Surgical Case Reports

Metachronous Isolated Inguinal Lymph Node Metastasis at a Previous Hernia Repair Site following Potentially Curative Surgery for Transverse Colon Cancer: A Case Report

Hiroyuki Fujimoto, et al.

INTRODUCTION: Inguinal lymph node metastasis from colon cancer is extremely rare. Therapeutic strategies have not been established regarding preventive measures for hernia recurrence following mesh removal when the mesh used in inguinal hernia repair is infiltrated by a tumor. Similarly, no treatment strategies have been developed regarding the necessity of prophylactic orchiectomy when a tumor infiltrates the spermatic cord and requires resection.

Read full article >

A Case of Fulminant Amebiasis in a Female Commercial Sex Worker in Japan Requiring Subtotal Colectomy: A Literature Review and Case Report

Seigo Kubota, et al.

INTRODUCTION: Fulminant amebiasis is a rare, potentially lethal condition caused by Entamoeba histolytica. It causes intestinal perforation and generalized peritonitis, and treatment requires an emergency operation and the administration of anti-amoebic drugs. Although E. histolytica infections are more commonly reported in men who have sex with men, we report a successfully treated case of fulminant amebiasis in a female commercial sex worker (CSW). This report presents a review of previously reported cases.

Read full article >

Conversion Surgery after Complete Response to Immune Checkpoint Inhibitor-Based Sequential Chemotherapy for Initially Unresectable Perihilar Cholangiocarcinoma: A Case Report

Takahiro Tomino, et al.

INTRODUCTION: Perihilar cholangiocarcinoma (PHCC) is often diagnosed at an advanced stage, and surgical resection is frequently precluded due to local progression, distant metastases, or insufficient liver remnant function. Although systemic chemotherapy has recently improved outcomes in unresectable biliary tract cancer, reports of conversion surgery after achieving pathological complete response (pCR) remain extremely rare, thus the role of salvage surgery remains unclear.

Read full article >

Ischemic Colitis with Perforation Occurring 15 Months after Colorectal Cancer Surgery in a Patient with Severe Heart Failure: A Case Report

Ryosuke Machi, et al.

INTRODUCTION: Ischemic colitis is a common gastrointestinal disorder. However, severe cases requiring surgical intervention are rare. Severe ischemic colitis is particularly uncommon following surgery for colorectal cancer, with a reported incidence of only 0.7%. To our knowledge, there have been no previous reports of ischemic colitis leading to perforation in the late postoperative period following colorectal cancer surgery. Herein, we report a rare case of ischemic colitis that developed following surgery for transverse colon cancer and progressed to colonic perforation despite conservative treatment, ultimately necessitating emergency surgery.

Read full article >

Robotic Pancreaticoduodenectomy Using the hinotori Surgical System with Extended Resection for Type II Circumportal Pancreas: A Case Report

Noriyuki Egawa, et al.

INTRODUCTION: Circumportal pancreas (CP) is a rare congenital anomaly in which pancreatic parenchyma encases the portal vein. CP poses significant technical challenges during pancreatic surgery, particularly in safely isolating the pancreas from the portal vein, determining the optimal transection line, and managing the pancreatic stump. This report describes a case of CP identified intraoperatively during a robotic pancreaticoduodenectomy (RPD), in which an extended resection was required to achieve a single pancreatic duct for safe reconstruction.

Read full article >

Jejunal Enterotomy for Specimen Retrieval in D-LECS: A Case Report

Kota Okuno, et al.

INTRODUCTION: Laparoscopic and endoscopic cooperative surgery for duodenal tumors (D-LECS) combines endoscopic submucosal dissection (ESD) with laparoscopic reinforcement, offering a minimally invasive option for superficial non-ampullary duodenal tumors. However, oral retrieval of resected specimens may be difficult for large or firm tumors, risking fragmentation and compromised pathological assessment.

Read full article >

A Case of Curative Resection by Minimally Invasive Surgery in Two Stages Using the Hormonal Mapping Test for Pancreatic Head ACTHoma with Multiple Liver Metastases

Shohei Motohashi, et al.

INTRODUCTION: Symptom control is sometimes as important as tumor burden control in patients with functional neuroendocrine tumors (NETs). The selective arterial calcium injection (SACI) test is widely used to localize functional NETs, particularly insulinomas and gastrinomas; however, its utility in adrenocorticotropic hormone (ACTH)-producing tumors (ACTHomas) remains unclear. We present a case of a pancreatic head ACTHoma with synchronous liver metastases in which the SACI test with venous sampling (“hormonal mapping”) enabled a safe, staged curative resection.

Read full article >

Perioperative Management of Hereditary Antithrombin Deficiency in a Patient Undergoing Minimally Invasive Thoracic Surgery: A Case Report

Hiromitsu Domen, et al.

INTRODUCTION: Hereditary antithrombin deficiency is a rare congenital disorder associated with an increased risk of venous thromboembolism, particularly during high-risk situations such as surgery. Effective perioperative anticoagulation management is critical to prevent thromboembolic complications in these patients.

Read full article >

Bladder Herniation through the Obturator Foramen Treated with Laparoscopic Transabdominal Preperitoneal Repair Using a Contralateral 3D Max Mesh: A Case Report

Ryozan Naito, et al.

INTRODUCTION: Obturator hernia is an uncommon condition. With the widespread adoption of laparoscopic surgery, incidental detection of obturator hernias has become increasingly frequent. Bladder herniation through the obturator foramen is extremely rare, with only 14 cases reported to date. Herein, we describe a rare case of obturator bladder hernia successfully repaired via the laparoscopic transabdominal preperitoneal (TAPP) approach, highlighting a novel technical modification.

Read full article >

Immune Checkpoint Inhibition as a Novel Strategy for Microsatellite Instability-High Duodenal Adenocarcinoma: A Report of Three Cases

Kojiro Shirabe, et al.

INTRODUCTION: Duodenal adenocarcinoma (DA) is an extremely rare malignancy, accounting for less than 1% of all gastrointestinal cancers. Most cases are diagnosed at an advanced stage, making curative resection difficult and leading to a poor prognosis. Recent advances in tumor immunology have identified microsatellite instability-high (MSI-H) and deficient mismatch repair (dMMR) as predictive biomarkers for immune checkpoint inhibitors (ICIs). However, clinical evidence regarding their efficacy in DA remains limited. We report 3 cases of MSI-H/dMMR DA.

Read full article >

Laparoscopic Cholecystectomy for Acute Cholecystitis in a Patient with Acquired Hemophilia A: A Case Report of Perioperative Hemostatic Management with Plasma Exchange

Koki Yasui, et al.

INTRODUCTION: Acquired hemophilia A (AHA) is a rare but potentially life-threatening bleeding disorder caused by autoantibodies against coagulation factor VIII (FVIII). Surgery in patients with AHA is challenging because of the substantial risk of severe perioperative hemorrhage. However, no consensus has been reached on the optimal perioperative hemostatic strategies, especially for urgent surgical settings that require rapid correction of coagulation function, because of the rarity of this condition.

Read full article >

Pancreatic-Type Acinar Cell Carcinoma of the Duodenum: A Case Report and Literature Review

Daisuke Shirai, et al.

INTRODUCTION: Acinar cell carcinoma (ACC) is a rare malignant tumor arising from pancreatic exocrine cells. While it typically originates in the pancreas, ectopic occurrences, especially in the duodenum, are extremely uncommon. Few reports exist of duodenal ACC, particularly those presenting as large tumors.

Read full article >