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Anterolateral Thigh Flap Reconstruction of Full Thickness Lateral Abdominal Wall Defect from Desmoid Tumour 大腿前外侧皮瓣重建蝶形瘤导致的全厚腹壁外侧缺损
IF 0.6 Pub Date : 2024-01-16 DOI: 10.1155/2024/1908212
Melissa Yeo
Desmoid tumours are benign but locally aggressive mesenchymal neoplasms that occur most commonly in the abdomen, with the potential to invade surrounding structures causing significant morbidity. Lateral abdominal wall defects are known to be more challenging and less frequently encountered compared to ventral abdominal wall defects. Asymmetric forces caused by contraction of remnant rectus and contralateral oblique muscles increase the risk of herniation postoperatively. We report a case of a challenging abdominal wall reconstruction after desmoid tumour resection in a 62-year-old male patient who presented to our hospital with a progressively enlarging left upper back lump of 6 months duration. A venous supercharged pedicled anterolateral thigh flap was combined with PROLENE® mesh for reconstruction, and the patient recovered well with good functional and aesthetic outcomes at 2-year follow-up. The pedicled anterolateral thigh flap with venous supercharging can be effectively used for the reconstruction of extensive lateral abdominal wall defects.
蝶形细胞瘤是一种良性但具有局部侵袭性的间叶肿瘤,最常发生在腹部,有可能侵犯周围结构,导致严重的发病率。众所周知,与腹壁缺损相比,腹壁外侧缺损更具挑战性,也更少见。残余直肌和对侧斜方肌收缩造成的不对称力增加了术后疝出的风险。我们报告了一例卵圆形瘤切除术后腹壁重建的挑战性病例,患者是一名 62 岁的男性,因左上背部肿块持续增大 6 个月到我院就诊。患者术后恢复良好,2 年随访时功能和美观效果良好。静脉充盈的带蒂大腿前外侧皮瓣可有效用于重建广泛的腹外侧壁缺损。
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引用次数: 0
Chronic Appendicitis: Possible Differential Diagnosis in Patients with Chronic Abdominal Pain 慢性阑尾炎:慢性腹痛患者的可能鉴别诊断
IF 0.6 Pub Date : 2024-01-09 DOI: 10.1155/2024/6032042
Iva Ljubas, Ivana Jurca, Dora Grgić
In the emergency department, patients frequently present with abdominal pain, with a variety of different causes ranging from intra-abdominal to extra-abdominal and retroperitoneal pathologies which can affect all age groups. Chronic appendicitis is a rare medical condition characterized by less severe and continuous abdominal pain and a clinical picture lasting longer than 1-2 days and extending over months, even years, and it is not always possible to consider it as a preliminary diagnosis. We represent a case report of chronic appendicitis where the patient’s clinical picture led the diagnostics and treatment in different directions and delayed the diagnosis. Namely, our patient was radiologically diagnosed with a collection of denser content retroperitoneally in the right lower quadrant of the abdomen, which in the first place was not related to possible appendicitis, regarding complaints. The existence of chronic appendicitis is a diagnosis unfamiliar to many clinicians and has no official diagnostic criteria. After diagnosis, treatment usually begins with antibiotics, and the next most common step is surgery. The optimal treatment for this condition is unknown. With this case report, we wish to draw attention to chronic appendicitis as a possible differential diagnosis in patients with chronic abdominal pain.
在急诊科,患者经常因腹痛就诊,病因多种多样,从腹腔内到腹腔外和腹膜后病变,可影响所有年龄段的患者。慢性阑尾炎是一种罕见的内科疾病,其特点是腹痛较轻且呈持续性,临床表现持续时间超过 1-2 天,并可延长数月甚至数年。我们报告了一例慢性阑尾炎病例,患者的临床表现将诊断和治疗引向了不同的方向,延误了诊断。也就是说,我们的患者经放射学诊断为右下腹腹膜后有密度较高的内容物聚集,就主诉而言,这首先与可能的阑尾炎无关。慢性阑尾炎是许多临床医生都不熟悉的诊断,也没有正式的诊断标准。确诊后,治疗通常从抗生素开始,下一个最常见的步骤是手术。这种疾病的最佳治疗方法尚不清楚。通过本病例报告,我们希望提请大家注意慢性阑尾炎可能是慢性腹痛患者的一个鉴别诊断。
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引用次数: 0
Colon Lipoma Causing Colo-Colic Intussusception in an Adult: A Case Report from Tanzania 结肠脂肪瘤导致成人结肠-结肠肠套叠:坦桑尼亚的病例报告
IF 0.6 Pub Date : 2024-01-06 DOI: 10.1155/2024/7777258
Jamil M. Suleiman, Mujaheed Suleman, Alex Mremi, Adnan Sadiq, Abbas Mohamedali, Dennis Machaku, J. Lodhia
Intussusception is rarely seen in adulthood but is commonly seen in the pediatric age group. Causes of intussusception in adults are commonly due to tumors and inflammatory diseases. Intussusception in adults accounts for less than 5% of intestinal obstruction. Colonic lipomas are usually asymptomatic and are mostly managed surgically with promising outcomes as seen in our case.
肠套叠很少见于成人,但常见于儿童。成人肠套叠的病因通常是肿瘤和炎症性疾病。成人肠套叠占肠梗阻的比例不到 5%。结肠脂肪瘤通常无症状,多采用手术治疗,效果很好,我们的病例就是如此。
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引用次数: 0
Sclerosing Encapsulating Peritonitis: Solving the Diagnosis Challenge of a Rare Entity. 硬化性包裹性腹膜炎:破解罕见病例的诊断难题
IF 0.6 Pub Date : 2023-12-27 eCollection Date: 2023-01-01 DOI: 10.1155/2023/4022487
Anwar Rahali, El Mehdi Aboulfath, Noureddine Njoumi, Mohammed Rebbani, Yasser El Brahmi, Mohammed Elfahssi, Abderrahman Elhjouji, Aziz Zentar, Abdelmounaim Ait Ali

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.

硬化性包裹性腹膜炎(SEP)是一种不常见的腹膜纤维炎性疾病,其特征是纤维膜包裹着小肠。关于这一主题的知识还不完全清楚。其病因可能是特发性的,也可能是继发于多种疾病、治疗和/或药物。我们介绍了一例 52 岁男性的病例,他患有非典型临床症状,包括反复腹水和肠梗阻。腹部计算机断层扫描显示出典型的 SEP 症状。因此,患者接受了剖腹探查术,确诊为特发性 SEP。术后,他再次出现肠梗阻,但通过使用类固醇得到了控制。对外科医生、消化科医生和放射科医生来说,SEP 的诊断确实是一项挑战。而图像对诊断非常有帮助。因此,所有医院的医生都必须区分这种病变和急性腹膜炎的其他病因。
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引用次数: 0
Incidental Discovery of Hepatocellular Carcinoma on 18F-PSMA PET CT Performed for Prostate Cancer Reassessment. 为前列腺癌复查而进行的 18F-PSMA PET CT 意外发现肝细胞癌。
IF 0.6 Pub Date : 2023-12-13 eCollection Date: 2023-01-01 DOI: 10.1155/2023/1458175
Lauren Hekman, Eva Napierkowski, Natalie C Hartman, Jeffrey L Ellis, Robert H Wagner, Davide Bova, Maria M Picken, Robert C Flanigan

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.

前列腺特异性膜抗原正电子发射断层扫描(PSMA PET)已获美国食品和药物管理局(FDA)批准,用于在生化复发的情况下鉴别前列腺癌,但也可鉴别其他恶性肿瘤。18F-PSMA PET 作为一种潜在的肝细胞癌(HCC)检测工具尚未得到研究。我们描述了这样一个病例:一名 76 岁的男性在前列腺癌明确治疗后前列腺特异性抗原 (PSA) 不断升高,但之前未进行过肝脏病理检查,18F-PSMA PET 意外发现他患有肝细胞癌。
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引用次数: 0
Schistosomiasis Involving the Central Nervous System: Case Report of a Rare Complication. 血吸虫病累及中枢神经系统:罕见并发症的病例报告。
IF 0.6 Pub Date : 2023-12-12 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9968155
Rahaf F Alanazi, Maryam Al Karawi, Abdulrahman Almalki, Fahd Sufiani, Sarmad Al Karawi

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.

导言:血吸虫病是由血吸虫侵入血液循环引起的寄生虫感染。神经血吸虫病是一种严重的脑部并发症,占报告病例的不到 2.3%。患者表现为进行性脑炎、癫痫发作或两者兼有。治疗方法包括抗寄生虫药物、类固醇和手术干预。病例介绍。我们报告了一例 44 岁女性的病例,她因一过性意识丧失(LOC)和癫痫发作前往急诊室就诊。放射学检查发现其右侧额叶脑损伤。组织病理学结果确诊为血吸虫病:结论:血吸虫病是一种寄生虫感染,常见于生活在热带地区的患者。需要通过放射学和组织病理学评估进行早期诊断,以确定有可能出现严重神经系统并发症的患者。
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引用次数: 0
Neonatal Testicular Torsion with Hydrocele: A Case Report Underscoring the Need for Early Recognition and Management. 新生儿睾丸扭转伴鞘膜积液:一例强调早期识别和处理必要性的病例报告。
IF 0.6 Pub Date : 2023-12-11 eCollection Date: 2023-01-01 DOI: 10.1155/2023/9979543
Kareem Omran, Sameh Ali Ali, Ehsan Ahmad, Hilal Matta, Wissam Jamal Al Tamr

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.

新生儿睾丸扭转(NTT)是出生后 30 天内发生的一种罕见但重要的疾病,可导致血管损伤和潜在的睾丸缺失。本文介绍了一例在双侧鞘膜积液新生儿中偶然发现的 NTT 病例,强调了早期诊断的挑战性和管理的复杂性。该婴儿接受了包括扭转术和双侧睾丸切除术在内的手术治疗,但最终因睾丸坏死而需要进行右侧睾丸切除术。本文强调了 NTT 合并鞘膜积液的发病率,并强调了家长教育和警惕随访的重要性。文中讨论了各种诊断方法(主要是超声波检查)和一系列处理策略,考虑了挽救的可能性、对侧睾丸的风险以及手术干预的风险和益处等因素。论文主张根据新生儿的具体情况和父母的偏好进行个体化管理,强调了知情和移情咨询的重要作用。该病例强调了提高意识、早期发现和慎重考虑治疗方法的迫切性,以防止出现不育和必须终身补充激素等破坏性后果。
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引用次数: 0
Colovesical Fistula due to Sigmoid Diverticulitis 乙状结肠憩室炎引起的结肠瘘
IF 0.6 Pub Date : 2023-12-04 DOI: 10.1155/2023/8835222
C. Stefanou, Spiridon Gkogkos, Stefanos Flindris, Apostolis K. Paxinos, Thomas Tsiantis, Polyxeni Oikonomou, K. Tepelenis, S. Stefanou
Introduction The incidence of colonic diverticulosis has risen significantly. Diverticular disease is the most frequent cause of colovesical fistulas, which are uncommon complications of diverticulitis. Clinical signs, such as fecaluria and pneumaturia, are typically required to confirm its presence. Finding the cause of the disease so that the proper therapy can be started is the primary goal of a diagnostic workup rather than observing the fistula tract itself. Case Presentation. We present a 43-year-old man complaining of frequent urinary tract infections for six months. On CT abdomen and pelvis, a colovesical fistula was diagnosed. Surgery was performed, and after the division between the sigmoid colon and the bladder, a sigmoidectomy and an end-to-end colorectal anastomosis were performed. During the surgery, the fistula tract was not detected. The patient was discharged in excellent condition on day six, and the catheter was removed on day 10. Conclusion In conclusion, as in our case, any patient with a urinary tract infection should be suspected of having this condition, especially if he has persistent symptoms that have not responded to standard medical care. Patients who present with fecaluria, pneumaturia, and other specific symptoms of a colovesicular fistula do not necessarily need a barium enema or cystography to confirm the presence of the fistula.
结肠憩室病的发病率明显上升。憩室疾病是引起膀胱瘘的最常见原因,而膀胱瘘是憩室炎的罕见并发症。通常需要临床症状,如粪尿和肺炎来确认其存在。诊断检查的主要目标是找出疾病的原因,以便开始适当的治疗,而不是观察瘘管道本身。案例演示。我们报告一位43岁的男性主诉频繁尿路感染6个月。腹部及骨盆CT诊断为膀胱瘘。手术后,乙状结肠与膀胱分离后,行乙状结肠切除术和端对端结肠吻合术。术中未发现瘘道。患者于第6天出院,情况良好,第10天拔除导管。总之,就像我们的病例一样,任何尿路感染的患者都应该怀疑患有这种疾病,特别是如果他有持续的症状,对标准的医疗护理没有反应。出现粪尿、肺炎和其他特定膀胱瘘症状的患者不一定需要钡灌肠或膀胱造影来确认瘘管的存在。
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引用次数: 0
Intraoperative Diagnosis of Gallbladder Volvulus. 胆囊扭转的术中诊断。
IF 0.6 Pub Date : 2023-10-31 eCollection Date: 2023-01-01 DOI: 10.1155/2023/1194077
Hassan Mohamed Ali, Eyad Rabih Abdul Wahab, Amjad Damaj, Bassam Moussawi, Walid Audi, Mohammad Haidar, Youssef Badra

Background: A gallbladder torsion typically presents as an acute abdomen presentation with nonspecific clinical signs. When not detected by a clinician preoperatively, it can lead to the delay of emergency surgery and possible misdiagnosis for other, more common causes of an acute abdomen. Case Presentation. We report the case of acute gallbladder volvulus in an 80-year-old woman complaining of constant pain in the right upper quadrant of the abdomen.

Conclusions: The patient was successfully treated with cholecystectomy. The case highlights the high index of suspicion required to diagnose the condition preoperatively in this population of patients to reduce complications such as biliary peritonitis and death.

背景:胆囊扭转通常表现为具有非特异性临床症状的急腹症。如果临床医生在术前没有发现,可能会导致紧急手术的延迟,并可能误诊为其他更常见的急腹症原因。案例介绍。我们报告了一位80岁的女性急性胆囊扭转的病例,她抱怨腹部右上腹持续疼痛。结论:患者胆囊切除术治疗成功。该病例强调了在这类患者中,术前诊断病情所需的高怀疑指数,以减少并发症,如胆汁性腹膜炎和死亡。
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引用次数: 0
Double Trouble: A Case of Gallstone Ileus as a Result of Multiple Obstructive Gallstones. 双重麻烦:一例多发性梗阻性胆结石引起的胆结石Ileus。
IF 0.6 Pub Date : 2023-10-27 eCollection Date: 2023-01-01 DOI: 10.1155/2023/7423380
Malsha Kularatna, Fransiska Falconer

Gallstone ileus is a rare condition. It accounts for approximately 1% of small bowel obstruction and is more prevalent in the elderly population. It is usually present in relatively comorbid patients posing further operative challenges. The following report investigates the management of two large gallstones resulting in two different points of obstruction. Is double trouble doubly hard to manage?

胆结石性肠梗阻是一种罕见的情况。它约占小肠梗阻的1%,在老年人群中更为普遍。它通常存在于相对共病的患者中,从而带来进一步的手术挑战。以下报告调查了导致两个不同梗阻点的两个大胆结石的处理。双重麻烦加倍难以管理吗?
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引用次数: 0
期刊
Case Reports in Surgery
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