Surgery Case Reports

Journal Information
ISSN / EISSN : 2733-225X / 2733-225X
Published by: Science Repository OU (10.31487)
Total articles ≅ 48
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Hirotaka Kato, Masaaki Deguchi, Yoshifumi Sakata
Published: 27 September 2022
Surgery Case Reports, Volume 2022, pp 1-3; https://doi.org/10.31487/j.jscr.2022.02.03

Abstract:
Introduction: Urachal remnants, such as the vesicourachal diverticulum, or urachal cysts are rarely involved in calculus or calcification. There are currently no case reports of urachal remnants with calculus just below the umbilicus. Case Presentation: A healthy 28-year-old man presented with umbilical drainage. Abdominal computed tomography showed inflammation just below the umbilicus with calculus. The patient was diagnosed with ombilitis with a urachal remnant and underwent laparoscopic resection for the urachal remnant after the attenuation of ombilitis. Surgical findings showed that the omentum adhered to the abdominal wall along with the urachal duct. The urachal duct with calculus was resected at the top of the bladder. The main component of calculus was silicic acid. Pathological findings were compatible with a urachal remnant and there was no evidence of a malignant tumor. Discussion: The main component of calculus is derived from necrotic material caused by inflammation because silicic acid was detected, indicating a different etiology from that of urinary calculus. Conclusion: We encountered a rare case of a urachal remnant with calculus below the umbilicus.
Christopher K. Mehta, Sandeep N. Bharadwaj, Stephen F. Chiu
Published: 12 September 2022
Surgery Case Reports, Volume 2022, pp 1-4; https://doi.org/10.31487/j.jscr.2022.02.01

Abstract:
Background: A 49-year-old male presented with a delayed diagnosis of infective endocarditis leading to extensive intracardiac destruction. Such cases present technical challenges to operative debridement as crucial anchoring points for replacement conduits are compromised. Case Presentation: Our patient presented at age 49 with nausea, lethargy, and diarrhea 2 weeks after recent travel. His prior history included bioprosthetic valve replacement for a bicuspid aortic valve. The patient was first given a trial of antimicrobials for a suspected UTI. Subsequently, he was admitted briefly to an outside hospital for a “cardiac work-up,” which returned negative. The patient sought care for the third time, during which he developed unstable supraventricular tachycardia, prompting echocardiography 16 days following the onset of symptoms. Echocardiography demonstrated a 6 cm abscess cavity invading the interventricular septum with a fistula into the left ventricular outflow tract, multiple ventricular septal defects (VSD), and suspected fistulae into the right ventricular outflow tract. The patient was treated with valve explant and extensive debridement. A valved-conduit for the aorta could not be sewn to the aortic annulus in the usual fashion due to destruction and debridement of the annulus, so a neo-annulus was created using the anterior leaflet of the mitral valve and the left ventricular outflow tract of the heart below the level of the VSDs. A mechanical-valved conduit was implanted onto the neo-annulus. A pacemaker was subsequently implanted. Conclusion: In patients with extensive intracardiac destruction with the compromise of the aortic annulus due to infective endocarditis, a low-seated, mechanical-valved conduit implanted directly to the aorto-mitral curtain and left ventricular outflow tract should be considered a novel, durable reconstructive option that allows complete debridement of infected tissues.
Nigro Belen, Ferrari-Ayarragaray Javier Eduardo
Published: 9 July 2022
Surgery Case Reports, Volume 2022, pp 1-4; https://doi.org/10.31487/j.jscr.2022.01.02

Abstract:
Takayasu´s arteritis is a rare inflammatory disease of large- and medium-sized arteries which predominantly affects women of middle-aged. We report an unusual case of Takayasu arteritis in a 54-year-old woman presenting with progressive lower limbs intermittent claudication. Aneurysmal and stenotic vascular lesions involving both common iliac arteries were identified which also represents a very uncommon anatomical distribution in this pathology. In addition, we share our experience with endovascular intervention for stenotic lesions.
Lim Han Sim, Khoh Phaik Shan, Chan Sook Kwan, Zairul Anuar B Kamarul Bahrin
Published: 7 July 2022
Surgery Case Reports, Volume 2022, pp 1-3; https://doi.org/10.31487/j.jscr.2022.01.05

Abstract:
Tongue bite injuries (TBI) resulting from the use of intra-operative neuromonitoring (IONM) during spinal surgeries are not as uncommon a complication as previously thought, especially when using transcranial motor evoked potential (TcMEP). The incidence of bite injuries ranged from 0.14% to 0.63%, with TBI occurring four times more frequently than lip injuries, and of these, 0.15% of tongue lacerations required surgical repair. Through our literature search, we discovered that these injuries have never been reported in Malaysia; additionally, this is the first incidence encountered by our team. We are reporting a 20-year-old male who sustained a TBI during posterior scoliosis corrective surgery while using TcMEP. We report on its management and reviewed literatures to explain the causes and the recommendations for the prevention of this injury. In conclusion, TBI is an unpleasant complication in spinal surgery related to the use of IONM. Safety precautions need to be taken during surgical preparation, and we propose using two to three soft bite blocks (SBB) to aid in reducing the rate of this complication.
Hashem Aliter, Daniel Neira, Claudio Diquinzio, Mathieu Castonguay, Keir Stewart
Published: 29 June 2022
Surgery Case Reports, Volume 2022, pp 1-2; https://doi.org/10.31487/j.jscr.2022.01.04

Abstract:
We report a case of early thrombosis of a sutureless Perceval valve after aortic valve replacement (AVR). Previous reports described Perceval AV thrombosis between 1-12 months [1, 2]. However, the patient was diagnosed with valve dysfunction 3 days later.
Arthur Gustavo Fernandes, Pedro A Rebello, Melina C Morales, Juliana Hs Mascato, Rodrigo B Fernandes
Published: 29 June 2022
Surgery Case Reports, Volume 2022, pp 1-4; https://doi.org/10.31487/j.jscr.2022.01.03

Abstract:
Choroidal melanoma is the most common primary intraocular malignancy in adults. Herein, the authors report two cases of subretinal hemorrhage associated with it. The first case presented with a large choroidal mass associated with subretinal hemorrhage, no history of trauma and choroidal melanoma diagnosis on ultrasound. The second case was initially diagnosed with retinal detachment but during the surgery a pigmented subretinal mass was observed, starting to bleed after scleral depression. Subretinal hemorrhage can occur due to ruptures in Bruch's membrane spontaneously or precipitated by inadvertent trauma. Despite an unusual manifestation, it should always be considered avoiding misdiagnosis.
I. Zeroual, A Zahraoui, R Hachimi Alaoui, M Miloudi, H Abid, M El Idrissi, A El Ibrahimi, A El Mrini
Published: 24 May 2022
Surgery Case Reports, Volume 2022, pp 1-2; https://doi.org/10.31487/j.jscr.2022.01.01

Abstract:
Simultaneous ipsilateral femoral neck and trochanteric fracture is a rare injury. it occurs most commonly in elderly patients with low energy trauma. Its management present a significant challenge to the orthopaedic surgeons. We report the case of 77 years old male, who sustained simultaneous transcervical femoral neck and intertrochanteric fractures caused by an olive tree fall. The patient was treated with a standard gamma nail, with a satisfactory functional result at 3 months follow-up.
Long Jiahuan Xanicia, Ng Kok Kit
Published: 15 October 2021
Surgery Case Reports pp 1-6; https://doi.org/10.31487/j.jscr.2021.02.03

Abstract:
Renal lymphangiectasia (RLM) is a rare condition characterized by dilatation of perirenal, parapelvic or intrarenal lymphatics. We report an unusual case of bilateral RLM in a 20-year-old Malay male who presented with 1 month duration of bilateral flank pain. Bedside ultrasound showed bilateral perinephric collections, which were further confirmed on computer tomography intravenous pyelogram (CT IVP). Other causes of perinephric collections were ruled out based on laboratory and radiological findings, and he was managed conservatively as for RLM with surveillance ultrasound kidneys at 3 to 6 monthly intervals.
John Petrie Iv, Arvind Manisundaram, Irene Yu, Steven Schwaitzberg
Published: 30 September 2021
Surgery Case Reports, Volume 2021, pp 1-3; https://doi.org/10.31487/j.jscr.2021.02.02

Abstract:
Introduction: A 46-year-old female with a past medical history of Graves’ disease refractory to medical management, thus requiring total thyroidectomy presented to clinic for recurrence of her hyperthyroidism and an increasing midline neck mass two years after her index operation. Case Description: CT imaging of the neck mass revealed a locally extensive enhancing abnormality immediately anterior to the hyoid bone within the infrahyoid muscles measuring 1.4x.1.9x4.0 cm. This was consistent with an exceedingly rare proliferation of a thyroglossal duct remnant secondary to recurrence of the patient’s Graves’ disease. The patient was treated with surgical resection of the neck mass shown to be ectopic Graves’ activated thyroid tissue by pathology. The patient was restarted on thyroid hormone replacement therapy and has remained euthyroid to date following surgical resection. Conclusion: The incidence of this event is estimated to be approximately one per a million persons and thus is a rare occurrence in endocrinology. This case highlights the potential shortcomings of surgical management of Graves’ disease. Following surgical resection, the autoimmune status of the patient remains unchanged. Ectopic thyroid tissue can be found anywhere along the embryologic descent of the thyroid gland and as low as the mediastinum. Thus, patients treated with total thyroidectomy should still be monitored regularly for recurrence of Graves’ disease secondary to ectopic thyroid tissue.
Jessica Audet, Brittany Noel Robles, Nicolle M Arroyo Lluberas, Daniel Faustin, Ralph Ruggiero
Published: 3 September 2021
Surgery Case Reports, Volume 2021, pp 1-3; https://doi.org/10.31487/j.jscr.2021.02.01

Abstract:
Ectopic pregnancy is a quite common and life-threatening pregnancy. The most common site of ectopic implantation of a fertilized embryo is the fallopian tube. In extremely rare situations, the embryo can implant in other locations, which makes the diagnosis and management even more complex. Although close observation of a new pregnancy is key in the diagnosis and treatment of an ectopic pregnancy, there is still a major risk of life-threatening outcomes. This is a case report of a 31-year-old patient with a history of multiple pregnancies who presented to a community hospital in the spring of 2021 with an ectopic caesarean scar pregnancy. A diagnosis of ectopic pregnancy was on a timely basis, and surgical management was advised. Upon refusal of treatment and admission, pharmacological management was initiated, but patient compliance challenged the success of the therapy. Patient non-compliance to close follow-up resulted in a ruptured uterus. Emergency laparotomy with supracervical hysterectomy was performed as a life-saving procedure.
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