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Volume 55, Issue 5
Displaying 1-6 of 6 articles from this issue
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K. Yamada2002 Volume 55 Issue 5 Pages 225-228
Published: 2002
Released on J-STAGE: December 03, 2009
JOURNAL FREE ACCESSLeiomyoma of the rectum is relatively rare and is difficult of histological diagnosis preoperatively. In some cases, a colonoscopic polypectomy is needed for definite diagnosis. With a large tumor, this procedure involves a risk of perforation through gastrointestinal system.
We successfully resected a leiomyoma of the rectum which was difficult of colonoscopic polypectomy by transanal endoscopic microsurgery.
A 72-year-old man had a laparoscopic cholecystectomy in our hospital on April 5, 2000. Digital examination revealed a thumb tip-sized hard mass on the low anterior wall of the rectum. Anoscopy showed a yellowish semilunar submucosal tumor, which was diagnosed as a myogenic submucosal tumor, and subsequently transanal endoscopic microsurgery was performed. The tumor was 25×15mm in size. The cut surface of the solid tumor was yellowish-white. The histological diagnosis was leiomyoma. The postoperative course was uneventful. It was thought that transanal endoscopic microsurgery might contribute to safe and minimally invasive resection for leiomyoma of the rectum.View full abstractDownload PDF (3330K) -
N. Kamata, N. Oshitani, R. Oiso, T. Kawacguta, M. Inagawa, D. Kawashim ...2002 Volume 55 Issue 5 Pages 229-233
Published: 2002
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 65-year-old woman was referred to our hospital because of an intractable sigmoid colon ulcer. She had undergone a right nephrectomy for kidney stones, at age 33, and a uterectomy at age 39, followed by radiation therapy. Lower abdominal pain and hematochezia developed suddenly, following a few days of constipation, in September 1999, when she was admitted to the previous hospital because of left hydronephrosis. A punched-out oval ulcer was found in the sigmoid colon, on colonoscopic examination. She was treated with total parenteral nutrition, prednisolone, and mesalazine administration. Although her hematochezia and abdominal pain disappeared, diarrhea and abdominal pain occurred after she began eating, and she was referred to our hospital for further examination. Although intestinal lavage solution was used for bowel preparation, stercoromas were found in the rectum, which had to be manually removed before colonoscopic examination, and a stercoral-ulcer was suspected. The sigmoid colonic ulcer was intractable. A biopsy specimen, taken from the bottom of the ulcer, revealed bizarre interstitial cells, each with a large oval nucleus, showing the so-called "owl-eye-appearance." Although the diagnosis of radiation sigmoiditis is sometimes difficult, "owl-eye-appearance" is a useful pathological finding in the diagnosis of late-phase radiation-induced colitis.View full abstractDownload PDF (4125K) -
M. Hashimoto, H. Kato, S. Endo, K. Yoshimatsu, K. Ogawa, S. Haga, T. K ...2002 Volume 55 Issue 5 Pages 234-238
Published: 2002
Released on J-STAGE: December 03, 2009
JOURNAL FREE ACCESSMesenteric panuculitis is a very rare nonspecific inflammatory disease. We herein report the case of a 77-year-old male who presented with mesenteric panuculitis after undergoing an abdominoperineal rectal resection for perianal Paget' s disease.
Ileus occurred a few days after the operation, and the patient was treated with conservative therapy at first. Thereafter, however, a digital examination from the sigmoidal stoma revealed narrowness and hardness in the sigmoidal colon. As a contrast examination of the intestinal tract showed a complete occlusion of the ileum, we decided to perform surgery again. During the operation, we found that the ileum had become adhered to the posterior peritoneum, and it had formed a cluster. In addition, the sigmoid mesenterium appeared to be thick and hard. The sigmoidal colon was too narrow and hard to pass feces. We therefore performed a partial resection of the ileum, a left colectomy, and a reconstruction of the stoma using the transverse colon. We made a final diagnosis of mesenteric panuculitis based on the findings of pathological examination. As the cause of mesenteric panuculitis has yet to be elucidated, a larger number of such cases should be investigated in detail, to clarify the pathogenesis of this disease.View full abstractDownload PDF (3615K) -
S. Izumi, M. Gotou, M. Nomura2002 Volume 55 Issue 5 Pages 239-242
Published: 2002
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSA 52-year-old man was admitted to our hospital with progressive and constant pain in the left lower abdomen. An elastic, tender, egg-sized mass was present in the left lower abdomen. Barium enema radiography revealed an extrinsic compression and a mucosal crenulation in the distal side of the descending colon. Colonoscopic examination showed a submucosal tumor-like protruded lesion covered with normal mucosa in the descending colon, and neither erosion nor ulceration was seen.
Computed tomography revealed wall thickening of the descending colon, with an increase of the surrounding fat tissue density. Although localized inflammation of adipose tissue was suspected, no definite diagnosis was possible.
At laparotomy, an enlarged, dark-red epiploic appendage was found on the distal side of the descending colon, and resection of the inflamed epiploic appendage was performed.
Pathological examination showed congestion, necrosis, and infiltration of inflammatory cells and foamy cells.
The diagnosis of epiploic appendagitis was established. It is extremely difficult to make a definite diagnosis of epiploic appendagitis prior to surgery ; none of the case reports were diagnosed preoperatively. The present case is thought to be a rare case in which the morphologic characteristics of epiploic appendagitis were displayed.View full abstractDownload PDF (3531K) -
Y. Usui2002 Volume 55 Issue 5 Pages 243-244
Published: 2002
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (2538K) -
2002 Volume 55 Issue 5 Pages 245-286
Published: 2002
Released on J-STAGE: June 05, 2009
JOURNAL FREE ACCESSDownload PDF (4557K)
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