Open Access Case Report

The Cystoscope – An Alternative Choledochoscope for Open Operative Bile Duct Stones Localization and Removal

R. Gazdar, P. J. Halder, A. Boxwalla, R. Kacheri

Asian Journal of Case Reports in Surgery, Page 21-25

Background: Large bile duct stones removal is a problem.  It has been reported that the impact of open choledochoscopy for reducing the rates of missed stones after Common Bile Duct (CBD) stone clearance.

Aim: To highlight an alternative way to visualize the bile duct intraoperatively using a cystoscope as a choledochoscope.

Case Presentation: A 30-year-old female presented in the department of Gastrointestinal and Hepatopancreatobiliary Surgery, Jagjivan Ram Hospital, Mumbai Central, Mumbai, India with obstructive jaundice and cholangitis. She had a past history of laparoscopic cholecystectomy in the year 2013 and an open Common Bile Duct (CBD) exploration for stones in the year 2019. Recent imaging studies showed a large stone in the distal CBD. Endoscopic Retrograde Cholangiopancreatography (ERCP) stone removal and CBD stenting attempt was unsuccessful. During the Open CBD exploration (OCBDE), the stone had slipped into the left hepatic duct and was finally localized and removed using a cystoscope as a ‘choledochoscope’. The cystoscope is a useful alternative for localization and removal of bile duct stones in the absence of a choledochoscope.

With this in mind, the case report also highlights the role of choledochoscopy for locating the slipped stone(s) and confirming stone clearance.

Conclusion: Cystoscope as a choledochoscope is useful for locating the slipped stones and preventing missed stones in OCBDE.

Open Access Case Study

Strangulated Umbilical Hernia on Peritoneal Dialysis: A Case Report

Driss Erguibi, El Batloussi Youssra, Fakhri Yassine, Naoufal Mtioui, Afifi Rania, Ramdani Benyouns, Rachid Boufettal, Saâd Rifki Jai, Farid Chehab

Asian Journal of Case Reports in Surgery, Page 1-5

Abdominal wall hernia is a frequent complication in peritoneal dialysis. Their prevalence varies between 7% and 27.5%. Established risk factors are male sex, an older age, multiparity and obesity. Polycystic kidney disease is controversial risk factors. The diagnosis is mainly clinical, though peritoneography imaging can be useful in difficult cases. Complications of abdominal wall hernia are a strangulation, incarceration, bowel occlusion and peritonitis; may result in death. A surgical repair is recommended. We report a case of strangulated umbilical hernia on peritoneal dialysis and also presenting the epidemiological, clinical and therapeutic features of this pathological association.

Open Access Case Study

Pancreatic Metastasis from Malignant Phyllodes Tumor of the Breast: A Rare Case Report and Literature Review

M. Shahimin, P. B. C. Pang, N. Hidayah, H. R. Aznim, A. Awang, J. Sidhu, Sadhana Mahamad

Asian Journal of Case Reports in Surgery, Page 6-15

Phyllodes tumors (PTs) are defined as a fibroepithelial neoplasm of the breast. Although most of the Phyllodes tumors are benign, malignant cases do uncommonly occur. Pancreatic metastasis from malignant Phyllodes tumor is extremely rare, and only 5 cases have been reported in the literature. We presented a case of a pancreatic metastasis in a patient diagnosed with a malignant phyllodes tumor who had completed her treatment two years ago. Our objective is to draw the readers’ attention to the possibility of pancreatic metastases from malignant phyllodes tumor in patients who had remission of malignant phyllodes and presented with signs and symptoms of primary pancreatic carcinoma.

Open Access Case Study

Hemangio Pericytoma of the Nasal Cavity

A. Raihane, Y. Oukessou, S. Rouadi, R. Abada, M. Roubal, M. Mahtar

Asian Journal of Case Reports in Surgery, Page 16-20

Hemangiopéricytoma (HP) is a rare, slow growing intranasal vascular tumour. Initially not very symptomatic, it is difficult to diagnose. The clinician should be alerted by a persistent unilateral nasal symptomatology and by the endoscopic appearance of a gray polypoid tumor. The diagnosis of certainty is histological, but biopsies are delicate, given the risk of hemorrhaging. The malignant potential of this tumor involves surgical removal. The pre-therapeutic assessment includes a naso-sinus scanner with iodine injection and magnetic resonance imaging (MRI). Some propose arteriography with pre-operative embolization. The reference surgical technique remains the para-latero-nasal pathway but endoscopic excisions have recently been reported.

Open Access Case Study

Successful Osmotic Reduction of Prolapsed Stoma Using Table Sugar: A Case Report

Mounir Bouali, Karim Yaqine, Abdelilah Elbakouri, Khalid Elhattabi, Fatimazahra Bensardi, Abdelaziz Fadil

Asian Journal of Case Reports in Surgery, Page 26-29

Stoma prolapse is a well-described complication after ileostomy or colostomy, it is typically asymptomatic and easily reduced. Acute incarceration of a prolapsed stoma is a rare event and a surgical emergency. In the presence of a prolapse, a very edematous one, the application of table sugar on the prolapsed segment for a few minutes reduces the edema by osmotic effect and causes or facilitates the reduction.

This case reports the successful application of sugar to a 45-year-old woman to reduce a prolapsed colostomy, eliminating the need for urgent surgery.

Successful reduction can prevent an emergent operation, allowing for medical optimization and elective surgical treatment if necessary.