A case of stricture-type ischemic colitis from excessive alcohol consumption, with follow-up to rule out colon cancer.

A 69-year-old man was admitted to Hanawa Kousei Hospital with acute hepatitis attributed to alcohol consumption. His condition improved with conservative treatment. Computed tomography (CT) showed localized thickening of the colonic wall at the splenic flexure;carcinoembryonic antigen level was slightly elevated to 9.7 ng/mL. Colonoscopy (CS) showed an ulcerative lesion in the colonic splenic flexure. Ischemic colitis (IC) and type 4 colon cancer were suspected, but biopsy was not confirmatory. Malignancy could not be ruled out by contrast-enhanced CT;repeat CS showed circumferential stenosis of the colonic splenic flexure. Ischemic colitis was suspected based on changes between the first and second CS. Biopsy histopathology led us to diagnose stricture-type IC. Constipation, but not intestinal obstruction, occurred. Conservative treatment improved the stenosis. Excessive alcohol consumption may lead to IC;imaging studies may be useful to distinguish IC from colon cancer. Since most cases of ischemic colitis can be improved with conservative treatment, patients with stricture-type ischemic colitis may also be treated without surgery early on, with follow-up that includes careful, periodic imaging.

Start and initial results of the Fukushima Prefecture acute myocardial infarction registration survey.

Acute myocardial infarction (AMI) remains one of the most serious heart diseases and elucidation of its pathogenesis and advances in treatment strategies have been desired. In 2009, to understand the status of AMI in Fukushima Prefecture for improving treatment outcomes, a new AMI registration survey system was conducted throughout the prefecture. A total of 1,556 cases were registered in the initial 2 years from 2009 to 2010. The hospital-based overall incidence of AMI in Fukushima Prefecture was 37.9 people per population of 100,000 per year. Mortality from AMI within 30 days of onset was 10.2%. We report herein the actual situation of AMI onset and treatment in Fukushima Prefecture based on the initial results of the survey.

A case of gastrointestinal stromal tumor with pneumomediastinum.

A 52-year-old man noticed physical weariness and anorexia in November 2008. Severe anemia was found. Pneumomediastinum was detected using x-ray and CT scanning. Esophagogastroduodenoscopy revealed a submucosal tumor with a deep ulcer in the anterior wall of the upper stomach, causing anemia. Partial gastrectomy was performed because microperforation was suspected. The resected specimen showed spindle-shaped tumor cells that were c-kit positive and CD34 positive on immunohistological staining, suggesting a diagnosis of gastrointestinal stromal tumor (GIST). Although emphysema in the abdominal cavity was not observed, air leakage from gastric GIST with necrosis in the upper stomach was inferred as the cause of pneumomediastinum.