All issues
Volume 52 (2019)
- Issue 12 Pages 695-
- Issue 11 Pages 611-
- Issue 10 Pages 551-
- Issue 9 Pages 485-
- Issue 8 Pages 405-
- Issue 7 Pages 345-
- Issue 6 Pages 281-
- Issue 5 Pages 239-
- Issue 4 Pages 191-
- Issue 3 Pages 137-
- Issue 2 Pages 83-
- Issue 1 Pages 1-
- Issue Special_Issue P･･･
- Issue Supplement2 Pag･･･
- Issue Supplement1 Pag･･･
Volume 44, Issue 5
Displaying 1-21 of 21 articles from this issue
- |<
- <
- 1
- >
- >|
ORIGINAL ARTICLE (Secondary Publication)
-
Shingo Noura, Masayuki Ohue, Tatsushi Shingai, Shingo Kano, Kentaro Ki ...Article type: ORIGINAL ARTICLE (Secondary Publication)
2011 Volume 44 Issue 5 Pages 511-518
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSBackground : Colorectal cancer (CRC) patients have a risk of developing other malignancies. Understanding the characteristics of the second primary cancers is important to establish an effective follow-up system. Methods : This study investigated 301 CRC patients to assess the risk factors for postoperative primary cancers arising from organs distinct from the colorectal area (extracolorectal cancers). The observed/expected ratio (O/E ratio) was calculated using the Osaka Cancer Registry, to determine the rate of increase of extracolorectal cancers. Results : The frequency of postoperative extracolorectal cancers was 12.6%. A logistic regression analysis showed only age to be an independent risk factor for postoperative extracolorectal cancer development. The O/E ratio of overall postoperative extracolorectal cancer was significantly higher than one (O/E ratio 2.6, P<0.01). In each organ, the frequency of lung and gastric cancers were significantly higher than one with O/E ratios of 3.2 (P<0.01) and 2.7 (P<0.05). Conclusions : The frequency of postoperative extracolorectal cancers in CRC patients was significantly higher than that in the normal population, especially for lung and gastric cancers. Clinicians should carefully follow patients for a possible recurrence of CRC and educate CRC patients with regard to the high risk of second primary cancers.View full abstractDownload PDF (685K)
CASE REPORT
-
Junya Morimoto, Masaichi Ohira, Naoshi Kubo, Hiroaki Tanaka, Kazuya Mu ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 519-525
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSEsophageal gastrointestinal stromal tumor (GIST) is rare, accounting for less than 2% of all GISTs. We report a case of esophageal GIST recurrence in the left iliopsoas muscle 11 years and 10 months after esophagectomy. A 52-year-old man referred for dysphagia, epigastralgia, and back pain was found on endoscopic examination to have a huge protruding type 2 tumor in the mid- to lower thoracic esophagus. Esophagectomy with gastric roll reconstruction was performed in February 1997. The histologic diagnosis was leiomyosarcoma. The postoperative course was uneventful. Eleven years and 10 months after esophagectomy, the man reported left back pain. An irregular homogeneous tumor in the left iliopsoas muscle was detected by detailed examinations. The left iliopsoas muscle was resected with the tumor in March 2009. Immunohistopathological examination showed the tumor to be positive for c-kit and CD34, yielding a diagnosis of GIST metastasis. The esophageal tumor resected 11 years and 10 months earlier was reexamined immunohistochemically and diagnosed as esophageal GIST. Thus the final diagnosis of esophageal was GIST metastasis. The postoperative course has been excellent, and adjuvant chemotherapy with imatinib mesylate (400mg/day) was begun in the outpatient clinic where the patient is being followed up.View full abstractDownload PDF (1370K) -
Tomohisa Okaya, Isamu Sugano, Shinichi Hayashi, Hirofumi Suzuki, Katsu ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 526-532
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 47-year-old woman was admitted to our hospital due to an upper abdominal mass and abdominal distension. Abdominal CT showed a giant multilocular cystic lesion with a maximum dimension of 25cm in the right lobe of the liver and multiple cysts in the left lobbe of the liver. Coarse calcification along the septa was found. Three-dimensional CT cholangiogram showed no findings of communication between the giant multilocular cystic lesion and the biliary tract. MRI showed a variety of low intensity levels on T1-weighted images and a variety of high intensity levels on T2-weighted images in the giant multilocular cystic lesion. Extended right hepatectomy was performed for the giant multilocular cystic lesion in the right liver, and unroofing was performed for the cysts in the left liver. Microscopic findings showed many cysts varying in size with fibrous stroma, proliferated small bile ducts of various sizesand peliosis-like hepatic remnant and lymphangiomatous lesions. The pathological diagnosis was mesenchymal hamartoma of the liver. Mesenchymal hamartoma of the liver is very rare in adults, but should be taken into account for a multilocular cystic lesion in the liver.View full abstractDownload PDF (997K) -
Kimihiko Ueno, Tetsuo Ajiki, Isamu Yamada, Hidehiro Sawa, Izuru Ohtsub ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 533-540
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSThe pathological differences between immunogloblinG4-related sclerosing cholangitis (IgG4-SC) and primary sclerosing cholangitis (PSC) have recently been elucidated. However, it is still difficult to make a differential diagnosis between IgG4-SC and hilar cholangiocarcinoma. We report a case of IgG4-SC with normal serum levels of IgG4 and without pancreatic lesions,resulting in a diagnosis of hilar cholangiocarcinoma. A 69-year-old woman who complained of general fatigue was found to have dilatation of the right hepatic duct on abdominal computed tomography (CT). A limited stricture of the hilar bile duct was found by endoscopic retrograde cholangiography (ERC), drip-infusion intravenous cholangiography (DIC-CT) and magnetic resonance cholangiopancreticography (MRCP). Although results of brushing cytology revealed class II, normal levels of IgG4 and negative anti-nuclear antibodies were found in laboratory tests. After hilar cholangiocarcinoma was diagnosed, a right hepatectomy was performed,but the pathological diagnosis given was IgG4-SC based on the postoperative immunohistochemical findings that showed a difference number of plasma cells that were positive for IgG4. This case suggests that it is crucial to make a differential diagnosis of hilar cholangiocarcinoma and atypical IgG4-SC.View full abstractDownload PDF (1730K) -
Takanori Kyokane, Hiroaki Shibahara, Junichi Takamizawa, Hayato Nakamu ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 541-548
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report an extremely rare case of biliary cystadenocarcinoma the natural history of which was retrospectively reviewed based on CT findings. A 79-year-old man was found to have a 13 x 8-cm hepatic cystic tumor with intraluminal papillary projection and extraluminal nodules in the left lobe and right anterior segment. Cholangiography revealed no communication between the cystic tumor and biliary tract. The liver cystic tumor had been identified on a CT series performed for follow-up of lung cancer surgery during the previous 10 years. The natural history from tumor origination to invasive cystaden-ocarcinoma was observed on those films. After surgical resection the histological diagnosis was biliary cystadenocarcinoma with invasion to the liver parenchyma. Low grade atypical mucosa, which was immunohistochemically positive for both CK17 and hepatocyte-paraffin 1, was observed in the cystic tumor. There was no ovarian-like stroma. He is alive 16 months after surgery without any signs of recurrence. This case may be valuable in considering the origins of the tumor based on CT findings as well as immunohistochemical findings. We reviewed 15 other cases of hepatic cystadenocarcinoma with neither ovarian-like stroma nor biliary tract communication reported in the literature.View full abstractDownload PDF (1632K) -
Ryosuke Kawai, Kanji Miyata, Norihiro Yuasa, Eiji Takeuchi, Yasutomo G ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 549-555
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 73-year-old man was admitted to our hospital for epigastric pain and jaundice. He had undergone endoscopic mucosal resection for an adenoma of the papilla of Vater at 66 years old. He had suffered from malignant lymphoma at 68 years old, but had complete remission after chemotherapy. On admission, endoscopic retrograde cholangiography revealed common bile duct stones and stricture of the middle bile duct. Endoscopic lithotripsy, nasobiliary drainage and biopsy were performed. Because histopathological examination of the biopsy specimen revealed adenocarcinoma, pancreaticoduodenectomy was performed. Macroscopically, the bile duct tumor showed papillary invasive type with granular superficial spreading. Histopathological examination of the resected specimen disclosed squamous cell carcinoma invading the subserosal layer in the papillary invasive lesion and adenosquamous cell carcinoma invading the mucosa and fibromuscular layer in the superficial spreading lesion of the upper and lower bile duct. The adenosquamous cell carcinoma showed bipolar differentiation to adenocarcinoma and squamous cell carcinoma. In addition, a small flat invasive type carcinoma of the gallbladder was found. To the best of our knowledge, there has been no report of adenosquamous cell carcinoma of the extrahepatic bile duct showing bipolar differentiation in the mucosal layer in the 42 Japanese reported cases. So our case is very rare and valuable for investigating the histogenesis of adenosquamous cell carcinoma of the extrahepatic bile duct.View full abstractDownload PDF (1853K) -
Takeo Nitta, Shunichi Okushiba, Daisuke Miyasaka, Takeshi Sasaki, Yuma ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 556-562
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 59-year-old woman with acute abdominal and back pain was referred with a diagnosis of pancreaticoduodenal artery aneurysms. Preoperative abdomen contrast computed tomography (CT) revealed a retroperitoneal hematoma around the pancreatic head. Angiography indicated a hypertrophic pancreaticoduodenal arcade and two pancreaticoduodenal artery aneurysms, together with retrograde hepatic, splenic, and left gastric artery flow via the gastroduodenal artery. We evaluated the blood flow of the common hepatic artery and aneurysms intraoperatively using indocyanine green (ICG) fluorescence imaging. Our findings suggested celiac artery trunk compression with multiple pancreaticoduodenal artery aneurysms. Surgery involved ligating the aneurysm branches and dividing the median arcuate ligament.View full abstractDownload PDF (1512K) -
Masashi Miguchi, Yasuhiro Matsugu, Takashi Urushihara, Ichiro Omori, H ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 563-570
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 57-year-old woman had been given a diagnosis of splenic cyst about three years previously and thereafter had been followed up at a local hospital. She consulted our hospital due to symptoms of upper abdominal colic. She had peritoneal irritation symptoms and high serum levels of CA19-9. A splenic cyst was identified on CT scans, but the form and the size had not recently changed and no ascites was observed. Although the administration of conservative therapy relieved the pain, the patient nevertheless underwent a laparoscopic splenectomy due to the recurrent pain. The pathological diagnosis was an epidermoid cyst, and the cyst wall showed hemorrhagic necrosis. The epithelial cells of the cyst showed diffuse immunoreactivity to CA19-9. The postoperative course was uneventful, and the serum CA19-9 levels normalized by one month after the operation. The hemorrhagic necrosis of the cystic wall was therefore presumed to have caused both the abdominal colic pain and high serum levels of CA19-9. We reviewed 29 similar cases of splenic cyst with high serum CA19-9 levels reported in the Japanese literature.View full abstractDownload PDF (1479K) -
Kiyoto Takehara, Toshiaki Morihiro, Yuko Fujiwara, Kohji Tanakaya, Hid ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 571-576
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAn 80-year-old woman under treatment for systemic sclerosis visited our hospital for abdominal distension and vomiting. The patient was given a diagnosis of small bowel volvulus based on the presence of a "whirl sign" on abdominal CT and underwent an emergency operation. The small bowel was twisted 540 degrees clockwise around the superior mesenteric vessels but was not necrotized. A simple detorsion was carried out. However, on postoperative day 39, the patient complained of abdominal pain. Abdominal CT demonstrated the "whirl sign" again, and an emergency operation was carried out under the diagnosis of recurrent small bowel volvulus. The small bowel was twisted 180 degrees counterclockwise around the superior mesenteric vessels. After detorsion, we added a mesenteric plication according to the Childs-Phillips procedure. While advantages of mesenteric fixation for small bowel volvulus are still uncertain, it can be said that mesenteric fixation must be considered in recurrent cases. Because the association between systemic sclerosis and small bowel volvulus is unclear, this case is intriguing.View full abstractDownload PDF (1414K) -
Koji Okuda, Keisuke Bando, Masaki Okada, Masataka Wada, Kazuhito Misaw ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 577-583
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report a case of mesenteric venous thrombosis caused by congenital antithrombin deficiency. A 30-year-old man was admitted to our hospital with a complaint of severe abdominal pain and vomiting. Contrast-enhanced computed tomography revealed thrombi in the superior mesenteric vein (SMV) and portal vein (PV). In addition, the small intestinal wall was found to be remarkably thickened. We performed emergency laparotomy and discovered congestive necrosis extending 40cm along the ileum. Following bowel resection and subsequent establishment of primary anastomosis, a large thrombus was removed from the incised SMV using a Fogarty catheter. Blood tests revealed antithrombin deficiency, thereby necessitating the administration of heparin and antithrombin concentrate. Although PV was not recanalized postoperatively, the development of collateral vessels prevented the progression of bowel necrosis. The patient is currently under warfarin therapy and requires long-term follow-up and monitoring of portal hypertension.View full abstractDownload PDF (1285K) -
Tadayoshi Yamaura, Hirohiko Sakamoto, Toshimasa Yatsuoka, Nobuaki Kawa ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 584-590
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report two cases of resection of pancreatic metastasis after operation for colorectal cancer in reference to the literature of very rare spermatic cord metastasis, one, a long-term survival case, and the other, accompanied by right spermatic cord metastasis. Case 1: A 63-year-old woman underwent total pelvic exenteration for rectal cancer, followed by adjuvant chemotherapy, and operation for pulmonary metastasis 24 months later. Abdominal computed tomography (CT) showed a mass in the pancreatic tail 69 months later. She underwent distal pancreatectomy and right partial nephrectomy. The postoperative course was uneventful and the patient is still alive at 85 months afterpancreatic operation. Case 2: A 56-year-old man underwent extended right hemicolectomy for carcinoma of the transverse colon. Operations for metachronous hepatic, pulmonary and lymph node metastases were performed at 12 months, 19 months, and 34 months after colectomy, respectively. An abdominal echography 49 months later showed a mass in the pancreatic body. Positron emission tomography (PET)/CT indicated accumulation in the pancreas and pelvis. Diagnosis of metastasis to the pancreas and the right spermatic cord was made. We resected the pancreatic body, tail and right spermatic cord 54 months after the colon operation.The pathological diagnosis was compatible with hematogenous metastasis of colon cancer. Aggressive surgery for pancreatic metastasis from colorectal cancer is often recommended and our experience supports this idea.View full abstractDownload PDF (1561K) -
Ryuta Taniguchi, Yasuhiro Nagata, Daisuke Niino, Yumi Mihara, Shinichi ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 591-595
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAn 88-year-old woman was admitted to our hospital due to melena. Colonoscopy revealed that the tumor was located at the hepatic flexure of the transverse colon and developed on the luminal side with a sharp demarcation. Histologically, the tumor consisted of packed tumor nests with scattered lymphocytes which invaded into the subserosal layer. The pathological diagnosis was lymphoepithelial-like carcinoma (LEC) with infiltration of CD3-positive lymphocytes into the tumor. Most LECs developed in the stomach, thymus, and salivary glands. There are, however, few reports about colonic LECs. Although Epstein-Barr virus (EBV) infection has been reported to be frequently associated with LECs, EBV infection was not detected in our patient. Clinical significance of lymphocyte invasion into the tumor and EBV infection is not yet clarified.View full abstractDownload PDF (844K) -
Yoshio Matsui, Takahisa KageyamaArticle type: CASE REPORT
2011 Volume 44 Issue 5 Pages 596-602
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSPrimary adenosquamous carcinoma of the large intestine is very rare and has been reported to be aggressive and have a poor prognosis. We report a case of adenosquamous carcinoma of the ascending colon with lymph node metastasis. A 54-year-old man was admitted to our hospital because of anemia and anal bleeding. Total colonoscopy revealed a type 2 tumor in the ascending colon, and the biopsy specimen showed moderately differentiated adenocarcinoma. Right hemicolectomy with D3 lymph node dissection was performed. The resected specimen demonstrated a type 3 tumor measuring 6.0 x 4.0cm. Microscopically, both carcinoma with squamous differentiation characterized by intracellular keratinization and adenocarcinomatous components with glandular differentiation were demonstrated. Pathologic metastasis was found in the dissected lymph nodes. The tumor was diagnosed as an adenosquamous carcinoma, A, type 3, pSS, pN2, sH0, sP0, sM0, fStage IIIb. Systemic chemotherapy with a combination of 5-fluorouracil and leucovorin was administered. The patient is alive without recurrence at 40 months after the operation.View full abstractDownload PDF (1380K) -
Tatsuya Tazaki, Hiroaki Tsumura, Hiroshi Hino, Tetsuya Kanehiro, Hiroa ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 603-609
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAn 86-year-old man with dementia who had previously undergone left inguinal hernia repair at age 75 was transported to our hospital after his family noticed a mass in his left inguinal region. Upon examination, there was no local redness. We were therefore able to diagnose and repair an incarcerated left inguinal hernia. The repositioning was fairly straightforward. We hospitalized the patient to observe his progress. He had intense pain in his entire abdomen two days after he was hospitalized. Ascites and small intestinal dilation were confirmed by an abdominal computed tomography (CT). We diagnosed acute peritonitis and performed an exploratory laparotomy. A sigmoid colon perforation was found and we proceeded to perform a life-saving procedure which consisted of closing the perforated sigmoid colon, drainage, constructing a loop colostomy using the transverse colon, and repairing the hernia orifice with a direct peritoneal suture. A case of colon perforation after repositioning of an incarcerated inguinal hernia is very rare. Given this experience, we assert that it is necessary to recognize the dangers of repositioning an incarcerated hernia because assessment of whether the incarcerated bowel has progressed to necrosis can often be difficult in elderly patients and patients with dementia with few symptoms.View full abstractDownload PDF (1396K) -
Akio Kaito, Tadamichi Hashimoto, Syuhei Takahashi, Hiroyuki Shibusawa, ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 610-616
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe report a case of rectal vascular malformation treated with transcatheter arterial embolization (TAE). A 52-year-old man with bleeding during hemorrhoidectomy at another hospital was admitted for emergency bleeding control and underwent transanal surgical hemostasis. He then began rebleeding and had to undergo hemostasis again. Colonoscopy (CS) showed a remnant pulsatile lesion in the anus, and contrast-enhanced computed tomography (CT) showed diffuse hypervascular lesions widely and deeply invading the pelvic wall, contraindicating complete resection. Under a definitive diagnosis of high-flow vascular malformation on angiography, we conducted superselective transcatheter arterial embolization (TAE) in two stages to embolize the main feeding arteries, i.e., right middle and inferior rectal arteries, using N-butyl-2-cyanoacrylate. Two days after the second-stage TAE, the anal pulsatile lesion had improved on CS. He has been free of anal rebleeding in the 7 months following TAE.View full abstractDownload PDF (1247K) -
Keijiro Kawasaki, Tomohide Mukogawa, Hisao Fujii, Fumikazu Koyama, Tad ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 617-623
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAn 83-year-old woman, underwent chemo-radiotherapy for uterine cervical cancer 21 years previously, resulting in complete response. The following year, she underwent a loop sigmoid colostomy due to radiation-induced colitis and recto-uterine fistula related to the past radiation therapy. During this time, she was admitted to our hospital with a complaint of anal bleeding. Advanced rectal cancer was diagnosed in the right side of the upper rectum by barium enema and colonoscopy. She received a Hartmann operation. Surgical specimens showed that the shape of the tumor was type 3, and the lumen was remarkably stenotic due to radiation-induced colitis and disuse atrophy caused by rectal diversion. Histological findings revealed that the main tumor was composed of mucinous carcinoma which invaded the serosa. Colitis cystica profunda (CCP) was observed in the neighboring mucosa, and immuno-histochemical staining of p53 and Ki 67 were positive in the dysplasia area. We present a case of radiation-induced rectal cancer in the diverted rectum originating from dysplasia due to radiation colitis.View full abstractDownload PDF (1486K) -
Hajime Morohashi, Norihisa Kimura, Satoko Morohashi, Yoshiyuki Sakamot ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 624-631
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe describe a case of lower colorectal cancer associated with Crohn colitis in which anus-preserving surgery was performed. The patient, a 40-year-old woman, was first given a diagnosis of Crohn disease (CD) in 1978, when a longitudinal ulcer and pseudopolyposis of the large intestine extending from the cecum to the sigmoid colon was discovered, together with stenosis of the ascending colon. She underwent subtotal proctocolectomy in 1988, and thereafter a wait-and-see approach was adopted by internal medicine specialists. However, stenosis developed at the site of anastomosis on several occasions from 2003, and the patient underwent endoscopic dilatation at regular intervals. Because high-grade dysplasia of the remnant rectal mucosa was found in January 2009, she was admitted to our hospital for surgery due to the possibility that cancer might develop. Extirpation of the remnant rectum and ileoanal anastomosis with diverting loop ileostomy was performed. The specimen was diagnosed pathologically as adenocarcinoma (tub1), pSM, N0, pStage I. Because of improvements in medical management, the number of CD patients undergoing long-term treatment has increased. We expect that surveillance will reveal more CD patients with precancerous dysplasia and early stage cancer in the future. Anus-preserving surgery is a realistic option for such patients.View full abstractDownload PDF (1141K) -
Yuki Homma, Nobuyuki Kamimukai, Yutaka Nagahori, Yosiro Obi, Tetsuo Ab ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 632-637
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSWe present a case of carcinoma associated with anal fistula, treated by abdomino-sacral resection after neoadjuvant chemoradiotherapy. The patient was a 78-year-old man who had a history of anal fistula for over 40 years. He was admitted to our hospital because of anal bleeding and fever. There was a tumor with mucous discharge on the left side of the anus. There were no distant metastases and no swollen lymph nodes on pelvic CT and MRI. The diameter of the tumor was 7cm. pelvic We performed neoadjuvant chemotherapy preoperatively. The size of the tumor decreased to 2.5cm and tumor marker levels decreased. After chemoradiotherapy, abdminosacral resection was performed. Surgical margins were negative and now the patient is alive with no evidence of recurrence. Neoadjuvant chemoradiotherapy was effective in this case of locally advanced carcinoma with anal fistula.View full abstractDownload PDF (1159K) -
Mitsumasa Takeda, Shintaro Nakajima, Kazuo Kitagawa, Tetsuya Yamagata, ...Article type: CASE REPORT
2011 Volume 44 Issue 5 Pages 638-644
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSA 61-year-old man presented with chest pain at another hospital. An abdominal computed tomography (CT) scan demonstrated a cystic tumor, 5cm in diameter, close to the anterior surface of the left sacroiliac joint. He was referred to our hospital in September, 2008. On repeated abdominal CT, the tumor had a thickened wall, inner calcification and a discrete border. An MRI study showed increased intensity only within the tumor margin (T1-weighted enhanced images), which led to the diagnosis of a schwannoma with cystic degeneration. He underwent excision of the tumor in November, 2008. The dorsal part of the tumor was strongly adherent to the surrounding tissues and several branches of the left internal iliac vein were entangled within the adhesions, and therefore were resected together. The pathohistological examination revealed a benign schwannoma. At 16 months after surgery, the patient remains in good condition without recurrence or muscle weakness. schwannoma is a benign tumor originating from the sheaths of Schwann of the peripheral nerves,which most commonly involve the head-neck region or extremities. Pelvic occurrence is extremely rare (1% of all schwannomas), and in Japan, only 11 cases have been reported in the past.View full abstractDownload PDF (1685K)
CLINICAL EXPERIENCE
-
Shusaku Ohira, Hitoshi Kubota, Hideaki Suzuki, Eiji Hayashi, Seiji Ish ...Article type: CLINICAL EXPERIENCE
2011 Volume 44 Issue 5 Pages 645-650
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSMaking the diagnosis of obturator hernia has recently become easier with the development of computed tomography (CT). However since this disease often affects elderly patients, some patients only consult a doctor after progression. As the incarcerated intestine often develops necrosis, a mesh prosthesis is not indicated, resulting in the simple closure of the obturator canal. We encountered 13 obturator hernia cases in the last 5 years of which 5 used a Kugel patch which was inserted into the preperitoneal space on the obturator orifice from the midline incision. In 1 of the 5 cases, resection of the small intestine was performed. This method only has minimal risk for infection from the patch due to closure of the preperitoneal space after insertion of the patch, and is an effective way to cover many pelvic hernias.View full abstractDownload PDF (1250K) -
Tadataka Hayashi, Yoshirou Nishiwaki, Takeshi Ueda, Yuki Nakata, Hiroa ...Article type: CLINICAL EXPERIENCE
2011 Volume 44 Issue 5 Pages 651-656
Published: May 01, 2011
Released on J-STAGE: May 24, 2011
JOURNAL FREE ACCESSAcute superior mesenteric arterial (SMA) occlusion is not a common disease, but its mortality rate is high due to resulting extensive intestinal tract necrosis. To improve outcome, it is important to maintain digestive tract absorption after extensive resection of the necrotic intestine. The longer the remaining intestine is preserved, the more the remnant bowel becomes necrotic. We need to discuss these opposing ideas to determine when the operative procedure should be done. We report a case of simultaneous anastomosis using a monitoring flap for extensive bowel resection for SMA occlusion in a 37-year-old Japanese man. Side-to-end anastomosis was performed after massive bowel resection. The end of the jejunum closed by a stapler was fixed to a 2- cm window through the abdominal wall. The window made it possible to observe the remnant bowel. Our modified reconstruction procedure is easy to perform without excessive stress for a patient, and is useful to anastomose intestines safely after extensive bowel resection for SMA occlusion.View full abstractDownload PDF (1208K)
- |<
- <
- 1
- >
- >|