International Journal of Surgery Case Reports最新文献_第10页

Intentional ingestion of plaster for suicide: A case report and literature review 故意吞下石膏自杀：1例报告及文献复习

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-16 DOI: 10.1016/j.ijscr.2025.112071

Ramin Bozorgmehr , Fatemeh Eghbal , Mina Fattah Hesari , Mahdie Kalhor

Introduction and importance

Bezoars are indigestible masses in the gastrointestinal tract, classified by their composition. Plaster ingestion is a rare and often suicidal act. Plaster hardens in the stomach, risking obstruction or perforation. This case highlights the clinical challenges associated with managing plaster-induced bezoars and underscores the importance of prompt surgical and psychiatric intervention in such rare presentations.

Presentation of case

A 47-year-old man with a history of depression and daily methadone use presented to the emergency department with epigastric pain, nausea, and vomiting 48 h after ingesting a mixture of plaster and water in a suicide attempt. Abdominal radiography revealed a large, radiopaque gastric mass. Upper gastrointestinal endoscopy confirmed a solidified plaster bezoar causing mucosal injury. An emergency gastrotomy was performed, successfully removing a 20 × 15 × 20 cm plaster cast from the stomach.

Clinical discussion

Plaster ingestion, though rare, can cause gastric outlet obstruction due to rapid hardening. Radiopaque masses on imaging. Early cases may respond to gastric irrigation or endoscopic management; however, delayed presentations typically require surgical intervention.

Conclusion

Plaster ingestion is a rare but life-threatening cause of gastric bezoar that often necessitates surgical intervention in delayed cases. This case emphasizes urgent management, psychiatric follow-up, and awareness of complications to improve outcomes in such uncommon presentations. Early recognition and intervention are critical to prevent severe consequences.

牛黄是胃肠道中不易消化的物质，按其成分分类。吞下石膏是一种罕见的自杀行为。石膏在胃里变硬，有阻塞或穿孔的危险。本病例强调了与处理石膏诱发的牛黄相关的临床挑战，并强调了在这种罕见的表现中及时进行外科和精神干预的重要性。病例介绍一名47岁男性，有抑郁史，每日使用美沙酮，在摄入石膏和水混合物48小时后，因上腹疼痛、恶心和呕吐被送往急诊室，企图自杀。腹部x线摄影显示一大且不透射线的胃肿块。上消化道内窥镜检查证实一固化石膏牛黄引起粘膜损伤。进行了紧急胃切除术，成功地从胃中取出了20 × 15 × 20厘米的石膏模型。临床讨论：吞食石膏虽然罕见，但因其迅速硬化，可引起胃出口梗阻。成像时不透射线的团块。早期病例可能对胃冲洗或内镜治疗有反应；然而，延迟表现通常需要手术干预。结论胃牛黄是一种罕见但危及生命的原因，迟发病例往往需要手术治疗。本病例强调紧急管理、精神病学随访和并发症意识，以改善这种罕见症状的预后。早期识别和干预对于防止严重后果至关重要。

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引用次数: 0

Normotensive functional para-aortic paraganglioma: A rare case report with surgical and histopathological correlation 正常血压功能性主动脉旁副神经节瘤：一例罕见的手术与病理相关的病例报告

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-14 DOI: 10.1016/j.ijscr.2025.112041

Ghazi Lâamiri , Hazem Alouani , Amine Abdelhedi , Mohamed Karim M'farrej , Mahdi Bouassida , Hassen Touinsi

Introduction

Paragangliomas are rare neuroendocrine tumors originating from extra-adrenal chromaffin tissue. Their clinical manifestations are variable, often depending on the tumor's size, location, and catecholamine secretion. While most functional paragangliomas present with hypertension, a small subset can remain normotensive, making diagnosis more challenging.

Case presentation

We report the case of a 45-year-old woman with no notable medical history, who presented with vague abdominal discomfort and episodic palpitations. Notably, she exhibited no documented hypertension. Biochemical evaluation revealed markedly elevated urinary normetanephrines. Cross-sectional imaging identified a 4.5 cm para-aortic mass, which was further confirmed by ^123I-MIBG scintigraphy. After adequate preoperative alpha- and beta-blockade, she underwent open surgical resection. Histopathological analysis confirmed paraganglioma, demonstrating characteristic zellballen architecture and immunohistochemical positivity for chromogranin A, synaptophysin, and S100. Her postoperative recovery was uneventful. At 12-month follow-up, she remained asymptomatic with normal catecholamine levels and no signs of recurrence. Genetic testing was offered but declined.

Clinical discussion

This case emphasizes the diagnostic difficulty posed by normotensive functional paragangliomas, which may be overlooked in the absence of classical hypertension. Biochemical screening and functional imaging are crucial even in atypical presentations. Preoperative pharmacologic preparation and expert surgical management are key to minimizing intraoperative risk and ensuring favorable outcomes.

Conclusion

Clinicians should maintain a high index of suspicion for paragangliomas in patients with suggestive symptoms, regardless of blood pressure status. A multidisciplinary approach and long-term follow-up are vital, particularly for extra-adrenal tumors, with consideration of genetic counselling in all cases.

副神经节瘤是一种罕见的起源于肾上腺外染色质组织的神经内分泌肿瘤。它们的临床表现是多变的，通常取决于肿瘤的大小、位置和儿茶酚胺的分泌。虽然大多数功能性副神经节瘤存在高血压，但一小部分可以保持正常血压，这使得诊断更具挑战性。病例报告：我们报告一位45岁女性，无明显的病史，她表现出模糊的腹部不适和阵发性心悸。值得注意的是，她没有表现出高血压。生化评价显示尿去甲肾上腺素明显升高。横断成像发现一个4.5 cm的主动脉旁肿块，^123I-MIBG闪烁成像进一步证实了这一点。在术前充分阻断α和β后，她接受了开放手术切除。组织病理学分析证实为副神经节瘤，显示出特征性的zellenen结构和嗜色粒蛋白A、突触素和S100的免疫组织化学阳性。术后恢复顺利。随访12个月，患者无症状，儿茶酚胺水平正常，无复发迹象。他们提供了基因检测，但被拒绝了。本病例强调了正常血压的功能性副神经节瘤的诊断困难，在没有典型高血压的情况下，这可能被忽视。即使在非典型表现中，生化筛查和功能成像也是至关重要的。术前药物准备和专家手术管理是降低术中风险和确保良好结果的关键。结论临床医生应对有提示症状的副神经节瘤保持高度的怀疑，无论血压状况如何。多学科方法和长期随访至关重要，特别是对于肾上腺外肿瘤，在所有情况下都要考虑遗传咨询。

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引用次数: 0

Unraveling the cocoon: A case report on preoperative ambiguity and definitive surgical management of encapsulating peritoneal sclerosis 解开茧：包膜性腹膜硬化症术前歧义及明确手术处理一例报告

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-14 DOI: 10.1016/j.ijscr.2025.112065

Suman Khadka , Diwakar Koirala , Ramesh Sapkota , Tek Nath Yogi , Kriti Basnet , Vijay Shrestha

Introduction

Abdominal cocoon, or sclerosing encapsulating peritonitis (SEP), is a rare condition characterized by a fibrocollagenous membrane encasing the intestines, often leading to obstruction. First described in 1907, its etiology remains unclear, with primary (idiopathic) and secondary forms linked to prior surgeries, infections, or systemic diseases. Preoperative diagnosis remains challenging due to nonspecific symptoms.

Case presentation

A 49-year-old female presented with abdominal pain, vomiting, and constipation. Imaging revealed dilated bowel loops and adhesions. Exploratory laparotomy confirmed SEP, with histopathology showing chronic active colitis and fibrous peritoneum. Adhesiolysis and loop ileostomy were performed, with the patient discharged in stable condition.

Discussion

SEP is classified into three anatomical types, with idiopathic cases often lacking identifiable risk factors. Diagnostic imaging (CT/MRI) aids suspicion, but definitive diagnosis typically requires laparotomy. The condition must be differentiated from peritoneal encapsulation, a distinct entity. Management depends on severity, ranging from membrane excision to bowel resection. A review of 14 published cases highlights laparotomy as the gold standard for both diagnosis and treatment, though laparoscopic approaches are emerging.

Conclusion

SEP remains a diagnostic dilemma, necessitating high clinical suspicion in cases of unexplained obstruction. Surgical intervention is often curative, but meticulous technique is vital to avoid complications. Further research into biomarkers and minimally invasive diagnostic tools is warranted.

腹茧，或硬化性包膜性腹膜炎（SEP）是一种罕见的疾病，其特征是纤维胶原膜包裹肠道，常导致梗阻。1907年首次报道，其病因尚不清楚，原发性（特发性）和继发性形式与既往手术、感染或全身性疾病有关。由于非特异性症状，术前诊断仍然具有挑战性。病例表现女性，49岁，腹痛、呕吐、便秘。影像学显示肠袢扩张和粘连。剖腹探查证实SEP，组织病理学显示慢性活动性结肠炎和纤维性腹膜。术后行粘连松解术及回肠袢造口术，出院时病情稳定。sep分为三种解剖类型，特发性病例通常缺乏可识别的危险因素。诊断成像（CT/MRI）有助于怀疑，但明确的诊断通常需要剖腹手术。这种情况必须与腹膜包封相区别，这是一种不同的实体。治疗取决于严重程度，从膜切除到肠切除术。一篇对14个已发表病例的综述强调剖腹手术是诊断和治疗的金标准，尽管腹腔镜方法正在出现。结论sep仍然是一个诊断难题，对于不明原因梗阻的病例，临床必须高度怀疑。手术干预通常可以治愈，但细致的技术对于避免并发症至关重要。进一步研究生物标志物和微创诊断工具是必要的。

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引用次数: 0

A rare case of undifferentiated embryonal sarcoma of the liver in an elderly patient misdiagnosed as intrahepatic cholangiocarcinoma 一例罕见的未分化胚胎性肝肉瘤误诊为肝内胆管癌

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112059

Xiang-Hui Geng , Deng-Shuai Li , Xing-Fu Wang , Wei Zhong , Min-Feng Liang , Jie Lin

Introduction

Undifferentiated embryonal sarcoma of the liver (UESL) is an exceptionally rare and aggressive malignancy, predominantly affecting children. Its occurrence in the elderly is exceedingly uncommon, posing significant diagnostic challenges. We present the oldest-reported case of UESL, initially misdiagnosed as intrahepatic cholangiocarcinoma (iCCA).

Presentation of case

An 88-year-old male presented with an upper abdominal mass and discomfort. Imaging (CT/MRI/PET-CT) and mildly elevated CA19–9 initially suggested iCCA (T1bN0M0, Stage IB). After 10 months of disease progression despite chemotherapy (capecitabine), left hemihepatectomy was performed. Histopathological examination revealed UESL (7.5 cm tumor; IHC: Vimentin+, CD10+, CD56+, Ki-67 80 %). The patient developed recurrent hepatic disease and pulmonary metastases 1.5 months postoperatively and succumbed to the disease shortly thereafter, with an overall survival of approximately one year.

Discussion

UESL in octogenarians is exceptionally rare, with nonspecific imaging and serological findings (e.g., mild CA19–9 elevation) leading to frequent misdiagnosis, often as iCCA. Pathological examination remains essential for definitive diagnosis. Despite radical resection, prognosis in elderly patients is poor due to aggressive biology and limited tolerance for adjuvant therapy. This case underscores the importance of considering UESL in atypical liver masses across all age groups.

Conclusion

UESL should be included in the differential diagnosis of atypical liver masses, even in elderly patients. Early surgical resection offers the best chance for survival, though outcomes remain dismal in advanced age due to rapid recurrence and metastasis. Heightened awareness of this entity is crucial to mitigate diagnostic delays.

未分化胚胎性肝肉瘤（UESL）是一种罕见的侵袭性恶性肿瘤，主要影响儿童。它在老年人中的发生极为罕见，给诊断带来了重大挑战。我们报告了最古老的UESL病例，最初被误诊为肝内胆管癌（iCCA）。病例表现一例88岁男性，因上腹部肿块及不适而就诊。影像学（CT/MRI/PET-CT）和轻度升高的CA19-9最初提示iCCA （T1bN0M0， IB期）。尽管化疗（卡培他滨），病情进展10个月后，进行左半肝切除术。组织病理检查示UESL （7.5 cm肿瘤，免疫组化：Vimentin+， CD10+, CD56+, Ki-67 80%）。患者术后1.5个月出现复发性肝病和肺转移，此后不久死亡，总生存期约为1年。uesl在80多岁老人中极为罕见，其非特异性影像学和血清学表现（如轻度CA19-9升高）常导致误诊，常误诊为iCCA。病理检查仍然是明确诊断的必要条件。尽管根治性切除，但由于其侵袭性生物学和对辅助治疗的耐受性有限，老年患者预后较差。本病例强调了在所有年龄组的非典型肝肿块中考虑非典型esl的重要性。结论不典型肝肿块的鉴别诊断应纳入超声检查，即使是老年患者。早期手术切除提供了最好的生存机会，尽管由于快速复发和转移，老年患者的预后仍然令人沮丧。提高对该实体的认识对于减轻诊断延误至关重要。

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引用次数: 0

Osteoid osteoma of the talus: a clinical case report and literature review 距骨类骨瘤1例临床报告及文献复习

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112053

M. Diop , M. Sow , B. Dembele , M. Daffé , B. Diop , A.D. Sané

Introduction and importance

Osteoid osteoma of the talus is a relatively rare benign tumor. It accounts for 10 to 11 % of all benign bone tumors. It generally affects long bones. In our patient, the initial clinical and radiological presentation led to the suspicion of a giant cell tumor.

Case presentation

The authors report the case of a 29-year-old patient who presented with chronic pain in the foot and ankle. X-ray and CT scan revealed well-defined lytic lesions of the talus. The treatment was surgical. A hollowing followed by the placement of cement was carried out. The diagnosis of osteoid osteoma was confirmed by pathological examination of the curettage product. The evolution was favorable with no sign of recurrence.

Clinical discussion

Treatment for this lesion is primarily surgical. The lesion was managed by curettage followed by cement augmentation. Arthroscopic resection is an increasingly used therapeutic option.

Conclusion

The outcome is usually favorable with a low risk of recurrence.

距骨类骨瘤是一种较为罕见的良性肿瘤。它占所有良性骨肿瘤的10%到11%。它通常影响长骨。在我们的病人，最初的临床和放射表现导致怀疑巨细胞瘤。病例介绍作者报告了一例29岁的患者，其表现为足部和踝关节慢性疼痛。x线和CT扫描显示距骨明显溶解性病变。手术治疗。先挖空，然后浇上水泥。通过刮除产物的病理检查证实了骨样骨瘤的诊断。进化很顺利，没有复发的迹象。临床讨论：这种病变的治疗主要是手术。病变通过刮除和骨水泥增强处理。关节镜切除是一种越来越常用的治疗方法。结论术后预后良好，复发风险低。

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引用次数: 0

Isolated metastasis of renal clear-cell carcinoma to the male breast following nephrectomy: A rare case report 肾切除术后孤立性肾透明细胞癌转移至男性乳房一例罕见报告

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112049

Anh Dung Hoang , Van Dinh Vu , Quang Anh Nguyen , Manh Cuong Thieu , Hong Quang Le

Introduction and importance

Renal cell carcinoma (RCC) accounts for approximately 2 % of adult malignancies, with clear-cell RCC being the most common histological subtype. Metastasis to the breast is extremely rare, particularly in male patients, and may mimic benign breast lesions, creating diagnostic challenges.

Presentation of case

We report the case of a 55-year-old male with a history of left nephrectomy for clear-cell RCC (pT3aN0M0) who presented three years later with a painless nodule in the left breast. Imaging revealed a well-circumscribed hypoechoic mass classified as BI-RADS 3. Wide local excision was performed, and histopathology with immunohistochemistry confirmed breast metastasis from renal clear-cell carcinoma. No adjuvant systemic therapy was administered, and the patient remains disease-free on follow-up.

Clinical discussion

Breast metastases from extramammary malignancies are uncommon and typically occur in women. In men, they are exceptionally rare and often mistaken for benign conditions such as gynecomastia. Histopathological and immunohistochemical analyses are crucial to distinguish metastasis from primary breast carcinoma. For selected patients with oligometastatic or oligo-recurrent disease, complete metastasectomy may offer prolonged disease control and defer systemic therapy.

Conclusion

This case highlights the importance of considering breast metastasis in male patients with a history of extramammary malignancy. Accurate histopathological diagnosis is essential, and in selected cases, surgical excision can be an appropriate management strategy.

肾细胞癌（RCC）约占成人恶性肿瘤的2%，其中透明细胞癌是最常见的组织学亚型。转移到乳房是极其罕见的，特别是在男性患者中，并可能模仿良性乳腺病变，创造诊断挑战。我们报告一例55岁男性，因透明细胞肾细胞癌（pT3aN0M0）而行左肾切除术，三年后在左乳房出现无痛性结节。成像显示边界清晰的低回声肿块，分类为BI-RADS 3。行局部大范围切除，组织病理及免疫组化证实肾透明细胞癌转移。未给予辅助全身治疗，随访时患者仍无疾病。临床讨论：乳腺外恶性肿瘤转移并不常见，多见于女性。在男性中，这种情况非常罕见，经常被误认为是良性疾病，如男性乳房发育症。组织病理学和免疫组织化学分析是区分原发性乳腺癌转移的关键。对于少数转移性或少复发性疾病的患者，完全转移切除术可以延长疾病控制时间，推迟全身治疗。结论本病例强调了有乳腺外恶性肿瘤病史的男性患者考虑乳腺转移的重要性。准确的组织病理学诊断是必要的，在选定的情况下，手术切除可以是一个适当的管理策略。

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引用次数: 0

Endoscopic marsupialization of a prostatic utricle cyst: A case report and literature review of an unusual clinical condition 内镜下前列腺小囊囊肿有袋化术：一罕见临床病例报告及文献复习

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112060

André Jin Ye , Filipe Quintas , Filipe Lopes , Paulo Pé-Leve , Rodrigo Garcia , José Palma dos Reis

Introduction

Prostatic utricle cysts are uncommon clinical conditions often associated with urogenital abnormalities. These cysts arise due to incomplete or aberrant regression of the Müllerian duct during embryological development. While predominantly asymptomatic, they can present with a range of clinical manifestations, including lower urinary tract symptoms, recurrent urinary tract infections or hematospermia. They are frequently associated with urogenital abnormalities like hypospadias, and rarely occur in individuals with normal external genitalia.

Presentation of case

This report describes the case of a 25-year-old Caucasian male with normal external genitalia who presented with painful ejaculation and hematospermia, ultimately diagnosed as a highly symptomatic prostatic utricle cyst after ultrasonography and magnetic resonance imaging. The condition was effectively managed with a transurethral cyst marsupialization.

Discussion

Prostatic utricle cysts are rare congenital anomalies typically associated with urogenital malformations. This case is unusual because no such anomalies are present. Diagnosis relies on imaging modalities such as ultrasonography, voiding cystourethrogram, retrograde urethrography, cystoscopy, and magnetic resonance imaging. Differential diagnosis includes Müllerian duct cysts, urachal cysts and seminal vesicle cysts. Symptomatic cases may require surgical intervention. Endoscopic approaches, including marsupialization, have the advantage of lower morbidity compared to complete surgical cyst resection, from open surgery to robotic-assisted techniques, despite having a higher risk of recurrence.

Conclusion

This case illustrates the successful diagnosis and endoscopic management of a symptomatic utricle cyst in a male with normal genitalia. Transurethral marsupialization proved effective and safe, with sustained symptom resolution.

前列腺小囊囊肿是一种罕见的临床疾病，常与泌尿生殖系统异常有关。这些囊肿是由于胚胎发育过程中勒氏管不完全或异常消退而产生的。虽然主要无症状，但他们可以表现出一系列临床表现，包括下尿路症状、复发性尿路感染或血精。它们通常与尿道下裂等泌尿生殖系统异常有关，很少发生在外生殖器正常的个体中。本报告描述了一例25岁外生殖器正常的白人男性，表现为射精疼痛和血精，经超声和磁共振成像最终诊断为高度症状性前列腺小囊囊肿。经尿道囊肿有袋化术有效地控制了这种情况。前列腺小囊囊肿是一种罕见的先天性异常，通常与泌尿生殖系统畸形有关。本病例是不寻常的，因为没有这种异常存在。诊断依赖于成像方式，如超声、排尿膀胱尿道造影、逆行尿道造影、膀胱镜检查和磁共振成像。鉴别诊断包括腋管囊肿、尿管囊肿和精囊囊肿。有症状的病例可能需要手术干预。尽管有较高的复发风险，但与完全手术切除囊肿相比，内镜方法，包括有袋化，具有低发病率的优势，从开放手术到机器人辅助技术。结论本病例成功地诊断和内镜下处理了男性正常生殖器的症状性小囊囊肿。经尿道有袋术证明是有效和安全的，症状持续缓解。

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引用次数: 0

Recurrent staphylococcus epidermidis prosthetic valve endocarditis with deep sternal infection in repaired tetralogy of fallot: A case report 法洛四联症修复后复发性表皮葡萄球菌假瓣膜心内膜炎合并胸骨深部感染1例

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112056

Mouna Kanaan , Ola Alayon Al-Dabbagh , Anas M. Alrefai , Ali Youssef Ali , Mohammad Nasser Khattab , Khaled Hamza

Introduction

Advances in surgical and medical management have significantly improved survival rates for patients with congenital heart disease (CHD), especially tetralogy of Fallot (TOF), which is the most common cyanotic CHD, with a 20-year survival rate of more than 90 %.However, this growing adult TOF population faces emerging challenges, particularly a 35-fold increased risk of infective endocarditis (IE) compared to the general population.

Case presentation

We describe a 26-year-old male with repaired tetralogy of Fallot (TOF) who experienced recurrent prosthetic valve endocarditis (PVE) caused by Staphylococcus epidermidis over three years. The patient required three pulmonary valve replacements (PVRs) secondary to bioprosthetic valve dysfunction. Although initial endocarditis episodes were successfully treated with antibiotic therapy, the final presentation was complicated by a deep sternal wound infection, presumably seeded from multiple prior sternotomies.

Discussion

Prosthetic valve endocarditis, deep sternal wound infection, perivalvular abscess formation, prosthetic valve dislocation, and aorto-pulmonary fistula development; their simultaneous occurrence underscores a critical pathophysiological triad: (1) cumulative prosthetic material burden, (2) compromised thoracic defense mechanisms from multiple sternotomies, and (3) healthcare access disparities exacerbating delayed detection.

Conclusion

This case underscores the persistent risk of PVE in TOF patients requiring repeated valve interventions and the critical relationship between sternal wound complications and hematogenous seeding of prosthetic valves. The clinical challenges of managing recurrent endocarditis in the setting of complex congenital heart disease are discussed.

手术和医疗管理的进步显著提高了先天性心脏病（CHD）患者的生存率，尤其是法洛四联症（TOF），这是最常见的紫绀型CHD，其20年生存率超过90%。然而，不断增长的成年TOF人群面临着新的挑战，特别是感染性心内膜炎（IE）的风险比普通人群增加了35倍。病例介绍：我们报告一位26岁的男性法洛四联症（TOF）患者，因表皮葡萄球菌引起的人工瓣膜心内膜炎（PVE）复发超过三年。该患者因生物瓣膜功能障碍需要三次肺瓣膜置换术（pvr）。虽然最初的心内膜炎发作通过抗生素治疗成功治疗，但最终表现为深部胸骨伤口感染，可能是先前多次胸骨切开术造成的。人工瓣膜心内膜炎、胸骨深伤口感染、瓣膜周围脓肿形成、人工瓣膜脱位、主动脉-肺瘘形成；它们的同时发生强调了一个关键的病理生理三重特征：(1)累积的假体材料负担，(2)多次胸骨切开术导致的胸腔防御机制受损，以及(3)医疗保健机会的差异加剧了延迟检测。结论本病例强调了需要多次瓣膜介入治疗的TOF患者发生PVE的持续风险，以及胸骨伤口并发症与人工瓣膜植入之间的重要关系。在复杂的先天性心脏病设置管理复发性心内膜炎的临床挑战进行了讨论。

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引用次数: 0

Necrotizing fasciitis of the abdominal wall revealing a delayed hepatic hydatid fistula: A rare and severe late complication 腹壁坏死性筋膜炎显示迟发性肝包虫瘘：罕见且严重的晚期并发症

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112058

Ghazi Lâamiri , Hazem Alouani , Khadija Yaich , Houda Gazzah , Mahdi Bouassida , Hassen Touinsi

Introduction

Hydatid liver disease is endemic in many regions and, though often curable with surgery, can lead to rare long-term complications.

Case presentation

We report a 57-year-old woman with a history of hydatid cyst excision and cholecystectomy 40 years prior, presenting with right hypochondrial parietal gangrene and fever. Imaging revealed hepatic subcapsular collections fistulizing into the abdominal wall, complicated by necrotizing fasciitis. Emergency debridement and drainage were performed, followed by broad-spectrum antibiotics. ERCP with sphincterotomy was later performed to remove bile duct stones.

Clinical discussion

This case highlights a rare and severe late complication of hydatid liver surgery. The delayed fistulization and secondary infection emphasize the need to consider remote surgical history in atypical soft tissue infections.

Conclusion

Necrotizing fasciitis due to a delayed hepatic hydatid fistula is exceptional. Early recognition, imaging, surgical intervention, and multidisciplinary care are vital for favorable outcomes.

包虫病是许多地区的地方性疾病，虽然通常可以通过手术治愈，但会导致罕见的长期并发症。我们报告一名57岁女性，40年前曾做过包虫病切除及胆囊切除术，表现为右肋软骨壁坏疽及发烧。影像显示肝包膜下积液呈瘘管状进入腹壁，并发坏死性筋膜炎。紧急清创引流，随后使用广谱抗生素。随后行ERCP联合括约肌切开术切除胆管结石。本病例是包虫病肝手术中一种罕见而严重的晚期并发症。延迟造瘘和继发感染强调需要考虑远程手术史在非典型软组织感染。结论迟发性肝包虫瘘致坏死性筋膜炎少见。早期识别、影像学、手术干预和多学科治疗对获得良好的预后至关重要。

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引用次数: 0

A rare case of conjunctival melanoma in an Asian lady: A case report 亚洲女性罕见结膜黑色素瘤1例报告

IF 0.7 Q4 SURGERY

International Journal of Surgery Case Reports

Pub Date : 2025-10-13 DOI: 10.1016/j.ijscr.2025.112061

Nawar Shandi , Sarah Alkabbani , Hachemi Nezzar

Introduction

Ocular melanoma is the second most prevalent after cutaneous melanoma. There are few studies published on conjunctival melanoma, and the literature is limited especially concerning surgical techniques of excision. Despite being rare, invasive ocular melanoma has a high mortality rate ranging from 18 to 44 %.

Presentation

We present a case of Conjunctival Melanoma in a 36-year-old Asian lady that presented with rapid changes in the characteristics of a pre-existing conjunctival nevus, associated with itchiness, burning, and a growing mass. Examination showed a large pedunculated vascularized melanotic mass, highly suggestive of melanoma. She underwent wide local excision with biopsy, with histopathology confirming invasive conjunctival melanoma. Patient was managed by a multi-disciplinary team including oncology.

Discussion

Conjunctival melanomas are associated with a high mortality rate and prompt close follow up. Ethnic and racial variations in prognosis have been reported in the literature.

Conclusion

Conjunctival melanomas are managed as a separate disease clinically due to the significant difference from other ocular melanomas in treatment and histopathology. A multi-disciplinary approach is needed to manage cases with respect to socioeconomic status.

眼部黑色素瘤是继皮肤黑色素瘤之后发病率第二高的肿瘤。关于结膜黑色素瘤的研究很少，特别是关于手术切除技术的文献也很有限。尽管很罕见，但侵袭性眼部黑色素瘤的死亡率很高，从18%到44%不等。我们报告一个36岁的亚洲女性结膜黑色素瘤病例，其表现为原有结膜痣特征的快速变化，伴有瘙痒、灼烧和肿块的增大。检查显示一个大的带梗血管化黑色肿块，高度提示黑色素瘤。她接受了广泛的局部切除和活检，组织病理学证实浸润性结膜黑色素瘤。患者由包括肿瘤学在内的多学科团队进行治疗。结膜黑色素瘤与高死亡率和及时密切随访相关。种族和种族的预后差异已在文献中报道。结论结膜黑色素瘤在治疗和病理组织学上与其他眼部黑色素瘤有显著差异，临床上应将其作为单独的疾病处理。需要一种多学科的方法来处理与社会经济地位有关的案件。

{"title":"A rare case of conjunctival melanoma in an Asian lady: A case report","authors":"Nawar Shandi , Sarah Alkabbani , Hachemi Nezzar","doi":"10.1016/j.ijscr.2025.112061","DOIUrl":"10.1016/j.ijscr.2025.112061","url":null,"abstract":"<div><h3>Introduction</h3><div>Ocular melanoma is the second most prevalent after cutaneous melanoma. There are few studies published on conjunctival melanoma, and the literature is limited especially concerning surgical techniques of excision. Despite being rare, invasive ocular melanoma has a high mortality rate ranging from 18 to 44 %.</div></div><div><h3>Presentation</h3><div>We present a case of Conjunctival Melanoma in a 36-year-old Asian lady that presented with rapid changes in the characteristics of a pre-existing conjunctival nevus, associated with itchiness, burning, and a growing mass. Examination showed a large pedunculated vascularized melanotic mass, highly suggestive of melanoma. She underwent wide local excision with biopsy, with histopathology confirming invasive conjunctival melanoma. Patient was managed by a multi-disciplinary team including oncology.</div></div><div><h3>Discussion</h3><div>Conjunctival melanomas are associated with a high mortality rate and prompt close follow up. Ethnic and racial variations in prognosis have been reported in the literature.</div></div><div><h3>Conclusion</h3><div>Conjunctival melanomas are managed as a separate disease clinically due to the significant difference from other ocular melanomas in treatment and histopathology. A multi-disciplinary approach is needed to manage cases with respect to socioeconomic status.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"136 ","pages":"Article 112061"},"PeriodicalIF":0.7,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145333001","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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