A Case of Asymptomatic Appendicolithiasis Treated by Laparoscopic Appendectomy / 日本農村医学会雑誌

A 69-year-old woman underwent total colonoscopy in a health checkup at a local clinic. Colonoscopic study revealed a submucocal tumor-like lesion at the appendiceal orifice. She was admitted to our hospital for an elaborate investigation and treatment. Abdominal plain X-ray showed calcification in the right lower abdomen. Abdominal CT scan demonstrated a high density mass in the ileo-cecal region. Thus, we diagnosed the symptom as asymptomatic appendicolithiasis. She underwent laparoscopic appendectomy. As asymptomatic appendicolithiasis is very rare, we report this case with a review of some literature.

A Case of Conservative Management of Idiopathic Segmental Infarction of the Greater Omentum / 日本農村医学会雑誌

A 39-year-old man was admitted to our hospital with right lower abdominal pains. Physical examination revealed focal tenderness in the right lower quadrant abdomen. Abdominal CT scan demonstrated heterogeneous increased fat density in the right greater omentum. That said, we diagnosed the disease as idiopathic segmental infarc- tion of the greater omentum.　　He underwent conservative management with antibiotics and analgesics.　　With his abdominal pains dramatically resolved, the patient was discharged from our hospital ten days after hospitalization. The standard treatment for the idiopathic segmental infarction of the greater omentum has not been established. We report this case together with a review of some literature.

A Successful Case of Refractory Ulcerative Colitis in an Old-Old Man by Total Proctocolectomy / 日本農村医学会雑誌

  A-77-old man was admitted to our hospital because of melena in August 2010. Colonoscopy was performed on him, and the case was diagnosed as ulcerative colitis. His symptoms did not abate despite the administration of mesaladine and steroid. He was thus diagnosed with reflactory ulcerative colitis, and underwent total proctocolectomy. The patient had an uneventaful postoperative course and was discharged from our hospital on the 31^st postoperative day. Total proctocolectomy was considerd one of the useful operative procedures for old patients with ulcerative colitis.

A Case of Mucinous Cystadenoma of Appendix Adhered to the jejunum and Treated with Combined Resection / 日本農村医学会雑誌

  A 67-year-old man was admitted to our hospital because of right lower abdominal pain. Abdominal CT scan showed swelling and hypertrophy of the appendix wall and presence of a low density area near the appendix. We thus diagnosed this case as acute appendicitis with abscess and performed an emergency operation. When laparotomy was done, we observed the swelling of the appendix, and a mass bordered on the appendix which adhered tightly to the jejunum. The patient underwent appendectomy and partial resection of the jejunum. A pathological examination revealed mucinous adenoma of the appendix. The mass bordered on the appendix was mucocele. The mucocele adhered to the jejunum and the mucus infiltrated to the muscularis propria of the jejunum. He had an uneventful post operative course and was discharged from our hospital on the 12th postoperative day.Mucinous cystadenoma of the appendix adhered to the jejunum is very rare and we report our case with some literature review.