Tsuneo Shiratori

A case of intestinal obstruction due to a hernia traversing the lesser sac

A case of a hernia traversing the lesser sac with a primary defect in the greater omentum and a secondary defect in the lesser omentum is reported herein. This type of internal hernia is extremely rare and we have found only three other reported cases apart from our case. All four cases in whom this type of hernia occurred were young people. The general manifestation resembles acute intestinal obstruction and a plain radiograph shows obstruction of the upper small intestine. An erect lateral view of the abdomen often shows the anatomical location more clearly. Bowel resection was performed in two cases and all of the four reported cases recovered uneventfully.

A case of hemangioendothelioma of the small intestine.

An 81-year-old female was admitted to hospital with anemia and abdominal discomfort, however, various pre-operative diagnostic workups for the gastro-intestinal tract revealed no significant change. At the time of surgery, a small intestinal tumor was discovered by means of endoscopy and seven centimeters of ileum was radically resected. The tumor was subsequently diagnosed histopathologically as hemangioendothelioma. The patient recovered quickly and now, 6 years later, has had no sign of tumor recurrence. The incidence of this tumor is reportedly less than 3 per cent of all tumors found in the small intestine and the prognosis of this tumor in the small intestine is poor. A five-year-survival rate can be referred to only 33.3 per cent of the reported cases.