Masahisa Uematsu

Primary Venous Aneurysms Case Reports

Venous aneurysms are rare lesions that may be the source of pulmonary emboli and can result in death. The authors have recently treated several patients who had venous aneurysms of the upper extremity, lower extremity, and jugular system. Venous aneurysms usually appear to have a safe natural history in these locations, although all of the reported patients required surgery after the development of symptoms owing to complaints of pain, and/or cosmetic appearance, and/or a diagnosis of thrombosis. These cases are presented, along with a review of venous aneurysms occurring at other sites and their causes.

Huge left atrial thrombus with mitral stenosis in congenital factor XII deficiency

Factor XII deficiency has been reported to be a risk factor for thromboembolism as a result of inactivation of fibrinolysis. We describe a case of a huge left atrial thrombus with mitral stenosis, which was successfully removed surgically in a Factor XII deficient patient.

Surgical treatment of refractory venous stasis ulcer due to a severe impairment of calf muscle pump function: evaluation by air plethysmography. A case report.

The authors encountered a forty-nine-year-old man with a lower limb ulcer refractory to intensive conservative therapy. No varicose vein was found anywhere, and the usual phlebographies and foot venous pressure measurement failed to diagnose it as a venous stasis ulcer. A direct phlebography method developed by the authors, in which a thin catheter is inserted into the deep vein, disclosed a reflux of the popliteal vein or a deep muscle branch from which an incompetent perforator arose toward the superficial vein above the ulcer. Air plethysmography (APG) showed a severe impairment of the calf muscle pump function. He underwent a subfascial ligation of two incompetent perfora tors together with a stripping of the great saphenous vein passing under the ulcer. Postoperatively, this ulcer was cured in an early phase, and the calf muscle pump function showed improvement in the APG.

Venous aneurysm of a cephalic vein: A case study

A venous aneurysm was diagnosed in a 78-year-old man who presented with a left elbow mass. The lesion was successfully resected with day surgery. Clinical features, including the complications, treatment, and etiology of these exceedingly uncommon lesions, are discussed.

A Case of Right Atrial Thrombus and Left Pulmonary Embolus after the Bjork Procedure.

5歳男児の三尖弁閉鎖症に対し, Bjork 手術を行ったが, 術後37日目に, 右房内血栓形成から左肺動脈血栓塞栓症をきたして死亡した症例を経験した. Bjork 手術は Fontan 型手術のうち, 肺動脈弁を温存し, 低形成の右室を pumping chamber として利用する術式であるが, 右房-右室吻合部での乱流発生や同部が低圧系であることから生ずる血流うっ滞により, 血栓を形成する危険性があるものと考えられた. Bjork 手術の術後には, 心エコーによる厳重なフォローと抗凝固療法の必要性が示唆された.

A RAPIDLY ADVANCED PANCREATIC CANCER AFTER RADICAL OPERATION FOR A GASTRIC CANCER-REVIEW OF 25 CASES WITH DOUBLE CANCER OF THE STOMACH AND PANCREAS IN JAPAN

Double cancer of the stomach and pancreas is very rare and the prognosis has been reported poor. This paper describes a case of double cancer of the stomach and pancreas, in which the rapidly advanced pancreatic cancer following radical operation for gastric cancer was successfully treated by pancreaticoduodenectomy. A 65-year-old man underwent distal partial gastrectomy for an early gastric cancer. Five months later, he was admitted to the hospital again because of reinforced jaundice. Pancreatic cancer was suspected by CT scan and ultrasonography, and pancreaticoduodenectomy was successfully performed. The patient is alive more than 3 years after the operation. In double cancer of the stomach and pancreas, gastric lesion is commonly detected in an early stage and radical operation is possible, but most pancreatic lesions are in an advanced stage when detected which makes a radical operation impossible. Therefore, prognosis of the double cancer of the stomach and pancreas is determined by the state of pancreatic cancer. We must pay full attention to probable coexistence of another lesion, even if the gastric cancer is in an early stage.