Abdominal ultrasonography examination in a 70-year-old man revealed a hepatic mass in the right hepatic lobe. The examination revealed a hepatic tumor with tumor thrombosis in the right portal vein, and rectal carcinoma. To prevent cavernous transformation of the veins, intestinal bleeding, and ascites, we performed concomitant surgery for abdominoperineal resection and right hepatic lobectomy with tumor thrombectomy. The pathological findings of the resected specimens from the rectum and right hepatic lobe showed a moderately differentiated adenocarcinoma. Consequently, we diagnosed the patient as having rectal carcinoma and metastatic hepatic tumor with portal vein tumor thrombosis. We show that operating simultaneously on these conditions improved the prognosis for the patient. Moreover, the elevated tumor markers in the patient decreased dramatically 4 months after the surgery. The patient had no recurrence and was treated with continued adjuvant chemotherapy. This is the first successful case reported of concomitant surgery of abdominoperineal resection and right hepatic lobectomy with thrombectomy.
Abdominoscrotal hydrocele (ASH) represents an uncommon condition resulting from the communication of a large scrotal hydrocele with the abdominal cavity through the inguinal canal. The pathogenesis and the treatment of ASH are unclear. This case study describes an 11 months-old boy with left side ASH. An 11-month-old boy was admitted to our hospital with a left scrotal mass. Ultrasonography demonstrated communication of the abdominal hydrocele and inguinoscrotal hydrocele and magnetic resonance imaging demonstrated ASH. We used the inguinal approach under laparoscopic assistance to successfully completely excise the ASH. Laparoscopic-assisted operation may therefore be useful both for revealing the possibility of the pathogenesis and for surgically removing an ASH.
We report a case of esophageal hiatal hernia with incarcerated stomach in the pleural cavity and its removal using upper gastrointestinal endoscopy. A 97-year-old woman went to a clinic complaining of abdominal pain and vomiting and she was referred to our hospital. Chest CT showed that the antrum and duodenum were incarcerated in the pleural cavity and obstructed, and that the stomach was expanded. Also, as we suspected that the esophageal hiatal hernia incarcerated the stomach, we implemented upper gastrointestinal endoscopy. This demonstrated blockage in the antrum and the endoscope could not pass. We attempted to insert the endoscope several times, and were able to insert it into the duodenum.