Journal of Surgical Case Reports and Images
Latest articles in this journal
Journal of Surgical Case Reports and Images, Volume 5, pp 01-08; https://doi.org/10.31579/2690-1897/105
Objectives: Aim of the study was to compare central venous oxygen saturation (ScvO2) and regional cerebral oxygen saturation (rSO2) to see which of the two is better predictor of prognosis of patients undergoing off–pump coronary artery bypass grafting (OPCABG). Heart rate (HR), invasive blood pressures, and partial pressure of oxygen (pO2) have also been recorded to see if they are independent predictors of prognosis in OPCABG patients. Materials and Methods: A total of 56 patients undergoing OPCABG were included in the study. Baseline values and intraoperative values of ScvO2, rSO2, HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), pO2 at different time periods were recorded. Post-operatively the patients were shifted to Intensive care unit (ICU) on elective ventilation, and time to extubation since shifting to ICU were noted. Results:The ScvO2 values after sternal closure (correlation coefficient r= -0.4821, P=0.0002), and on shifting to ICU (correlation coefficient r= -0.4575, P=0.0004) showed strong correlation with time to extubation. Similarly the rSO2 values after sternal closure (correlation coefficient r=-0.5198, P<0.0001) and on shifting to ICU (correlation coefficient r = -o.5498, P0.05). Conclusion:ScvO2 and rSO2 both have strong correlation with time to extubation and are capable of predicting prognosis in OPCABG patients.
Journal of Surgical Case Reports and Images, Volume 5, pp 01-03; https://doi.org/10.31579/2690-1897/099
Background: Large bowel obstruction due to pancreatic tail carcinoma is extremely rare. Case report: We present a case of large bowel obstruction and cecal perforation due to carcinoma of the tail of the pancreas. Conclusion: Despite of the poor prognosis of the cases reported so far, our patient is alive and disease free 12 months after emergent aggressive surgical therapy and adjuvant therapy.
Journal of Surgical Case Reports and Images, Volume 5, pp 01-03; https://doi.org/10.31579/2690-1897/096
Case: Eighty-three years old female patient who sustained a simultaneous bilateral hip fractures after a mechanical fall. The bilateral nature of the problem was not appreciated by the emergency team and was found after the orthopedic consultation. The patient underwent a single stage bilateral cemented bipolar hemiarthroplasty without perioperative complications. Conclusion: Simultaneous bilateral hip fractures in elderly are not commonly encountered after a low energy mechanism but early recognition of this diagnosis is important to optimize perioperative management. Having bilateral cemented stems did not lead to any significant cardiopulmonary complications as can often be concerned with so called cement syndrome.
Journal of Surgical Case Reports and Images, Volume 5, pp 01-06; https://doi.org/10.31579/2690-1897/098
Foot injuries make up a not insignificant proportion of sports injuries, but the kind of frequency varies depending on the sport. According to the 2018 Sports Report of the Verwaltungs-Berufsgenossenschaft (VBG), basketball accounted for 7.4 % of foot injuries
Journal of Surgical Case Reports and Images, Volume 5, pp 01-03; https://doi.org/10.31579/2690-1897/081
Renal cell carcinomas are tumors known for their metastatic potential. The lungs, the lymph nodes, the lungs, the spleen, the adrenal gland and the cervix remain the metastatic sites of predisposition. The symptoms of metastatic lesion may be due to the initial manifestation of renal malignancy. We report in this work a buccal localization of metastases from renal cell carcinoma to clear cells in a patient aged 65 years or less in our department of otolaryngology and cervical-facial surgery.
Journal of Surgical Case Reports and Images, Volume 5, pp 01-09; https://doi.org/10.31579/2690-1897/094
Bisphosphonate (BP) therapy for moderate to severe osteogenesis imperfecta (OI) has become a mainstay of treatment in the last three decades. Given the significant improvements in bone mineral density and theoretical reductions in fracture risk, many patients are treated with bisphosphonates for prolonged periods of time. There currently lacks consensus in the optimal duration of BP therapy for patients with OI, and patients are often treated on a case-by-case basis. Long-term BP therapy has been associated with atypical femur fractures in adult patients treated for osteoporosis. The American Society for Bone and Mineral Research concluded that the median duration of BP therapy in patients with atypical femur fractures was 7 years. The role of long-term BP therapy in OI patients with atypical femur fractures remains unclear. Here, a case report is presented of an adolescent patient with type V OI that sustained a subtrochanteric femur fracture with features of an atypical pattern following treatment with intravenous pamidronate for 10.5 years. At the time of injury, the contralateral femur was also found to have atypical features suggestive of an impending fracture. The completed fracture was treated with closed reduction and cephalomedullary nail fixation. The impending fracture was prophylactically stabilized using the same technique. Prior to the injury, limb-length radiographs obtained to evaluate lower extremity alignment demonstrated features of an impending fracture but went unnoticed. Further studies are needed to clarify the role of long-term BP therapy in patients with OI suffering from atypical femur fractures.
Journal of Surgical Case Reports and Images, Volume 5, pp 01-04; https://doi.org/10.31579/2690-1897/093
Osteoid osteoma is a benign tumor that accounts for roughly 10-12% of all benign bone forming tumors. This tumor generally occurs within the first three decades of life and occurs more commonly in males. This lesion is painful and is generally worse at night and has relief of symptoms with the use of NSAIDs. Osteoid osteoma is characterized by the production of osteoid surrounded by a rim of sclerotic bone. These lesions most commonly occur in long bones such as the proximal femur, however they can occur anywhere. Rarely, as with our patient, have these lesions been reported in the acetabulum.
Journal of Surgical Case Reports and Images, Volume 5, pp 01-03; https://doi.org/10.31579/2690-1897/101
Chronic exertional compartment syndrome (CECS) is a serious, yet underdiagnosed condition that can cause severe lower extremity pain in running athletes. CECS is a transient increase in compartment pressure leading to severe pain, paresthesia, and vascular compromise. Understanding the detailed anatomy is paramount to proper diagnosis and treatment. Diagnosis is made with measuring compartments pressures before and after exercise at certain time intervals. When properly diagnosed and treated, CECS can be appropriately managed and patients can return to their previous level of activity.
Journal of Surgical Case Reports and Images, Volume 4, pp 01-05; https://doi.org/10.31579/2690-1897/082
Background: Sentinel lymph node biopsy (SLNB) is standard of care in clinico- radiologically negative axilla in early breast cancer case. It’s an oncologically safe alternative to Axillary lymph node dissection (ALND), however factors predicting sentinel node metastasis in Indian population is lacking. Methods: A prospective observational study which recruited 80 patients with breast cancer who underwent SLNB with or without ALND, with evaluation of predictive factors including size, type and quadrant , hormonal status of breast this characteristics were prospectively analyzed to predict the axillary metastasis and need of SLNB . Result: Mean age of the patients included in our study was 52.4 years. On univariate analysis, size (p<0.013), upper outer quadrant (UOQ) (p<0.038), central quadrant (CQ) (0.07) were significantly associated with axillary node metastasis in T2 tumors. While on multivariate analysis, UOQ (P<0.009), CQ (p<0.02) metastasis were associated with axillary node metastasis in T2 tumors. Overall sensitivity, specificity, positive predictive valve (PPV) and negative predictive valve (NPV) of SLNB in predicting axillary node status was 77.59%, 100%, 100% and 62.86% respectively. The overall accuracy was 83.7%. Conclusion: Upper outer quadrant, central quadrant and size of the tumors are important prognostic factors to predict axillary node metastasis without the need of sentinel node biopsy in early breast cancers.
Journal of Surgical Case Reports and Images, Volume 4, pp 01-04; https://doi.org/10.31579/2690-1897/088
Gallstone ileus is common in elderly female population. To obtain a diagnosis of gallstone ileus is a challenge requiring clinical and radiological assistance. It’s a rare cause of intestinal obstruction, accounts approximately 1-4%. Here we report a case of 56 years old lady presented with intestinal obstruction sign and symptoms. Per abdomen examination revealed generalised tenderness with sluggish bowel sound. Abdominal X-ray revealed prominent small bowel with presence of gas till rectum. CT abdomen noted intraluminal mass over distal small bowel loops mimickering intusseption. Exploratory laparotomy with small bowel enterotomy was performed. Intra-operative finding noted impacted gallstone measuring 2x3cm, 360cm from duodenal-jejunal flexure and 50cm from terminal ileum. Post-operative patient had speedy recovery and discharged home. Here we emphasize in elderly female patient presented with sign and symptoms of intestinal obstruction, diagnosis of gallstone ileus should be one of differential diagnosis.