-
Shinichiro Kashiwagi, Yuka Asano, Satoru Noda, Tsutomu Takashima, Naoy ...
2013 Volume 38 Issue 6 Pages
1170-1173
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
Spindle cell carcinoma of the breast is a rare subtype of invasive cancer, in which the pathological differential diagnosis becomes very important. In this study, we experienced a case that was diagnosed to be adenomyoepithelioma based on the preoperative findings, but was later was diagnosed to be spindle cell carcinoma of the breast in the final diagnosis. The case pertains to a 68-year-old female. She consulted a local doctor due to a lump in her left breast, and was then referred to our hospital. A low echoic tumor measuring approximately 2.5 cm in size was observed in the AC region of her left mammary gland, and adenomyoepithelioma was strongly suspected based on a needle biopsy carried out at this site. A breast partial resection and sentinel node biopsy were carried out, because treatments according to malignancy are preferable, and the patient was diagnosed with spindle cell carcinoma of the breast according to the final pathological diagnosis. Regarding the diagnosis of spindle cell carcinoma, evidence must be obtained proving that the granulomatous spindle cells are epithelial. It is believed that making a correct diagnosis from a small amount of sampled tissue from a needle biopsy is difficult. Therefore, during the diagnosis of adenomyoepithelioma, it is preferable to not only conduct a needle biopsy, but also to carry out a pathological diagnosis of the entire carcinoma based on an excisional biopsy.
View full abstract
-
Miki Miyazawa, Takeshi Shimakawa, Shinichi Asaka, Atsuko Usuda, Kentar ...
2013 Volume 38 Issue 6 Pages
1174-1179
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 78-year-old female patient on anticoagulant therapy for paroxysmal atrial fibrillation and ventricular septal defect received emergency treatment at our hospital for the chief complaint of pain from the pharynx to the upper epigastrium after taking a bath. She was directly admitted on that day. Following admission, the patient vomited a small amount of blood and upper gastrointestinal endoscopy was performed. A giant hematoma covered by esophageal epithelium was observed extending from the esophageal orifice to directly above the esophagogastric junction, and a diagnosis of giant esophageal submucosal hematoma was made. The patient was given conservative treatment consisting of a nil-by-mouth regime, total parenteral nutrition (TPN) management and administration of a proton pump inhibitor (PPI) and vitamin K during which no hemorrhage was observed. After verifying the disappearance of the hematoma, the patient began eating again and was discharged without complications.
View full abstract
-
Takeshi Shimakawa, Shinichi Asaka, Atsuko Usuda, Kentaro Yamaguchi, Sh ...
2013 Volume 38 Issue 6 Pages
1180-1185
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
Cases of so-called “upside down stomach”, or volvulus of the stomach prolapsing into the mediastinum, are rare. We encountered a patient of advanced age who developed a large esophageal hiatus hernia with an upside down stomach, which was surgically treated. An 89-year-old female patient had repeated vomiting and hematemesis requiring emergency hospital admission. Upper gastrointestinal contrast study revealed severe esophageal hiatus hernia and gastric volvulus resulting in the stomach turning upside down. Computed tomography showed prolapse of the large portion of the stomach into the mediastinum. Because the patient had undergone epigastric laparotomy, surgery was initiated with opening the upper abdomen followed by returning the stomach into the peritoneal cavity. The hiatus hernia was sutured, and floppy Nissen fundoplication was performed as well as stomach fixation under the diaphragm. The patientʼs food intake was favorable postoperatively, and she was discharged.
View full abstract
-
Koichi Deguchi, Kazuhiro Nishikawa, Kazuhiro Iwase, Junji Kawada, Hiro ...
2013 Volume 38 Issue 6 Pages
1186-1190
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
We report a rare case of Addisonʼs disease due to bilateral adrenal metastasis from gastric cancer. The patient was an 85-year-old man, who had underwent distal gastrectomy and received postoperative adjuvant chemotherapy for gastric cancer. In 2009, the patient was found to have multiple metastases in the para-aortic lymph nodes and the left adrenal gland. Chemotherapy for metastatic gastric cancer was initiated; however, subsequently metastasis to the right adrenal gland was noted. In January 2012, the patient presented at our hospital with aspiration pneumonia. He was found to have general fatigue, hyponatremia, hyperkalemia, and eosinophilia. Although he seemed like cachexia at first glance, we suspected adrenal insufficiency because these abnormalities didnʼt improve with nonspecific therapy. A rapid adrenocorticotropic test was performed, and as no increase in the blood cortisol levels was demonstrated, a diagnosis of Addisonʼs disease was made. The patient improved dramatically with hydrocortisone treatment. Thus, the possible diagnosis of Addisonʼs disease must be considered and an adrenal function test should be performed for patients with bilateral adrenal metastasis.
View full abstract
-
Norimichi Kogure, Norihiro Haga, Kouki Kuwabara, Toru Ishiguro, Jun So ...
2013 Volume 38 Issue 6 Pages
1191-1195
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
The patient, a 65-year-old male, underwent total gastrectomy and Roux-en-Y reconstruction for gastric cancer in April 2010. Esophagus jejunum anastomosis was performed using a circular stapler (25 mm). Anastomosis of the jejunum was performed approximately 40 cm distal to the esophagus jejunum anastomosis using a circular stapler (21 mm). On visiting our hospital in August 2012 with the onset of upper quadrant pain, dilatation of the afferent loop was noted on an abdominal computed tomography (CT) scan. Afferent loop syndrome due to Roux-en-Y anastomotic stenosis was suspected. Emergency laparotomy under general anesthesia revealed an obstruction of the jejuno-jejunostomy. We incised the anastomotic portion and reconstructed the jejuno-jejunostomy. He has been well without any complaints for six month postoperatively.
In patients presenting with abdominal distention after total gastrectomy and Roux-en-Y reconstruction, we should note this rare complication.
View full abstract
-
Tomohiko Nakagawa
2013 Volume 38 Issue 6 Pages
1196-1201
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 73-year-old woman, complaining of upper abdominal pain, was admitted. She had a distal gastrectomy for a gastric cancer 16 years ago. Abdominal enhanced CT scan showed a “target sign” of the small intestine in the left upper abdomen, which represented the ongoing intussusception of the jejunum, so we performed the operation. We found that the reconstruction had been made by the Billroth Ⅱ method without a Braunʼs anastomosis, and that the efferent distal jejunum had invaginated toward the remnant stomach. No lesion, such as tumors, likely to cause the intussusceptions could be recognized. A Hutchinson procedure was performed. The patientʼs postoperative course was uneventful without recurrence. We report very rare case of retrograde intussusception of the jejunal loop through gastrojejunostomy, and review the relevant Japanese literature.
View full abstract
-
Tatsuomi Miyauchi, Takao Katsube, Jun Kinoshita, Atsuko Usuda, Kentaro ...
2013 Volume 38 Issue 6 Pages
1202-1206
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
We report a case of bowel obstruction due to gastric cancer with peritoneal dissemination in which the quality of life was improved by percutaneous endoscopic gastrostomy with jejunal extension:PEG-J. In November 2010, a 57-year-old woman with advanced gastric cancer (Stage Ⅳ [T4b (SI), M1 (OVA), P1, CY1]) underwent distal gastrectomy (Roux en Y reconstruction) and removal of bilateral Krukenberg tumors. After the surgery, the patient had been receiving systemic chemotherapy. In April 2011, she was admitted to our hospital immediately after the diagnosis of bowel obstruction with ascites. Distension of the small intestine was resolved after decompression with an ileus tube; however, the remnant stomach was significantly distended. We planned to carry out percutaneous endoscopic gastrostomy with jejunal extension (PEG-J). After removing ascites by abdominal paracentesis, percutaneous endoscopic gastrostomy (PEG) was carried out. Then we replaced the PEG catheter with a PEG-J catheter. The patient was relieved symptoms and pain by successful decompression of the small intestine and the remnant stomach. Following her wishes and those of her family, the patient was discharged to receive home care. In the treatment of bowel obstruction due to gastric cancer with peritoneal dissemination that is one of the terminal care, decompression with a PEG-J catheter is a useful technique nicely balanced in the treatment and the quality of life of patients.
View full abstract
-
Ryutaro Mori, Michio Ueda, Chikara Kunisaki, Itaru Endo
2013 Volume 38 Issue 6 Pages
1207-1213
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 70-year-old man was referred to our hospital due to deformity of the duodenal wall by upper gastrointestinal series for medical check. A duodenal submucosal tumor was diagnosed as duodenal gastrointestinal stromal tumor (GIST) by histological findings obtained by EUS-FNA. It seemed difficult to perform local resection because the tumor was adjacent to the pancreas. Thus, we performed laparoscopy assisted pancreaticoduodenectomy (LAPD). Operation time was 507 minutes and intraoperative bleeding was 565ml. He had a good post-operative course and discharged on 9th postoperative day. Experienced laparoscopic surgeons can perform LAPD safely. However, further investigation is needed for operative indications and long term outcome as well as improvement of operative procedures.
View full abstract
-
Kosuke Toyooka, Yasunobu Shioji
2013 Volume 38 Issue 6 Pages
1214-1217
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
An 80-year-old man was referred with complaints of abdominal pain and diarrhea. Gastrografin enema and colonoscopy revealed a pelvic tumor which complicated from fistula to the rectum. The abdominal CT examination after Gastrografin enema revealed a pelvic abscess and contrast medium flew in the small intestine. A surgical operation was performed under the diagnosis of a pelvic abscess and intestinal-rectal fistula. We found that a neoplastic lesion of the ileum perforated to the pervic cavity and formed a pelvic abscess. Pathological findings showed a diffuse and large B-cell malignant lymphoma of the ileum. However, the postoperative course was uneventful, his condition deteriorated rapidly and died 5 months after surgery.
View full abstract
-
Ryohei Nishiguchi, Ryota Matsuo, Miki Miyazawa, Teppei Kono, Akira Miy ...
2013 Volume 38 Issue 6 Pages
1218-1223
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 52-year-old man visited a hospital because of upper abdominal pain. Three days later, he visited our hospital because his symptom worsened. He had low grade fever, tenderness and rebound pain of the right lower abdomen, but no defence. Laboratory tests showed elevated white blood cell count and C-reactive protein level. Abdominal CT scan showed wall thickness of the terminal ileum and fluid collection which a diagnosis of ileitis complicating abscess was made. Conservative treatment was done, but the next day, abdominal pain worsened with peritoneal irritation sign. Enhanced abdominal CT scan was done and there was a wall defect of the terminal ileum continuing to the abscess cavity including free air. With the diagnosis of perforation of the ileum, ileocecal resection was performed. On the resected specimen, an ileal diverticulum penetrating into the mesentery was found at the point 3cm oral to the Bauhinʼs valve. Pathological examination demonstrated a mesenteric abscess caused by penetration of the ileal diverticulum. Postoperative course was uneventful and the patient was discharged 9 days after the operation.
View full abstract
-
Hidetaka Kurebayashi, Mitsuhiro Morikawa, Katsuji Sawai, Kenji Koneri, ...
2013 Volume 38 Issue 6 Pages
1224-1228
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
We report 2 cases of cecal volvulus here. In case 1, a 32-year-old woman who had cerebral palsy complained of abdominal fullness. A plain abdominal radiography showed a giant colonic gas shadow. We diagnosed her condition as cecal volvulus by using multidetector row computed tomography (MDCT). We subsequently performed colonoscopic detorsion; however, the patient experienced a relapse the following day. We therefore performed a laparoscopic surgery. Owing to the intraoperative findings of torsion and dilatation of the cecum, we performed a right colon resection. In case 2, a 90-year-old woman was admitted to our hospital because of lower abdominal pain and fullness. We diagnosed her condition as cecal volvulus and strangulated ileus by using abdominal radiography and MDCT, and performed an emergency right colon resection. Cecal volvulus is a rare condition, and the cases reported here reaffirm that when feasible, laparoscopic surgery proves useful in the treatment of this condition.
View full abstract
-
Yusuke Ohashi, Seiji Chuubachi, Hirokazu Takahashi, Masaki Nakui
2013 Volume 38 Issue 6 Pages
1229-1233
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
We report the experience that we performed distal gastrectomy with post-colon basis Billroth Ⅱ reconstruction for a case with submucosal tumor (gastrointestinal stromal tumor ; GIST) of duodenal bulb. After surgery, for a long period of time, due to stenosis of the gastro-jejunal anastomosis, oral intake was impossible. Although endoscopic balloon dilatation, surgical adhesiolysis, erythromycin administration, herbal medicine were not effective, the case was markedly improved by administration of steroids and oral intake had become possible. It was speculated that anastomostic stricture was provoked by mesenteric panniculitis at Mesocolon transversum.
View full abstract
-
Keiichiro Ishibashi, Satoshi Hatano, Norimichi Okada, Kensuke Kumamoto ...
2013 Volume 38 Issue 6 Pages
1234-1239
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
The cosmetic appearance of skin incisions performed for a prophylactic proctocolectomy in young patients with familial adenomatous polyposis (FAP) should be considered. Recently, single-incision laparoscopic surgery (SILS) has been rapidly introduced and seems to be meeting the needs of these patients; however, only a few reports of SILS in patients with FAP have been reported. We herein report the case of a 25-year-old woman with FAP (sparse type) who underwent a total colectomy and ileorectal anastomosis using SILS and a novel skin incision developed by our group. Briefly, a 3/4 circumferential incision around the umbilicus was made, and three 5-mm radial skin incisions were then added to expand the wound. Using a “home-made” multichannel port system utilizing a surgical glove, a total colectomy and ileorectal anastomosis was performed. At the time of closing, the crushed skin edge was trimmed for better adaptation. The operation time was 360 minutes, and the blood loss was minimal. The patient was discharged on the 10th postoperative day and did not experience any complications. Our unique incision method for performing an SILS colectomy seems to be feasible and safe for young patients with FAP.
View full abstract
-
Toshiaki Suzuki, Masaichi Ogawa, Masahisa Ohkuma, Tadashi Anan, Ken Et ...
2013 Volume 38 Issue 6 Pages
1240-1244
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
We describe herein a rare case of early colon cancer with high FDG accumulation on FDG PET-CT. A 67-year-old woman had undergone partial mastectomy for stage Ⅰ breast cancer in 2006 and underwent adjuvant chemotherapy. However, sacrum and lung metastases were detected, and radiation therapy was given to sacrum metastases. Although enhaced CT could not show clear signs of a new lesion, F-fluorodeoxyglucose-positron emission tomography (FDG PET-CT) demonstrated high FDG accumulation in the transeverse colon with a standardized uptake of 6.5. Colonoscopy revealed a 20 mm Ip polyp in diameter, for which polypectomy was performed three months later. The histopathological diagnosis was tubular adenocarcinoma, well-moderately differentiated type in tubulovillous adenoma, Stage Ⅰ. To our knowledge, reports on detection of early colon cancer by FDG PET-CT is rare. We herein report such a case and review the literature.
View full abstract
-
Kenta Nakahara, Shungo Endo, Daisuke Takayanagi, Yusuke Takehara, Tomo ...
2013 Volume 38 Issue 6 Pages
1245-1250
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
From April 2001 to March 2013, we have experienced 4 cases of metachronous ovarian metastasis from colorectal cancer. 3 cases in 4 were recurrence after curative resection. Pathological examination of primary colorectal cancer showed serosal invasion in all cases, and lymph node metastasis in 2 cases. The ovarian metastasis from colorectal cancer was similar to primary ovarian cancer, so we could not diagnose them as metastases by laboratory data, tumor marker or imaging. Pathological examination by HE staining was also not enough, although immunohistochemical studies were useful for their diagnosis. Cytokeratin (CK) 7 staining was negative and CK 20 staining was positive in metastasis cases. CK 7 was positive in primary ovarian cancer, however CK 7 was negative and CK 20 was positive in most colorectal cancer. Peritoneal metastasis was observed in all cases after resection of ovarian matastasis, then we suggested that ovarian metastasis may be a form of peritoneal matastasis. Women before menopause, or those who show serosal invation of colorectal cancer, are high-risk patients of ovarian metastasis. Surgical excision reduces discomfort and efficiently relieves abdominal symptoms. And in some cases, long-term survival after surgery has reported. For these reason, surgical resection of ovarian metastasis would be indicated for surgery despite the poor prognosis.
View full abstract
-
Youhei Kimura, Takanori Goi, Akio Yamaguchi
2013 Volume 38 Issue 6 Pages
1251-1254
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A rare case of rectal leiomyosarcoma originating in the muscularis mucosae is reported. A 72-year-old man was admitted to the urology department for a tumor of the right epididymis. A pedunculated tumor was then found in the rectum on abdominal computed tomography. After surgery for the right epididymal tumor, rectal amputation was performed for the rectal tumor. Histopathologically, the rectal tumor was diagnosed as early stage leiomyosarcoma that arose from the muscularis mucosae. Rectal leiomyosarcoma is a relatively unusual rectal tumor. In addition, most rectal leiomyosarcomas arise from the external muscular layer or the muscularis propria. Rectal leiomyosarcoma originating in the muscularis mucosae is extremely rare.
View full abstract
-
Masaki Hirota, Jyunichi Hasegawa, Syoki Mikata, Jyunzo Shimizu, Masaka ...
2013 Volume 38 Issue 6 Pages
1255-1259
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
The patient was an 88-year-old man who was examined at our department for chronic recurrences of anal fistula since he was 30 years old. Mucin-like drainage was confirmed at a secondary orifice, and carcinoma was diagnosed by examining the biopsy tissue obtained under lumbar anesthesia. Pelvic T2-weighted magnetic resonance (MR) image showed a multilocular tumor with high signal intensity; the tumor was restricted to the left ischiorectal fossa. Laparoscopic abdominoperineal resection was performed with no lymph node metastasis. The final diagnosis was confirmed as muc, A, ly0, v0, pN0, and Stage Ⅱ. No relapses were detected within 3 years following surgery. We believe that the laparoscopic abdominoperineal resection performed after assessment of the region exhibiting oncogenesis via MR imaging was a curative excision.
View full abstract
-
Shutaro Ozawa, Kei Kano, Nobuko Fujiuchi, Minoru Sukigara
2013 Volume 38 Issue 6 Pages
1260-1264
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 69-year-old female had undergone abdominoperineal resection for rectal cancer 15 years before admission. After the surgery, she had taken care of the colostomy by herself. In October 2012, she pressed the skin around the colostomy with her fingers due to constipation and conduct disimpaction. She noticed pain around the colostomy and went to a nearby clinic. She was referred to our hospital for a diagnosis of dermatitis around the colostomy site. At the initial diagnosis, redness, pus and swelling around the colostomy were remarkable. We diagnosed the patient with an abdominal wall abscess due to perforation of the colostomy. After hospitalization, we performed double barrel colostomy at the transverse colon. The inflammation around the colostomy of the sigmoid colon improved, and the patient was discharged from the hospital. Six months later, we performed closedown of the transverse colostomy and reconstruction of the sigmoid colostomy.
Cases of colostomy injury due to self-care are rare. The mechanism of colostomy injury associated with disimpaction was unknown. A parastomal hernia was observed in this case. Therefore, the tissue of the buried abdominal wall around the colostomy was weak, which may have increased pressure around the site.
View full abstract
-
Kazuhiro Suzumura, Yasukane Asano, Nobukazu Kuroda, Yuji Iimuro, Tadam ...
2013 Volume 38 Issue 6 Pages
1265-1269
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 65-year old man was seen at another hospital because of general fatigue. He was admitted to our hospital for the examination of gallbladder and liver tumor. His CA19-9 level was found to be elevated. Computed tomography showed a mass lesion of the gallbladder invading the liver. Fluorodeoxyglucose positron emission tomography (FDG-PET) showed uptake (standard uptake value:SUV max early 6.96, delay 9.35). We diagnosed a gallbladder carcinoma invading the liver, and performed cholecystectomy with left trisegmentectomy of the liver and lymph node dissection. Histopathological diagnosis was poorly differentiated squamous cell carcinoma of the gallbladder. The patient was discharged from the hospital on the 36th postoperative days. But he developed recurrence to the remnant liver and died 4 months after the operation. Since squamous cell carcinoma is rare, we report on this case with some bibliographical comments.
View full abstract
-
Yuji Oshima, Naoto Koike, Makio Kawakami
2013 Volume 38 Issue 6 Pages
1270-1274
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 67-year-old woman was hospitalized because of a cystic lesion of the pancreas. Ultrasonography, computed tomography, and magnetic resonance imaging revealed a 4-cm cystic lesion of the pancreatic body. Because of an increase in the tumor size, hand-assisted laparoscopic spleen-preserving distal pancreatectomy was performed. In recent times, spleen-preserving distal pancreatectomy has been the preferred procedure for benign or low-grade malignant tumors of the pancreatic body or tail, because splenectomy could result in post-splenectomy sepsis or an elevated platelet count. This procedure can be safely performed for lesions adjacent to the major vessels.
View full abstract
-
Norio Yukawa, Yasushi Rino, Hiroshi Tamagawa, Tsutomu Sato, Naoto Yama ...
2013 Volume 38 Issue 6 Pages
1275-1280
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
We report a case of metachronous liver metastases from a retroperitoneal paraganglioma. The patient was a 39-year-old man who had undergone resection of a retroperitoneal tumor with the left kidney, left adrenal gland, and spleen in May 2009. Pathological examination revealed a retroperitoneal paraganglioma. In April 2010, a recurrent tumor at the xiphoid process was resected. In August 2010, re-resection of a recurrent tumor arising in the chest-abdominal wall with the ribs, costal cartilage, diaphragm, and liver was performed. The chest-abdominal wall was reconstructed with a skin flap and fascia lata by plastic surgeons. In April 2012, enhanced computed tomography (CT) revealed a solitary metastasis to liver segment 3. To preserve the reconstructed abdominal wall, we performed a laparoscopic partial hepatectomy with the use of an ultrasonic energy system for dissection, cutting, and coagulation (Harmonic® Scalpel), applying microwave coagulation therapy. The postoperative course was uneventful, and the patient was discharged on the ninth day after the operation.
View full abstract
-
Hidetaka Kurebayashi, Kenji Koneri, Takanori Goi, Akio Yamaguchi
2013 Volume 38 Issue 6 Pages
1281-1285
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 51-year-old woman was admitted with an abdominal mass that was detected by an ultrasonography during routine screening. Abdominal computed tomography showed a huge multilocular cystic mass with a calcified lesion in the right side of the retroperitoneum. Magnetic resonance imaging showed a mucus-filled cystic mass with no sign of invasion of the surrounding tissue. Therefore, we diagnosed the patient with retroperitoneal mucinous cystadenoma and performed a tumorectomy. The tumor was located in the retroperitoneal fatty tissue, and we were able to extirpate the tumor en bloc. On histological examination, the tumor appeared to be an ovarian mucinous cystadenoma with no signs of malignancy; therefore, the condition was diagnosed as retroperitoneal mucinous cystadenoma. Retroperitoneal mucinous cystadenomas are rare, and accurate determination of the type of malignancy is difficult. We herein report a case of preoperatively diagnosed retroperitoneal mucinous cystadenoma.
View full abstract
-
Tomoichiro Hirosawa, Michio Itabashi, Mamiko Ubukata, Shigetomo Suzuki ...
2013 Volume 38 Issue 6 Pages
1286-1290
Published: 2013
Released on J-STAGE: December 25, 2014
JOURNAL
FREE ACCESS
A 65-year-old male. One year following abdominoperineal rectal resection due to rectal cancer in 2010, parastomal hernia was observed and laparoscopic parastomal hernioplasty was carried out by the sugarbaker method using dual mesh two years postoperatively. Because swelling was observed around the stoma two months following the repair similarly as in the preoperational state and the small intestine was found to have penetrated into the hernia orifice upon CT scan, we made a diagnosis of recurrence of the hernia and carried out surgery once again. Due to this recurrence, surgery was carried out laparotomically and it was found that the mesh used for repairing outward from the head side of the soma was everted, with the hernia orifice observed at the same site. Because the mesh showed strong adhesion, the sandwich method, wherein the keyhole method is used in combination with the sugarbaker method, was carried out for repair with mesh. It has been reported that the recurrence of laparoscopic repair is often observed outside the stoma and thus it is believed that it is necessary to pay special attention to fixing the mesh and especially reinforcing it on the outside.
View full abstract
