ABSTRACT
Introduction: Penile fracture is typically defined as the rupture of the corpus cavernosum. Case presentation: A 61-year-old man presented with swelling, pain, and bruising of his penis, along with gross hematuria. He reported that he sustained this injury while having sex with his wife. We suspected a penile fracture and obtained magnetic resonance imaging, which showed a rupture of the ventral corpus spongiosum and clarified the appropriate approach for repair. We used a direct transverse incision to repair both the urethral injury and the corpus spongiosum. Surgery went well, without any significant intraoperative or postoperative complications. We removed the urinary catheter on postoperative day 8, and cystoscopy showed no urethral stenosis on postoperative day 17. The patient's postoperative erectile function was the same as before his injury. Conclusion: Magnetic resonance imaging was useful for detect the site of rupture. Ventral direct transverce incision made him a good clinical course.
ABSTRACT
A 72-year-old man presented with the chief complaint of asymptomatic macroscopic hematuria. Cystoscopy revealed a non-papillary sessile tumor in the left bladder wall. Computed tomography revealed a large invasive tumor in the bladder and left hydronephrosis; no metastases were observed. Laboratory examination showed leukocytosis (27,600 /µl) and a high serum level of granulocyte-colony stimulating factor (G-CSF; 158 pg/ml). A diagnosis of locally advanced bladder cancer producing G-CSF was made; therefore, the patient underwent a total cystectomy and urinary diversion with an ileal conduit. Histopathological examination of the surgical specimen revealed a urothelial carcinoma with squamous differentiation (pT3a, pN0, ly1, v1). In terms of their immunohistochemistry, the tumor cells were shown to express G-CSF. After surgery, the leukocyte count and serum level of G-CSF decreased to normal values. No recurrence was observed in the 41 months after surgery without adjuvant therapy. We reviewed 73 cases of bladder cancer producing G-CSF reported in the literature in Japan.
ABSTRACT
Case: An 88-year-old female with Alzheimer's-type dementia who mis-swallowed a press-through package visited our emergency department. Outcome: Plain radiography detected no foreign bodies, whereas plain computed tomography showed an elliptical body with a high density in the lower esophagus. The press-through package containing a tablet in the esophagogastric junction was successfully removed without severe complications using the endoscopic protector hood. In cases of press-through package mis-swallowing, it is important for emergency physicians to make an early and correct diagnosis of the location of the package, which shows high radiolucency. Based on the results of this case, we hypothesize that carrying out early computed tomography examinations is useful for identifying swallowed press-through packages. Our retrospective investigation showed that computed tomography has a sensitivity of 100% for detecting press-through packages. Conclusion: We experienced a case of press-through package mis-swallowing diagnosed on computed tomography. We recommend performing computed tomography examinations, especially in patients with an uncertain history and unclear symptoms.
