International Journal of Surgery Case Reports最新文献

{"title":"Internal mammary artery perforator-based plug flap","authors":"Nello Pirozzi ,&nbsp;Nicola Rocco ,&nbsp;Maurizio Bruno Nava ,&nbsp;Maíra Teixeira Dória ,&nbsp;Camilla Victoria Weigert ,&nbsp;Cícero de Andrade Urban","doi":"10.1016/j.ijscr.2024.110567","DOIUrl":"10.1016/j.ijscr.2024.110567","url":null,"abstract":"<div><h3>Introduction</h3><div>Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fascio-cutaneous pedicled chest wall perforator flaps or local perforator flaps (CWPF).</div></div><div><h3>Case presentation</h3><div>We present a case of reconstruction with internal mammary artery perforator (IMAP)-based plug flap to fill the infero-medial defect caused by a tumor close to skin, with visible retraction.</div></div><div><h3>Clinical discussion</h3><div>A 52 years old woman, with an extensive palpable mass (3 cm) in the lower medial quadrant of the right breast, the tumor was close to skin, with visible retraction. The patient has small and round breasts, without ptosis.</div></div><div><h3>Conclusion</h3><div>In this situation and when there is skin that needs to be removed, reconstruction can be done with a pedicle flap skin paddle; the IMAP flap is an ideal donor site in these cases. It is a safe flap with good vascularization and offers a great cosmetic result.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110567"},"PeriodicalIF":0.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630558","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}

{"title":"Metatypical basal cell carcinoma: A successful balance between oncologic outcome and aesthetic result, a case report","authors":"Eya Rahmouni ,&nbsp;Fatma Saadallah ,&nbsp;Ines Zemni ,&nbsp;Amira Gallas ,&nbsp;Ghada Sahraoui ,&nbsp;Tarek Ben Dhiab","doi":"10.1016/j.ijscr.2024.110569","DOIUrl":"10.1016/j.ijscr.2024.110569","url":null,"abstract":"<div><h3>Introduction</h3><div>Metatypical basal cell carcinoma is a rare and aggressive subtype of skin cancer. It necessitates a careful and nuanced approach to management. The first-line treatment is a wide surgical excision, which can lead to significant tissue loss. Herein is our case.</div></div><div><h3>Case report</h3><div>A 67-year-old female patient presented with an ulcerated exophytic mass on the right parietal scalp. She underwent a large excision of the tumor, sentinel lymph node biopsy, and reconstruction with a transposition flap. Histopathological examination revealed a metatypical basal cell carcinoma with minimal clear surgical margins of 1 cm; lymph nodes were negative. Adjuvant radiotherapy was recommended.</div></div><div><h3>Discussion</h3><div>Metatypical basal cell carcinoma is a rare and aggressive subtype of non-melanoma skin cancer, accounting for about 2 % of all cases. It has a higher risk of metastasis and recurrence compared to typical basal cell carcinoma.</div><div>Metatypical basal cell carcinoma most often develops in sun-exposed areas of the head, although it can occur in other locations less frequently.</div><div>Despite the absence of established treatment guidelines, it is recommended to use wider surgical margins than those typically applied for basal cell carcinoma. This approach often leads to substantial tissue loss, which may necessitate challenging reconstructive procedures.</div><div>Ongoing research is crucial as we navigate the complexities of managing metatypical basal cell carcinoma, particularly concerning surgical margin cutoffs, lymph node staging, and adjuvant therapies.</div></div><div><h3>Conclusion</h3><div>Due to its rarity, metatypical basal cell carcinoma presents ongoing challenges with no consensual management strategies.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110569"},"PeriodicalIF":0.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630569","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}

{"title":"Ectopic adrenocortical adenoma in the abdominal wall linked to the head of the pancreas: A case report","authors":"Ghena Alhadwah ,&nbsp;Nahar Ismaiel ,&nbsp;Jaafar Shater ,&nbsp;Ali Daoud ,&nbsp;Maen Haidar","doi":"10.1016/j.ijscr.2024.110568","DOIUrl":"10.1016/j.ijscr.2024.110568","url":null,"abstract":"<div><h3>Introduction</h3><div>Ectopic adrenocortical adenomas are infrequent adrenal tumors that deviate from their usual location. Herein, we report a case of an ectopic black adrenocortical adenoma situated in the abdominal wall, intricately linked to the head of the pancreas.</div></div><div><h3>Case presentation</h3><div>A 27-year-old female presented to the emergency room with severe right iliac pain, nausea, vomiting, and high fever. Clinical exam showed signs of acute appendicitis in addition to distinctly outlined, slightly painful, and immobile mass located in the right hypochondrium. Both the inflamed appendix and mass were removed surgically. Pathological examination of said mass with subsequent immunohistochemical staining confirmed the diagnosis of an ectopic adrenocortical adenoma.</div></div><div><h3>Discussion</h3><div>Our case is unique as it occurred in an adult female which is rare for these types of lesions. In addition to that the lesion was located in the anterior abdominal wall intimately linked with the head of the pancreas making this case the first documented case of such a location in the medical literature.</div></div><div><h3>Conclusion</h3><div>The successful diagnosis and management of this rare presentation underscore the significance of a collaborative and multidisciplinary approach.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110568"},"PeriodicalIF":0.6,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630346","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}

{"title":"Case report: Bladder stone caused by dislocated Cu-IUD","authors":"Elvin Piriyev ,&nbsp;Ahdab Ali Azim ,&nbsp;Gamzat Jigarov ,&nbsp;Azad Suleymanov ,&nbsp;Emil Mukhtarov ,&nbsp;Thomas Römer","doi":"10.1016/j.ijscr.2024.110562","DOIUrl":"10.1016/j.ijscr.2024.110562","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>The intrauterine device, usually in the form of a copper IUD or levonorgestrel intrauterine system, is a widely used contraceptive method. The risk of uterine perforation is low and ranges from 0.3 to 2.2 per 1000 insertions for Cu-IUD. The bladder, with 24 %, is, after the bowel, the second most common location among all intra-abdominal locations of the migrated IUDs, which can cause development of a bladder stone.</div></div><div><h3>Case presentation</h3><div>We present a case of a 32-year-old woman who attends with increasing dysuria. She reported using an IUD before her last pregnancy. Abdominal sonography and computed tomography revealed a lost IUD migrated into the bladder with stone formation. An open abdominal cystotomy was carried out in order to remove the IUD. Patient reported improvement of the symptoms postoperatively.</div></div><div><h3>Clinical discussion</h3><div>In the case of transvesical migration of IUD, lower urinary tract symptoms can occur and vesicolithiasis can develop. If the IUD is completely inside the bladder or if it gets small stones inside it, the device and stones may need to be removed through a cystoscopic or suprapubic approach. When large stones have formed or when the IUD has partially penetrated the bladder wall, open surgery has been the method of choice for removal.</div></div><div><h3>Conclusion</h3><div>In case of migrated IUD, a vaginal and abdominal ultrasound, X-rays, and computed tomography are useful tools for detecting dislocated IUDs. For the treatment physicians can choose a cystoscopic, laparoscopic, or abdominal approach based on the symptoms, the size of the stones, the IUD's location on the bladder wall, and their experience in laparoscopy and open surgery. If patients report dysuria after inserting of IUD a migrated IUD into the bladder should be taken into account.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110562"},"PeriodicalIF":0.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630429","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}

{"title":"Radical nephrectomy for retroperitoneal fibrosis: Case report","authors":"Matheus Miranda Paiva ,&nbsp;Eloi Guilherme Provinciali Moccellin ,&nbsp;Alessandro Vengjer ,&nbsp;Guilherme Henrique Silveira Stiirmer ,&nbsp;Fernando Oliveira dos Santos ,&nbsp;Paulo Peixoto do Nascimento","doi":"10.1016/j.ijscr.2024.110560","DOIUrl":"10.1016/j.ijscr.2024.110560","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Retroperitoneal fibrosis is a proliferative disease of fibroblasts with a still unclear appearance and low incidence. The clinical manifestations are nonspecific and appear late, pain is the most common symptom present. Elevated serum IgG4 levels are observed in up to 60 % of the patients and the main goal of treating this condition is to preserve kidney function.</div></div><div><h3>Case presentation</h3><div>We present a case of an asymptomatic 34-year-old man. A poorly defined mass in the pre-aortic, pre-caval and right rim regions with possible malignancy was observed. After 3 biopsies, it was treated as low-grade follicular lymphoma with chemotherapy. With new growth after 1 year, right radical nephrectomy was performed to resect the lesion. Pathology showed that it was advanced retroperitoneal fibrosis with negative IgG4.</div></div><div><h3>Clinical discussion</h3><div>RPF usually presents as an irregular mass of periaortic tissue that frequently has malignancy as a risk factor and may be associated with high levels of IgG4. Most of the time, the disease is asymptomatic. When the patient presents symptoms, pain is the most common, although late. Its diagnosis is made by imaging and histopathological exams. Treatment varies according to the progression of the disease, but aims to try to preserve renal function.</div></div><div><h3>Conclusion</h3><div>RPF is a disease characterized by the accumulation of fibroblasts in the abdominal region with an etiology that has not yet been fully discovered, which can present in several ways, generally identified by imaging exams and can be treated individually depending on the invasiveness of the disease.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110560"},"PeriodicalIF":0.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592692","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}

{"title":"WALANT technique for acute compartment syndrome of the arm in a COVID-19 patient: A case report","authors":"Abdellatif Djelti ,&nbsp;Amira Loukriz ,&nbsp;Youcef Demdoum ,&nbsp;Amine Mohamed Bouras ,&nbsp;Youcef Seddik Debbache ,&nbsp;Mahfoud Nabil Bouhraoua","doi":"10.1016/j.ijscr.2024.110557","DOIUrl":"10.1016/j.ijscr.2024.110557","url":null,"abstract":"<div><h3>Introduction</h3><div>Compartment syndrome is a surgical emergency caused by elevated pressure within a closed fascial compartment, leading to compromised tissue perfusion and the potential for irreversible damage if not treated promptly. This report presents a rare case of upper limb compartment syndrome in a COVID-19 patient on anticoagulation therapy following multiple failed venipuncture attempts. This work has been reported in line with the SCARE criteria.</div></div><div><h3>Case presentation</h3><div>A 67-year-old man with hypertension, diabetes, and congenital hydrocephalus was admitted for COVID-19 pneumonia. He required anticoagulation therapy with Enoxaparin due to his high risk for thromboembolic events. Following multiple failed attempts to secure venous access in the right upper limb, the patient developed severe pain, swelling, and numbness in the limb. Clinical examination revealed pallor, paresthesia, and pulselessness, raising suspicion of compartment syndrome. Ultrasonography confirmed the absence of radial and ulnar arterial flow, with evidence of significant muscular edema and hematoma formation in the anterior compartment of the arm.</div><div>Due to the patient's pulmonary compromise and elevated risk for general anesthesia, the decision was made to perform a fasciotomy under the WALANT (Wide Awake Local Anesthesia No Tourniquet) technique. Following the procedure, pulses were restored after evacuation of a deep hematoma compressing the humeral artery, with immediate improvement in hand perfusion. The patient was transferred back to the infectious diseases department for continued COVID-19 management, and the postoperative course was uneventful. At 6-month follow-up, the patient had fully recovered mobility of the shoulder, elbow, wrist, and fingers.</div></div><div><h3>Discussion</h3><div>This case underscores the rare development of upper limb compartment syndrome in a patient on anticoagulation therapy for COVID-19, likely due to venipuncture-related trauma. It highlights the challenges of diagnosing and managing compartment syndrome in critically ill patients, and demonstrates the utility of the WALANT technique in performing fasciotomy in high-risk patients. Early recognition and timely intervention were crucial in ensuring the patient's full functional recovery.</div></div><div><h3>Conclusion</h3><div>Compartment syndrome should be considered in patients on anticoagulation therapy, particularly those with multiple venipuncture attempts. The WALANT technique provides a viable surgical option for fasciotomy in critically ill patients.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110557"},"PeriodicalIF":0.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607006","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}

{"title":"Ewing sarcoma of the thumb presenting in a Hispanic patient: A case report.","authors":"Carlos Guevara, José I Acosta Julbe, Derick Rodríguez-Reyes, Juan Bibiloni","doi":"10.1016/j.ijscr.2024.110552","DOIUrl":"https://doi.org/10.1016/j.ijscr.2024.110552","url":null,"abstract":"<p><strong>Introduction: </strong>Ewing sarcoma (EwS) is an uncommon and highly aggressive cancer primarily affecting children and young adults. This tumor constitutes 10 % to 15 % of all bone sarcomas and often presents in the pelvis, axial skeleton, and femur. Despite its rarity, EwS's rapid progression and early metastatic potential make it a significant concern in pediatric oncology, highlighting the need for effective treatment protocols and further research.</p><p><strong>Case presentation: </strong>We report the case of an 18-year-old Hispanic male who presented with an initially asymptomatic growing mass in his right distal left thumb. The diagnosis of an extra-axial EwS was confirmed after histopathologic evaluation. He was managed with a trans-interphalangeal disarticulation followed by adjuvant chemotherapy with no signs of recurrence at 24-months. This case has been reported in line with the SURGICAL CASE Reports (SCARE) guidelines.</p><p><strong>Discussion: </strong>EwS is known for rapid growth and early metastasis, often remaining asymptomatic until advanced stages, complicating treatment and reducing survival. Common symptoms include tenderness and swelling. In our case, the patient presented with a slowly enlarging, initially asymptomatic thumb mass, leading to delayed diagnosis. EwS in the hand, especially the thumb, is rare, with only nine cases reported.</p><p><strong>Conclusion: </strong>While EwS rarely manifests in fingers, it remains crucial to include this diagnosis and other malignant tumors as a potential consideration when evaluating lesions found in this area.</p>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"110552"},"PeriodicalIF":0.6,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142682804","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}

{"title":"Recurrence of multiple localizations of false tuberculous aneurysms after aortic surgery: A case report","authors":"Jdar Asma ,&nbsp;Lekehal Mehdi ,&nbsp;Bounssir Ayoub ,&nbsp;Bakkali Tarik ,&nbsp;Lekehal Brahim","doi":"10.1016/j.ijscr.2024.110558","DOIUrl":"10.1016/j.ijscr.2024.110558","url":null,"abstract":"<div><h3>Introduction and importance</h3><div>Tuberculous aortic aneurysms require rigorous medical and surgical management due to the various complications that pose a significant life risk, with recurrence being one of the most formidable postoperative complications. This recurrence is linked to significant hemorrhage and infection, subsequently increasing the risk of mortality. Aneurysmal involvement due to tuberculosis is documented and can affect all arteries, but localization in the common iliac artery is rare and serious, necessitating immediate management.</div></div><div><h3>Case presentation</h3><div>We present the case of a 47-year-old man who had previously been treated for urogenital tuberculosis and underwent an aorto-aortic bypass three years ago for a juxtarenal abdominal aneurysm. The patient presented to the emergency room with abdominal pain. An emergency CT angiogram revealed a pseudoaneurysm at the site of the distal anastomosis of the bypass and a new pseudoaneurysm of the left common iliac artery. The patient underwent surgery, which involved the removal of the old aortic graft and a new aorto-bilateral iliac bypass using a Dacron graft. Histological analysis of the arterial samples collected during the operation confirmed the tuberculous origin of the aneurysm, and antituberculous treatment was extended for six months. After six months, the patient was in good general condition, and the bypass was patent.</div></div><div><h3>Clinical discussion</h3><div>For optimal results, medical treatment should precede surgical intervention. The choice between conventional and endovascular surgery is individualized for each case. However, endovascular treatment does not allow for debridement of the infected periaortic tissues, which is associated with a high risk of progression and recurrence of the infection, potentially leading to a fatal outcome.</div></div><div><h3>Conclusion</h3><div>Effective management requires antituberculous treatment and antibiotic therapy prior to surgical intervention to eliminate the aneurysm, control postoperative outcomes, and minimize complications related to tuberculosis.</div><div>The work has been reported in line with the SCARE criteria (Sohrabi et al., 2023 [17]).</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110558"},"PeriodicalIF":0.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592018","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}

{"title":"Paediatric rhinolith: Case report and literature review","authors":"Alya AlZabin ,&nbsp;Abdulrahman M. Aloufi ,&nbsp;Rayan Alfallaj ,&nbsp;Yazeed AlSuliman","doi":"10.1016/j.ijscr.2024.110561","DOIUrl":"10.1016/j.ijscr.2024.110561","url":null,"abstract":"<div><h3>Introduction</h3><div>Rhinolithiasis, the presence of nasal stones, is uncommon in children. It can pose a diagnostic challenge because of the unusual presentation and difficulties associated with its identification.</div></div><div><h3>Presentation of case</h3><div>This article describes a 2-year-old boy who came to our clinic with his parents complaining of foul-smelling nasal discharge, which was unilateral and greenish in color. A rhinolith was found and successfully removed in the emergency room.</div></div><div><h3>Discussion</h3><div>Several studies have shown that patients with rhinolithiasis may present with cacosmia, epistaxis, headache, facial pain, and epiphora. The usual presentation of rhinolithiasis is between the ages of 8 and 25, with a higher rate of occurrence in females. Various imaging techniques do not show rhinoliths clearly; instead, endoscopic examination plays a major role in the diagnosis.</div></div><div><h3>Conclusion</h3><div>Rhinolithiasis is a rare clinical etiology, especially in this age group. If left untreated, further destruction of the nasal cavity will occur. Otolaryngologists should consider an appropriate diagnostic and management approach in such cases, and rhinolithiasis should be one of the top differentials in cases of sudden unilateral nasal obstruction.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110561"},"PeriodicalIF":0.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630575","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}

{"title":"Restoration of elbow flexion in patient with prolonged incomplete brachial plexus injury treated with bipolar latissimus dorsi muscle transfer: A case report","authors":"R. Malik,&nbsp;Y.S. Robiady,&nbsp;A.R. Ichwan","doi":"10.1016/j.ijscr.2024.110554","DOIUrl":"10.1016/j.ijscr.2024.110554","url":null,"abstract":"<div><h3>Introduction</h3><div>The functional deficits resulting from traumatic brachial plexus damage are substantial. In this study, we provide a clinical case with the successful restoration of elbow and shoulder function following a bipolar latissimus dorsi muscle transfer procedure.</div></div><div><h3>Case presentation</h3><div>A male patient, aged 26, presented at the outpatient clinic with a primary concern of left upper limb weakness that had persisted for a duration of 1.5 years subsequent to an industrial incident. The patient's motor function was assessed as M0 for shoulder abduction and elbow flexion, indicating a range of motion of zero degrees for both movements. Additionally, the Mayo Elbow Score (MES) measurement was recorded as 60. Persistent tingling feelings were observed in the wrist and hand. The neurological assessment revealed a partial impairment of motor function in the radial, median, and ulnar nerves.</div></div><div><h3>Clinical discussion</h3><div>The electromyographic assessment provided evidence and substantiated the diagnosis of an incomplete left brachial plexopathy. Prompt restoration of elbow flexion was observed on the initial day subsequent to the surgery, accompanied by a minor degree of shoulder abduction. At the six-month mark, the patient demonstrates the ability to execute a 100-degree flexion of the elbow and a 30-degree abduction of the shoulder, exhibiting motor strength at the M4 level.</div></div><div><h3>Conclusion</h3><div>Following a late brachial plexus injury, the utilization of a bipolar latissimus dorsi muscle flap has demonstrated an exceptional outcome in the context of elbow reconstruction. The preoperative evaluation of donor muscle strength will serve as a reliable indicator for predicting a favorable postoperative result.</div></div>","PeriodicalId":48113,"journal":{"name":"International Journal of Surgery Case Reports","volume":"125 ","pages":"Article 110554"},"PeriodicalIF":0.6,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630597","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}