Case Reports in Surgery最新文献

Iliopsoas phlegmon/abscess is uncommon, and individuals often present with nonspecific symptoms. Diagnosis is often delayed and almost always requires advanced imaging techniques such as computed tomography or magnetic resonance imaging. We report a case of a 51-year-old woman who presented with right lower limb swelling and associated rash with imaging demonstrating iliopsoas abscess secondary to an infected intrauterine contraceptive device. This rare case highlights the nonspecific presentation of iliopsoas abscess and the need to consider unusual sources of infection such as an intrauterine contraceptive device in women presenting with iliopsoas phlegmon and abscess.

Introduction: Isolated fallopian tube torsion (IFTT) has rarely been confirmed in sexually inactive adolescents, and preoperative diagnosis of IFTT is difficult because of the absence of specific symptoms. Therefore, pediatric patients with IFTT tend to be misdiagnosed before the surgery.

Case: A 15-year-old female patient with no history of abdominal surgery or sexual intercourse presented with acute left lower abdominal pain and purpura. MRI revealed hydrosalpinx in the left adnexal region. Her abdominal pain had completely resolved at our examination; she was followed up as an outpatient. One month after the initial presentation, she experienced a large volume of watery discharge. Magnetic resonance imaging, which was performed every three months, showed a gradual decrease in the size of the hydrosalpinx; however, it persisted in the left adnexal region. She was counseled to receive laparoscopy to treat the hydrosalpinx, which was the most likely cause of the watery discharge. IFTT was detected during the laparoscopy, and left salpingectomy was performed for pathological evaluation of the persistent hydrosalpinx. Following laparoscopy, the patient's watery discharge was resolved. Pathological findings confirmed no signs of malignancy.

Conclusion: Our current report highlighted watery discharge as an indicative symptom of IFTT. It is unclear whether IFTT induced the hydrosalpinx or vice versa. We presumed that the patient's hydrosalpinx occurred due to IFTT, because the patient complained watery discharge one month after the initial appearance, and noncongenital hydrosalpinx in adolescents, especially without a history of sexual intercourse, is a rare event. Clinicians should consider IFTT in patients presenting with unremitting watery discharge and hydrosalpinx, because IFTT may persist even after the pain disappears.

Sclerosing encapsulating peritonitis (SEP) is an unusual fibroinflammatory disease of the peritoneum marked by the development of a fibrous membrane enveloping generally the small intestines. The knowledge around this subject is not completely understood. And the etiology can be either idiopathic or secondary to several diseases, treatments, and/or medications. We present a case of a 52-year-old man suffering from atypical clinical symptoms including recurrent abdominal ascites and intestinal obstruction. An abdominal computed tomography showed findings typical of SEP. Therefore, the patient benefited from exploratory laparotomy, which confirmed the diagnosis of idiopathic SEP. Postoperatively, he again had an episode of bowel obstruction, but this was controlled with steroids. Diagnosis of SEP is a real challenge to surgeons, gastroenterologists, and radiologists. And imagery is very helpful to make the diagnosis. Consequently, it is imperative that all hospital practitioners should distinguish between this lesion and other etiology of acute peritonitis.

Prostate-specific membrane antigen positron emission tomography (PSMA PET) has been approved by the Food and Drug Administration (FDA) to identify prostate cancer in the setting of biochemical recurrence but can also identify other malignancies. 18F-PSMA PET has not been studied as a potential tool for hepatocellular carcinoma (HCC). We describe the case of a 76-year-old male with a rising prostate-specific antigen (PSA) after definitive prostate cancer treatment and no prior liver pathology who was incidentally found to have HCC on 18F-PSMA PET.

Introduction: Schistosomiasis is a parasitic infection caused by schistosome invasion of blood circulation. Neuroschistosomiasis is a severe cerebral complication that accounts for less than 2.3% of reported cases. Patients present with progressive encephalitis, seizures, or both. Management includes antiparasitic medications, steroids, and surgical intervention. Case Presentation. We report a case of a 44-year-old female who presented to the ER with a history of transient loss of consciousness (LOC) and seizure. Radiological investigations revealed a right frontal brain lesion. Histopathological results confirmed the diagnosis of schistosomiasis.

Conclusion: Schistosomiasis is a parasitic infection commonly diagnosed in patients who live in tropical areas. Early diagnosis with radiological and histopathological evaluation is required to identify patients at risk of developing severe neurological complications.

Neonatal testicular torsion (NTT) is a rare but significant condition occurring within the first 30-day postbirth, leading to vascular compromise and potential testicular loss. This paper presents a case of NTT detected incidentally in a neonate with bilateral hydrocele, emphasizing the challenge of early diagnosis and management complexities. The infant underwent surgical intervention involving detorsion and bilateral orchiopexy but eventually required right orchiectomy due to necrosis. The paper highlights the prevalence of NTT in conjunction with hydrocele and stresses the importance of parent education and vigilant follow-up. Various diagnostic methods, primarily ultrasonography, and a range of management strategies are discussed, considering factors such as salvage potential, risk to the contralateral testicle, and surgical intervention's risks and benefits. The paper argues for individualized management, taking into account specific neonate conditions and parental preferences, underlining the essential role of informed and empathetic consultation. The case reinforces the urgent need for increased awareness, early detection, and carefully considered therapeutic approaches to prevent devastating outcomes like infertility and the necessity for lifelong hormone supplementation.