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Volume 62, Issue 8
Displaying 1-8 of 8 articles from this issue
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Clinical Studies
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Amane Kanazawa, Manabu Shiozawa, Daisuke Inagaki, Nobuhiro Sugano, Mak ...2009 Volume 62 Issue 8 Pages 497-501
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSWe investigated the risk factors for postoperative intestinal obstruction in patients with loop ileostomy as a diverting stoma after low anterior resection and examined preventive measures for intestinal obstruction. Two groups totaling 23 patients undergoing diverting loop ileostomy were studied retrospectively over a 19-month period. One group (10 patients) had intestinal obstruction, and the other (13 patients) had not. In univariate and multivariate analyses, thickness of the rectus muscle of the abdomen was a significant prognostic factor in intestinal obstruction after constructed ileostomy.
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Yurika Satoh, Tatsuya Abe, Yoshikazu Hachiro, Masao Kunimoto2009 Volume 62 Issue 8 Pages 502-505
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSPURPOSE: The Goligher classification, which is widely used, describes four grades based on the appearance of hemorrhoids. However, a quantitative classification of hemorrhoids has never been reported. The aim of the present study was to evaluate submucosa thickness (SMT) of the anal canal in patients with internal hemorrhoids and to compare the results with the Goligher classification.
SUBJECTS AND METHODS: Endoanal ultrasonography with a 10-MHz rotating endoprobe was performed in 376 patients. SMT was measured in the thickest part of the anal canal.
RESULTS: Mean SMT of grade 1 to 4 were 2.30±0.56, 3.39±1.00, 4.20±1.26, and 5.86±0.49mm respectively. SMT was correlated with the degree of hemorrhoids (r=0.98, p<0.001).
CONCLUSION: SMT was considered to be a useful index for the severity of hemorrhoidal changes.
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Takahiro Okamoto, Ryuji Tamura, Yoshihiko Kadowaki2009 Volume 62 Issue 8 Pages 506-510
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSDiverticulosis of the appendix is a relatively rare pathological finding. Appendiceal diverticulosis is usually an incidental finding and clinically asymptomatic. When symptomatic, the majority of cases undergo appendectomy under the diagnosis of acute appendicitis. We conducted a retrospective analysis of all appendectomy specimens received in our hospital. We experienced 15 cases of diverticulosis (6.2%) of the appendix among 242 patients on whom appendectomy was performed. Three of the 15 cases (20%) were given the correct diagnosis preoperatively. In the postoperative pathological study, 11 cases (73.3%) had severe suppurative inflammation, 9 of whom (81.9%) had perforations. In addition, 6 cases (40%) had mucous retention in the diverticular lumen and peristroma, of whom 3 cases (50%) had perforations.
Accordingly, we report in this pathological study that if appendiceal diverticulosis has severe suppurative inflammation, there may be a rapid progression to perforation.
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Case Reports
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Hiroyuki Watanabe, Makoto Matsushima, Yoshiaki Tanaka, Yasuhiro Shimoj ...2009 Volume 62 Issue 8 Pages 511-515
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSA case of sarcoidosis of the rectum that developed in the lower part of the rectum is reported. The patient was a 64-year-old female who presented with malaise in the anal region. Digital examination of the anus and rectum, transanal ultrasonography and computed tomography of the pelvic cavity revealed a tumor with a size of approximately 3.0×4.0cm at the lower rectum. To make a definite diagnosis, an ultrasonography-guided needle biopsy was performed and the results strongly suggested sarcoidosis, which is a systemic disorder of unknown cause that rarely develops at the rectum.
Subsequent general examinations including Ga scintigraphy and computed tomography of the chest revealed abnormal density at the anterior superior mediastinum. The patient is currently under observation while undergoing detailed examinations.
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Kouichi Fujimoto, Hajime Ohnishi, Yasuhisa Yamamoto, Takehisa Ohnishi, ...2009 Volume 62 Issue 8 Pages 516-521
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSAs a relatively rare mucinous cystoma of the appendix, mucinous cyst adenoma and mucinous cyst adenocarcinoma are known, both of which are often involved in the pathogenesis of pseudomyxoma peritonei. We recently experienced a case of mucinous cyst adenoma of the appendix which was surgically removed as a mass including appendix and ovary under the diagnosis of ileocecal tumor with the site of origin identified successfully by immunolohistochemical staining as reported hereinafter. The patient was a 77 year-old-woman who had visited our hospital with a main complaint of abnormal evacuation. The subsequent colonoscopic examination revealed a protuberant lesion in the appendix root. Although pseudomyxoma peritonei was not developed yet, a mucinous cyst adenoma of the appendix was diagnosed by referring to the results of various examinations and then removed by surgical intervention.
Because the specimen taken from the resected lesion showed a mass of appendix and ovary, the identification of primary focus was difficult macroscopically but succeeded by immunolohistochenical staining with the aid of immune staining components of CK7, CK20, MUC 1 and MUC 2. A mucinous cyst adenoma of the appendix in origin was then diagnosed based on the histopathological results. This immunolohistochemical staining technology is thus considered to be very useful not only for identification of the primary focus of pseudomyxoma peritonei but also for decision of its therapeutic strategy.
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Tatsuki Nanami, Kimihiko Funahashi, Yoko Oshima, Junichi Koike, Masash ...2009 Volume 62 Issue 8 Pages 522-526
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSIt is extremely rare for chronic ischemia of the mesenteric artery to cause constrictive ischemic colitis in the right colon. A 71-year-old man began to complain of a mild sense of bloating and constipation, and was referred to our hospital for further evaluation. A barium enema examination revealed a constriction of the ascending colon. Colonoscopy showed the constricted area had erosion, which blocked the passage of the colonoscope. A biopsy led to categorization as Group 1. Abdominal angiography predicted that blood flow to the right colon from the inferior mesenteric artery via the left colic artery, the marginal artery and the middle colic artery would be found. The obstruction had persisted for approximately 3 months, and so a right hemicolectomy was performed. A 6-cm-long circumferential stricture was observed in the ascending colon, and ischemic changes with ulcerative lesions that showed inflammatory exudate and granulation were histologically identified. No particular complications were found either during or after the surgery.
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Toshio Sekioka, Masahiko Saitou, Toshiki Tanaka, Sorou Takeda, Shin'ic ...2009 Volume 62 Issue 8 Pages 527-533
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSAn 82-year-old woman was admitted to our hospital with a sudden onset of colicky abdominal pain in October 2008. She had been taking various medications including lansoprazole for six months. Physical examination revealed direct and rebound tenderness in the upper abdomen. Abdominal CT showed wall thickening of the left side of the transverse colon and splenic flexure. She rapidly became symptom-free in a few days. On colonoscopy, two longitudinal ulcers were noted on the left side of the transverse colon and splenic flexure. The ulcers appeared as if a sharp knife had cleanly slashed the mucosa open. These endoscopically distinctive lesions were named "fractured colon" by Sherman. Colonic biopsies showed thickened subepithelial collagen bands. Three months later, the two longitudinal ulcers were found to have healed completely on colonoscopy. After discontinuing lansoprazole, her symptoms disappeared. We report a rare case of lansoprazole-associated collagenous colitis with peritonitis due to colonic tear.
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How I do it
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Hiroshi Azuma, Koichi Sato, Yasunobu Tsujinaka2009 Volume 62 Issue 8 Pages 534-536
Published: 2009
Released on J-STAGE: August 06, 2009
JOURNAL FREE ACCESSDownload PDF (693K)
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