Kazuo Kataoka

Report of Three Resected Cases of Adenosquamous Carcinoma of the Liver.

肝原発腺表皮癌はまれな疾患であり, 切除例の報告は少ない.今回, 私達は切除しえた肝原発腺表皮癌の3例を経験し, 本疾患の臨床病理学的特徴を検討したので報告する.症例1は57歳の女性で, 左葉切除を行った.腫瘍径は15×13.5×9cmで, 4か月後に残肝再発にて死亡した.症例2は74歳の女性で, 左葉・尾状葉切除を行い, 腫瘍径は7×7×5cmであった.術後11週目に再発死亡した.症例3は68歳の男性.拡大右葉・尾状葉切除, 門脈合併切除を行った.腫瘍径は4×3cmで術後3か月めに骨転移にて死亡した.肝原発腺表皮癌は, 急速に増大する性質を有しており, リンパ節転移をきたしやすく, 予後はきわめて不良で, 治療に難渋することが多い.治療成績の改善に対しては, 今後症例を重ねて検討すべき問題であろう.

Frank melena in a patient with fallopian tube pregnancy

We present herein a case of a young woman who experienced lower intestinal hemorrhage caused by ischemic necrosis of the small intestine induced by the compression of a Fallopian tube hematoma in an ectopic pregnancy. All accessible preoperative attempts to clear the site of the bleeding were unsuccessful and an exploratory laparotomy was indicated seventeen days after the development of melena. An ileocecal resection and right salpingectomy finally had to be performed.

CLINIKAL STUDY OF PRIMARY ILEUS

In the 15 years from 1969 to 1983, 229 patients with primary ileus not caused by previous laparotomy were treated in Okayama Saiseikai General Hospital. This was 25.7% of all operative cases of ileus. As for the primary disease, colon cancer was the most common. Sixty patients had histories of previous laparotomies, but in these cases, primary ileus occurred more than five years after the first operationd. Among the patients, 61.6% were more than 60 years old, and primary diseases varied in the different age groups. In 113 cases, the duration of illness was less than three days, but in ileus of the colon, many patients suffered from symptoms of subileus. For the diagnosis. plain radiogram and barium enema are important, and we should diagnose carefully on the basis on anamnesis and synthesis of the radiographic findings.