We divided injuries of the main abdominal vessels into three categories, namely, injury due to general abdominal trauma, iatrogenic injury, and injury due to anomalies in vascular arborization, and studied the seven cases we encountrered in our department during the past 10 years. There was I case of dull trauma due to a traffic accident in the general abdominal trauma category and 5 cases of iatrogenic injury, 3 of which were due to resection of a malignant tumor and 2 due to operation for a benign tumor (1 case related to laparoscopic surgery). The surgical procedure consisted of replacement of the abdominal aorta in I case, reconstruction of the proper hepatic artery (end-to-end anastomosis) in 2 cases, ligation in 2 cases, and reconstruction of a vein (end-to end anastomosis) in 2 cases. The interval between occurrence of the injury and repair ranged from 15 to 250 minutes. The patient's life was saved and organ ischemia was prevented in every case. Patency was found to have been obtained in every case during follow-up. When injury of the main vessels of the abdomen has occurred and requires emergency treatment, it is necessary to make an accurate and speedy diagnosis and take measures, centering on surgical procedures, to deal with the vessels under time limitations because of organ ischemia.

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We report a case of intestinal obstruction by metastatic lung cancer.A 64-year-old man who had under gone therapy for squamous cell carcinoma of the lung and brain metastasis wasadmitted to the hospital complaining of nausea and vomiting.An abdominal X-ray study showed a dilated smallintestine.An abdominal CT scan and small intestine gastrogram examination suggested a massexpanding in the small intestine.Emergency laparotomy was performed, and a solitary tumor about 8cmdiameter was found in the jejunum 60cm distal to the ligament of Treitz.Partial resection of the smallintestine was carried out. Histological examination of the resected specimen revealed a poorly differentiatedsquamous cell carcinoma with features similar to the lung tumor.Attention should be directed to thepossibility of small intestinal metastasis in patients with lung cancer associated with digestive symptoms.

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We report a case of pancreatic abscess complicated by duodenal transitdisturbance, duodenal fistula, and biliary stenosis treated by interventional radiology.The patient was a 77-year-oldfemale with severe acute pancreatitis.She was initially treated intensively by pancreatic arterial infusiontherapy (antibiotics and protease inhibitor), but on day 6, she developed a pancreatic abscess.Her condition was improved by percutaneous abscess drainage, but the duodenal transit disturbance persisted.She was observed with nasojejunal enteral feeding, but a duodenal fistula formed, and we therefore performed percutaneous endoscopic gastrostomy/jejunostomy.We subsequently performed percutaneous transgastric drainage of the pancreatic abscess, and the procedure was followed by rapid healing of pancreaticocutaneous, fistula and pancreaticoduodenal fistula, and recovery from the duodenal transit disturbance, which had continued for two months.Suprapancreatic biliary stenosis then developed, and treatment by percutaneous transhepatic biliary drainage (PTBD) and percutaneous transhepatic biliary endoprosthesis (PTBE) was followed by recovery.We describe the possibility of non-operative management of pancreatic abscess and its complications.

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