Satoshi Wakasugi

Hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic stones.

Abstract: We present a patient with complication of huge hepatic subcapsular hematoma after extracorporeal shock wave lithotripsy (ESWL) for pancreatic lithotripsy. The hematoma measured 78–110 mm. Angiography showed a subcapsular hematoma, rather than a hematoma in the liver. In the arterial phase, the distal end of the small vessel showed spotty opacification similar to microaneurysma, suggesting that it was an injury caused by separation of the liver and its capsule, caused by the shock waves. The portal vein and hepatic vein were normal. After 8 weeks of conservative therapy, the hematoma was gradually absorbed and the patient was discharged. Eight months after the accident, the hematoma had decreased to 40 mm in size. After 20 months, it was completely absorbed. The reported rate of renal subcapsular hematoma after ESWL for renal or ureter stones is 0.1%–0.7%. To date, however, only five cases of hepatic subcapsular hematoma after right renal stone disintegration have been reported. This is the first report of hepatic subcapsular hematoma after ESWL for pancreatic stones.

Endoscopically resected granular cell tumor of the stomach-a case report

Abstract: We report a rare case of granular cell tumor of the stomach resected endoscopically. The patient was a 53‐year‐old man who visited our clinic because of a protruding lesion incidentally found by X‐ray examination of the stomach at a mass screening. Endoscopic examination revealed an apparent submucosal tumor at the anterior wall of the upper body of the stomach. An endoscopic ultrasonographic (EUS) study showed that the tumor was a hypoechoic lesion localized in the third layer (submucosal layer). On resection, a lesion measuring 6X5X3 mm was found to be localized in the submucosa. It was histologically diagnosed as granular cell tumor, which is quite uncommon in the stomach with only 44 cases having been reported to date.