Jidabokuippo (JDI) is a Japanese traditional medicine used for contusion-induced swelling and pain. In recent years, it has been reported to be used for postoperative swelling and hematoma. We report the effect and usage of JDI in treating scrotal swelling after orchiopexy. We examined 25 patients who underwent orchiopexy and were prescribed JDI in our department from June 2017 to December 2019. The median age at surgery was 2 years (range: 0 years 7 months to 13 years), the median weight was 10 kg (range: 7.6 to 53 kg), and the median administration period was 7 days (range: 6 to 56 days). The prescribed dose of this drug was 0.2 to 0.3 g/kg body weight/day. The outpatient doctor in charge assessed and categorized the swelling of the scrotum into one of three stages (A, scrotum and spermatic cord swelling improved; B, scrotum swelling improved and only spermatic cord thickening remained; C, swelling of both the scrotum and spermatic cord remained). The degree of improvement in the swelling was observed to be as follows: A, 15 cases (60%); B, 7 cases (28%); and C, 3 cases (12%). From the experience in our department, the administration of JDI improves postoperative scrotal swelling with subcutaneous hematoma.

One of the complications of indwelling central venous catheters is the difficulty in their removal. We experienced treating a case in which the catheter was last replaced at the age of 15 years for nutritional management and was left in place from the left internal jugular vein to the superior vena cava at the age of 23 years owing to difficulty in its removal. The duration in which the last catheter was left in place was 14 years and 8 months. The patient died at the age of 30 years owing to a worsening respiratory condition caused by infection and progressive prerenal renal failure associated with gastrointestinal bleeding. Pathological autopsy revealed scar tissue surrounding the catheter, and foreign bodies scattered in the scar tissue. In addition, there was fibrous stenosis or occlusion in the peripheral pulmonary artery, and foreign bodies were found inside the peripheral pulmonary artery. Our experience suggests that parts of the catheter might spontaneously detach and scatter as foreign bodies as time passes. In patients who can survive for a long time, catheter removal, including via open-heart surgery, should be considered.

The patient was a girl aged two years and five months, who had been diagnosed as having intussusception. We performed hydrostatic reduction five times within three days. We suspected that the patient had a primary disease in the cecum, as a remnant shadow was detected even after repeated reduction. First, we performed colonoscopy and found a mucosal protrusion in the cecum. We then performed laparoscopic-assisted appendectomy through the umbilical port insertion site. In this patient, appendiceal intussusception caused recurrent intussusception. Retrospectively consideration, an echo examination, radiographic contrast enema, and colonoscopy were useful for diagnosing appendiceal intussusception. When appendiceal intussusception is suspected, a laparoscopic-assisted operation should be performed as soon as possible to prevent the onset of recurrent intussusception.

Segmental dilatation of intestine (SDI) is a relatively rare disease that was first reported by Swenson in 1959 and has since been reported in various disease forms and concepts. We report a case of SDI with Hirschsprung disease in a 0-day-old girl. Her gestational age was 38 weeks and 6 days, and her birth weight was 2,396 g. After birth, the baby was transferred to our hospital because of respiratory distress. She had a defecation disorder; roentgenography showed an abnormal distribution of intestinal gas indicative of a pelvic mass, and enema examination showed marked dilatation of the sigmoid colon and narrowing of the rectum. We suspected SDI and short-segment Hirschsprung disease. We performed rectal biopsy and colostomy at 8 days of age and laparoscopic-assisted transanal pull-through and resection of the dilated intestine at 10 months of age. After that, she was able to self-defecate. Although the treatment of SDI is excision of the lesion, the possibility of the coexistence of other diseases cannot be ruled out. Careful attention should be paid to diagnosis and surgical treatment.

A female patient had a tumor with a constriction on the left side of the perineum since birth, which appeared to have a similar surface to that of the surrounding skin. The tumor was not detected antenatally. Magnetic resonance imaging (MRI) at one month of age confirmed that the tumor measured 1.5 cm in diameter, and a bone-like nodule measuring 0.5 cm in diameter was identified at the depth of the tumor. The tumor did not invade the anal sphincter or levator ani muscles. Further evaluation did not reveal spina bifida occulta, anorectal malformations, or genitourinary malformations. We planned tumor excision after the patient had gained adequate weight to undergo surgery. The patient underwent tumor resection, and the tumor and deep nodule were removed at nine months of age. Histopathological evaluation of the resected specimen confirmed that the tumor was a lipoma, and the deep nodules were cartilage and osseous components. During the operation, a continuity between the tumor and the deep nodule was observed macroscopically. It was suspected that the lipoma contained the nodule. Congenital perineal lipoma is a rare disease that may occur in combination with various malformations and may contain cartilage and osseous tissue, as observed in our case. Preoperative MRI evaluation is important to confirm tumor characteristics, the presence of other tissues such as cartilage and bone, and combined malformations, if any.