Pancreaticoduodenectomy with Preservation of a Prior Hepaticojejunostomy for Ampullary Carcinoma: A Case Report

Yasunori Uesato, et al.

INTRODUCTION: Pancreaticoduodenectomy (PD) can be technically challenging in patients who previously underwent biliary reconstruction, particularly hepaticojejunostomy. The optimal strategy for managing a prior hepaticojejunostomy during PD has not been well established.

Solid Pseudopapillary Neoplasm of the Pancreas Showing Spontaneous Regression Followed by Regrowth: A Case Report

Yuji Ikeda, et al.

INTRODUCTION: Solid pseudopapillary neoplasm (SPN) of the pancreas is a rare, low-grade malignant tumor. Although SPNs generally exhibit indolent behavior, spontaneous regression detected on CT imaging is exceedingly rare, and to the best of our knowledge, regrowth following regression has not been previously reported.

Standard-Based Port-Sharing Workflow for Simultaneous Robot-Assisted Distal Gastrectomy and Right-Sided Colectomy: A Case Report

Sho Ueda et al.

INTRODUCTION: Synchronous gastric and colorectal cancers occur in approximately 4% of patients. Although simultaneous resection is common in laparoscopic surgery, robot-assisted simultaneous procedures are less frequently reported because of logistical constraints in multi-quadrant targeting and port geometry. Herein, we describe a standardized and reproducible workflow using the da Vinci Xi system (Intuitive Surgical, Sunnyvale, CA, USA) that focuses on strategic port sharing and planned redocking.

Open Thoracoabdominal Aortic Replacement in a Long-Term Survivor of Early-Onset Marfan Syndrome

Yuma Yokoyama, et al.

INTRODUCTION: Early-onset Marfan syndrome (eoMFS) is a rare and severe connective tissue disorder marked by cardiovascular complications in early life. It carries a poor prognosis, often causing death within the first 2 years of life due to heart failure. However, aggressive medical management and early surgical intervention can result in long-term survival, and these patients may subsequently develop aortic disease in early adulthood. Herein, we present a rare case in which we successfully treated an aortic dissection in a patient with eoMFS.

A Case of Colon Cancer-Induced Hemophagocytic Lymphohistiocytosis with Lymphangitic Carcinomatosis

Ayaka Tachikawa, et al.

INTRODUCTION: Hemophagocytic lymphohistiocytosis (HLH) is a syndrome involving extreme hyperinflammation driven by a cytokine storm, which leads to the pathological autophagocytosis of blood cells. Although secondary HLH is frequently associated with underlying malignancies, the majority of which are hematological, cases triggered by colorectal cancer are quite rare. We report herein a case of HLH induced by ascending colon cancer.

Laparoscopic Peritoneal Flap Closure for Internal Hernia Associated with Colostomy: Two Case Reports

Ryo Kanoda, et al.

INTRODUCTION: Internal hernia associated with colostomy (IHAC) is a rare but serious complication after colorectal surgery, especially when performed via the intraperitoneal route. Optimal treatment strategies remain unclear.

Duodenal Gastrointestinal Stromal Tumor Causing Gastrointestinal Bleeding and Duodenal Obstruction in Third-Trimester Pregnancy Successfully Treated with Pancreaticoduodenectomy after Emergency Cesarean Section: A Case Report

Ayumi Nakashima, et al.

INTRODUCTION: We report a case of a pregnant woman suffering from gastrointestinal bleeding and duodenal obstruction caused by a gastrointestinal stromal tumor (GIST) that required pancreaticoduodenectomy after an emergent cesarean section.

Delayed Cardiac Tamponade Caused by Right Atrial Perforation from a Fractured Permanent Inferior Vena Cava Filter: A Case Report

Kensuke Oue, et al.

INTRODUCTION: Inferior vena cava (IVC) filters are used to prevent pulmonary embolism in patients with deep vein thrombosis (DVT). Although generally safe, long-term indwelling filters may cause complications such as fracture, migration, and organ perforation. Cardiac tamponade due to right atrial (RA) perforation is extremely rare, particularly with permanent filters.

Liver Resection after Disease Control with Abemaciclib for Solitary Liver Metastasis from Breast Cancer: A Case Report

Yuki Kurokawa, et al.

INTRODUCTION: Liver metastases from breast cancer are associated with a poorer prognosis than bone or soft tissue metastases. In hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)–negative recurrent or metastatic breast cancer, endocrine therapy combined with cyclin-dependent kinase 4/6 (CDK4/6) inhibitors has been established as the standard of care. Abemaciclib has demonstrated favorable efficacy in phase III clinical trials and is considered an important option for long-term disease control. With recent advances in systemic therapy, an increasing number of patients achieve sustained disease control; however, prolonged treatment may lead to impaired QOL, financial burden, and the need for long-term therapy. Consequently, the role of local treatment in carefully selected patients with well-controlled disease has increasingly been discussed. Here, we report a case of breast cancer with postoperative recurrent solitary liver metastasis in which disease control was achieved with endocrine therapy plus abemaciclib, followed by liver resection, resulting in long-term recurrence-free survival.

Necrotizing Fasciitis Extending from the Left Iliopsoas to the Left Thigh Due to Retroperitoneal Penetration of the Descending Colon: A Case Report

Yuhi Matsuo et al.

INTRODUCTION: Necrotizing fasciitis is a severe soft tissue infection characterized by rapid destruction of the fascia and subcutaneous tissue, with a high mortality rate of 20%–40%. Although trauma and insect bites are common causes, gastrointestinal perforation as an etiology is exceedingly rare.

Laparoscopic Roux-en-Y Duodenojejunostomy for Duodenal Obstruction after Endovascular Aneurysm Repair Mimicking Superior Mesenteric Artery Syndrome: A Case Report

Ryusei Takahashi, et al.

INTRODUCTION: Superior mesenteric artery (SMA) syndrome is a rare cause of duodenal obstruction, typically associated with weight loss–related narrowing of the aortomesenteric angle. In contrast, fixed mechanical compression after endovascular aneurysm repair (EVAR) may produce duodenal obstruction that mimics SMA syndrome through a different mechanism.