Surgical Case Reports

Thoracoscopic Removal of a Fish Bone Retained in the Lung for Five Years without the Need for Lung Resection: A Case Report

Takaaki Nakatsukasa et al.

INTRODUCTION: The accidental ingestion of fish bones is a common clinical occurrence, especially in regions with high fish consumption. While most foreign bodies pass uneventfully or are removed endoscopically, sharp objects such as fish bones may perforate the gastrointestinal tract and migrate to adjacent organs, occasionally leading to severe complications. Migration into the lung parenchyma is extremely rare.

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Mitral Valve Repair for Mitral Regurgitation Associated with Antiphospholipid Syndrome: A Case Report

Masaru Yoshikai, et al.

INTRODUCTION: Antiphospholipid syndrome (APS) is a multisystem autoimmune disorder of hypercoagulability, characterized by arterial and venous thrombosis, recurrent fetal losses, thrombocytopenia, and circulating antiphospholipid antibodies. Among valvular manifestations associated with APS, mitral regurgitation (MR) is the most common, followed by aortic regurgitation. Surgical interventions for APS-related valvular diseases carry high perioperative morbidity and mortality. There are no established guidelines regarding the surgical management of APS-related MR.

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Esophageal Perforation Following Pneumatic Dilation in Esophageal Achalasia Successfully Managed with Two-Stage Laparoscopic Surgery

Yuki Sakai, et al.

INTRODUCTION: Endoscopic treatment frequently results in minimal gastrointestinal content leakage and mild symptoms. However, surgical intervention may become necessary when the patient’s general condition is unstable. Further management of the underlying disease is required in cases where esophageal perforation occurs during endoscopic treatment. This report presents a case of esophageal perforation that occurred during the treatment of achalasia, underscoring the success of a two-stage laparoscopic approach.

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Cardiac Tamponade from Chylopericardium Following Lobectomy and Mediastinal Lymph Node Dissection for Lung Cancer: A Case Report

Masakazu Katsura, et al.

INTRODUCTION: Chylopericardium is a rare but serious complication after thoracic surgery, caused by injury to thoracic duct tributaries during procedures like lymph node dissection. It leads to chylous fluid in the pericardial cavity. Prompt diagnosis is vital to prevent cardiac tamponade, malnutrition, and immunosuppression due to disrupted lymphatic drainage.

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Surgery Experience with Calcified Amorphous Tumor of the Mitral Valve Complicated by Infective Endocarditis

Kazuki Iwamoto, et al.

INTRODUCTION: Cardiac calcified amorphous tumors (CAT) are non-neoplastic cardiac lesions composed of calcified nodules. These lesions are associated with underlying factors such as hypertension, diabetes mellitus, and end-stage renal dysfunction. However, its association with infective endocarditis remains unclear.

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Amebic Liver Abscess in a Patient with Polycystic Liver Disease: A Case Report

Mamoru Matano, et al.

INTRODUCTION: Amebic liver abscess is a parasitic infection caused by Entamoeba histolytica, which reaches the liver via the portal circulation after invading the colon. While it typically presents with fever, right upper quadrant pain, and elevated inflammatory markers, its clinical and radiologic features can resemble those of bacterial liver abscesses. In patients with structural liver abnormalities, such as polycystic liver disease, symptoms may be atypical and delay diagnosis.

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Thoracic Reconstruction Using a Poly-L-Lactic Acid Mesh Plate for an Infant with Pectus Excavatum and Complex Congenital Heart Disease Preventing Chest Closure

Masaya Yamoto, et al.

INTRODUCTION: Pectus excavatum (PE) is the most common anterior chest wall deformity, but surgical intervention during infancy is rarely indicated. In patients with complex congenital heart disease (CHD), however, PE may severely compromise mediastinal capacity, particularly after repeated sternotomies. Although delayed sternal closure is a standard approach to address postoperative hemodynamic instability, in cases where chest wall deformity directly compresses the heart, definitive thoracic reconstruction may be required.

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Long-Term Survival after Surgical Resection and Radiotherapy for Anterior Mediastinal Neuroblastoma in an Older Patient: A Case Report

Ayako Hirai, et al.

INTRODUCTION: Neuroblastoma is commonly seen in children younger than 5 years but is extremely rare in adults. There are only 23 reported cases of mediastinal neuroblastoma in adults, and no standard treatment strategy has been established.

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Multiple Pulmonary Cavernous Hemangioma: A Case Report

Shinogu Takashima, et al.

INTRODUCTION: Pulmonary cavernous hemangioma (PCH) is extremely rare and, due to the lack of specific radiological characteristics, is often misdiagnosed as other pulmonary diseases, including metastatic tumors. Here, we report a case of multiple PCH lesions with concomitant hepatic cavernous hemangioma (HCH), emphasizing the diagnostic implications of imaging findings.

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Pulmonary Artery Intimal Sarcoma Mimicking Intraluminal Seeding: A Case Report

Akira Akazawa, et al.

INTRODUCTION: Pulmonary artery intimal sarcoma (PAIS) is a rare vascular malignancy. Complete surgical resection is crucial for favorable outcomes; however, intraoperative delineation of the tumor extent poses a significant challenge.

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Splenic Torsion in a Patient with Polysplenia Syndrome and Dorsal Pancreatic Agenesis: A Case Report

Kensuke Kishida, et al.

INTRODUCTION: Partial splenic torsion in polysplenia syndrome is an extremely rare condition. We encountered and performed surgery for a case of partial splenic torsion in a patient with polysplenia syndrome coexisting with agenesis of the dorsal pancreas.

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A Case of Postoperative Wernicke Encephalopathy Mimicking Cerebellar Infarction Complicated by Postoperative Nausea and Vomiting: A Critical Diagnostic Pitfall for Thoracic Surgeons

Tomonari Oki, et al.

INTRODUCTION: Wernicke encephalopathy (WE) is a potentially life-threatening neurological disorder caused by a thiamine deficiency, most commonly associated with alcoholism or malnutrition. Although its occurrence after gastrointestinal surgery has been increasingly recognized, WE following thoracic surgery remains extremely rare and is often underrecognized by thoracic surgeons. Given that neurological symptoms of WE can mimic those of cerebral infarction, a timely diagnosis is challenging, especially when complicated by postoperative nausea and vomiting (PONV).

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