HighlightsThe localization of small intestine sources of obscure gastrointestinal bleeding is a challenge.The use of indocyanine green (ICG) is effective in aiding intraoperative localization.The ICG fluorescence imaging can visualize the lesion as an arteriovenous malformation.
Guest Editor's Introduction: This paper was originally presented at the 9th congress of ASAIO in April 1963. The original paper was printed in Volume IX of Trans. Soc. Artif. Int. Organs 1963, pages 358–362. It was reprinted with permission in Therapeutic Apheresis, Volume 4, Issue 1, 2000 as a millennium project of the International Society for Apheresis. This paper describes for the first time a hybrid artificial live and extracorporeal circulatory system composed of a specially developed high permeable gel type cellophane membrane. This membrane separated the patient's blood and the metabolic fluid in which freeze‐dried canine liver granules were contained. Carbohydrate metabolism and ammonia detoxification were maintained in this metabolic chamber, eventually helping the patient's metabolic functions. In addition to experimental studies, four clinical studies were briefly reported.
INTRODUCTIONColorectal obstructive endometriosis is relatively rare in Japan and its differentiation from malignancy is often difficult. We report a case of rectal obstructive endometriosis.PRESENTATION OF CASEA 37-year-old woman was referred to our hospital with a suspected ileus. Her chief symptoms were left lower abdominal pain and vomiting. Colonoscopy showed an intraluminal mass of redness in the upper rectum. A proctectomy was performed because of the bowel obstruction. The rectum was filled with an intraluminal mass measuring 5 cm × 4 cm, and endometriosis was diagnosed pathologically.DISCUSSIONA preoperative diagnosis of colorectal obstructive endometriosis is often difficult because of the lack of definite diagnostic, clinical, sonographic, or radiological findings that are characteristic of this disease. Medical treatment is not always effective for colorectal obstructive endometriosis, and surgery is often performed.CONCLUSIONColorectal obstructive endometriosis should be considered as a differential diagnosis in cases of various gastrointestinal symptoms in women who are of reproductive age.
We report a rare case of colonic metastasis from primary carcinoma of the lung. A 59-year-old man who underwent pulmonary surgery for lung cancer was referred to our hospital in June 2007. The patient complained of abdominal pain, and barium enema examination at another hospital had demonstrated a descending colon tumor. Postoperative histopathological and immunohistochemical findings indicated that the tumor was a colonic metastasis of lung cancer. Three months postoperatively, the cancer had metastasized to the brain, and the patient underwent radiotherapy. He survived for more than 1 year after colonic surgery. Clinically apparent metastases from lung cancer to the colon are rare, and in the 50 Japanese cases retrospectively investigated here, the prognosis was poor.
AIM:A colocutaneous fistula is a rare late complication of percutaneous endoscopic gastrostomy (PEG) feeding placement that occurs as a result of the interposition of the colon between the anterior abdominal and gastric walls. In the current study, we sought to retrospectively study the method of introducing the water-soluble contrast agent into the stomach by using a nasogastric tube before PEG feeding placement, with the intention to develop a method to prevent PEG-related colocutaneous fistula. MATERIALS AND METHODS: Between October 2003 and April 2020, 341 patients underwent PEG placement at Seiwa Memorial Hospital. Patients were divided into two groups: 232 patients in Group A were given water-soluble contrast agent and 109 patients in Group B were not. All patients underwent PEG using introducer method placement after gastropexy under fluoroscopy. RESULTS: In Group A, 139 (59.9%) patients received PEG with a water-soluble contrast agent placed into the transverse colon, 75 (32.3%) received PEG with gas in the colon, and 7 (3.0%) patients received surgical gastrostomy. In Group B, 38 (34.8%) patients received PEG with gas in the colon, 60 (55.1%) patients received PEG with finger palpation and transillumination, and 10 (9.2%) patients received surgical gastrostomy. Colocutaneous fistula was not observed in either group, but there was a significant difference in the frequency of surgical gastrostomy between Group A and B (p = 0.0148). CONCLUSION: The use of water-soluble contrast agent in the stomach was safe, reliable, and cost effective for PEG tube placement, and is recommended to decrease surgical gastrostomy.
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