Successful Management of Obstructive Fibrinous Tracheal Pseudomembrane with a Coring Technique after Preoxygenation with a High-Flow Nasal Cannula: A Case Report

Takafumi Iguchi, et al.

INTRODUCTION: Obstructive fibrinous tracheal pseudomembrane, an extremely rare but potentially fatal complication of tracheal intubation, occurs several days after intubation and is characterized by central airway obstruction due to the formation of a fibrinous pseudomembrane. Early diagnosis is crucial. Treatment typically involves bronchoscopic removal of the pseudomembrane. Herein, we describe a patient whose pseudomembrane was successfully cored out using fiberoptic intubation after achieving preoxygenation with high-flow nasal cannula oxygen therapy.

Proximal Jejunal Bypass with Sleeve Gastrectomy for Severe Obesity and Type 2 Diabetes: First Case Report in Japan

Taiki Nabekura, et al.

INTRODUCTION: Laparoscopic sleeve gastrectomy is the most common metabolic bariatric surgery performed in Japan. Nevertheless, concerns persist regarding its long-term efficacy, which is considered inferior to that of procedures involving gastrointestinal bypass. In response to these concerns, a modified approach known as the “sleeve plus procedure” has been introduced and is now covered by insurance for patients with severe obesity and type 2 diabetes mellitus (T2DM). We successfully performed proximal jejunal bypass with sleeve gastrectomy (PJB-SG), a variant of this approach, marking the first documented case of its kind in Japan. This report presents the clinical outcomes of this procedure along with a review of the relevant literature.

Combined Posterior and Interlobar Approaches Enable S10 Segmentectomy for a Centrally Located Intrapulmonary Schwannoma Diagnosed by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration: Surgical Strategy and Technical Consideration

Tomonari Oki, et al.

INTRODUCTION: Intrapulmonary schwannoma is a rare benign tumor that often presents diagnostic and therapeutic challenges due to its nonspecific radiological findings and central location. Establishing a histological diagnosis before surgery is crucial to avoid unnecessary extensive lung resection.

Improvement in Protein-Losing Gastroenteropathy Due to Gastric Polyposis by Laparoscopic Total Gastrectomy: A Case Report

Manatsu Mizuno, et al.

INTRODUCTION: Juvenile polyposis syndrome (JPS) is a rare disease characterized by multiple hamartomatous polyps in the gastrointestinal tract that may cause protein-losing gastroenteropathy. In such cases, symptoms such as hypoalbuminemia and anemia are often difficult to manage. Although clinical guidelines provide recommendations for diagnosis and management, standardized treatment strategies remain to be fully established.

A Case of Primary Gastric Carcinosarcoma with Small Intestine Metastasis

Chikara Mashiba, et al.

INTRODUCTION: Primary gastric carcinosarcoma is extremely rare. Herein, we report a case of primary gastric carcinosarcoma with small intestinal intraluminal metastasis.

Bladder Irritation without Mesh Penetration after Hernia Repair: A Case Report

Kenichi Ishibayashi, et al.

INTRODUCTION: Bladder irritation after inguinal hernia repair is typically associated with mesh migration into the bladder. Notably, no previous cases have described bladder irritation symptoms in the absence of direct mesh penetration. This report presents a rare instance of bladder symptoms caused by a folded mesh, despite normal cystoscopic and cystographic findings.

Dual-Outlet Stomach-Partitioning Gastrojejunostomy for Malignant Duodenal Obstruction: A Novel Palliative Bypass Technique

Kensuke Kudou, et al.

INTRODUCTION: Stomach-partitioning gastrojejunostomy (SPGJ) is widely performed for malignant gastric outlet obstruction; however, its utility may be limited when the obstruction is located in the distal duodenum, where digestive fluid stasis can become problematic. We devised a novel modification, termed dual-outlet stomach-partitioning gastrojejunostomy (DO-SPGJ), to address this limitation by adding a 2nd gastrojejunostomy distal to the gastric partition.

Partial Atrioventricular Septal Defect Repair through Right Thoracotomy in A 73-Year-Old Woman

Yuta Kitagata, et al.

INTRODUCTION: While surgical treatment for partial atrioventricular septal defect (AVSD) is commonly performed in pediatric patients, its application is relatively rare in older patients.

A Case of Occult Breast Cancer Diagnosed during Immune Checkpoint Inhibitor Treatment for Recurrent Metastatic Lung Cancer

Mio Makino et al.

INTRODUCTION: Occult breast cancer (OBC) is a rare subtype of breast cancer, typically presenting as axillary lymph node metastasis without an identifiable primary tumor in the breast. Axillary lymphadenopathy requires differential diagnosis, including OBC. However, in patients undergoing treatment for another malignancy, distinguishing OBC from axillary metastasis of the known primary cancer can be challenging. Immune checkpoint inhibitors (ICIs) have extended survival in advanced non-small cell lung cancer (NSCLC), potentially allowing time for 2nd primary cancers to develop and be detected.

Hydronephrosis Caused by Polyglycolic Acid Spacer Placement Prior to Carbon Ion Radiotherapy for Local Recurrence of Rectal Cancer: Case Report

Katsuya Ueda, et al.

INTRODUCTION: Carbon-ion radiotherapy (CIRT) for pelvic recurrent rectal cancer has recently attracted attention due to its excellent therapeutic outcomes. A spacer is often inserted before CIRT to ensure a certain distance between the recurrent lesion and the adjacent intestine. We report a case of hydronephrosis due to ureteral stenosis after laparoscopic insertion of a polyglycolic acid (PGA) spacer.

Chest Wall Reconstruction Using a Titanium Mesh Plate and an Expanded Polytetrafluoroethylene Sheet: A Case Report

Takahide Toyoda, et al.

INTRODUCTION: The integrity and stability of the chest wall (CW) are major factors that ensure the protection of the thoracic organs and proper respiratory function. In cases requiring extensive CW resection for tumor control, reconstruction using autologous tissue or synthetic materials is often performed. However, the optimal approach remains undetermined. We report a case of successful CW reconstruction using a combination of a titanium mesh plate and a dual-surface expanded polytetrafluoroethylene (ePTFE) sheet.

Left Ventricular Pseudoaneurysm Possibly Associated with Rivaroxaban Therapy Disappeared after Cessation of Rivaroxaban: Case Report and Literature Review

Kentaro Kiryu et al.

INTRODUCTION: Although iatrogenic left ventricular pseudoaneurysm (LVPA) is rare, its treatment strategy needs consideration. We report a case in which postoperative initiation of rivaroxavan led to iatrogenic LVPA, which resolved spontaneously after drug cessation.