Case Reports in Emergency Surgery and Trauma

Giant infected hydrocele: a case report

Aristeidis Papadopoulos — 2025-05-29

We present the case of a 72-year-old male admitted with a giant infected hydrocele. His medical history includes a transurethral resection of the prostate for benign prostatic hyperplasia and a total thyroidectomy complicated by postoperative hematoma necessitating a tracheostomy. The patient reported a three-year history of right hemiscrotal enlargement, with significant symptom exacerbation in the preceding month. Physical examination revealed a markedly enlarged, tender scrotum with epidermolysis and a body temperature of 38°C. Laboratory findings showed leukocytosis and elevated C-reactive protein levels. Imaging studies demonstrated well-vascularized testes with significant inflammatory changes and septations, consistent with a complex hydrocele. Surgical intervention involved drainage of approximately 3 liters of purulent fluid, debridement of necrotic tissue, and right orchiectomy. Postoperative management included a 10-day course of antibiotics, leading to favorable progress. The patient was discharged on the tenth postoperative day and remained in good health at the three-month follow-up.

Gallbladder perforation following abdominal liposuction: case report of a radiological pitfall

Alessandro Bergna — 2025-05-20

Liposuction is a widely performed aesthetic procedure. However, its potential for serious complications remains underestimated. We report a rare case of delayed liver trauma and gallbladder perforation in a 33-year-old woman following abdominal liposuction. After developing persistent abdominal pain, imaging revealed perihepatic fluid collections but failed to clearly identify a gallbladder injury. The clinical examinations suggested the presence of a localized peritonitis; therefore, an exploratory laparoscopy was performed, showing a minor hepatic injury and an active bile leakage from a gallbladder perforation, necessitating a laparotomic cholecystectomy. The patient recovered uneventfully. This case report underscores the importance of clinical judgment when imaging is inconclusive and highlights the role of diagnostic laparoscopy in the management of intra-abdominal injuries.

Delayed complicated extraperitoneal bladder rupture after blunt trauma: a case report

Binayak Deb — 2025-05-12

We present a case of extraperitoneal bladder rupture occurring 15 days after pelvic trauma, despite no apparent bladder injury being evident at the time of the incident. A 66-year-old male fell from a height of 20 feet and sustained injuries to the chest, pelvis, and left upper and lower limbs. All injuries were managed uneventfully. On the day of his planned discharge, he developed acute abdominal distension with suprapubic tenderness and gross hematuria. Imaging revealed a complicated extraperitoneal bladder rupture, which warranted surgical repair in this case due to its complicated nature. He was discharged on a follow-up basis with a suprapubic catheter in situ.