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Journal of Surgical Case Reports

Jonathan Rubin, Daniel R Principe, Blake Movitz, Matthew Ng, Kunal Kochar
Barotrauma to the colon and rectum is well documented, most commonly due to endoscopic complications. Here, we describe the unique case of a 56-year-old male presenting with peritonitis after self induced barotrauma to his colon following an attempt to alleviate 4-day obstipation with a toilet plunger. Exploratory laparotomy revealed a perforated and gangrenous right colon, which was promptly treated with an open right hemicolectomy and end-loop Prasad ileocolostomy. To our knowledge, this represents the first case of its kind and highlights the distinct pathology for colorectal barotrauma depending on the underlying mechanism of injury...
March 2019: Journal of Surgical Case Reports
Glenda C Herrera, Amílcar C Herrera, Patricia Pontón, Gabriel Alejandro Molina, Jonathan Eduardo Constante, Jhony Alejandro Delgado
Acute appendicitis is one of the most common abdominal emergencies, even though most cases of appendicitis will be due to obstruction of the appendiceal lumen, in rare occasions and mostly due to poor sanitary conditions a parasitic infection may cause appendicitis. Entamoeba histolytica is a common parasite and has a broad clinical spectrum from an asymptomatic disease to a life-threatening condition. In rare occasions, trophozoites can invade the appendiceal wall causing appendicitis. Preoperative diagnosis of acute amebic appendicitis is usually difficult, yet surgical treatment as in non-amebic appendicitis is the treatment of choice...
March 2019: Journal of Surgical Case Reports
Emad Aljohani, Atheer S Alotaibi
A 42-year-old lady presented to emergency department with a 3 days history of right-sided abdominal pain. She was afebrile, haemodynamically unstable and the initial diagnosis was acute abdomen with unknown pathology. The CT abdomen/pelvis done, which showed well-defined fatty texture at right lower quadrant suggestive of an epiploic appendagitis and left adnexal cyst. The patient failed to improve on conservative management, diagnostic laparosocopy showed gangrenous sigmoid epiploic appendigitis adherent to the right lower quadrant...
March 2019: Journal of Surgical Case Reports
Fabian Wehrmann, Elsheikh Hashim, Shahbaz Mansoor
Denture ingestion is a rare clinical entity among foreign body ingestions. The caveat is that there is often no recollection of the event and that dentures are radiolucent and as such hard to identify on conventional imaging. To date not all dentures contain radiopaque marker. Here we present the case of a 52-year-old male who was admitted with clinical and radiological signs of perforated diverticular disease. A curvilinear metallic foreign body was picked up on repeat CT imaging at day 3, which was part of an unknowingly swallowed partial denture that became impacted and perforated the sigmoid colon...
March 2019: Journal of Surgical Case Reports
John D L Brookes, Manish Mathew, Charlene P Munasinghe, John C Gribbin, David A Devonshire, Prashant Joshi, Andrew D Cochrane
Pseudocyst of the pancreas extending into the thorax represents a rare but potentially catastrophic diagnosis. It can be difficult to both diagnose and manage, with only limited management suggestions within the literature. While pleural effusion is a common complication of pancreatitis, transthoracic extension of a pseudocyst is a rare phenomenon. Herein we discuss a patient with a difficult to recognize extension of pancreatic pseudocyst into the left hemithorax, with unique imaging findings. He had good response to trans-gastric and percutaneous drainage and ultimately proceeded to thoracotomy and decortication...
March 2019: Journal of Surgical Case Reports
Yuhei Waki, Ryo Ashida, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Katsuhisa Ohgi, Katsuhiko Uesaka
A 67-year-old woman with epigastric pain was diagnosed with resectable pancreatic head cancer and underwent pancreatoduodenectomy. Preoperative computed tomography showed that the common hepatic artery formed a common trunk with the left gastric artery running to the liver through the lesser omentum, and no other arterial supply to the liver was identified. Pancreatoduodenectomy was performed uneventfully without injury to any hepatic arteries. The postoperative clinical course was largely uneventful, and the patient was discharged on postoperative day 19...
March 2019: Journal of Surgical Case Reports
Joshua N Hammerschlag, Clemente Chia, Chaminda Saranasuriya
Prostate cancer is the most commonly diagnosed cancer in males and third most common cause of cancer deaths in Australia. With improved survival rates and increasing reports of metastatic disease, we can expect to see more interesting and unusual presentations of recurrent disease. We present the case of a 66-year-old male with a prostate cancer recurrence to small bowel after curative treatment. We present this case to raise clinical suspicion in the medical fraternity regarding cancer recurrence; Even in the absence of biochemical markers or typical clinical signs and symptoms...
March 2019: Journal of Surgical Case Reports
Raguraj Chandradevan, Ian H Rutkofsky, Mary Charmaine E Campana, Harkirat Kaur, Felisha L Kitchen, Craig C Odum, Randolph S Devereaux, James D Colquitt, Sarah E Hamler, John T Williams Iv
Primary appendicular adenocarcinoma is a rare tumor, mucinous variety, being most common. The case presentation highlights the unusual appearance and diagnostic dilemma of an appendicular adenocarcinoma. Our elderly patient presented with an ill-defined tender lump which later was diagnosed as a perforated appendicular adenocarcinoma, responsive to single-staged surgery and adjunct chemotherapy. We considered the single-staged surgery since the appendix was perforated and right colectomy would not aid the prognosis...
March 2019: Journal of Surgical Case Reports
S Gussago, P Spina, A Guerra
Benign Multicystic Peritoneal Mesothelioma (BMPM) is a rare benign cystic neoplasm that arise from the peritoneum, typically found in young females (83%), with a high incidence of local recurrence after resection (almost 50% of cases). Fewer than 200 cases have been reported worldwide in 2017. Due to its rarity and the lack of a classical clinical presentation, the diagnosis pre-operatively is challenging; moreover a great part of the literature is composed of case reports and small group studies. Nowadays, guidelines are still not available, and treatment is en bloc resection of the lesion...
March 2019: Journal of Surgical Case Reports
Syed Sohail Ahmad, Kaleem Khalilullah, Katherine McGowan, Katrina Dillon
Rectal cancer metastasis to the breast is rare with around 19 cases reported in literature. It signifies diffuse disseminated disease or highly aggressive tumour, such that surgical intervention other than palliation has a limited role. We report a case of a 43-year-old with the above presentation. As the management differs and because of its rarity the importance of the diagnosis between primary and the metastatic breast cancer is imperative.
March 2019: Journal of Surgical Case Reports
Timothy Trestrail, Emily K Martin, Neal Bhutiani, Garrett F Mortensen, Vladimir Davidyuk, Gary C Vitale
A case of a 39-year-old woman diagnosed with superior mesenteric artery syndrome after a 25-year history of nausea, vomiting, and abdominal pain that began as a teenager and the absence of any significant weight loss illustrates the diagnostic complexity of this entity, particularly among teenagers and young adults who present with these symptoms. The patient underwent multiple upper endoscopies and serologic evaluations before a contrasted CT demonstrated an acutely angled SMA and duodenal compression, prompting the diagnosis of SMA syndrome...
March 2019: Journal of Surgical Case Reports
Salman Al Sabah, Eliana Al Haddad, Jonathon D Vaz
Bochdalek hernias are diaphragmatic defects seen in pediatrics. About 5-25% of the cases are diagnosed in adulthood, and present with symptoms of chest and abdominal problems. This is a case of an 18-year-old male who presented to the emergency department with epigastric pain, vomiting and dyspnea. Most of the left-sided organs had herniated to the left chest cavity. Immediate surgery was performed. The stomach, spleen and colon were reduced into the abdominal cavity. The diaphragm defect was repaired laparoscopically, but there were limitations due to inadequate space, leading to difficult visualization of the posterior diaphragmatic leaflet...
March 2019: Journal of Surgical Case Reports
Salman Alsabah, Rawan Elabd, Jonathon D Vaz
Vertical banded gastroplasty (VBG) was one of the most common bariatric surgeries worldwide in the beginning of the 21st century. However, recently we have increasingly encountered its long-term complications. We present two cases of VBG mesh erosion, alongside videos for their management. The first is of a 35-year-old female that presented 10 years after her VBG, while the second is of a 38-year-old female presenting 9-years post hers. Patient one presented with weight regain, regurgitation, epigastric pain, and dysphagia...
March 2019: Journal of Surgical Case Reports
Fabrizio Masciello, Aaron Fargion, Alessandro Alessi Innocenti, Elena Giacomelli, Luca Voltolini, Walter Dorigo, Carlo Pratesi
Type II endoleak following hybrid treatment of aneurysms of aberrant subclavian arteries (AARSA) and requiring reintervention is rare. A retroesophageal AARSA with a 70 mm diameter was treated with left and right carotid to subclavian bypasses and thoracic endografting to exclude its ostium. The distal neck was embolized with a vascular plug. At 22 months postoperatively, an angio-computed tomography (CT) scan performed for worsening of dysphagia showed the presence of a Type II endoleak from bronchial arteries with significant sac enlargement...
March 2019: Journal of Surgical Case Reports
Yuta Koichi, Hayato Ise, Seima Ohira, Daita Kobayashi, Sentaro Nakanishi, Natsuya Ishikawa, Hiroyuki Kamiya
Minimally invasive cardiac surgery has recently become widespread because it has few disadvantages. However, lung hernia has been reported as a rare complication of minimally invasive cardiac surgery (MICS), and normally requiring additional surgical procedures. We describe herein a case of manual repositioning of lung hernia after MICS.
March 2019: Journal of Surgical Case Reports
Corinna Chiong, Peter Yoon, Fred Boseto
Amyand's hernia is a rare type of hernia where the appendix is found within the hernial sac. We present a case of appendicitis within an Amyand's hernia in a 72-year-old man who presented with a acutely painful, irreducible right inguinal lump. He underwent open appendicectomy and primary tissue repair with subsequent delayed elective mesh hernioplasty 3 months later.
March 2019: Journal of Surgical Case Reports
Dimosthenis Chrysikos, Theodore Troupis, John Tsiaoussis, Markos Sgantzos, Vasileios Bonatsos, Vasileios Karampelias, Theodoros Piperos, Vasileios Kalles, Panagiotis Theodoropoulos, Dimosthenis Kakaviatos, Ioannis Flessas, Euthumios Nikou, Theodoros Mariolis-Sapsakos
Superior mesenteric artery (SMA) or Wilkie's syndrome is a rare clinical entity of partial or complete duodenal obstruction. The pathogenic mechanism is an acute angulation of the SMA which leads to compression of the third part of the duodenum between the SMA and the aorta. This is commonly due to loss of fatty tissue as a result of a variety of debilitating conditions. Its treatment is initially conservative and in case of failure, surgical therapy is unavoidable. We present a case of a 68-year-old female patient who presented in our Department with symptoms of dehydration after persistent vomiting for months...
March 2019: Journal of Surgical Case Reports
Christopher J Micallef, Jamie N Johnson, R Michael Johnson
In the USA, external beam radiation is offered to patients as an alternative to surgery for non-melanoma skin cancers. While this technique may be useful in highly specific patient populations, recalcitrant chronic radiation wounds can result. These complex wounds ultimately may require major reconstructive surgery to achieve closure. Porcine urinary bladder matrix (UBM) may be effective in the treatment of radiation wounds and eliminating the need for vascularized tissue transfers. A case report of an elderly male with bilateral radiation wounds of the lower extremity, one extremity treated with free flap reconstruction and the other with porcine urinary bladder matrix, is presented...
March 2019: Journal of Surgical Case Reports
Cutts Rebecca, Martin J Connor, Luxi Sun, Thomas Johnston, Rachel Gooch, John McLoughlin
Well-differentiated papillary mesothelioma (WDPM) is a rare histological subtype of mesothelioma arising from the tunica vaginalis. We present a case of a 23-year-old male with a palpable para-testicular lump of 3 years duration. Scrotal exploration revealed a grossly abnormal cystic appearance of his tunica vaginalis. An excision biopsy confirmed WDPM of the tunica vaginalis. The three subtypes of mesothelial tumours of the tunica vaginalis are described by their distinct histological features, tumour growth and reported prognosis...
March 2019: Journal of Surgical Case Reports
David Aguirre-Mar, Berta A Serrano, Carlos Morales, Katerina Toro, Julian Burgos
Rectovaginal fistulas (RVF) are the cause of major affliction to the affected patient and are a foremost challenge for the attending surgeon. Traditional techniques for treatment of RVF are quite extensive and particularly invasive. A more local procedure, with an acceptable success rate, would be the ideal first approach in treatment of this particular ailment. The aim of the current study is to show the step-by-step technique to correct a complex recurrent RVF (rRVF) using a biomesh implant. A 61-year-old female, who had undergone a prior vaginal hysterectomy, presented with a complex recurrent RVF...
March 2019: Journal of Surgical Case Reports
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