Surgical Complication of Omental Infarction in Ulcerative Colitis Following Laparoscopic Colectomy.

Omental infarction is a rare cause of acute abdomen, often mimicking more common abdominal emergencies such as appendicitis and cholecystitis, presenting significant diagnostic challenges. A 47-year-old male with a history of ulcerative colitis underwent laparoscopic total colectomy with end ileostomy. Postoperatively, he developed severe abdominal pain, chills, nausea, and increased abdominal distension.

Pulmonary embolism: a complication of endoscopic variceal treatment.

Gastric varices (GVs) are dilated veins in the stomach submucosa, typically caused by portal hypertension. A prompt diagnosis is needed, given the significant risk of bleeding and mortality. Endoscopic cyanoacrylate injections are widely adopted for treating GV due to their efficacy in preventing rebleeding with lower complication rates.

A rare case of recurrent adenoid cystic carcinoma of the breast with weak hormone receptor positivity.

Adenoid cystic carcinoma (ACC) of the breast is an exceptionally rare malignancy, accounting for less than 0.1% of all breast cancers. Despite its favorable prognosis, optimal management remains undefined due to its rarity and lack of consensus guidelines.

Who is at risk for tPA/DNase treatment failure in empyema?-protocol to identify key predictors for early surgical intervention from a retrospective study.

Background: Empyema, characterized by the accumulation of pus in the pleural cavity, poses significant treatment challenges. While intrapleural tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) therapy is effective for many patients, a substantial proportion require surgical intervention, such as video-assisted thoracoscopic surgery (VATS), following treatment failure. Identifying tPA/DNase treatment failure-associated predictors is crucial for optimizing patient management and improving outcomes.

Early CRPS Is a Heterogeneous Condition: Results From a Latent Class Analysis.

Background: Complex regional pain syndrome (CRPS) is a debilitating condition characterised by significant heterogeneity. Early diagnosis is critical, but limited data exists on the condition's early stages. This study aimed to characterise (very) early CRPS patients and explore potential subgroups to enhance understanding of its mechanisms.

Complications of Post-Roux-en-Y Gastric Bypass: A Case of Excluded Stomach Perforation.

Roux-en-Y gastric bypass (RYGB) is a common surgical treatment for morbid obesity, but rare complications involving the excluded gastric remnant can pose significant challenges. A 65-year-old female with a history of RYGB presented with sudden onset of left upper quadrant abdominal pain, bloating, nausea, and loss of appetite. Laboratory tests revealed leukocytosis.

The Role of Empiric Antifungal Therapy in Patients With Perforated Peptic Ulcer: An Updated Systematic Review and Meta-Analysis.

Fungal growth is common in intraoperative cultures of patients with perforated peptic ulcer (PPU) leading to the common use of empiric antifungal therapy, with current evidence not clearly supporting this practice. The goal of this updated systematic review and meta-analysis was to synthesize the effect of empiric antifungals in patients with PPU. Eligible studies were identified through a comprehensive literature search in the MEDLINE (PubMed) and EMBASE databases, following the PRISMA 2020 statement.

Artificial Intelligence-Driven Advances in Coronary Calcium Scoring: Expanding Preventive Cardiology.

Coronary artery disease (CAD) remains a leading global cause of morbidity and mortality, underscoring the need for effective cardiovascular risk stratification and preventive strategies. Coronary artery calcium (CAC) scoring, traditionally performed using electrocardiogram (ECG)-gated cardiac computed tomography (CT) scans, has been widely validated as a robust tool for assessing cardiovascular risk. However, its application has been largely limited to high-risk populations due to the costs, technical requirements, and limited accessibility of cardiac CT scans.

Should Mesh Plug Use Be Discontinued in Hernia Repair Practices?

Mesh plugs are commonly used in inguinal hernia repair due to their perceived efficacy in reducing recurrence rates. However, their use has been associated with significant complications, including mesh migration, chronic pain, infection, hernia recurrence, adhesions, and erosion into adjacent organs. This case series presents three patients who experienced complications from mesh plug migration post-hernia repair.

Can Intrapleural Tissue Plasminogen Activator and Deoxyribonuclease Be Used to Treat Persistent Hemothorax After Robotic Lobectomy?

Hemothorax is a serious complication following thoracic surgery, often resulting from vessel injury or rib fractures, and is typically managed with chest tube drainage. Persistent or loculated hemothorax, referred to as retained hemothorax, may require more invasive interventions, such as thoracotomy. Although the intrapleural administration of tissue plasminogen activator (tPA) and deoxyribonuclease (DNase) has shown promise in managing pleural infections, its use for hemothorax remains controversial due to bleeding risks.

Intrahepatic Rupture of Acute Cholecystitis Complicated by Septic Portal Thrombosis.

Gallbladder rupture, though rare, is a serious complication often arising from choledocholithiasis and subsequent interventions such as endoscopic retrograde cholangiopancreatography (ERCP). In this case, the patient presented with acute choledocholithiasis and underwent ERCP with sphincterotomy and stone extraction, followed by placement of a fully covered metal stent in the common bile duct (CBD). While the use of covered stents is appropriate, it is important to note that these stents can obstruct the cystic duct orifice in patients with a gallbladder.

Blunt trauma-induced complete esophageal avulsion: A case report on surgical intervention and clinical insights.

Blunt esophageal injury is an exceptionally rare condition, with complete esophageal avulsion being almost unprecedented in adults. This case study details the clinical presentation, surgical management, and postoperative course of a 50-year-old male who sustained a complete esophageal avulsion following blunt abdominal trauma. The patient presented with increasing abdominal pain two hours after falling while stepping up onto a high truck step, striking his upper abdomen on the step.

Intraosseous Hemangioma of the Iliac Bone: An Incidental Finding Mimicking Metastatic Disease.

Intraosseous hemangiomas are rare benign vascular tumors predominantly occurring in the axial skeleton. This case report describes a 44-year-old female with a history of multiple renal stones and benign breast calcifications, who was incidentally found to have a 1.2 cm lucent lesion in the left iliac bone during imaging for nephrolithiasis.

Coronary-Pulmonary Artery Fistula and critical LAD stenosis: surgical ligation and revascularization.

Coronary-pulmonary artery fistulas are rare congenital anomalies that can lead to significant clinical complications, especially when associated with coronary artery disease. We present a case of a 61-year-old male who presented with progressive dyspnea and chest discomfort. Imaging revealed a coronary-pulmonary artery fistula with 60% stenosis in the proximal left anterior descending artery.

Surgical stress as a potential trigger for spontaneous coronary artery dissection: A case report.

Introduction And Importance: Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome, predominantly affecting women without traditional cardiovascular risk factors. It is often underdiagnosed, especially in postoperative patients, due to its atypical presentation and the challenges in distinguishing it from other causes of chest pain.

Case Presentation: We report the case of a 62-year-old woman with type 2 diabetes mellitus, hypertension, hyperlipidemia, and recent bilateral mastectomy for invasive ductal carcinoma, who presented three days post-surgery with sudden onset of chest pain radiating to her left arm.

Advanced Squamous Cell Carcinoma in the Paratracheal Region: Navigating Diagnosis and Comprehensive Treatment Challenges.

This case of a paratracheal mass emphasizes the importance of early detection and flexibility in the treatment planning for advanced squamous cell carcinoma, especially when logistical challenges impact access to care. A 69-year-old woman presented with a four-month history of progressive dysphagia, significant weight loss, and the recent onset of stridor, suggesting potential airway obstruction. Imaging studies revealed a large heterogeneous mass in the superior mediastinum, extending from the base of the neck into the thoracic inlet.

A case series on parathyroid carcinoma: Diagnostic challenges and therapeutic approaches.

Introduction: Parathyroid carcinoma is an exceptionally rare endocrine malignancy, constituting <1 % of primary hyperparathyroidism (PHPT) cases. It presents with more severe hypercalcemia and higher PTH levels than benign parathyroid diseases, requiring increased clinical awareness for accurate identification and specialized management. The results of this case series may provide insight into the clinical presentation, diagnostic workup, surgical management, and prognosis of parathyroid carcinoma, supplemented by a comprehensive review of current diagnostic and therapeutic approaches.

Dormancy Leading to Late Recurrence in Breast Cancer: A Case of Hormone Receptor-Positive Supraclavicular Metastasis 10 Years After the Initial Treatment.

Breast cancer recurrence can occur many years after the initial treatment, particularly in hormone receptor-positive (HR+) cases, where the risk of late recurrence remains significant. Late recurrences are well documented, with research showing that they can happen even decades after the primary diagnosis, necessitating extended monitoring and personalized therapeutic approaches. A 65-year-old woman with a history of stage IIIC invasive ductal carcinoma, initially treated with neoadjuvant chemotherapy, bilateral mastectomies, adjuvant chemoradiation, and prolonged hormonal therapy, presented 10 years later with metastasis to the left supraclavicular lymph nodes.

Can a breast hematoma lead to hemorrhagic shock in elderly trauma patients with multiple comorbidities and reduced physiological reserve? Examining the risks and management strategies.

Breast trauma in elderly patients with multiple comorbidities can result in severe complications such as hemorrhagic shock due to the highly vascular nature of breast tissue. This case involves a 65-year-old female with a history of rheumatoid arthritis and prior breast cancer who developed a significant breast hematoma following a motor vehicle accident. Initially stable, she rapidly deteriorated with hypotension and altered mental status after imaging revealed a large hematoma with active hemorrhage.

When life-saving measures lead to trauma: Subcapsular hepatic hematoma after CPR.

Cardiopulmonary resuscitation (CPR) is a critical intervention for cardiac arrest but can result in significant internal injuries due to the force of chest compressions. Among these, subcapsular hepatic hematoma is a rare and serious complication. Here we present a 55-year-old male with a history of alcohol abuse presented with a severe ischemic stroke and subsequently required CPR due to pulseless ventricular tachycardia.

Can aspiration provide symptom relief in pneumoperitoneum for peritoneal dialysis patients? A comprehensive case presentation and analysis.

Introduction And Importance: Pneumoperitoneum, the presence of free air in the peritoneal cavity, is typically a concerning finding, often associated with gastrointestinal perforation. However, in peritoneal dialysis (PD) patients, pneumoperitoneum can occur without such severe underlying pathology, frequently due to air entering during dialysis exchanges.

Case Report: This case report discusses a 64-year-old male with end-stage renal disease (ESRD) on PD who presented with abdominal pain and distention.

Integrated approach to aortic valve replacement, coronary intervention, and aortic aneurysm in severe LV dysfunction: A case report.

Introduction And Importance: In the complex field of cardiac care, managing patients with severe aortic stenosis, coronary artery disease, aortic aneurysm, and left ventricular dysfunction poses significant challenges. Traditionally, such conditions demand highly invasive surgeries, like open-heart surgery with prolonged cardiopulmonary bypass, increasing the risk of complications and the need for mechanical circulatory support.

Case Presentation: This case report details a management of a 53-year-old with no significant past medical history who presented with a three-month history of progressive exertional dyspnea, mixed aortic valve disease, comprising severe aortic regurgitation and moderate aortic stenosis, in addition to coronary artery disease and left ventricular dysfunction.