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 45, Issue 8
Displaying 1-11 of 11 articles from this issue
- |<
- <
- 1
- >
- >|
CASE REPORT
-
Naoki Tanimine, Nobutaka Hatanaka, Yukinobu Yoshikawa, Yousuke Shimizu ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 817-825
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLWe report a case of esophageal gastrointestinal stromal tumor (GIST) occurring with epiphrenic diverticulum. A 36-year-old man admitted because of an abnormal shadow detected on a medical check-up chest X-ray. Computed tomography and magnetic resonance imaging showed a 5-cm left epiphrenic tumor. It was difficult to define the tumor origin by preoperative examinations. We performed operation in consideration of its malignant potential. Laparoscopic observation could not find the tumor. After conversion to open surgery, the tumor protruding from the esophagus toward the left side was found by dilating the esophageal hiatus. The tumor originated from an epiphrenic diverticulum, tumor resection was performed by diverticulectomy. Immunopathological findings yielded definitive diagnosis of intermediate risk GIST. Considering the intraoprative findings and the results of postoperative esophageal motor function tests, the existence of esophageal GIST might have the possibility of causing epiphrenic diverticulum. Preoperative definitive diagnosis of GISTs is often difficult. Furthermore, esophageal GISTs can be difficult to manage because of the specific localization. Individual consideration is required for each cases. This case was able to be resected while preserving the esophagus because of its particular pattern of occurrence.View full abstractDownload PDF (2039K) Full view HTML -
Masashi Zuguchi, Fumiyoshi Fujishima, Hiroshi Okamoto, Takashi Kamei, ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 826-833
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 68-year-old man who was admitted with dysphagia had undergone endoscopic and pathological examinations at another hospital, before being referred to our hospital with a diagnosis of esophageal adenocarcinoma. Endoscopy showed a type-3 lesion, 30–37 cm from the incisors. The pathological examination showed the lesion to be squamous cell carcinoma. He underwent thoracoscopic esophagectomy, without neoadjuvant therapy. A pathological examination of the excised specimens showed the lesion to contain a squamous cell carcinoma component, an adenocarcinoma component and a basaloid-squamous carcinoma component. These components were similar in volume. The deepest part of the carcinoma was located at the adventitia. The squamous cell carcinoma had metastasized to the 106 recR lymph nodes. The pathological stage was pT3pN1cM0 and pStage III. Esophageal carcinomas with these 3 components are rare.View full abstractDownload PDF (1714K) Full view HTML -
Daisuke Takeyama, Go Miyata, Ko Onodera, Hirofumi Ichikawa, Takashi Ka ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 834-841
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLWe report the case of a patient with an alpha-fetoprotein (AFP)-producing esophageal carcinoma with different histological patterns. A 58-year-old man was admitted for bowel obstruction after undergoing appendectomy; he was found to have a protruding tumor in the lower esophagus. Tumor biopsy showed adenocarcinoma. Preoperative serum AFP concentration elevated to 3,788 ng/ml. The patient underwent thoracoscopic esophagectomy with D2 regional lymphadenectomy and reconstruction using a gastric tube. Histological examination showed findings of combined carcinoma with enteroblastic differentiation, hepatoid adenocarcinoma, and tubular adenocarcinoma arising in Barrett esophagus. An immunohistochemical study yielded positive results for AFP. The patient received adjuvant chemotherapy with S-1. The serum AFP concentration decreased; the patient survived, and no recurrence has been observed for 22 months after the surgery. Few cases of AFP-producing esophageal carcinomas have been reported in the literature. In this study, we have described a very rare case of AFP-producing esophageal carcinoma.View full abstractDownload PDF (2062K) Full view HTML -
Hiroyuki Koami, Shinichiro Kameyama, Haruka Motonari, Haruki Taniguchi ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 842-849
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLWe report 3 rare cases of communicating accessory bile duct (CABD). Case 1: A 60-year-old woman was given a diagnosis of cholelithiasis and was referred to our hospital. Preoperative MRCP did not show any abnormalities. Laparoscopic cholecystectomy was performed. Intraoperative cholangiography showed a CABD (Goor classification; F3). Case 2: A 26-year-old man was given a diagnosis of cholelithiasis and was referred to our hospital. Preoperative MRCP showed an aberrant bile duct between the right hepatic duct and cystic duct. He underwent laparoscopic cholecystectomy and intraoperative cholangiography confirmed CABD (F2). Case 3: A 40-year-old woman with a diagnosis of calculus cholecystitis was referred to our hospital. Preoperative MRCP did not show any abnormalities. She underwent open cholecystectomy and intraoperative cholangiography showed CABD (F2). We estimate that the reported prevalence of CABD is higher than ever due to developments in modern diagnostic technology. If CABD is suspected, it is important that we dissect around the gallbladder neck carefully and perform intraoperative cholangiography.View full abstractDownload PDF (1443K) Full view HTML -
Eiji Sunami, Isao Kurosaki, Kazuyasu Takizawa, Ken Nishikura, Katsuyos ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 850-856
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 78-year-old woman underwent splenectomy under a diagnosis of intraabdominal bleeding caused by spontaneous rupture of a splenic cyst in September 2002. During the operation, splenic vessels were dissected by mass ligation of the artery and vein. About 4 years after the operation, the then asymptomatic patient was found to have dilatation of the splenic vein by abdominal US and was referred to our hospital in June 2006. Abdominal CT films showed a well-enhanced tumor, 7-cm with the same density as the splenic vein, located in the neighborhood of the pancreatic tail. Abdominal MRI films demonstrated that the tumor was markedly enhanced in the early phase and at the same time the slightly dilated portal vein was well-enhanced. Thus the tumor was diagnosed as arteriovenous fistula of the splenic vessels, and the operation was performed 3 years and 11 months after the previous splenectomy. Laparotomy showed the tumor had abundant pulsatile arterial blood flow, necessitating fistulectomy with ligation and resection of each splenic artery and vein. The Operative diagnosis was also splenic arteriovenous fistula, which was considered to have been derived from mass ligation of the splenic artery and vein. Cases of postsplenectomy arteriovenous fistula of the splenic vessels are very rare in Japan.View full abstractDownload PDF (1690K) Full view HTML -
Masahiro Ito, Masayuki Sho, Takatsugu Yamada, Kiyoshi Kamada, Yasunori ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 857-864
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 76-year-old man was found to have a 3-cm asymptomatic splenic mass, during screening abdominal ultrasonography. Abdominal enhanced CT and abdominal MRI revealed no definitive diagnosis. Since fluorine-18-fluorodeoxyglucose and positron emission tomography (FDG-PET) showed high FDG accumulation in the spleen, we performed splenectomy for suspected malignant tumor. It was histopathologically diagnosed as primary splenic inflammatory myofibroblastic tumor (IMT). The postoperative course was uneventful and recurrence did not occur. However, he suffered from primary lung cancer two years and three months after splenectomy. He received chemotherapy, but died of lung cancer three years and four months after splenectomy. We reported a rare case of primary splenic IMT. In the Japanese literature, only 5 cases of primary splenic IMT have been reported so far.View full abstractDownload PDF (2193K) Full view HTML -
Eiichiro Watanabe, Atsuo Tokuka, Toyonari Kubota, Keiko Aoki, Shinichi ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 865-874
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 58-year-old man with bronchial asthma under steroid therapy was suspected to have allergic granulomatous angitis (AGA) because eosinophilia and peripheral neuropathy of the right extremities were observed, and he was referred to our hospital due to exacerbated abdominal pain. Physical examination showed both defense and rebound tenderness in the entire abdomen. Blood examination revealed elevated serum inflammatory data such as 29,600/μl WBC and 24.6 mg/dl CRP. Abdominal CT scan revealed free air both in bilateral subphrenic and the pelvic spaces. We performed subtotal small intestinal resection because multiple small intestinal necroses and perforations from the ligament of Treitz to the terminal ileum, about 30 cm proximal to the Bauhin valve, were observed. In addition, gastrostomy for the purpose of drainage and enterostomy for the purpose of nutritional support were performed. Some reports regarding AGA with intestinal perforations have been published, but, to the best of our knowledge, there has been no survived case that performed more than 4 m subtotal small intestinal resection. Herein, we report one of the rare cases of the AGA.View full abstractDownload PDF (1787K) Full view HTML -
Takehiro Kato, Seiji Ogiso, Kenji Kobayashi, Kazuo KatoArticle type: CASE REPORT
2012 Volume 45 Issue 8 Pages 875-880
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 66-year-old man presented at the emergency department because of a 2-week history of nausea and anorexia. Abdominal ultrasonography and computed tomography showed an intussusception of the small intestine caused by a tumor, with synchronous liver metastases. Laparotomy revealed a 40-cm jejuno-jejunal intussusception caused by a 5-cm elastic hard mass located 100 cm on the anal side of the ligament of Treitz. Manual reduction of the intussusception was performed, followed by a partial resection of the jejunum with regional lymph node dissection. Histological findings showed that the tumor cells were spindle-shaped. An immunohistochemical study showed that the tumor cells were positive for αSMA and negative for KIT, CD34, desmin and S-100. Therefore, the tumor was diagnosed to be a leiomyosarcoma of the jejunum. He was discharged without complications 9 days after the operation. Partial hepatectomy for liver metastases was performed one month later. Unresectable multiple liver metastases were found 7 months after the first operation. He refused chemotherapy, and 15 months after the first operation, died from disease progression.View full abstractDownload PDF (1524K) Full view HTML -
Michiya Kudo, Hiroaki Urayama, Tomoyuki Shiga, Hideyuki IchikawaArticle type: CASE REPORT
2012 Volume 45 Issue 8 Pages 881-888
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLAn 84-year-old man, who had no history of a disease, except hypertension, was admitted for lower abdominal pain. We performed an operation under a tentative diagnosis of pan-peritonitis, and local, segmental and skipping necrosis of the ileum were observed. Histological examination of the resected specimen revealed cholesterol crystal embolization (CCE) in the small arteries. The man was discharged at 29 days after the operation, and is still alive after five years. CCE is a systemic disease with poor prognosis, caused by micro showers of cholesterol crystals after arterial catheterization, aortic surgery, thrombolytic therapy, or anticoagulation. Although CCE often causes renal insufficiency and cutaneous manifestations, CCE, as in our case, can cause small intestinal necrosis spontaneously and suddenly under circumstances without iatrogenic risk factors, such as vascular procedures. Therefore, the possibility of CCE must be kept in mind in the diagnosis and treatment for acute abdomen of elderly men.View full abstractDownload PDF (1217K) Full view HTML -
Mina Kitamura, Tomoharu Shimizu, Eiji Mekata, Takeshi Tatsuta, Hiroya ...Article type: CASE REPORT
2012 Volume 45 Issue 8 Pages 889-896
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 48-year-old woman with increasing abdominal pain revisited our outpatient clinic, although gastric endoscopy performed the day before had revealed no abnormalities. An enhanced CT revealed invagination in the left side of colon. Intraoperative findings during emergency surgery revealed that the tip of invagination existed in the sigmoid colon, which was easily restored to its normal position by hand manipulation. We found a tumor in the transverse colon as the tip of invagination and another 1 cm nodule in the major omentum at 15 cm in an anal direction from the previous tumor. Transverse colectomy removing the omental tumor, and colostomy were performed. Pathological findings revealed a poorly differentiated adenocarcinoma in the colon and an inflammatory myofibroblastic tumor (IMT) in the major omentum. The patient received surgery for ileus and stoma closure because of adhesive ileus 31 days after the first surgery. There was no obvious lesion identifiable as the origin of IMT during the second surgery or by the findings of positron emission tomography-CT after surgery. We speculated that the origin of the IMT might be the major omentum. No report of invagination due to colon cancer accompanied with IMT was found. Although IMT usually is a low-grade malignancy with a good prognosis, recurrence should be considered, including colon cancer in such cases.View full abstractDownload PDF (2069K) Full view HTML
CLINICAL EXPERIENCE
-
Masaki Sunagawa, Masatoshi Isogai, Toru Harada, Yuji Kaneoka, Keitaro ...Article type: CLINICAL EXPERIENCE
2012 Volume 45 Issue 8 Pages 897-904
Published: August 01, 2012
Released on J-STAGE: August 20, 2012
JOURNAL FREE ACCESS FULL-TEXT HTMLA 62-year-old woman was examined at our hospital due to upper abdominal pain. Ultrasonography showed a biliary stone in the dilated extrahepatic bile duct and a cholecystolith. Enhanced CT showed a cystic dilatation of the extrahepatic bile duct, primarily in the common hepatic duct. However, a pancreaticobiliary maljunction was not found by either ERCP or ultrasonographic endoscopy. Since it is difficult to precisely evaluate the mode of the junction between the non-dilated intrahepatic bile duct and the cystic dilated extrahepatic bile duct by ordinary cholangiography, a 3D-cholangiogram was obtained using cholangiography via endoscopic nasal bile duct (ENBD) drainage tube and multi-detector row CT (MDCT). The right intrahepatic biliary system was found to consist of 3 bile ducts: a common duct of the anterior upper abdominal branch and an anterior lower segmental branch, a common duct of the anterior upper exterior branch and posterior branch, an inferior posterior segmental branch joined with the dilated bile duct and the left intrahepatic biliary system consisting of two bile ducts: an exterior segmental branch and an interior segmental branch joined with the dilated bile duct. Congenital biliary dilatation of the Todani Ia type without a pancreaticobiliary maljunction was diagnosed and the gallbladder and extrahepatic bile duct were resected and a hepatic duct jejunal Roux-en-Y anastomosis was performed. The 3D-cholangiogram was found to be useful when diagnosing the pattern of the junction between the intrahepatic bile duct and the cystic dilated extrahepatic bile duct to ensure safe surgery.View full abstractDownload PDF (2554K) Full view HTML
- |<
- <
- 1
- >
- >|