Journal of surgical case reports
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A malignant fungating wound is a cutaneous infiltration of malignant tumor or metastatic lesion that develop into ulceration. Local control is often difficult to obtain, because the Quality of Life of patients can decrease considerably due to bleeding, exudation, odor and pain from the wound. ⋯ Mohs' paste controlled the infection, odor and exudation in approximately 2 weeks, and good visualization of the surgical field was obtained due to tumor volume reduction. We found that Mohs' paste is effective as a neoadjuvant therapy for disintegrated soft tissue sarcoma.
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The urachus is an embryonic tube that connects the upper portion of the bladder to the umbilicus, and obliterates normally during embryonic development stages forming the median umbilical ligament. Incomplete obliteration of this tube results in many anomalies such as congenital patent urachus, umbilical urachal sinus, vesicourachal diverticulum and urachal cyst. ⋯ We performed an exploratory laparotomy and found a mass above the bladder connected to the umbilicus; we excised the mass and sent a specimen to pathology that confirmed Urachal cyst. Urachal cyst is usually asymptomatic unless it is complicated; depending on our case, we recommend surgical management by complete excision for complicated urachal cyst.
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Case Reports
A rare anatomical variant: transosseous supraclavicular nerve identified during clavicle fracture fixation.
We describe a rare case of an anatomical variant of the supraclavicular nerve in the intra-operative setting of clavicle fixation for a fracture. Intra-operatively it was noted that one of the supraclavicular nerves was passing through a foramen in the clavicle shaft. A 60-year-old gentleman presented with a displaced multifragmentary fracture of the left clavicle after a fall. ⋯ Post-operatively the patient was left with some incisional chest numbness. Surgeons should aim to preserve the branches of the supraclavicular nerve although this may not always be possible as we have demonstrated. The patient should be warned about potential deficit.
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Case Reports
Cardiac tamponade communicating with a posterior mediastinal chylocele after esophagectomy.
A 75-year-old male received neoadjuvant chemotherapy for locally advanced squamous cell carcinoma of the mid-thoracic esophagus, followed by right transthoracic esophagectomy with extended mediastinal lymphadenectomy. Cardiac tamponade developed on postoperative Days 1 and 13, for which emergency ultrasound-guided drainage was required. Pericardial drainage fluid became chylous after administration of polymeric formula. ⋯ Based on these findings, the diagnosis of chylopericardial tamponade communicating with a posterior mediastinal chylocele was made. The ligation of the thoracic duct was successfully performed via the left-sided thoracoscopic approach on postoperative Day 20 and the clinical course after the second operation was uneventful. The possible mechanisms of this exceptionally rare complication after esophagectomy were discussed.
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Case Reports
Sub-capsular effusion of liver as a rare complication of ventriculoperitoneal shunt in a child.
The most common procedure to deal with hydrocephalus is ventriculoperitoneal (VP) shunt. The purpose of the shunt is to drain cerebrospinal fluid from cerebral ventricles to abdominal cavity. ⋯ However, sub-capsular effusion of liver is a rare complication of VP shunt. In this case report, We described an unusual case of VP shunt complication in a 2-year-old child who presented with intermittent fever and abdominal pain.