Preoperative assessment of perigastric vascular anatomy by multidetector computed tomography angiogram for laparoscopy-assisted gastrectomy.

Purpose: We aimed at investigating the efficacy of multidetector computed tomography (MDCT) angiogram reconstructed using the maximum intensity projection (MIP) technique for the assessment of perigastric vascular anatomy before laparoscopy-assisted gastrectomy (LAG) for gastric cancer.

Methods: Seventy-one patients who underwent LAG were enrolled in the study. Contrast-enhanced scans of the portal venous phase were performed by a MDCT scanner.

Isolated splenic peliosis presenting with giant splenomegaly and severe coagulopathy.

We herein describe a case of successful surgical treatment of isolated splenic peliosis presenting with giant splenomegaly and severe coagulopathy. Pathological features of the spleen included multinodular, blood-filled, cyst-like lesions distributed throughout the whole organ. The pathogenesis of isolated splenic peliosis is controversial, and no definitive disease mechanism has been reported.

Adnexal torsion of mature cystic teratoma with hemorrhagic infarction: helpful findings on successive plain abdominal radiographs.

Adnexal torsion is a relatively rare cause of lower abdominal pain in women, but in many cases it leads to a serious condition. We present a case of adnexal torsion of a mature cystic teratoma in which hemorrhagic infarction was reflected by progressive enlargement and wall thickening on successive plain abdominal radiographs. There has been no other report describing such changes of adnexal torsion on plain abdominal radiographs.

Noninsulinoma pancreatogenous hypoglycemia syndrome: a rare case of adult-onset nesidioblastosis.

The most common cause of hyperinsulinemic hypoglycemia in adults is insulinoma. Nesidioblastosis is a rare, but well-recognized disorder of persistent hyperinsulinemic hypoglycemia in infancy, but adult-onset nesidioblastosis associated with hyperinsulinemic hypoglycemia, termed noninsulinoma pancreatogenous hypoglycemic syndrome (NIPHS), has been reported. Here, we describe an extremely rare case of NIPHS in an elderly man.

A crescent-shaped sparing proximal to a liver tumor may indicate underlying portal tumor thrombus.

A primary or metastatic liver tumor sometimes blocks portal venous flow and causes a focal sparing in the fatty liver. We herein report a case of segmental sparing due to the portal tumor thrombus extending from the metastatic liver tumor. The present case demonstrates characteristic computer-associated tomographic findings, a distal oval hypodense tumor with proximal "crescent-shaped sparing", which may indicate underlying portal tumor thrombus at the apex of the sparing.