Motoo Takahashi

Primary Small Cell Carcinoma of the Common Bile Duct, in Which Surgical Treatment was Performed After Neoadjuvant Chemotherapy: Report of a Case

Primary small cell carcinoma of the hepatobiliary tract is rare. Most cases occur in the gallbladder or in the ampulla of Vater, and such cases in the common bile duct (CBD) are extremely rare. We herein report a case of small cell carcinoma arising in the CBD. In this case, neoadjuvant chemotherapy followed by pylorus-preserving pancreaticoduodenectomy showed an excellent response. To our knowledge, this is the first reported case of small cell carcinoma of the CBD in which a radical resection was performed after successful neoadjuvant chemotherapy.

Heterotopic gastric mucosa in the gallbladder: Report of two cases

This report presents two cases of heterotopic gastric mucosa in the gallbladder. In case 1, the patient was a 43-year-old man who presented with diarrhea and fever. Abdominal ultrasonography showed a sessile polypoid lesion in the body of the gallbladder that grew over 2 months. Gallbladder carcinoma was suspected and a cholecystectomy was performed. Examination of an intraoperative frozen specimen of the elevated lesion in the body of the gallbladder suggested a gallbladder carcinoma invading the subserosal layer. A bile duct resection and regional lymph node dissection were performed. However, the postoperative permanent sections revealed heterotopic gastric mucosa in the gallbladder. Case 2 was an 80-year-old man. Screening abdominal ultrasonography revealed a sessile polypoid lesion in the gallbladder. This lesion was correctly diagnosed as heterotopic gastric mucosa in the gallbladder by the intraoperative frozen examination. The pertinent literature on this topic is reviewed.

A Case Report of Perfornated Intestinal Tuberculosis.

近年, 我が国における結核患者数は増加傾向を示しており, それに伴い腸結核症に遭遇する機会も増加している. 今回, 我々は穿孔を来した腸結核症の1例を経験したので報告する. 症例は54歳の男性で, 腹痛を主訴に当院救急外来を受診した. るいそう著明で, 胸部単純X線にて両側上肺野に侵潤影および一部に空洞形成を認めた. また, 腹部は板状硬であり汎発性腹膜炎と診断し同日, 緊急手術を施行した. 小腸から大腸にかけて合計26か所の多発性輪状潰瘍を認め, うち1か所が穿孔していた.穿孔部腸管の切除を施行し全身管理を行ったが術翌日に突然の心停止を来たし死亡した. 部検の結果, 肺結核症, 腸結核, および粟粒性結核症が確診された.今後, 結核患者にあっては急性腹症の鑑別疾患として腸結核穿孔も念頭に置く必要があるものと考えられた.