Kazushi Miyata

Peritonitis after percutaneous endoscopic gastrojejunostomy for levodopa-carbidopa intestinal gel treatment despite concomitant use of gastropexy

A 58‐year‐old man with Parkinsons disease experienced peritonitis after percutaneous endoscopic gastrojejunostomy (PEG‐J) for levodopa–carbidopa intestinal gel treatment despite concomitant use of gastropexy. Although gastropexy reduces complications including peritonitis, clinicians should consider structural characteristics of PEG‐J devices and patients’ anatomical differences. We recommend that suture threads are removed 2–4 weeks after PEG‐J and that the PEG‐J tube length outside the body is routinely recorded to assess tube dislocation.

Gradually shrinking intra-abdominal desmoid tumor derived from the stomach in a young boy: a case report

BackgroundIntra-abdominal desmoid tumors, particularly those derived from the stomach, are rare. Such tumors are associated with a history of familial adenomatous polyposis (FAP), trauma, or surgical procedures in general. In addition, spontaneous shrinking of an intra-abdominal desmoid tumor is rarer. And desmoid tumors most commonly arise during the fourth decade of life.Case presentationA 17-year-old boy with lower abdominal pain was diagnosed with a gastrointestinal stromal tumor (GIST) or a hematoma at a local hospital. He had no history of FAP, trauma, or previous surgery. Abdominal computed tomography (CT) was performed for observational purposes three times over a 9-month period. The tumor gradually decreased in size over time; however, the tumor did not shrink sufficiently to be diagnosed as a hematoma. Because there was a high possibility of a GIST from the stomach, he underwent laparotomy. Operative findings revealed that the tumor was a hard mass firmly attached to both the greater curvature of the stomach and the inferior pole of the spleen. Pathologically, the tumor was diagnosed as a desmoid tumor derived from the stomach.ConclusionFor a young boy without a history of FAP, trauma, or surgical procedures, it is difficult to define an intra-abdominal tumor near the stomach as a desmoid tumor. In such cases, surgical resection is recommended for a definitive diagnosis.