ABSTRACT
We report the first case in the Japanese literature of toxic shock syndrome following incisional hernia repair. We performed incisional hernia repair in a 54-year-old man with a BMI of 32.6 kg/m2 who underwent sigmoidectomy for cancer of the sigmoid colon one and half years earlier. Postoperative course was complicated by subcutaneous hemorrhage, which resolved with conservative management, and he was discharged on the 9th postoperative day. However, 3 days after discharge, he was readmitted with shock, high fever, diarrhea, vomiting, somnolence, and acute renal failure. He was diagnosed with toxic shock syndrome (TSS) due to TSS toxin-1 produced by MRSA infection of the subcutaneous hematoma. Drainage was performed and vancomycin, clindamycin, and gamma-globulin therapy were administered, with intensive supportive care. Treatment was successful and he was discharged 24 days after admission.
ABSTRACT
We report a case of accessory breast cancer in the right axillary region. A 67-year-old woman visited our department complaining of a lump in the right underarm. We suspected cancer of an accessory breast from the findings of mammography and ultrasonography; a histological diagnosis of breast cancer was obtained by needle biopsy. With a preoperative diagnosis of accessorybreast cancer accompanied by ipsilateral axillary nodal involvement, the patient underwent wide local resection of the right axillary region with lymph-node dissection (level II). Histopathological findings of the resected specimen revealed that the tumor was composed of solid tubular carcinoma with intraductal component, with normal breast tissue in the region adjacent to the tumor. A diagnosis of right axillary accessory breast cancer (pT2, N1, pStage IIb) was confirmed. Postoperative chemotherapy and radiotherapy were administered. At present, 18 months after surgery, no sign of recurrence has been observed.
ABSTRACT
During the 13-year period from 1979 Jan. to 1992 Apr., 93 patients with carcinomas of the biliary tract including the ampulla of Vater and the pancreas were surgically treated at Kumiai General Hospital in the northern Hida district of Gifu Prefecture. In these 93 patients, 31 were diagnosed as suffering from carcinomas of the extrahepatic bile duct; 19, gallbladder carcinomas; 5, carcinomas of the ampulla of Vater and 38, pancreatic carcinomas. But the majority of these patients were classified into the far-advanced stages in accordance with the Japanese stage classification. Resectability was 58.1% in carcinoma of the extrahepatic bile duct, 42.1% in gallbladder carcinoma, 100% in periampullary carcinoma and 31.5% in pancreatic carcinoma and their survival rates were discouragingly low. To improve the postoperative results, it should be advocated that early diagnosis and treatment are most important for biliary tract carcinoma of m and fm in pathological depth, gallbladder carcinoma of m and pm in depth and small pancreatic carcinoma smaller than 2 cm.