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Surgical Case Reports

Takuya Saito, Kohei Yasui, Shintaro Kurahashi, Kenichi Komaya, Seiji Ishiguro, Takashi Arikawa, Shunichiro Komatsu, Kenitiro Kaneko, Masahiko Miyachi, Tsuyoshi Sano
BACKGROUND: Intrapericardial diaphragmatic hernia (IPDH), defined as prolapse of the abdominal viscera into the pericardium, is a rare clinical condition. This case illustrates the possibility of IPDH after esophagectomy with antethoracic alimentary reconstruction, although such hernias are extremely rare. IPDH often presents with symptoms of bowel obstruction such as abdominal discomfort or vomiting. If not properly treated, life-threatening necrosis and/or perforation of the herniated contents may occur...
August 13, 2018: Surgical Case Reports
Hideki Kogo, Satoshi Matsumoto, Eiji Uchida
BACKGROUND: We report the case of a young woman with a large abdominal cystic lymphangioma that was successfully resected using single-port laparoscopic-assisted cystectomy. This avoided the need for a large surgical incision, as would result during conventional laparotomy. CASE PRESENTATION: A 17-year-old young woman was admitted to our hospital complaining of abdominal pain that had persisted for 3 days. Computed tomography revealed a 10 × 10 × 10-cm low-density area in the mid-abdomen, and magnetic resonance imaging showed a large abdominal cystic lesion...
August 13, 2018: Surgical Case Reports
Takuro Konno-Kumagai, Daisuke Takeyama, Toru Nakano, Tadashi Sakurai, Yusuke Taniyama, Takahiro Heishi, Chiaki Sato, Takashi Kamei
BACKGROUND: Prolapse of a small part of the proximal stomach through the hiatus into the mediastinum is relatively common. Hiatal hernia involving the postoperative stomach has been reported previously, but the degree of hernia was not so severe, and hiatal hernia involving the prolapse of the entire stomach following gastrectomy into the mediastinum has never been reported. We describe a very rare case of large hiatal hernia involving the entire postoperative stomach. CASE PRESENTATION: A 79-year-old man with a history of distal gastrectomy for submucosal benign tumor 40 years ago was referred to our hospital because of dysphagia and weight loss...
August 13, 2018: Surgical Case Reports
Toshio Fujino, Masayuki Tanahashi, Haruhiro Yukiue, Eriko Suzuki, Naoko Yoshii, Masayuki Shitara, Yasunori Kaminuma, Hiroshi Niwa
BACKGROUND: Left sleeve pneumonectomy is a challenging operation that requires individualized approaches. Here, we present a new minimally invasive combined thoracoscopic approach. CASE PRESENTATION: A 61-year-old woman was diagnosed with tracheobronchial adenoid cystic carcinoma. The tumor originated from the left main stem bronchus, and tumor with carinal involvement was observed. We judged that complete resection would be possible via left sleeve pneumonectomy...
August 10, 2018: Surgical Case Reports
Shigehiro Kojima, Tsuguo Sakamoto, Yuko Nagai, Masayuki Honda, Fumihiro Ogawa
BACKGROUND: Colorectal metastases from primary colorectal cancers are very rare, and little is known about their epidemiological aspects or the best diagnostic and therapeutic strategies. Herein, we report a case of a 65-year-old woman with suspected metachronous metastasis to the rectum from primary transverse colon cancer. CASE PRESENTATION: The patient underwent a laparoscopic extended right hemicolectomy for primary transverse colon cancer. Histopathological examination showed moderately differentiated adenocarcinoma, and the tumor was diagnosed as stage IIA (T3, N0, M0)...
August 9, 2018: Surgical Case Reports
Masanori Shimomura, Shunta Ishihara, Masashi Iwasaki
BACKGROUND: In rare cases, rheumatoid pleural nodules can rupture into the pleural cavity to cause pneumothorax or empyema. We report successful surgical treatment of a patient with an intractable secondary pneumothorax due to rupture of a subpleural rheumatoid nodule into the pleural cavity. CASE PRESENTATION: A 75-year-old man with a medical history of rheumatoid arthritis, acute coronary syndrome, and diabetes was admitted to our hospital because of left chest pain and dyspnea...
August 8, 2018: Surgical Case Reports
Akiko Serizawa, Kiyoaki Taniguchi, Takuji Yamada, Kunihiko Amano, Sho Kotake, Shunichi Ito, Masakazu Yamamoto
BACKGROUND: Although patients with stage IV gastric cancer who respond well to systemic chemotherapy can be treated with gastrectomy, the prognosis of patients with unresectable gastric cancer with para-aortic lymph node metastasis is poor. We herein report a case of remnant gastric cancer with para-aortic lymph node metastasis that was treated with potentially curative conversion surgery after showing a complete response to chemotherapy with S-1 and oxaliplatin (SOX). CASE PRESENTATION: An 81-year-old man was diagnosed with type 3 remnant gastric cancer with giant para-aortic lymph node metastasis, and he received SOX chemotherapy...
August 7, 2018: Surgical Case Reports
Daisuke Kaneyuki, Tomoki Sakata, Anan Nomura, Manabu Sakurai, Kenji Mogi, Yoshiharu Takahara
BACKGROUND: Epicardial cysts are rarer benign tumors than pericardial cysts. There have been few reports on surgical management for epicardial cysts. CASE PRESENTATION: A 73-year-old woman with dyspnea on exertion had a giant cyst (12 × 10 cm in diameter) on preoperative computed tomography. Compression of the left atrium and ventricle by the cyst was considered to be the cause of her symptoms. The cyst was diagnosed with an epicardial cyst intraoperatively...
August 6, 2018: Surgical Case Reports
Nao Kakizawa, Shingo Tsujinaka, Yasuyuki Miyakura, Rina Kikugawa, Fumi Hasegawa, Hideki Ishikawa, Sawako Tamaki, Jun Takahashi, Toshiki Rikiyama
BACKGROUND: Diversion colitis (DC) is characterized by nonspecific inflammation in the remaining colon or rectum, and loss of the fecal stream plays a major role in the disease's development. Although the majority of patients are asymptomatic, medical and/or surgical treatment is required for those who are symptomatic. There is a particular interest on how to manage patients with acute and severe clinical presentations, but the pathogenesis is not fully understood. We report the rare case of a man with acute and severe DC mimicking ulcerative colitis (UC) with extra-intestinal manifestations that was successfully managed with surgical treatment...
August 2, 2018: Surgical Case Reports
Toru Yoshikawa, Tomoyuki Abe, Hironobu Amano, Keiji Hanada, Tomoyuki Minami, Tsuyoshi Kobayashi, Shuji Yonehara, Masahiro Nakahara, Hideki Ohdan, Toshio Noriyuki
BACKGROUND: Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by mucocutaneous pigmentation and hamartomatous gastrointestinal polyposis. It is well known that individuals with PJS are at an increased risk of cancer in a variety of organs. CASE PRESENTATION: Here, we present a patient with PJS who achieved long-term survival by undergoing repeat curative surgery for metachronous triple cancer. Her medical history included hilar cholangiocarcinoma and cervical carcinoma; curative surgery was performed for both conditions...
August 1, 2018: Surgical Case Reports
Takahiro Yoshioka, Yoshitaka Kondo, Toshiyoshi Fujiwara
BACKGROUND: The indications for negative pressure wound therapy (NPWT) continue to expand, and NPWT has become a powerful tool for the treatment of interactive wounds. Recently, the use of NPWT over closed incisions has been shown to prevent surgical site infection (SSI) in patients undergoing contaminated or acute care surgery as prophylactic NPWT. In this article, we present our successful experience using NPWT without primary skin closure for wound treatment after a highly contaminated enterological surgery...
August 1, 2018: Surgical Case Reports
Jun Iwabu, Tsutomu Namikawa, Hiroyuki Kitagawa, Kazune Fujisawa, Toyokazu Oki, Maho Ogawa, Natsuko Iwai, Akiko Yano, Motone Kuriyama, Takeki Sugimoto, Kazuhiro Hanazaki
BACKGROUND: The demand for breast reconstruction after mastectomy is rising. The use of deep inferior epigastric perforator (DIEP) flap in autologous reconstruction is a popular approach. There were some reports about abdominal complications after breast reconstruction. However, there was no report about spontaneous rupture of abdominal wall. CASE PRESENTATION: A 46-year-old female patient was diagnosed with left breast cancer. Left mastectomy with sentinel lymph node biopsy was performed, and the breast was reconstructed using DIEP flap simultaneously...
July 31, 2018: Surgical Case Reports
Akira Fujita, Hiroshi Kurazumi, Ryo Suzuki, Masaya Takahashi, Akihito Mikamo, Kimikazu Hamano
BACKGROUND: Coronary vasospasm after coronary artery bypass grafting (CABG) is a rare but potentially lethal complication. It is often refractory to several vasodilators. We report a case of refractory coronary vasospasm relieved by fasudil injection. CASE PRESENTATION: A 74-year-old woman who had three instances of in-stent stenosis at the left anterior descending artery (LAD) was referred for CABG treatment. Preoperative coronary angiography showed 90% in-stent stenosis of the proximal LAD and 75% stenosis of the diagonal branch...
July 27, 2018: Surgical Case Reports
Akihiko Sano, Shinji Sakurai, Chika Komine, Yuichi Tabe, Kana Saito, Takaharu Fukasawa, Shinsuke Kiriyama, Hideki Yamamoto, Masachika Tani, Hiroshi Naitoh, Ken Shirabe, Hiroyuki Kuwano
BACKGROUND: Extramammary Paget's disease (EMPD) of the esophagus is a rare tumor, with most cases originating from invasive adenocarcinoma of the esophagus. Pure esophageal Paget's disease, in which no underlying invasive carcinoma component is present, is extremely rare. In this report, we describe a case of EMPD of the esophagogastric junction with no evidence of invasive carcinoma. CASE PRESENTATION: An 81-year-old Japanese woman with a 2-week history of abdominal distension presented to our hospital for assessment...
July 25, 2018: Surgical Case Reports
Akikazu Yago, Mitsuko Furuya, Ryutaro Mori, Yasuhiro Yabushita, Yu Sawada, Takafumi Kumamoto, Ryusei Matsuyama, Michio Shimizu, Itaru Endo
BACKGROUND: Medullary carcinoma of the pancreas (MCP) is a rare malignant pancreatic tumor. The World Health Organization classification defines the tumor as a subtype of pancreatic ductal carcinomas. MCP is histologically characterized as having highly pleomorphic cells with syncytial morphology, expansive tumor growth, and necrosis. The pathogenesis and clinical course of MCP are largely unknown. Herein, we report an unusual case of MCP that was radiologically followed up for 9 years prior to surgical intervention...
July 24, 2018: Surgical Case Reports
Tomoko Jogo, Eiji Oki, Minako Fujiwara, Junji Kurashige, Ryota Nakanishi, Masahiko Sugiyama, Yuichiro Nakashima, Hiroshi Saeki, Shinichi Tsuruta, Masataka Nishimura, Yoshinao Oda, Yoshihiko Maehara
BACKGROUND: Juvenile polyposis is an autosomal dominant inherited disease characterized by the development of numerous hamartomatous and nonneoplastic polyps of the gastrointestinal tract. Juvenile polyposis has also recently been reported as a predisposition for gastrointestinal cancer. CASE PRESENTATION: A 63-year-old man underwent esophagogastroduodenoscopy because of anemia and hypoalbuminemia during a follow-up for gastric polyposis, which showed multiple reddish polyps and two elevated lesions in the stomach...
July 24, 2018: Surgical Case Reports
Makiko So, Yoshiro Itatani, Kazutaka Obama, Shigeru Tsunoda, Shigeo Hisamori, Kyoichi Hashimoto, Yoshiharu Sakai
BACKGROUND: Arteriovenous malformations (AVM) developed in the small intestine are rare, and it is sometimes difficult to identify and treat bleeding from small intestinal AVMs endoscopically because of their localization. We present a case of a jejunal AVM successfully treated with the combination of metallic coil embolization and laparoscopic surgery. CASE PRESENTATION: A 50-year-old woman with a history of repetitive gastrointestinal bleeding was admitted to the hospital...
July 18, 2018: Surgical Case Reports
Teiko Sakurai, Hidenori Kusumoto, Tomoko Wakasa, Yoshio Ohta, Eiichi Konishi, Hiroyuki Shiono
BACKGROUND: Epithelioid sarcoma (ES) is a rare variant of soft tissue sarcoma. The proximal type of ES occurs in various locations. We present a resected case with proximal-type ES that occurred in the chest wall and discuss the relevant literature. CASE PRESENTATION: A 47-year-old woman was referred for a 6-month history of a right anterior chest mass with tenderness. Chest computed tomography showed an invasive chest wall mass with calcification surrounding the third rib...
July 13, 2018: Surgical Case Reports
Masashi Nakamura, Shinya Hayami, Masaki Ueno, Manabu Kawai, Atsushi Miyamoto, Norihiko Suzaki, Seiko Hirono, Ken-Ichi Okada, Motoki Miyazawa, Yuji Kitahata, Hiroki Yamaue
BACKGROUND: Radiofrequency ablation (RFA) for hepatocellular carcinoma (HCC) is already fully established worldwide. Needle tract implantation and peritoneal seeding occasionally occur by RFA, and the prognosis of these cases is thought to be poor. In this study, intraoperative real-time near-infrared fluorescence (NIRF) system by indocyanine green (ICG) incidentally detected both needle tract implantation and peritoneal seeding. As the utility of this system for identification of implanted and disseminated lesions after RFA for HCC has not been widely reported, we report a case of successful detection by real-time ICG-NIRF imaging and subsequent resection...
July 13, 2018: Surgical Case Reports
Toko Shinkai, Kentaro Ono, Kouji Masumoto, Yasuhisa Urita, Chikashi Gotoh
BACKGROUND: Nonoperative management (NOM) has been established as the standard treatment for isolated blunt organ injury in hemodynamically stable pediatric patients. Although delayed splenic rupture or bleeding is a rare complication in NOM, it is an issue that many pediatric surgeons are greatly concerned about. We herein report a rare pediatric case concerning the mechanisms involved in delayed splenic rupture after NOM. CASE PRESENTATION: A 9-year-old boy with severe abdominal pain was transferred to our hospital...
July 11, 2018: Surgical Case Reports
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