A 70-year-old woman visited our hospital with repeated vomiting for about 2 months. After examination, she was diagnosed with type III hiatal hernia and underwent elective laparoscopic hiatal hernia repair. The crus was closed with suture, followed by reinforcement with a prosthetic mesh and circumferential fixation into the diaphragm using a hernia stapler. On the day after surgery, oxygenation decreased, blood pressure dropped rapidly, and tachycardia was observed. Cardiac tamponade was immediately diagnosed and percutaneous cardiocentesis was performed. On postoperative day 18, the patient developed cardiac tamponade again. The patient was discharged from hospital on postoperative day 45 without recurrence. A retrospective review of the surgical video showed that the patient had a medically-induced cardiac tamponade caused by a hernia stapler with mesh fixation. This disease has an extremely high mortality rate, making it important to prevent its onset by use of correct equipment and to respond promptly to any postoperative abnormalities in vital signs.

An 84-year-old woman was admitted to our hospital with a stomach tumor. Upper gastrointestinal endoscopy revealed an ulcerated tumor of 2 cm in diameter with a thickened wall without a clear margin. The tumor gradually increased in size and developed a different appearance over the course of three months. A biopsy specimen showed no definite malignancy, and contrast-enhanced CT showed no evidence of lymph node metastasis or distant metastasis, which would have indicated malignancy. However, PET revealed abnormal accumulation in the tumorous lesion. Therefore, laparoscopic distal gastrectomy with lymph node dissection was performed. A histopathological examination revealed gastric plasmacytoma. The tumor was located and localized in the submucosal and muscular layers without lymph node metastasis. The patient has survived for more than five years after surgery without adjuvant therapy.

The patient was a 63-year-old woman who was diagnosed with a pancreatic tumor in an abdominal ultrasound examination. CT showed a 33-mm low density mass anterior to the tail of the pancreas. The lesion showed incremental and heterogeneous contrast. MRI showed a low intensity signal on T1WI, a low intensity signal in the center and a mildly high intensity signal in the margins on T2WI, and a high intensity signal in the margins and a low intensity signal in the center on DWI. Based on these findings, solid pseudopapillary neoplasm (SPN) or desmoid tumor was suspected as the differential diagnosis. Considering the risk of seeding, we decided not to conduct a biopsy and to perform laparoscopic pancreatectomy. Intraoperative findings suggested invasion of the gastric wall. Therefore, distal pancreatectomy with partial resection of the stomach wall and splenectomy was performed. The pathological diagnosis was desmoid tumor. Reports of laparoscopic pancreatic resection for intra-abdominal desmoid tumor are rare, and we report our findings including a literature review.

A 78-year-old male was diagnosed with ascending colon cancer (T1b N1a M0 Stage IIIa) and underwent laparoscopic partial colectomy. At 24 months after surgery, a 37-mm tumor in the abdomen was identified on contrast-enhanced CT. Surgical resection was planned for suspected postoperative recurrence of peritoneal dissemination. During laparotomy, a 5-cm tumor was identified in the mesentery, and combined resection with the small intestine was performed. A mesenteric desmoid tumor was confirmed in a postoperative histopathological examination. Three months later, follow-up contrast-enhanced CT detected an 11-mm nodule in the mesentery, which was suspected to be a recurrence of the desmoid tumor. The patient is currently under careful observation at 6 months after surgery. Observation, rather than surgical resection, has recently become the recommended approach for management of desmoid tumors, but there are limited reports on identification of cases that require aggressive treatment. Therefore, in this report, we also provide a review of domestic cases, and we suggest that desmoid tumors larger than 65 mm might show symptoms, indicating a potential need for therapeutic intervention.

An 87-year-old woman was diagnosed with rectal cancer and underwent robot-assisted Hartmann surgery. On postoperative day (POD) 6, back pain appeared, and CT showed an infected aortic aneurysm and multiple liver abscesses. Klebsiella pneumoniae was detected in blood culture and the patient was treated with antibiotics. On POD 14, CT showed an enlarged aortic aneurysm, and the patient was diagnosed with an urgent rupture and underwent an emergency stent graft insertion. The patient’s progress was good and she was discharged ambulatory on POD 46. Klebsiella pneumoniae is an attenuated resident bacterium in the gastrointestinal tract. Patient factors, surgical invasion, and other factors, in addition to bacteremia caused by intestinal mobilization and manipulation at the time of resection and stoma placement, may have led to sepsis, resulting in infection of the aortic wall and multiple liver abscesses. We describe this case as the first report of infected aortic aneurysms and multiple liver abscesses in the early postoperative period after surgery for colorectal cancer.

A 57-year-old woman was taken to our hospital with an abdominal stab wound. She was diagnosed with traumatic celiac axis injury, hepatic injury, and pancreatic injury, and underwent emergency surgery. Intraoperative findings revealed hepatic injury, pancreatic injury and avulsion of the celiac axis, and hemostasis was achieved by ligation of the celiac axis. Due to an Adachi type VI vascular anomaly, in which the common hepatic artery bifurcated from the superior mesenteric artery, blood flow to the liver was well maintained after surgery. The patient was discharged on the 34th postoperative day. Ligation of the celiac axis may result in inadequate blood flow to the liver and stomach. However, there are cases in which blood flow to organs is maintained due to vascular anomalies, even when the celiac axis is disrupted. As an example of such a case, we report this case of traumatic celiac axis injury with an Adachi type VI vascular anomaly.