a significant past medical history of infertility of unknown origin...
2018: Case Reports in Surgery
C J Salgado, H AlQattan, A Nugent, D Gerth, W Kassira, C S McGee, L Wo
Gender affirmation surgeries in male-to-female patient transitioning include breast augmentation, genital construction, and facial feminization surgery (FFS). FFS improves mental health and quality of life in transgender patients. The nose and forehead are critical in facial attractiveness and gender identity; thus, frontal brow reduction and rhinoplasty are a mainstay of FFS. The open approach to reduction of the frontal brow is very successful in the feminization of the face; however, risks include alopecia and scarring...
2018: Case Reports in Surgery
Ikuo Watanobe, Hiroko Kida, Yuuki Sekine, Masaya Kawai, Shozo Miyano, Michio Machida, Toshiaki Kitabatake, Hiroyuki Sugo, Yoshifumi Lee, Kuniaki Kojima
Congenital epidermolysis bullosa is a rare, genetic condition in which even slight stimulation can cause blistering of the skin or mucosa. While previous reports of treatments requiring general anesthesia in these patients were focused on anesthesia-related procedures, such as endotracheal intubation, no report has described specific management required for these patients during surgery, such as preparation of the surgical site, fixation of infusion lines and other tubes, and adjustment of the operation table...
2018: Case Reports in Surgery
Surasak Puvabanditsin, Marissa Botwinick, Charlotte Wang Chen, Aditya Joshi, Rajeev Mehta
Background: The presence of distal bowel gas in an infant does not exclude the diagnosis of duodenal atresia. Case Presentation: We report a term neonate with Down syndrome. The infant developed vomiting and cyanosis with each feeding soon after birth. Plain film abdominal X-rays showed a nonspecific gas-filled stomach and small bowel. Duodenal atresia and an anomalous common bile were noted on an upper GI study and exploratory laparotomy. Conclusion: In the absence of a "double bubble" appearance and intestinal gas distally on a plain radiograph, one must not exclude duodenal atresia as the differential diagnosis...
2018: Case Reports in Surgery
Syed Muhammad Nazim, Ayesha Nusrat, Zehra Kazmi
Intrascrotal lesions are common findings with a majority occurring in paratesticular tissue. Fibrous pseudotumors are rare, benign lesions of the testicular tunics and present with mass lesion(s) in the scrotum. Preoperative clinical and radiological diagnosis is challenging. We report a case of a 34-year-old man who presented with a 3-year history of left testicular swelling and was advised left radical orchidectomy by another surgeon. Physical examination revealed a firm, nontender mass attached to the lower pole of the testis...
2018: Case Reports in Surgery
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