Primary vaginal adenocarcinomas are one of the rarest malignant neoplasms, which develop in the female genital tract. Because of the extremely low incidence, their clinical and pathologic characteristics are still obscure. Recently, we experienced a case of vaginal adenocarcinoma that appeared 7 yr after hysterectomy because of cervical intraepithelial neoplasia. The patient, a 65-yr-old obese woman, was diagnosed as having adenocarcinoma in the vaginal stump and was treated by simple tumor excision and radiation. Immunohistochemical and molecular biologic examinations indicated a potential association with human papilloma virus infection in the development of the vaginal adenocarcinoma. There has been no evidence of recurrence for 3 yr after the operation.
We experienced a case of ventilation difficulty after intubation due to tracheal diverticulum caused by radical surgery for esophageal atresia/tracheoesophageal fistula repair. The patient was a sevenmonth-old male infant. Esophageal stricture was found after radical surgery for type C esophageal atresia, so an esophageal balloon dilatation under general anesthesia was scheduled. Tracheal intubation was easily accomplished after general anesthesia was induced, but audible breathing and chest movements were not detected after manual ventilation, so extubation was performed and mask ventilation initiated. Similar ventilation difficulties occurred after re-intubation, but ventilation became possible with a shallow intubation. Upon further investigation using bronchoscopy, it was determined that the ventilation difficulty had been caused by the tip of the tracheal tube straying into a posterior tracheal wall diverticulum. Tracheal diverticulum, which is a complication of radical surgery for esophageal atresia/tracheoesophageal fistula repair, should be considered as a potential cause of ventilation difficulties following intubation.
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