A Case of Single-Incision Laparoscopic Surgery for Lipoma of the Terminal Ileum

A 52-year-old woman presented with a right lower abdominal mass, lower abdominal pain, and distension in July 2011. She had myasthenia gravis, but did not have any surgical history. Clinical examination showed a right lower abdominal mass, abdominal distension, decreased bowel sounds, and rebound tenderness in the lower abdomen. Abdominal computed tomography showed an intussusception involving the ileocecal junction. A gastrografin enema image of the colon showed a 30-mm filling defect in the ascending colon. The patient underwent resection of the intussuscepted intestine by single-incision laparoscopic surgery (SILS). The resected specimen contained a round tumor measuring 35 × 35 × 20 mm, which was diagnosed histopathologically as lipoma of the terminal ileum. The patient remains asymptomatic eight months after surgery

A Case of Gallstone Ileus

A 57-year-old woman was admitted to our hospital with abdominal pain and vomiting. Her abdomen was distended, and obstructive bowel sounds were discovered on examination. Diffuse abdominal tenderness was present, but no palpable masses were apparent. Abdominal computed tomography confirmed a large gallstone obstructing the small bowel. Colonoscopy revealed a large gallstone lodged at the terminal ileum, which was subsequently fragmented using electronic hydraulic lithotripsy (EHL). The patient has remained asymptomatic for over 3 years of follow-up after the EHL treatment. Here, we present this case of small intestinal obstruction caused by a large gallstone in the lower ileum

A Case of Ischemic Ileal Obstruction Secondary to Seat Belt Trauma

We report a case of seat belt trauma with delayed ischemic ileal obstruction. A 62-year-old woman presented with symptoms and signs of bowel obstruction three weeks after an automobile traffic accident. A plain radiograph of the abdomen showed dilated small bowel loops with air fluid levels that were consistent with intestinal obstruction. Enhanced computed tomography clearly demonstrated a stenotic ileal loop with mural thickening that was associated with a mesenteric hematoma. Upper endoscopy revealed an ulcer of the ischemic ileal obstruction. The patient underwent resection of the stenotic ileal loop by single-incision laparoscopic surgery. The stenotic ileal loop was located 120 cm oral side from the terminal ileum. In gross finding, the wall of stenotic ileal loop was thickened and the adjacent mesentery was shortened with a hematoma. The mucosa of the ischemic ileal obstruction showed ulcerative changes. The abnormal ileal loop, which was 15 cm in length, was resected. Postoperative recovery was uneventful

Association between Physical Frailty Subdomains and Oral Frailty in Community-Dwelling Older Adults

This cross-sectional study aimed to demonstrate the association between physical frailty subdomains and oral frailty. This study involved community-dwelling older adults (aged ≥65 years). Physical frailty was assessed with the Japanese version of the Cardiovascular Health Study criteria. Oral frailty was defined as limitations in at least three of six domains. Logistic regression analysis was used to analyze the association between physical frailty risk and oral frailty. In addition, we examined the association between physical frailty subdomains (gait speed, grip strength, exhaustion, low physical activity, and weight loss) and oral frailty. A total of 380 participants were recruited for this study. Overall, 18% and 14% of the participants were at risk of physical frailty and had oral frailty, respectively. Physical frailty risk (odds ratio (OR) = 2.40, 95% confidence interval (CI): 1.22–4.75, p = 0.012) was associated with oral frailty in multivariate analysis. In secondary analysis, among physical frailty subdomains, gait speed (OR = 0.85, 95% CI: 0.73–0.97, p = 0.019) was associated with oral frailty. The present findings suggest that physical frailty is closely related to oral frailty. Among physical frailty subdomains, decreased gait speed in particular is an important indicator related to the development of oral frailty