Surgery Case Reports最新文献

英文中文

When surgery isn't the culprit: A case report of barium poisoning mistaken for a post-operative complication 当手术不是罪魁祸首：一例钡中毒被误认为是术后并发症

Surgery Case Reports

Pub Date : 2025-03-23 DOI: 10.1016/j.sycrs.2025.100095

Maria Mourão , Raquel Lalanda , Vítor Correia , Filipa Nogueira , Pedro Marques , Olavo Gomes

Barium poisoning can progress from gastrointestinal hypermotility (vomiting, abdominal cramps, and diarrhea) to flaccid paralysis, areflexia, respiratory failure, and cardiovascular dysfunction. This report aims to present a case of a 25-year-old woman with severe obesity, who underwent a sleeve gastrectomy complicated by a suture line leak and subsequent gastric stenosis. Following the resolution of the stenosis, the patient experienced recurrent gastrointestinal symptoms without an apparent cause, accompanied by hypokalemia. Over time, she developed generalized muscle weakness. The patient presented to the ED with altered mental status, nystagmus, generalized muscular weakness, and hypokalemia (2.7 mmol/L). A thorough etiological investigation of neurological symptoms was initiated. Testing revealed elevated urinary barium levels (43.9 µg/L) 12 days after admission, suggesting that higher levels would have been identifiable at admission and may have contributed to vomiting and muscular weakness.

钡中毒可从胃肠运动亢进（呕吐、腹部痉挛和腹泻）发展到弛缓性麻痹、反射性松弛、呼吸衰竭和心血管功能障碍。本报告的目的是提出一个25岁的女性严重肥胖，谁接受了袖胃切除术并发缝合线泄漏和随后的胃狭窄。狭窄消退后，患者出现了无明显原因的反复胃肠道症状，并伴有低血钾。随着时间的推移，她出现了全身肌肉无力。患者以精神状态改变、眼球震颤、全身肌无力、低钾血症（2.7 mmol/L）就诊于急诊科。对神经系统症状进行了彻底的病因学调查。入院后12天检测显示尿钡水平升高（43.9 µg/L），提示入院时可识别出较高水平，可能导致呕吐和肌肉无力。

引用次数: 0

Hypergranulation-induced graft failure in meshed split thickness skin graft: A case report 网状裂皮移植中颗粒过多导致的移植失败1例报告

Surgery Case Reports

Pub Date : 2025-02-14 DOI: 10.1016/j.sycrs.2025.100090

Luis Eduardo Rentas , Karla C. Maita , Gustavo Huaman , Sacha Scott , Ricardo Castrellon

Objective

Meshed split-thickness skin grafts (mSTSG) are frequently used to address skin defects. Effective fixation methods are crucial for optimizing graft integration and minimizing complications. This case report demonstrates the role of negative pressure wound therapy (NPWT) in managing recurrent axillary hidradenitis suppurativa.

Methods

A 65-year-old male with recurrent axillary hidradenitis suppurativa underwent mSTSG placement, followed by NPWT to support graft integration. The initial graft failed due to necrotic hypergranulation, necessitating regrafting and personalized postoperative care.

Results

Initial graft failure occurred due to necrotic hypergranulation at the graft site. After regrafting, NPWT facilitated granulation tissue formation and enhanced healing. Complications such as hypergranulation required continuous monitoring and intervention. The patient ultimately showed significant clinical improvement with successful graft integration.

Conclusion

NPWT can enhance graft survival and wound healing in complex cases of recurrent axillary hidradenitis suppurativa. However, vigilant monitoring is essential to manage complications such as necrotic hypergranulation. Personalized postoperative care and timely interventions are key to overcoming graft failures and achieving optimal outcomes. Tailoring treatment strategies to individual wound healing dynamics is crucial for long-term success.

目的：网状裂厚皮肤移植（mSTSG）是修复皮肤缺损的常用方法。有效的固定方法是优化移植物融合和减少并发症的关键。本病例报告显示负压伤口治疗（NPWT）在治疗复发性腋窝化脓性汗腺炎中的作用。方法65岁男性复发性腋窝化脓性汗腺炎患者行mSTSG置入术，并行NPWT支持移植物融合。由于坏死性肉芽过多，首次移植失败，需要再次移植和个性化的术后护理。结果移植失败主要是由于移植部位的坏死性肉芽肿。再移植后，NPWT促进肉芽组织形成并增强愈合。如颗粒过多等并发症需要持续监测和干预。患者最终表现出明显的临床改善，移植物成功融合。结论npwt对复杂的复发性腋窝化脓性汗腺炎具有提高移植物存活和伤口愈合的作用。然而，警惕的监测是必要的，以管理并发症，如坏死性肉芽肿。个性化的术后护理和及时的干预是克服移植物失败和获得最佳结果的关键。根据个体伤口愈合动态量身定制治疗策略对于长期成功至关重要。

{"title":"Hypergranulation-induced graft failure in meshed split thickness skin graft: A case report","authors":"Luis Eduardo Rentas , Karla C. Maita , Gustavo Huaman , Sacha Scott , Ricardo Castrellon","doi":"10.1016/j.sycrs.2025.100090","DOIUrl":"10.1016/j.sycrs.2025.100090","url":null,"abstract":"<div><h3>Objective</h3><div>Meshed split-thickness skin grafts (mSTSG) are frequently used to address skin defects. Effective fixation methods are crucial for optimizing graft integration and minimizing complications. This case report demonstrates the role of negative pressure wound therapy (NPWT) in managing recurrent axillary hidradenitis suppurativa.</div></div><div><h3>Methods</h3><div>A 65-year-old male with recurrent axillary hidradenitis suppurativa underwent mSTSG placement, followed by NPWT to support graft integration. The initial graft failed due to necrotic hypergranulation, necessitating regrafting and personalized postoperative care.</div></div><div><h3>Results</h3><div>Initial graft failure occurred due to necrotic hypergranulation at the graft site. After regrafting, NPWT facilitated granulation tissue formation and enhanced healing. Complications such as hypergranulation required continuous monitoring and intervention. The patient ultimately showed significant clinical improvement with successful graft integration.</div></div><div><h3>Conclusion</h3><div>NPWT can enhance graft survival and wound healing in complex cases of recurrent axillary hidradenitis suppurativa. However, vigilant monitoring is essential to manage complications such as necrotic hypergranulation. Personalized postoperative care and timely interventions are key to overcoming graft failures and achieving optimal outcomes. Tailoring treatment strategies to individual wound healing dynamics is crucial for long-term success.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100090"},"PeriodicalIF":0.0,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143419210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mesothelioma disguised as a left inguinal hernia: A case report 伪装为左腹股沟疝的间皮瘤1例

Surgery Case Reports

Pub Date : 2025-02-03 DOI: 10.1016/j.sycrs.2025.100091

Kyra Sage Hunsberger , Burke DeLange

We present the case of a 72-year-old female diagnosed with low-grade malignant mesothelioma initially suspected to be a benign left inguinal hernia. The patient presented with progressive left lower extremity swelling and a reducible inguinal mass. Imaging suggested a cystic lesion in the groin, prompting surgical exploration. Pathological findings revealed mesothelioma involving regional lymph nodes. With this case, we aim to highlight an exceedingly rare extra-thoracic presentation and underscore the importance of maintaining a broad differential diagnosis for groin masses. Surgical biopsy and histopathological evaluation remain critical in diagnosing atypical malignancies with unique presentation.

我们提出的情况下，72岁的女性诊断为低度恶性间皮瘤最初怀疑是良性左腹股沟疝。患者表现为进行性左下肢肿胀和腹股沟肿块可缩小。影像学提示腹股沟囊性病变，需手术探查。病理显示间皮瘤累及局部淋巴结。在这个病例中，我们的目的是强调一个极其罕见的胸外表现，并强调对腹股沟肿块保持广泛鉴别诊断的重要性。手术活检和组织病理学评估仍然是诊断具有独特表现的非典型恶性肿瘤的关键。

引用次数: 0

Clinical improvement of lead poisoning following extraction of retained bullet fragments 子弹残片取出后铅中毒的临床改善

Surgery Case Reports

Pub Date : 2025-02-03 DOI: 10.1016/j.sycrs.2025.100092

Ashley Wittmer , Emilia Coffey , Francis Buzad

Lead poisoning presents with variable symptoms, ranging from asymptomatic cases to significant neurological deficits. This report describes a 39-year-old male with chronic symptoms, including abdominal pain, back pain, and mood changes, 12 years after sustaining a gunshot wound to the thigh with retained bullet fragments. Preoperative serum lead levels were mildly elevated at 5.3 µg/dL. Surgical removal of major bullet fragments was performed with fluoroscopic guidance, minimizing tissue trauma. Postoperatively, the patient experienced substantial improvement in symptoms suspected to be caused by lead exposure, including resolution of abdominal pain and fatigue. Serum lead levels gradually declined to 4.4 µg/dL at seven months post-surgery. This case demonstrates the potential benefits of surgical intervention for retained lead fragments when symptoms are suspected to result from lead toxicity. The intervention led to improvement of the patient’s symptoms and reduced serum lead levels. Further research is warranted to establish guidelines for the optimal management of retained bullet fragments, balancing surgical risks with potential clinical benefits.

铅中毒表现为各种症状，从无症状病例到严重的神经功能缺损。本报告描述了一名患有慢性症状的39岁男性，包括腹痛、背痛和情绪变化，12年前大腿中枪，子弹碎片残留。术前血清铅含量轻度升高，为5.3 µg/dL。手术切除主要的子弹碎片是在透视引导下进行的，最大限度地减少了组织损伤。术后，患者疑似铅暴露引起的症状明显改善，包括腹痛和疲劳的缓解。术后7个月血清铅含量逐渐下降至4.4 µg/dL。该病例表明，当怀疑症状是由铅中毒引起时，手术干预对残留铅碎片的潜在益处。干预措施改善了患者的症状，降低了血清铅水平。进一步的研究是必要的，以建立指导方针的最佳管理保留的子弹碎片，平衡手术风险和潜在的临床效益。

{"title":"Clinical improvement of lead poisoning following extraction of retained bullet fragments","authors":"Ashley Wittmer , Emilia Coffey , Francis Buzad","doi":"10.1016/j.sycrs.2025.100092","DOIUrl":"10.1016/j.sycrs.2025.100092","url":null,"abstract":"<div><div>Lead poisoning presents with variable symptoms, ranging from asymptomatic cases to significant neurological deficits. This report describes a 39-year-old male with chronic symptoms, including abdominal pain, back pain, and mood changes, 12 years after sustaining a gunshot wound to the thigh with retained bullet fragments. Preoperative serum lead levels were mildly elevated at 5.3 µg/dL. Surgical removal of major bullet fragments was performed with fluoroscopic guidance, minimizing tissue trauma. Postoperatively, the patient experienced substantial improvement in symptoms suspected to be caused by lead exposure, including resolution of abdominal pain and fatigue. Serum lead levels gradually declined to 4.4 µg/dL at seven months post-surgery. This case demonstrates the potential benefits of surgical intervention for retained lead fragments when symptoms are suspected to result from lead toxicity. The intervention led to improvement of the patient’s symptoms and reduced serum lead levels. Further research is warranted to establish guidelines for the optimal management of retained bullet fragments, balancing surgical risks with potential clinical benefits.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100092"},"PeriodicalIF":0.0,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143302060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Surgical-prosthetic management of an advanced stage IV periodontitis in the aesthetic zone: A case report 手术修复术治疗美学区晚期IV期牙周炎1例

Surgery Case Reports

Pub Date : 2024-12-31 DOI: 10.1016/j.sycrs.2024.100087

Samadi Alaa , Kriouach Nada , Er-Raji Samir , El Yamani Amal

Background and objective

Stage IV periodontitis is a severe form of periodontal disease leading to significant bone resorption, potential tooth loss and masticatory dysfunction. The objective of this article is to show the interest of multidisciplinary management in the treatment of tissue deficits caused by advanced stage IV periodontitis.

Results

We report the case of a 29-year-old female patient who lost both upper right incisors due to advanced stage IV periodontitis. Advanced ridge defects caused by periodontitis were managed by two autogenous connective tissue grafts performed in two stages using the pocket technique allowing obtaining a significant increase in height and thickness of the ridge. An associated corrective gingivectomy made it possible to perfect the alignment of the gingival margins and ensure good integration of the future prosthetic rehabilitation.

A temporary bridge of ovoid pontic design helped guiding post-surgical healing and ensure better distribution of occlusal loads while respecting the adaptive threshold of the weakened periodontal terrain and taking into account the patient's physiological anatomical landmarks thanks to the axiographic recording of the sagittal condylar inclination (SCI). One year after complete healing, definitive restorations were able to be placed combining aesthetics and function.

Conclusion

This case report showed that the soft tissue grafting step by step by pouch technique associated with corrective gingivectomy can be considered as an effective therapeutic alternative to guided bone regeneration in the management of advanced ridge defects due to periodontal disease. Additionally, tooth-supported fixed prostheses can lead to better results without the need for implant therapy.

背景与目的牙周炎是一种严重的牙周病，可导致严重的骨吸收、潜在的牙齿脱落和咀嚼功能障碍。这篇文章的目的是显示的兴趣多学科管理在治疗组织缺损引起的晚期IV期牙周炎。结果我们报告一位29岁女性病患，因晚期牙周炎而失去右上门牙。由牙周炎引起的牙嵴缺损，采用两种自体结缔组织移植，分两个阶段进行，使用口袋技术，使牙嵴的高度和厚度显著增加。相关的矫正牙龈切除术使牙龈边缘的排列更加完美，并确保未来假肢康复的良好整合。临时卵状桥设计有助于指导术后愈合，确保更好的咬合负荷分布，同时尊重牙周地形减弱的适应阈值，并考虑到患者的生理解剖标志，这要感谢轴向记录矢状髁倾角（SCI）。完全愈合一年后，最终修复能够结合美学和功能。结论在牙周病晚期牙嵴缺损的治疗中，采用眼袋分步软组织移植联合牙龈矫正切除术是一种有效的骨再生治疗方法。此外，牙齿支持的固定假体可以导致更好的结果，而不需要种植治疗。

{"title":"Surgical-prosthetic management of an advanced stage IV periodontitis in the aesthetic zone: A case report","authors":"Samadi Alaa , Kriouach Nada , Er-Raji Samir , El Yamani Amal","doi":"10.1016/j.sycrs.2024.100087","DOIUrl":"10.1016/j.sycrs.2024.100087","url":null,"abstract":"<div><h3>Background and objective</h3><div>Stage IV periodontitis is a severe form of periodontal disease leading to significant bone resorption, potential tooth loss and masticatory dysfunction. The objective of this article is to show the interest of multidisciplinary management in the treatment of tissue deficits caused by advanced stage IV periodontitis.</div></div><div><h3>Results</h3><div>We report the case of a 29-year-old female patient who lost both upper right incisors due to advanced stage IV periodontitis. Advanced ridge defects caused by periodontitis were managed by two autogenous connective tissue grafts performed in two stages using the pocket technique allowing obtaining a significant increase in height and thickness of the ridge. An associated corrective gingivectomy made it possible to perfect the alignment of the gingival margins and ensure good integration of the future prosthetic rehabilitation.</div><div>A temporary bridge of ovoid pontic design helped guiding post-surgical healing and ensure better distribution of occlusal loads while respecting the adaptive threshold of the weakened periodontal terrain and taking into account the patient's physiological anatomical landmarks thanks to the axiographic recording of the sagittal condylar inclination (SCI). One year after complete healing, definitive restorations were able to be placed combining aesthetics and function.</div></div><div><h3>Conclusion</h3><div>This case report showed that the soft tissue grafting step by step by pouch technique associated with corrective gingivectomy can be considered as an effective therapeutic alternative to guided bone regeneration in the management of advanced ridge defects due to periodontal disease. Additionally, tooth-supported fixed prostheses can lead to better results without the need for implant therapy.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100087"},"PeriodicalIF":0.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disseminated histoplasmosis causing duodenal obstruction in pediatric patient: A case report 小儿播散性组织胞浆菌病致十二指肠梗阻1例

Surgery Case Reports

Pub Date : 2024-12-26 DOI: 10.1016/j.sycrs.2024.100086

Shivani Kamal , Ayesha Baig , James R. Pierce

Introduction

Histoplasmosis in children with associated bowel obstruction is rare, and its clinical management is based on data and experience on adult patients.

Case report

A previously healthy five-year-old girl who recently immigrated to the US from Mexico presented with 5 days of abdominal pain, fever, cough and emesis. On workup, chest x-ray showed diffuse bilateral micro nodules in a miliary pattern, and urine and serum were positive for histoplasma antigen. Barium upper GI series showed distal duodenal obstruction and biopsies taken during endoscopy were positive for histoplasma. Medical therapy with antifungals did not improve the obstruction. On laparotomy, the distal duodenum was obstructed with intrinsic and extrinsic inflammation requiring a diamond duodeno-jejunostomy bypass. Postoperatively, the patient recovered and was discharged home with prolonged antifungals and infectious disease follow up.

Conclusion

Our case emphasizes the need for early surgical consultation and careful selection of contrast for luminal imaging. We advocate for an initial attempt at antifungal management to avoid operative treatment during active inflammation and lower surgical risk.

儿童组织胞浆菌病合并肠梗阻是罕见的，其临床处理是基于成人患者的数据和经验。病例报告：一名先前健康的5岁女孩最近从墨西哥移民到美国，出现腹痛、发烧、咳嗽和呕吐5天。检查时，胸部x线显示双侧弥漫性小结节呈军性征，尿液和血清组织浆抗原阳性。上消化道钡餐显示十二指肠远端梗阻，内镜下活检组织浆阳性。抗真菌药物治疗并没有改善梗阻。开腹手术时，远端十二指肠因内源性和外源性炎症阻塞，需要行钻石十二指肠空肠造口旁路术。术后患者康复出院，并进行了长时间的抗真菌和传染病随访。结论本病例强调了早期手术咨询和谨慎选择造影造影剂的必要性。我们提倡初步尝试抗真菌治疗，以避免活动性炎症和降低手术风险的手术治疗。

{"title":"Disseminated histoplasmosis causing duodenal obstruction in pediatric patient: A case report","authors":"Shivani Kamal , Ayesha Baig , James R. Pierce","doi":"10.1016/j.sycrs.2024.100086","DOIUrl":"10.1016/j.sycrs.2024.100086","url":null,"abstract":"<div><h3>Introduction</h3><div>Histoplasmosis in children with associated bowel obstruction is rare, and its clinical management is based on data and experience on adult patients.</div></div><div><h3>Case report</h3><div>A previously healthy five-year-old girl who recently immigrated to the US from Mexico presented with 5 days of abdominal pain, fever, cough and emesis. On workup, chest x-ray showed diffuse bilateral micro nodules in a miliary pattern, and urine and serum were positive for histoplasma antigen. Barium upper GI series showed distal duodenal obstruction and biopsies taken during endoscopy were positive for histoplasma. Medical therapy with antifungals did not improve the obstruction. On laparotomy, the distal duodenum was obstructed with intrinsic and extrinsic inflammation requiring a diamond duodeno-jejunostomy bypass. Postoperatively, the patient recovered and was discharged home with prolonged antifungals and infectious disease follow up.</div></div><div><h3>Conclusion</h3><div>Our case emphasizes the need for early surgical consultation and careful selection of contrast for luminal imaging. We advocate for an initial attempt at antifungal management to avoid operative treatment during active inflammation and lower surgical risk.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100086"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Micro-drainage for management of extensive subcutaneous emphysema: A case report 微引流术治疗大面积皮下肺气肿1例

Surgery Case Reports

Pub Date : 2024-12-26 DOI: 10.1016/j.sycrs.2024.100085

Majd Oweidat , Iyad Al Jada , Wasef Alhroub , Abdalhakim Shubietah , Mousa Humeedat

Extensive subcutaneous emphysema (ESE) is a rare complication requiring prompt intervention to prevent serious outcomes. We present the case of a man in his sixties with chronic obstructive pulmonary disease and a history of pulmonary tuberculosis, admitted with community-acquired pneumonia and respiratory failure. Following central venous line placement, he developed progressive ESE refractory to standard chest tube drainage. A novel approach using a fenestrated microcatheter was employed to manage the ESE. The catheter, connected to an underwater seal and combined with targeted compressive massage, successfully evacuated approximately 2500 mL of air, leading to complete resolution within 24 hours. This case highlights the efficacy of minimally invasive drainage techniques in managing refractory ESE, offering a safe and effective alternative to surgical interventions.

广泛的皮下肺气肿（ESE）是一种罕见的并发症，需要及时干预以防止严重的后果。我们提出的情况下，在他的六十多岁的男子慢性阻塞性肺疾病和肺结核的历史，承认与社区获得性肺炎和呼吸衰竭。中心静脉置管后，患者出现进行性ESE，对标准胸管引流难治。一种新颖的方法使用开孔微导管来管理ESE。导管连接到水下密封件并结合有针对性的压缩按摩，成功地抽出了大约2500 mL的空气，在24 小时内完全解决了问题。该病例强调了微创引流技术在治疗难治性ESE方面的有效性，为手术干预提供了一种安全有效的替代方法。

引用次数: 0

Anterior abdominal wall abscess due to toothpick ingestion: A case report 牙签误食致前腹壁脓肿1例

Surgery Case Reports

Pub Date : 2024-12-26 DOI: 10.1016/j.sycrs.2024.100088

Doğuş Can Ekdal , Ahmet Akmercan , Tevfik Kıvılcım Uprak

Ingestion of foreign bodies represents a common clinical emergency, especially in pediatric and geriatric populations. In the majority of cases, ingested foreign objects pass through the gastrointestinal tract without incident and are expelled without causing symptoms. However, complications can arise depending on the size, shape, and structure of the ingested item. A 53-year-old male with a history of diabetes, hypertension, chronic obstructive pulmonary disease, and obesity was admitted to the hospital due to recurrent subcutaneous abscesses and cellulitis in the right upper quadrant of the anterior abdominal wall. The patient's medical history reveals several times of abscess puncture in the same area. The patient underwent subcutaneous abscess drainage under local anesthesia, and toothpick material fixed to the subcutaneous tissues was detected. Following the removal of the toothpick, debridement of the wound was performed, and the patient was discharged with antibiotherapy. No recurrence was noted during the follow-up outpatient clinic visit three months later. This case report highlights the rare and complex complication of subcutaneous migration following foreign body ingestion, leading to recurrent subcutaneous abscesses. The exact pathogenesis of foreign body migration is not fully understood, but it is probable that the toothpick penetrates the subcutaneous fatty tissue from the transverse colon segment near the anterior abdominal wall, leading to the spontaneous closure of the colonic fistula tract. The foreign body was detected in radiological imaging in approximately 42.6 % of cases. A high level of clinical suspicion and a thorough patient history are essential for the identification of radiolucent foreign bodies.

摄入异物是一种常见的临床急症，尤其是在儿科和老年人群中。在大多数情况下，摄入的异物会顺利通过胃肠道，排出体外也不会引起症状。然而，并发症的发生取决于所摄入食物的大小、形状和结构。男，53岁，有糖尿病、高血压、慢性阻塞性肺疾病、肥胖病史，因前腹壁右上象限反复皮下脓肿和蜂窝织炎入院。患者病史显示同一部位多次穿刺脓肿。局部麻醉下行皮下脓肿引流术，检查固定于皮下组织的牙签材料。拔除牙签后，对创面进行清创，患者接受抗生素治疗出院。3个月后门诊随访未见复发。这个病例报告强调了罕见和复杂的并发症皮下迁移后的异物摄入，导致复发性皮下脓肿。异物迁移的确切发病机制尚不完全清楚，但可能是牙签从靠近前腹壁的横结肠段穿透皮下脂肪组织，导致结肠瘘道自发关闭。放射成像检测到异物的病例约为42.6% %。高度的临床怀疑和彻底的病史是鉴别透光异物的必要条件。

{"title":"Anterior abdominal wall abscess due to toothpick ingestion: A case report","authors":"Doğuş Can Ekdal , Ahmet Akmercan , Tevfik Kıvılcım Uprak","doi":"10.1016/j.sycrs.2024.100088","DOIUrl":"10.1016/j.sycrs.2024.100088","url":null,"abstract":"<div><div>Ingestion of foreign bodies represents a common clinical emergency, especially in pediatric and geriatric populations. In the majority of cases, ingested foreign objects pass through the gastrointestinal tract without incident and are expelled without causing symptoms. However, complications can arise depending on the size, shape, and structure of the ingested item. A 53-year-old male with a history of diabetes, hypertension, chronic obstructive pulmonary disease, and obesity was admitted to the hospital due to recurrent subcutaneous abscesses and cellulitis in the right upper quadrant of the anterior abdominal wall. The patient's medical history reveals several times of abscess puncture in the same area. The patient underwent subcutaneous abscess drainage under local anesthesia, and toothpick material fixed to the subcutaneous tissues was detected. Following the removal of the toothpick, debridement of the wound was performed, and the patient was discharged with antibiotherapy. No recurrence was noted during the follow-up outpatient clinic visit three months later. This case report highlights the rare and complex complication of subcutaneous migration following foreign body ingestion, leading to recurrent subcutaneous abscesses. The exact pathogenesis of foreign body migration is not fully understood, but it is probable that the toothpick penetrates the subcutaneous fatty tissue from the transverse colon segment near the anterior abdominal wall, leading to the spontaneous closure of the colonic fistula tract. The foreign body was detected in radiological imaging in approximately 42.6 % of cases. A high level of clinical suspicion and a thorough patient history are essential for the identification of radiolucent foreign bodies.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100088"},"PeriodicalIF":0.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ruptured gastroepiploic artery aneurysm causing massive intraperitoneal hemorrhage: A case report and literature review 胃网膜动脉瘤破裂致大量腹膜内出血1例并文献复习

Surgery Case Reports

Pub Date : 2024-12-25 DOI: 10.1016/j.sycrs.2024.100084

Marissa Leann Ritter, Tiffany Killblane, David Grantham

Introduction

Visceral artery aneurysms, including gastroepiploic artery aneurysms, are a rare cause of gastrointestinal bleeding. Gastroepiploic artery aneurysms are usually silent with a high chance of rupture and hemorrhage.

Case

We present a case of a man with a ruptured gastroepiploic artery aneurysm following a fall from standing height. On arrival, he was hypotensive with an acute abdomen. Due to hemodynamic instability and a positive FAST exam, an exploratory laparotomy was performed, which revealed pulsatile bleeding at the greater curvature of the stomach and a subserosal hematoma with an active bleeding vessel visible. The gastroepiploic vessels were ligated, and a partial gastrectomy was performed. He recovered well and was discharged after five days.

Discussion

Gastroepiploic artery aneurysms are a rare occurrence, most commonly occurring in males over the age of 50. Causes include arterial dysplasia, perivascular inflammation, and trauma. Trauma was likely the cause in this patient’s case. Most gastroepiploic artery aneurysms are asymptomatic. They are usually found incidentally or once complications arise. Patients with ruptured gastroepiploic artery aneurysms usually present with peritoneal signs and shock. All patients with gastroepiploic artery aneurysms should be treated immediately due to the risk of rupture and subsequent complications. A variety of techniques exist to treat these aneurysms.

Conclusion

Although visceral artery aneurysms are uncommon, they can be life-threatening. Therefore, it is important to remember them as a potential source of intraperitoneal hemorrhage, even from minor trauma.

内脏动脉瘤，包括胃网膜动脉瘤，是一种罕见的引起胃肠道出血的原因。胃网膜动脉瘤通常是无声的，有很高的破裂和出血的机会。我们提出一个病例的男子胃网膜动脉瘤破裂后，从站立高度跌落。到达时，他有低血压和急腹症。由于血流动力学不稳定和FAST检查阳性，进行了剖腹探查，发现胃大弯曲处有搏动性出血和浆膜下血肿，可见活动性出血血管。结扎胃网膜血管，行部分胃切除术。他恢复得很好，五天后出院了。星形大网膜动脉瘤是一种罕见的疾病，最常见于50岁以上的男性。病因包括动脉发育不良、血管周围炎症和创伤。在这个病例中，创伤可能是病因。大多数胃网膜动脉瘤是无症状的。它们通常是偶然发现的或在出现并发症时发现的。胃大网膜动脉瘤破裂的患者通常表现为腹膜体征和休克。所有胃大网膜动脉瘤患者应立即治疗，因为有破裂和并发症的风险。治疗这些动脉瘤的技术多种多样。结论内脏动脉瘤虽不常见，但可危及生命。因此，重要的是要记住它们是腹膜内出血的潜在来源，即使是轻微的创伤。

{"title":"Ruptured gastroepiploic artery aneurysm causing massive intraperitoneal hemorrhage: A case report and literature review","authors":"Marissa Leann Ritter, Tiffany Killblane, David Grantham","doi":"10.1016/j.sycrs.2024.100084","DOIUrl":"10.1016/j.sycrs.2024.100084","url":null,"abstract":"<div><h3>Introduction</h3><div>Visceral artery aneurysms, including gastroepiploic artery aneurysms, are a rare cause of gastrointestinal bleeding. Gastroepiploic artery aneurysms are usually silent with a high chance of rupture and hemorrhage.</div></div><div><h3>Case</h3><div>We present a case of a man with a ruptured gastroepiploic artery aneurysm following a fall from standing height. On arrival, he was hypotensive with an acute abdomen. Due to hemodynamic instability and a positive FAST exam, an exploratory laparotomy was performed, which revealed pulsatile bleeding at the greater curvature of the stomach and a subserosal hematoma with an active bleeding vessel visible. The gastroepiploic vessels were ligated, and a partial gastrectomy was performed. He recovered well and was discharged after five days.</div></div><div><h3>Discussion</h3><div>Gastroepiploic artery aneurysms are a rare occurrence, most commonly occurring in males over the age of 50. Causes include arterial dysplasia, perivascular inflammation, and trauma. Trauma was likely the cause in this patient’s case. Most gastroepiploic artery aneurysms are asymptomatic. They are usually found incidentally or once complications arise. Patients with ruptured gastroepiploic artery aneurysms usually present with peritoneal signs and shock. All patients with gastroepiploic artery aneurysms should be treated immediately due to the risk of rupture and subsequent complications. A variety of techniques exist to treat these aneurysms.</div></div><div><h3>Conclusion</h3><div>Although visceral artery aneurysms are uncommon, they can be life-threatening. Therefore, it is important to remember them as a potential source of intraperitoneal hemorrhage, even from minor trauma.</div></div>","PeriodicalId":101189,"journal":{"name":"Surgery Case Reports","volume":"4 ","pages":"Article 100084"},"PeriodicalIF":0.0,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Utilization of autogenous split rib graft for cranioplasty in a child: A case report 自体裂肋移植用于儿童颅骨成形术1例

Surgery Case Reports

Pub Date : 2024-12-25 DOI: 10.1016/j.sycrs.2024.100089

Nauman Shah , Muhammad Salman Farsi , Muhammad Sanaan Noor , Muhammad Maaz Bin Zahid , Yasir Aziz , Muhammad Wasim Sajjad , Azam Jan , Nasir Ali

A cranioplasty is a surgical procedure intended to correct cranial abnormalities resulting from prior trauma or surgeries, using various materials to fill up the defect, most commonly a synthetic substance or a fragment of the patient's bone. We present a case of an 8-month-old child, presented with post-traumatic skull injury resulting from a head injury at the age of one month. On physical examination, the patient had soft swelling of the skull, that bulged out through the defect with coughing. The case was taken up for cranioplasty under general anesthesia and the defect was exposed, and the graft bed was prepared. Two rib grafts were harvested before cranioplasty that were split into two halves and spread like an open book which were enough to cover the defect. Each graft was stabilized with a titanium micro screw. In this case report we discuss a case of post-traumatic cranial defect in an 8-month patient treated with cranioplasty using split rib grafts.

颅骨成形术是一种外科手术，旨在纠正先前创伤或手术导致的颅骨异常，使用各种材料填补缺陷，最常见的是合成物质或患者的骨头碎片。我们提出了一个8个月大的孩子的情况下，提出了创伤后颅骨损伤导致的头部损伤在一个月的年龄。在体格检查中，病人有轻微的颅骨肿胀，由于咳嗽而从缺损处凸出。全麻下行颅骨成形术，暴露缺损，准备移植床。在颅骨成形术前采集了两根肋骨，将其分成两半，像一本打开的书一样展开，足以覆盖缺损。每个移植物用钛微螺钉固定。在这个病例报告中，我们讨论了一个创伤后颅骨缺损的病例，在8个月的病人治疗颅骨成形术使用裂肋移植。

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Surgery Case Reports

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀