Mitsuaki Sakatoku

Transpericardial bronchial closure with omentopexy for postpneumonectomy bronchopleural fistula

We report a case of successful closure of a postpneumonectomy bronchopleural fistula by means of the transpericardial approach with omentopexy through a median sternotomy incision. This method minimizes problems of infection, healing, and pulmonary function.

Laparoscopic decompression of a stricture of the celiac artery caused by the median arcuate ligament in a gastric cancer patient: A case of report: Decompression of median arcuate ligament

Stricture of the celiac artery caused by the median arcuate ligament induces abdominal ischemic symptoms and aneurysm near the pancreatic head. However, the need to treat asymptomatic patients is unclear. We safely performed surgical decompression of a stricture of the celiac artery by MAL in an asymptomatic patient at the same time as gastrectomy for gastric cancer. After surgery, the stricture of the celiac artery had disappeared as demonstrated by CT scan and 3‐D CT angiography.

A CASE OF ISCHEMIC STRICTURE OF THE SMALL INTESTINE AFTER REPAIRING OF AN INCARCERATED INGUINAL HERNIA

A 66-year-old man experienced incarceration of a left inguinal hernia on June 13, 1991. The incarcerated inguinal hernia was repaired without taxis after 24 hours. Six days later the patient underwent radical operation for the hernia at elsewhere, however, abdominal pain and vomiting appeared 3 days after the operation. From physical symptoms and imaging findings, the patient was diagnosed as having an intestinal obstruction and was referred to the department for examination because of persistent symptoms. Conservative therapy did not provide any symptomatic remission and operation was performed on August 28. During surgery a stenosis was found in the ileum 40cm oral from the ileum end and the 20cm ileum was removed. From histological findings, the patient was diagnosed as ischemic enteritis with stenotic change following the ligation of incarcerated inguinal hernia. We rarely encounter a case of incarcerated inguinal hernia with ischemic stenotic change after repair of the hernia causing ileus. We should carefully follow the patient after repairing of incarcerated inguinal hernia, entertaining a possible occurrence of the delayed small bowel stenosis following ischemic enteritis.