Pub Date : 2023-12-12DOI: 10.31487/j.jscr.2023.03.03
Abdel Malick Idrissa, Benlafqih C, Briki J, Saadouni Y, Rhissassi J, Sayah R, Laaroussi M
Acute aortic syndromes are composed of aortic dissection (AD), intramural hematoma (IMH) and penetrating or atheromatous ulcer of the aorta (PAU). Three entities well individualized on the etiological, pathophysiological and therapeutic level, but whose evolutionary border towards one of the forms is not so clear. We report the case of a patient operated on for PAU associated with IMH complicated with AD.
急性主动脉综合征包括主动脉夹层（AD）、壁内血肿（IMH）和主动脉穿透性或粥样溃疡（PAU）。这三种疾病在病因学、病理生理学和治疗学层面上具有很强的个体差异性，但其向其中一种形式演变的边界并不十分明确。我们报告了一例因伴有 IMH 并发 AD 的 PAU 而接受手术的患者。
{"title":"Penetrating Ulcer of the Ascending Aorta Associated With Intramural Hematoma and Complicated by Dissection: A Case Report","authors":"Abdel Malick Idrissa, Benlafqih C, Briki J, Saadouni Y, Rhissassi J, Sayah R, Laaroussi M","doi":"10.31487/j.jscr.2023.03.03","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.03.03","url":null,"abstract":"Acute aortic syndromes are composed of aortic dissection (AD), intramural hematoma (IMH) and penetrating or atheromatous ulcer of the aorta (PAU). Three entities well individualized on the etiological, pathophysiological and therapeutic level, but whose evolutionary border towards one of the forms is not so clear. We report the case of a patient operated on for PAU associated with IMH complicated with AD.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"13 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139009522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.31487/j.jscr.2023.01.01
George Oosthuizen, Hendry K, Geraty S, Čačala SR, George Oosthuizen
Subcutaneous or surgical emphysema (SE) following chest trauma is usually not of major concern in itself and tends to be self-limiting, provided the underlying cause has been addressed. Occasionally, a patient may present with massive SE which may threaten the patient’s airway and breathing. It is important for clinicians to have a management approach to such patients. Here we present such a case that was admitted to our hospital, describing the management approach and review the existing literature on the subject.
{"title":"Airway Compromise Due to Extensive Subcutaneous Emphysema Following Trauma: A Case Report","authors":"George Oosthuizen, Hendry K, Geraty S, Čačala SR, George Oosthuizen","doi":"10.31487/j.jscr.2023.01.01","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.01.01","url":null,"abstract":"Subcutaneous or surgical emphysema (SE) following chest trauma is usually not of major concern in itself and tends to be self-limiting, provided the underlying cause has been addressed. Occasionally, a patient may present with massive SE which may threaten the patient’s airway and breathing. It is important for clinicians to have a management approach to such patients. Here we present such a case that was admitted to our hospital, describing the management approach and review the existing literature on the subject.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"16 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-06DOI: 10.31487/j.jscr.2023.03.05
Filip Siembida, Alexander M. Kravets, Filip Siembida, Ashley Langley, Ahmer Khan
Cecal volvulus is a rare, potentially life-threatening cause of large bowel obstruction (LBO). Discerning LBO in the background of chronic episodes of epigastric or abdominal pain ensures timely treatment and reduces the risk of complications. Atypical demographic presentation may pose a clinical danger that can be best avoided with standardized diagnostic imaging. We report a case of cecal volvulus in a male patient with a history of alcohol use disorder and pancreatitis. The patient underwent a right hemicolectomy with small bowel resection and primary anastomosis.
{"title":"Cecal Volvulus Presenting after Onset of Acute Pancreatitis: A Case Report","authors":"Filip Siembida, Alexander M. Kravets, Filip Siembida, Ashley Langley, Ahmer Khan","doi":"10.31487/j.jscr.2023.03.05","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.03.05","url":null,"abstract":"Cecal volvulus is a rare, potentially life-threatening cause of large bowel obstruction (LBO). Discerning LBO in the background of chronic episodes of epigastric or abdominal pain ensures timely treatment and reduces the risk of complications. Atypical demographic presentation may pose a clinical danger that can be best avoided with standardized diagnostic imaging. We report a case of cecal volvulus in a male patient with a history of alcohol use disorder and pancreatitis. The patient underwent a right hemicolectomy with small bowel resection and primary anastomosis.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135350761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-08-03DOI: 10.31487/j.jscr.2023.03.04
Soumith Subhash, S. Ethiraj, U. Bagchi
Background: Richter's hernia occurs when a portion of the anti-mesenteric border of a bowel wall is captured within the hernia sac, resulting in ischaemia, gangrene, and perforation. Only part of the circumference of the bowel wall is involved in Richter's hernia, which causes strangulation without obstruction. Femoral hernia presenting as a Richter’s hernia is rare. Aim: This is to report a case of Richter’s hernia in a femoral hernia occurring in an adult female. Case Report: In this case, a 62-year-old woman presented with a history of sudden generalized abdominal pain. Before the presentation, she had a six-year history of reducible left inguino-labial swelling that became irreducible two weeks ago. Pallor was present. Her temperature was 39.2°C, her pulse rate was 112 per minute, and her blood pressure was 132/62 mmHg. A diagnosis of a left femoral hernia was made. She was revived, and the groin swelling was explored through a midline incision over the abdomen. There was ischaemia of the anti-mesenteric border of the ileum, along with strangulated preperitoneal fat. The bowel vascularity over the anti-mesenteric border was doubtful, so a resection anastomosis of the segment of the bowel was done followed by a reduction of the bowel loop and herniorraphy. Conclusion: It is rare for a femoral hernia to present with a Richter's hernia, but it can happen even in the absence of obstructive symptoms. Any time there is groin swelling, it is important to get a quick, correct diagnosis and treatment. If there is a delay in identification and treatment, a spontaneous faecal fistula, an uncommon complication, may develop. The relevant authorities must address this as it reflects the status of healthcare in the developing world.
{"title":"Femoral Hernia Presenting as Richter’s Variant: A Rare Case Report","authors":"Soumith Subhash, S. Ethiraj, U. Bagchi","doi":"10.31487/j.jscr.2023.03.04","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.03.04","url":null,"abstract":"Background: Richter's hernia occurs when a portion of the anti-mesenteric border of a bowel wall is captured within the hernia sac, resulting in ischaemia, gangrene, and perforation. Only part of the circumference of the bowel wall is involved in Richter's hernia, which causes strangulation without obstruction. Femoral hernia presenting as a Richter’s hernia is rare.\u0000Aim: This is to report a case of Richter’s hernia in a femoral hernia occurring in an adult female.\u0000Case Report: In this case, a 62-year-old woman presented with a history of sudden generalized abdominal pain. Before the presentation, she had a six-year history of reducible left inguino-labial swelling that became irreducible two weeks ago. Pallor was present. Her temperature was 39.2°C, her pulse rate was 112 per minute, and her blood pressure was 132/62 mmHg. A diagnosis of a left femoral hernia was made. She was revived, and the groin swelling was explored through a midline incision over the abdomen. There was ischaemia of the anti-mesenteric border of the ileum, along with strangulated preperitoneal fat. The bowel vascularity over the anti-mesenteric border was doubtful, so a resection anastomosis of the segment of the bowel was done followed by a reduction of the bowel loop and herniorraphy.\u0000Conclusion: It is rare for a femoral hernia to present with a Richter's hernia, but it can happen even in the absence of obstructive symptoms. Any time there is groin swelling, it is important to get a quick, correct diagnosis and treatment. If there is a delay in identification and treatment, a spontaneous faecal fistula, an uncommon complication, may develop. The relevant authorities must address this as it reflects the status of healthcare in the developing world.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87103381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-31DOI: 10.31487/j.jscr.2023.03.01
Nisi Antonella, M. Marini, Fulco E., Pelfini E., Vescovi L., Costanzo A., Caprioli M., Flavio M., Elia Armellini, Sonzogni A., PatellI G., Piazzini Albani A.
We present the case of a 58-years-old caucasian male who was hospitalized in our hospital with an early diagnosis of a jejunal tumor. However, all the instrumental and laboratory testing conducted were inconclusive and a preoperative diagnosis was not established. Patient was scheduled for surgery and en-bloc resection of the jejunal mass was performed. Microscopic analysis of the specimen reported the presence of intense mixed lympho-granulocytic inflammatory infiltrate of the mucosa associated with entamoeba parasites and a diagnosis of intestinal ameboma was ruled out. Ameboma is a rare complication of chronic amoebic colitis. usually found in the cecum and ascending colon. To our knowledge, this is the first case of an intestinal ameboma involving the jejunum to be reported in medical literature.
{"title":"Intestinal Ameboma Involving the Jejunum: First Case Reported in Medical Literature","authors":"Nisi Antonella, M. Marini, Fulco E., Pelfini E., Vescovi L., Costanzo A., Caprioli M., Flavio M., Elia Armellini, Sonzogni A., PatellI G., Piazzini Albani A.","doi":"10.31487/j.jscr.2023.03.01","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.03.01","url":null,"abstract":"We present the case of a 58-years-old caucasian male who was hospitalized in our hospital with an early diagnosis of a jejunal tumor. However, all the instrumental and laboratory testing conducted were inconclusive and a preoperative diagnosis was not established. Patient was scheduled for surgery and en-bloc resection of the jejunal mass was performed. Microscopic analysis of the specimen reported the presence of intense mixed lympho-granulocytic inflammatory infiltrate of the mucosa associated with entamoeba parasites and a diagnosis of intestinal ameboma was ruled out. Ameboma is a rare complication of chronic amoebic colitis. usually found in the cecum and ascending colon. To our knowledge, this is the first case of an intestinal ameboma involving the jejunum to be reported in medical literature.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75173778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-17DOI: 10.31487/j.jscr.2023.02.03
Niall Fitzpatrick, A. Bilal, A. Pillai
Epithelial inclusion cysts are benign lesions that rarely occur in the extremities in the absence of trauma. They may demonstrate slow but progressive enlargement. This case relates to a 50 year old female who presented with a grade 1 pressure ulcer to the plantar surface of her right foot, associated with discomfort mobilising and pain upon wearing traditional footwear. Surgical excision was performed, and histology demonstrated an epithelial inclusion cyst, leading to complete recovery and resolution of the plantar pressure ulcer.
{"title":"Epithelial Inclusion Cyst of the Foot Causing Pressure Ulcer and Skin Breach","authors":"Niall Fitzpatrick, A. Bilal, A. Pillai","doi":"10.31487/j.jscr.2023.02.03","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.02.03","url":null,"abstract":"Epithelial inclusion cysts are benign lesions that rarely occur in the extremities in the absence of trauma. They may demonstrate slow but progressive enlargement.\u0000This case relates to a 50 year old female who presented with a grade 1 pressure ulcer to the plantar surface of her right foot, associated with discomfort mobilising and pain upon wearing traditional footwear.\u0000Surgical excision was performed, and histology demonstrated an epithelial inclusion cyst, leading to complete recovery and resolution of the plantar pressure ulcer.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"282 5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86551066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-15DOI: 10.31487/j.jscr.2023.03.02
Ajil Antony, Y. S, Ananth Vijay
Gallstone ileus is a rare complication of cholelithiasis which represent 1-3% of the causes of intestinal obstruction in the general population and is more commonly seen in females. Gallstone ileus does not present with unique symptoms, making the diagnosis difficult. Symptoms are often non-specific with intermittent intestinal obstruction. The management is surgical, but there is no consensus as to which of the different surgical techniques is the procedure of choice. We report an interesting case of a 78-year-old male brought to casualty with abdominal pain following a history of fall. Managed as a case of blunt trauma abdomen initially. Surprisingly investigations showed features of small bowel obstruction, a hyperdense structure in the distal jejunum with dilated proximal jejunal loops suggestive of gallstone ileus. The patient had undergone exploratory laparotomy with enterotomy and removal of gallstones without any postoperative complications. Intraoperatively cholecystoduodenal fistula was identified and the patient was electively planned for cholecystectomy and fistula repair.
{"title":"Enterolithotomy for Gallstone Ileus: An Uncommon Cause of Intestinal Obstruction","authors":"Ajil Antony, Y. S, Ananth Vijay","doi":"10.31487/j.jscr.2023.03.02","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.03.02","url":null,"abstract":"Gallstone ileus is a rare complication of cholelithiasis which represent 1-3% of the causes of intestinal obstruction in the general population and is more commonly seen in females. Gallstone ileus does not present with unique symptoms, making the diagnosis difficult. Symptoms are often non-specific with intermittent intestinal obstruction. The management is surgical, but there is no consensus as to which of the different surgical techniques is the procedure of choice. We report an interesting case of a 78-year-old male brought to casualty with abdominal pain following a history of fall. Managed as a case of blunt trauma abdomen initially. Surprisingly investigations showed features of small bowel obstruction, a hyperdense structure in the distal jejunum with dilated proximal jejunal loops suggestive of gallstone ileus. The patient had undergone exploratory laparotomy with enterotomy and removal of gallstones without any postoperative complications. Intraoperatively cholecystoduodenal fistula was identified and the patient was electively planned for cholecystectomy and fistula repair.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76571968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-05-13DOI: 10.31487/j.jscr.2023.02.01
K. Kawaguchi, Yuta Kishi, Mami Suzuki, Nahoko Miyashita, Ryota Matsubara, Masaaki Yasukawa
A conduit for peripheral nerve regeneration (NERBRIDGE®; Toyobo Co., Japan) in cases of disconnection or deficiency of the peripheral nerve was approved in Japan in 2013. NERBRIDGE® is a polyglycolic acid-collagen (PGA) product derived from porcine skin. The use of NERBRIDGE® has been reported mainly in orthopaedic surgery. Reports on its use for sensory nerve injuries in the oral region are scarce. This case report describes a case of significant sensory recovery obtained by nerve repair using NERBRIDGE® in a patient with schwannoma-induced inferior alveolar nerve resection. At the 1-year postoperative evaluation, sensory nerve recovery using the two-point discrimination test was confirmed.
{"title":"Nerve Regeneration Using Polyglycolic Acid-Collagen Tube Following Tumor Resection in The Inferior Alveolar Nerve","authors":"K. Kawaguchi, Yuta Kishi, Mami Suzuki, Nahoko Miyashita, Ryota Matsubara, Masaaki Yasukawa","doi":"10.31487/j.jscr.2023.02.01","DOIUrl":"https://doi.org/10.31487/j.jscr.2023.02.01","url":null,"abstract":"A conduit for peripheral nerve regeneration (NERBRIDGE®; Toyobo Co., Japan) in cases of disconnection or deficiency of the peripheral nerve was approved in Japan in 2013. NERBRIDGE® is a polyglycolic acid-collagen (PGA) product derived from porcine skin. The use of NERBRIDGE® has been reported mainly in orthopaedic surgery. Reports on its use for sensory nerve injuries in the oral region are scarce. This case report describes a case of significant sensory recovery obtained by nerve repair using NERBRIDGE® in a patient with schwannoma-induced inferior alveolar nerve resection. At the 1-year postoperative evaluation, sensory nerve recovery using the two-point discrimination test was confirmed.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89462383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-10-31DOI: 10.31487/j.jscr.2022.02.02
Diwakar Phuyal, E. Jacob, Lydia Rafferty, E. S. Yang, Luis Oceguera, Raul Monzon
Background: Massive retroperitoneal and pelvic hematoma leading to hemorrhagic shock following stapled hemorrhoidectomy is rare. To the best of our knowledge at the time of this publication, there are no reported cases of postoperative pelvic or retroperitoneal hematoma without intraluminal bleeding reported after stapled hemorrhoidopexy. We describe such a case in a patient with grade III internal hemorrhoid who was treated with colonoscopy and stapled hemorrhoidectomy. Case Summary: A 64-year-old female with a past medical history significant for deep vein thrombosis and pulmonary embolism for which she was anticoagulated with warfarin presented with hemorrhoids and rectal bleeding and associated iron deficiency anemia. The warfarin was held five days prior to the planned combined colonoscopy and hemorrhoidectomy procedure. While still recovering in the post-anaesthesia care unit (PACU) a few hours post-operatively, she was found to be hypotensive, tachycardic, and somnolent. A CT abdomen/pelvis was obtained, which identified a large collection of blood in the pelvis and retroperitoneum. She was taken back to the OR for an emergent exploratory laparotomy and flexible sigmoidoscopy. She was admitted to the ICU where she required placement on BiPAP for respiratory acidosis and resuscitation with a total of seven units of pRBCs and two units of FFP. She was clinically stable three days later. Conclusion: In a patient with a history of chronic anticoagulation, one should consider intraluminal, retroperitoneal, and pelvic bleeding if the patient is in hemorrhagic shock after stapled hemorrhoidectomy. Furthermore, one should not rule out the possibility of retroperitoneal or pelvic bleeding even if there is no evidence of intraluminal bleeding. Emergent laparotomy and sigmoidoscopy may be considered for unstable patients with unidentified external bleeding.
{"title":"Hemorrhagic Shock from Massive Retroperitoneal and Pelvic Hematoma After Stapled Hemorrhoidopexy","authors":"Diwakar Phuyal, E. Jacob, Lydia Rafferty, E. S. Yang, Luis Oceguera, Raul Monzon","doi":"10.31487/j.jscr.2022.02.02","DOIUrl":"https://doi.org/10.31487/j.jscr.2022.02.02","url":null,"abstract":"Background: Massive retroperitoneal and pelvic hematoma leading to hemorrhagic shock following stapled hemorrhoidectomy is rare. To the best of our knowledge at the time of this publication, there are no reported cases of postoperative pelvic or retroperitoneal hematoma without intraluminal bleeding reported after stapled hemorrhoidopexy. We describe such a case in a patient with grade III internal hemorrhoid who was treated with colonoscopy and stapled hemorrhoidectomy.\u0000Case Summary: A 64-year-old female with a past medical history significant for deep vein thrombosis and pulmonary embolism for which she was anticoagulated with warfarin presented with hemorrhoids and rectal bleeding and associated iron deficiency anemia. The warfarin was held five days prior to the planned combined colonoscopy and hemorrhoidectomy procedure. While still recovering in the post-anaesthesia care unit (PACU) a few hours post-operatively, she was found to be hypotensive, tachycardic, and somnolent. A CT abdomen/pelvis was obtained, which identified a large collection of blood in the pelvis and retroperitoneum. She was taken back to the OR for an emergent exploratory laparotomy and flexible sigmoidoscopy. She was admitted to the ICU where she required placement on BiPAP for respiratory acidosis and resuscitation with a total of seven units of pRBCs and two units of FFP. She was clinically stable three days later.\u0000Conclusion: In a patient with a history of chronic anticoagulation, one should consider intraluminal, retroperitoneal, and pelvic bleeding if the patient is in hemorrhagic shock after stapled hemorrhoidectomy. Furthermore, one should not rule out the possibility of retroperitoneal or pelvic bleeding even if there is no evidence of intraluminal bleeding. Emergent laparotomy and sigmoidoscopy may be considered for unstable patients with unidentified external bleeding.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85607443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-09-27DOI: 10.31487/j.jscr.2022.02.03
Hirotaka Kato, M. Deguchi, Y. Sakata
Introduction: Urachal remnants, such as the vesicourachal diverticulum, or urachal cysts are rarely involved in calculus or calcification. There are currently no case reports of urachal remnants with calculus just below the umbilicus. Case Presentation: A healthy 28-year-old man presented with umbilical drainage. Abdominal computed tomography showed inflammation just below the umbilicus with calculus. The patient was diagnosed with ombilitis with a urachal remnant and underwent laparoscopic resection for the urachal remnant after the attenuation of ombilitis. Surgical findings showed that the omentum adhered to the abdominal wall along with the urachal duct. The urachal duct with calculus was resected at the top of the bladder. The main component of calculus was silicic acid. Pathological findings were compatible with a urachal remnant and there was no evidence of a malignant tumor. Discussion: The main component of calculus is derived from necrotic material caused by inflammation because silicic acid was detected, indicating a different etiology from that of urinary calculus. Conclusion: We encountered a rare case of a urachal remnant with calculus below the umbilicus.
{"title":"A Rare Case of Urachal Remnant with Calculus Just Below Umbilicus","authors":"Hirotaka Kato, M. Deguchi, Y. Sakata","doi":"10.31487/j.jscr.2022.02.03","DOIUrl":"https://doi.org/10.31487/j.jscr.2022.02.03","url":null,"abstract":"Introduction: Urachal remnants, such as the vesicourachal diverticulum, or urachal cysts are rarely involved in calculus or calcification. There are currently no case reports of urachal remnants with calculus just below the umbilicus.\u0000Case Presentation: A healthy 28-year-old man presented with umbilical drainage. Abdominal computed tomography showed inflammation just below the umbilicus with calculus. The patient was diagnosed with ombilitis with a urachal remnant and underwent laparoscopic resection for the urachal remnant after the attenuation of ombilitis. Surgical findings showed that the omentum adhered to the abdominal wall along with the urachal duct. The urachal duct with calculus was resected at the top of the bladder. The main component of calculus was silicic acid. Pathological findings were compatible with a urachal remnant and there was no evidence of a malignant tumor.\u0000Discussion: The main component of calculus is derived from necrotic material caused by inflammation because silicic acid was detected, indicating a different etiology from that of urinary calculus.\u0000Conclusion: We encountered a rare case of a urachal remnant with calculus below the umbilicus.","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"134 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77900357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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