フククウキョウカ ニ チリョウ シエタ ガイショウセイ ショウチョウ センコウ ノ 1レイ

In this paper the authors report a case of laparoscopic surgery for a blunt abdominal trauma with small bowel injury. The patient, a-24-year-old woman, was admitted to the authors’ hospital. She had abdominal pain caused by blunt abdominal trauma. Physical Examination showed muscular defense and rebound tenderness on the abdomen. A computed tomography showed focal wall thickness and pneumatosis intestinalis in the jejunum, and fluid collection in the pelvis. A preoperative diagnosis was traumatic perforation of jejunum. The authors performed laparoscopic surgery. A3-mm perforation on the jejunum was observed. The authors performed laparoscopic repair of jejunal perforation. The postoperative course was uneventful and the patient was discharged 9 days after the operation. In selected cases of blunt abdominal trauma, laparoscopic surgery may be a safe and useful procedure

Adenomyomatosis Concomitant with Primary Gallbladder Carcinoma

Some clinicians have proposed a relationship between gallbladder (GB) cancer and adenomyomatosis (ADM) of the gallbladder, although the latter condition is not considered to have malignant potential. We retrospectively reviewed the surgical pathology database of patients who underwent resection for ADM of the gallbladder at our institution from March 2005 to May 2015. In total, 624 patients underwent surgical resection of the gallbladder with Rokitansky-Aschoff sinuses. Of these cases, 93 were pathologically diagnosed with ADM of the gallbladder, with 44 (47.3%) classified macroscopically as fundal-type ADM, 26 (28.0%) as segmental type, and 23 (24.7%) as diffuse-type ADM. In 3 of the 93 (3.2%) resected specimens, early-stage GB carcinoma was detected, although preoperative imaging did not suggest a malignant neoplasm of the gallbladder in any of these patients. GB cancer subsequently developed in the mucosa of the fundal compartment distal to the annular stricture of the segmental-type ADM in 2 of these patients and against the background of the fundal-type ADM in 1 patient. This study revealed the difficulty of early diagnosis of primary GB cancer in the setting of concurrent ADM, and clinicians should be aware of this frequent coexistence