Journal of Surgical Case Reports最新文献

Ectopic pancreatic tissue (EPT) is a rare condition in which pancreatic tissue is situated outside its normal position. It is commonly found in the stomach and small bowel, typically asymptomatic, and is usually discovered incidentally during histopathological analysis. Although fewer than 40 cases of ectopic pancreatic tissue in the gallbladder have been reported, its significance relies on the risk of malignant transformation, highlighting the need for a thorough pathological study. This case report describes the presence of EPT in the gallbladder incidentally found during the pathological examination following a laparoscopic cholecystectomy of a 37-year-old female due to chronic cholecystitis.

Gallstone ileus results in a mechanical small bowel obstruction when an itinerant gallstone tumbles downstream and obstructs the bowel lumen. Associated proximal intestinal injury with perforation is rare, and concomitant perforation of multiple segments of bowel in the setting of gallstone ileus has never been reported in the literature. We are reporting the case of a 67-year-old female patient who had gallstone ileus causing perforation of multiple segments of small bowel. At operation, she was found to have a 3.2-cm gallstone lodged at the terminal ileum, perforation of both the mid ileum and mid jejunum, and gross enteric spillage. She underwent removal of the gallstone and small bowel resection × 2. She was initially left in discontinuity with an open abdomen. She returned to the operating room 2 days later for bowel anastomosis and abdominal closure. She recovered well after surgery and was discharged home.

Bronchobiliary fistula (BBF) is one of the most exceptional complications following hepatic surgery. By integrating evidence-based case studies from existing literature, this review offers critical insights into the efficacy of diverse imaging modalities and therapeutic approaches across a broad spectrum of clinical scenarios. Computed tomography, and magnetic resonance cholangiography or even scintigraphy shows an abnormal tractus between biliary ducts and pulmonary bronchi and minimally invasive techniques using endoscopy are considered the techniques of choice. Surgery should only be considered in complicated cases due to significant morbidity and mortality rate. We report the case of a 46-year-old man with metastatic adenocarcinoma of the rectum involving the liver, treated with metastasectomy, which was complicated by a BBF. The patient underwent radiological external drainage followed by endoscopic placement of biliary endoprosthesis with favorable outcome.

Hyalinizing cholecystitis is a rare subtype of chronic cholecystitis in which the gallbladder tissue is replaced with hyaline sclerosis, more or less, and has a characteristic intraoperative appearance. Preoperative diagnosis is hard to establish. The entity is strongly associated with gallbladder carcinoma. Therefore, the pathologist should perform a thorough microscopic analysis. We present a case of an unusual intraoperative finding in a male patient with chronic cholecystitis which was proved to be a hyalinizing cholecystitis.

This case report focuses on a 29-year-old female who presented with acute abdominal pain at Mater Dei Hospital, Malta. Her clinical presentation, followed up by diagnostic imaging, led to the diagnosis of a rare congenital abnormality known as dorsal agenesis of the pancreas. This condition is characterized by the absence or underdevelopment of the dorsal portion of the pancreas, a crucial aspect of pancreatic anatomy and function. The following text details the clinical presentation, diagnostic findings, and the broader implications of dorsal pancreatic agenesis in medical practice, reflecting on the rarity of this condition and the complexity of its diagnosis and management.

Teratomas are germ cell tumors, commonly affecting ovaries. Teratomas rarely affect extragonadal tissues. Few cases of teratomas occurring in extragonadal tissues have been reported in the past. However, no studies have reported cases of primary teratomas occurring in the broad ligament. In this study, we report a case of a sexually inactive young woman with a 3-day history of lower abdominal pain. B-ultrasound examination revealed an abnormal strong echogenicity mass in the left adnexal area. An exploratory laparotomy was performed on her. The surgery revealed normal size and appearance of both ovaries and uterus. However, a cyst was observed in the left broad ligament, which was diagnosed as benign mature teratoma based on pathology. In this study, we report a rare case of broad ligament teratoma. The clinical data enrich our understanding of teratomas and provide a reference for further studies.

Lateral tibial plateau fractures with significant articular depression and metaphyseal comminution in the setting of osteoporosis are challenging to manage. The subchondral bone defect and capacious cancellous void after surgical elevation of the articular surface is usually filled with nonstructural graft such as autologous cancellous bone graft, allogenic cancellous bone graft, or bone graft substitutes. Reports have shown a high rate of subsidence with these grafts when patients start to bear weight and ultimately failure of the construct. Structural grafts demonstrated stronger mechanical properties and lower subsidence rates. The purpose of this note is to describe a novel surgical technique using structural tricortical iliac crest allograft for the treatment of osteoporotic depressed lateral tibia plateau fracture.

Pulmonary sequestration is a rare congenital malformation in which a nonfunctional segment of lung tissue has no communication with the tracheobronchial tree and does not participate in gas exchange. We present a rare case of a 20-month old female with extralobar pulmonary sequestration that was diagnosed at birth. The patient was also found to have a coexisting intralobar sequestration, found during surgery.

Intra-abdominal hypertension (IAH) and abdominal compartment syndrome (ACS) impact morbidity and mortality in burn patients, exacerbated by extensive fluid resuscitation required for more than 20% of total body surface area burns. We report a case of a 28-year-old male with severe burns and a TBSA of 49% who presented after a fire incident. The trauma team managed the patient's fluid resuscitation, followed by early burn debridement. A TraumaGuard catheter was used for continuous intra-abdominal pressure (IAP) monitoring. On the second day of admission, a critical IAP of 20 mm Hg was detected, indicative of impending ACS. Immediate intervention with cistracurium and increased sedation reduced the IAP to 9 mm Hg, preventing the progression to ACS. This case demonstrates the importance of routine IAP monitoring in severely burned patients to prevent ACS. Early identification and management of elevated IAP can avert the progression to ACS and reduce the need for more invasive interventions.

Common femoral vein aneurysms are rare and they are often misdiagnosed as soft tissue masses or as hernias. In this case report, we review literature and describe a patient who presented with left inguinal mass associated with ipsilateral limb swelling. He was initially misdiagnosed as cystic adventitial disease of common femoral vein. Later, he underwent surgical exploration and found out to have common femoral vein aneurysm which was treated by aneurysmectomy and lateral venorrhaphy.