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All Journal Sriwijaya Journal of Surgery Open Access Indonesian Journal of Medical Reviews
Iman Hakim Wicaksana
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Health Professions Medicine & Pharmacology

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An Unusual Presentation of Pancreatic Neuroendocrine Carcinoma in a Young Woman: A Case Report Iman Hakim Wicaksana; Suryo Wahyu Raharjo
Sriwijaya Journal of Surgery Vol. 8 No. 1 (2025): Sriwijaya Journal of Surgery
Publisher : Surgery Department, Faculty of Medicine Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjs.v8i1.117

Abstract

Introduction: Pancreatic neuroendocrine tumors (PNETs) are rare neoplasms arising from the endocrine cells of the pancreas. They are typically diagnosed in older adults, with a peak incidence between 70 and 74 years. PNETs in young adults are uncommon and often present with non-specific symptoms, leading to delays in diagnosis and treatment. Case presentation: We report the case of a 22-year-old woman who presented with a large, non-functional PNET located in the tail of the pancreas. The patient initially complained of vague abdominal discomfort, nausea, and vomiting. Imaging studies revealed a large, heterogeneous mass in the left upper quadrant. The patient underwent a distal pancreatectomy, and histopathological examination confirmed the diagnosis of a poorly differentiated pancreatic neuroendocrine carcinoma. Conclusion: This case highlights the challenges in diagnosing PNETs in young adults. Clinicians should maintain a high index of suspicion for PNETs in young patients presenting with abdominal symptoms, even in the absence of classic hormonal syndromes. Early diagnosis and surgical intervention are crucial for improving outcomes in these patients.
Delayed Traumatic Diaphragmatic Hernia Presenting as Pneumothorax: A Case Report Iman Hakim Wicaksana; Suryo Wahyu Raharjo
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.708

Abstract

Traumatic diaphragmatic hernias (TDHs) are a serious complication of both blunt and penetrating trauma, often requiring prompt surgical intervention. While most TDHs present acutely, a subset of cases may have a delayed presentation, posing diagnostic and management challenges. This case report describes a 66-year-old woman who developed a delayed left-sided TDH following a motor vehicle accident, initially misdiagnosed as pneumothorax. A 66-year-old female presented to our hospital with complaints of severe left-sided chest pain and progressive dyspnea four days after a motor vehicle accident. Initial assessment at another hospital revealed rib fractures and pneumothorax, for which a chest tube was inserted. However, her respiratory symptoms persisted, prompting further evaluation. A chest X-ray and subsequent thoracoabdominal CT scan revealed a large left-sided diaphragmatic hernia with herniation of abdominal viscera into the thoracic cavity. The patient underwent emergency laparotomy and diaphragmatic hernia repair with primary closure. Postoperatively, the patient's symptoms improved significantly, and she was discharged home with complete resolution of her complaints. In conclusion, this case highlights the importance of maintaining a high index of suspicion for TDH in patients with a history of trauma, even in the absence of initial suggestive findings. Delayed presentation of TDH can occur, and a thorough evaluation, including imaging studies, is crucial for accurate diagnosis and timely management.
Adiposity-Induced Voiding Dysfunction: Unraveling the Association Between Overweight Status and Symptom Severity in Non-Retentive Benign Prostatic Hyperplasia Iman Hakim Wicaksana; Setya Anton Tusarawardaya; Suharto Wijanarko; Wibisono; Amru Sungkar
Open Access Indonesian Journal of Medical Reviews Vol. 6 No. 1 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v6i1.845

Abstract

Benign prostatic hyperplasia (BPH) has historically been viewed through a prostato-centric lens, attributing lower urinary tract symptoms (LUTS) primarily to prostatic volume and mechanical obstruction. However, this model fails to account for the substantial symptom burden observed in patients without significant retention or massive enlargement. Emerging evidence suggests that systemic metabolic dysregulation, particularly adiposity, plays a crucial role in the pathophysiology of LUTS. This study aims to evaluate the association between Overweight status and the subjective severity of LUTS in a specific cohort of non-retentive BPH patients, thereby isolating metabolic contributors from acute mechanical failure. We conducted an observational analytic cross-sectional study at the Urology Polyclinic of RSUD Dr. Moewardi, Surakarta, Indonesia, from June 2024 to January 2025. The study enrolled 110 men diagnosed with BPH who met strict criteria for non-retentive status (post-void residual <150 mL, no indwelling catheter). Participants were stratified into normal BMI (<25 kg/m²) and Overweight (≥25 kg/m²) groups. Symptom severity was quantified using the International Prostate Symptom Score (IPSS). Data were analyzed using the Mann-Whitney U test and Chi-square analysis. The cohort comprised 72 (65.5%) normal-weight and 38 (34.5%) overweight patients. A statistically significant disparity in symptom severity was observed. The overweight group exhibited a significantly higher mean IPSS (17.87 ± 5.18) compared to the normal group (11.54 ± 4.71) (p<0.001). Notably, 44.7% of overweight patients presented with severe LUTS, compared to only 5.6% of normal-weight patients. Conversely, 90.9% of patients with mild symptoms belonged to the normal-weight group. In conclusion, overweight status is significantly associated with increased LUTS severity in non-retentive BPH patients. The findings suggest that adiposity exacerbates voiding dysfunction through systemic inflammatory, hormonal, and autonomic pathways independent of urinary retention. These results advocate for the integration of weight management as a core therapeutic strategy in BPH care.
Co-Authors Amru Sungkar Setya Anton Tusarawardaya Suharto Wijanarko Suryo Wahyu Raharjo Wibisono