A case of intestinal intussusception with unique hemorrhagic polyps due to AL amyloidosis and excessive anticoagulation.

Most adult intussusceptions are secondary to various pathological conditions that serve as a lead point. Because of their serious nature, intussusceptions often require emergency surgery. We report a surgical case of amyloidosis associated with intussusception, probably due to polypoid protrusions and bleeding tendencies.

[A Case of Jejunal Cancer Treated by Laparoscopic Partial Jejunectomy].

The patient was a 30s male visited our hospital with the complaints of abdominal pain and melena. The internal medicine physician could not detect the cause of the melena by upper and lower gastrointestinal endoscopy. Although the patient resolved with a fast as conservative management so he left our hospital once, he relapsed nausea and abdominal pain.

Clinical Impact of Two-Week Placement of a Subcutaneous Suction Drain in Preventing Incisional Surgical Site Infection in Open Gastrointestinal Surgery with Class 4 Dirty Wound: A Retrospective Study.

Two recent randomized controlled trials demonstrated the beneficial effects of subcutaneous drainage in preventing incisional surgical site infection (SSI) in colorectal surgery. This study aimed to evaluate the efficacy of subcutaneous suction drains (SSDs) compared with primary skin closure (PC) in class 4 dirty wound surgery. Eighty-one patients undergoing open gastrointestinal surgery with class 4 dirty wounds were enrolled in this study, 30 of whom underwent SSD insertion, whereas the other 51 were treated with PC.

Continuous ghrelin infusion attenuates the postoperative inflammatory response in patients with esophageal cancer.

Purpose: The aim of this study was to clarify whether ghrelin infusion is useful for suppressing inflammatory responses after esophagectomy.

Methods: A phase I study of ghrelin administration after esophagectomy was performed in 20 patients with esophageal cancer. The anti-inflammatory effect of ghrelin was compared with 20 consecutive patients who did not receive ghrelin infusion.

[A Case of Successful Management of Postoperative Chylous Ascites by Combination Therapy with Octreotide and Etilefrine].

We have report a case of an 81-year-old woman who underwent distal pancreatectomy for pancreatic body cancer. Chy- lous ascites with high triglyceride(TG)level, 201mg/dL, occurred on postoperative day 2. Continuous drainage and conservative management, such as low fat diet, fasting, total parental nutrition, and octreotide monotherapy, could not resolve the problem.

[Two Cases of Hepatic Encephalopathy after Chemotherapy for Metastatic Colorectal Cancer].

We reported 2 cases of hepatic encephalopathy after chemotherapy for advanced colorectal cancer. Case 1: A 49-year-old male was diagnosed advanced sigmoid colon cancer with peritoneal dissemination, multiple liver metastasis and multiple osseous metastasis. After resection of primary lesion, we administered mFOLFOX6 plus bevacizumab combination therapy.

[Anorectal Malignant Melanoma Is a Very Rare Disease and Has a Poor Prognosis].

We performed abdomino-perineal-resection(APR)on 2 cases of anorectal malignant melanoma. The first case was a 70- year-old woman suffering from bloody stool. Colonoscopy showed a black tumor in the rectum.

[A Colorectal Cancer with Invasive Micropapillary Carcinoma].

A 76-year-old woman with bloody stool visited a nearby hospital. Colonoscopy showed a type 1 tumor in the rectum, and the biopsy indicated moderately differentiated adenocarcinoma. She was referred to our hospital.

[A Case of Unresectable Advanced Gastric Cancer Treated with Palliative Radiation Therapy for Massive Bleeding].

The patient was a 77-year-old man. He was diagnosed with Stage IV gastric cancer with pancreatic invasion and pyloric stenosis. After gastrojejunostomy, S-1 monotherapy was started.

[Experiences of Colonic Stents in Patients with Colonic Stenosis Due to Peritoneal Dissemination of Gastric Cancer].

Stoma is a treatment option often adopted for large bowel obstruction accompanying peritoneal dissemination of gastric cancer, but the invasiveness of this intervention can be an issue for patients with limited prognosis and reduced quality of life. In our hospital, colonic stenting for bowel obstruction due to peritoneal dissemination from gastric cancer was performed for 7 consecutive patients. Oral ingestion became possible in 5 cases, and colonic stent was considered a useful treatment choice for appropriate cases.

[A Patient Underwent Pancreaticoduodenectomy with Reconstruction of Replaced Right Hepatic Artery].

A 78 year-old man was diagnosed as a pancreatic cancer in department of gastroenterology in our hospital. Enhanced computed tomography demonstrated an aberrant right hepatic artery(ARHA)arising from superior mesenteric artery(SMA). We conducted sub-stomach preserving pancreaticoduodenectomy(SSPPD- II A-1).

[A Case of an Elderly Patient with Advanced Gastric Cancer Successfully Treated with Combination S-1 and Oxaliplatin Therapy].

The patient was an 80-year-old man. He had a chief complaint of epigastric pain. The upper gastrointestinal endoscopy showed a type 4 tumor of the stomach, and the CT scan showed multiple para-aortic lymph node metastases.

[A Case of Appendiceal Mucinous Cystadenoma Treated Using Laparoscopic Appendectomy].

A 73 year-old woman who was treated for breast cancer and visited our hospital regularly was suspected of having a mucinous cystadenoma of the appendix. Malignancy could not be determined using abdominal computed tomography, magnetic resonance imaging, or colonoscopy. Even if mucinous cystadenoma is benign, there is the possibility that the tumor will rupture, discharge its contents, and cause pseudomyxoma peritonei.

[A Case of Metastatic Colorectal Cancer Refractory to Standard Chemotherapies Treated with TAS-102 with Bevacizumab].

A 51-year-oldwoman with lung, liver, andd istant lymph node metastases from sigmoidcolon cancer was treatedusing TAS-102 with bevacizumab as fourth-line chemotherapy. There was a 35%decrease in the size of target lesions after the first 4 cycles of therapy, and disease control has been maintained for 9 months. The only Grade 3 or worse adverse event experiencedwas neutropenia.

[Surgical Outcome of Palliative Surgery for Gastric Cancer Patients with Bowel Obstruction Due to Peritoneal Dissemination].

A retrospective cohort analysis was performed for 21 consecutive patients who underwent palliative surgery for bowel obstruction due to peritoneal metastasis from gastric cancer. Surgical site infection occurred in 5 of 21 patients, but there were no severe(Clavien-Dindo Grade III or higher)complications, and symptoms of bowel obstruction were improved in 20 of 21 patients. The median survival time was 6.

Tubular adenoma of the common bile duct with uptake in F-FDG PET: A case report.

A 64-year-old man presented with epigastric discomfort and nausea. Laboratory analyses revealed increased levels of total and direct bilirubin, and increased levels of aminotransferases. Computed tomography revealed the presence of a mass in the distal common bile duct.

[Long-Term Survival with Multidisciplinary Therapy for Rectal NET with Liver Metastases--A Case Report].

We report a case of a 71-year-old man with liver metastases from a rectal neuroendocrine tumor(NET). The patient's chief complaint was melena. He was diagnosed with rectal carcinoma with liver metastases during his initial visit.

[A Case of Surgical Treatment for Mixed Adenoneuroendocrine Carcinoma of the Ampulla of Vater].

A 56-year-old woman was referred to our hospital because of epigastric discomfort and jaundice. Contrast-enhanced computed tomography and gastrointestinal endoscopy revealed an ampullary tumor. A biopsy specimen showed adenocarcinoma of the ampulla of Vater.

[A Case of Intractable Bile Leakage after Surgery for Gallbladder Cancer Successfully Treated by Transcatheter Arterial Embolization].

An 83-year-old man underwent extended cholecystectomy for gallbladder cancer. On postoperative day 13, he developed fever and computed tomography (CT) revealed fluid collection at the cut surface of the liver. Ultrasound-guided fluid drainage was conducted, and he was diagnosed with biliary leakage.

[Effect of Post-Gastrectomy Adjuvant S-1 Chemotherapy on Muscle Volume in Gastric Cancer Patients].

Objective: To examine the effect of S-1 adjuvant chemotherapy on muscle volume after curative gastrectomy in gastric cancer patients.

Patients: Forty-eight gastric cancer patients (31 men and 17 women) who underwent curative gastrectomy (distal gastrectomy: n=37, and total gastrectomy: n=11) between April 2010 and July 2011 were enrolled in this study. Sixteen patients underwent S-1 adjuvant chemotherapy (S-1 group) for 1 year after the operation, and 32 patients did not (NT group).

Feasibility and Safety of Urgent Laparoscopic Cholecystectomy for Acute Cholecystitis After 4 Days from Symptom Onset.

Background: It is preferable to perform laparoscopic cholecystectomy for acute cholecystitis in the acute phase, within 72 h of symptom onset. The feasibility and safety of performing urgent laparoscopic cholecystectomy in the late phase (4-7 days after symptom onset) are unclear. The aim of this study was to clarify the feasibility and safety of late phase urgent laparoscopic cholecystectomy.

[A case report of neuroendocrine carcinoma of the stomach with liver metastases curatively resected after neoadjuvant chemotherapy].

The patient was a 73-year-old male with advanced gastric cancer in the lesser curvature of the antrum.Abdominal computed tomography revealed multiple liver metastases(S5, S8).He was diagnosed with clinical Stage IV gastric cancer (cT3N0M1H1).

[A case report of advanced gastric cancer with bulky lymph node metastases successfully treated with induction chemotherapy followed by curative resection].

The patient was a 74-year-old woman with advanced gastric cancer in the greater curvature of the antrum and lesser curvature of the angle.Abdominal computed tomography revealed bulky lymph node metastases of No. 3, 8a, and 11p.

Effects of ghrelin administration on the early postoperative inflammatory response after esophagectomy.

Purpose: Ghrelin is a unique gastric hormone, which has pleiotropic biological functions, including anti-inflammatory effects. The aim of this study was to investigate the effects of administering ghrelin on reducing postoperative systemic inflammation in patients undergoing esophagectomy.

Methods: The safety and effectiveness of postoperative ghrelin administration were investigated among twenty esophageal cancer patients who underwent esophagectomy between May 2010 and August 2011.

Clinical application of ghrelin in the field of surgery.

Ghrelin was discovered as an intrinsic ligand for the growth hormone (GH)-secretagogue receptor (GHS-R) in 1999. The endogenous production of ghrelin occurs mainly in the stomach. Ghrelin has multiple functions; it has orexigenic action, stimulates GH secretion, has anti-inflammatory activities, stimulates gastrointestinal activity, stabilizes heart function and has other metabolic roles.