Actinomycosis is an uncommon disease caused by actinomycoses, which is a normal flora in the human mucosal membrane. It is difficult to diagnose pre- and intra-operatively and requires long-term use of antibiotics even after surgery. Especially, abdominal actinomycosis is frequently misdiagnosed as a tumor, diverticulitis, chronic inflammatory disease, or other infectious disease preoperatively. Thus, we report the case of a 21-yr-old male patient who was thought to have acute appendicitis and who underwent a cecal wedge resection, including the appendix, with the assistance of laparoscopy for appendiceal actinomycosis.
Actinomycosis ; Anti-Bacterial Agents ; Appendicitis ; Appendix ; Communicable Diseases ; Diverticulitis ; Humans ; Laparoscopy ; Male ; Membranes

Malignant degeneration of mature cystic teratoma has been reported in 1~3% of cases, usually between the age of 30 and 70 years with a peak incidence of 40~60 years. The most common malignancy developing in such tumors is squamous cell carcinoma arising in a mature cystic teratoma. Hirakawa reported two patients with benign teratomas diagnosed 25 and 32 years prior to surgery for malignancy and Dorothea reported a patient who was diagnosed as benign teratoma 50 years prior to operate for carcinoma. But there has been no report of squamous cell carcinoma arising in the mature cystic teratoma with direct invasion to gastrointestinal tract. We report a case of squamous cell carcinoma with direct invasion to transverse colon and jejunum in 62-year-old female who was diagnosed as mature cystic teratoma 20 years ago.
Carcinoma, Squamous Cell* ; Colon, Transverse* ; Female ; Gastrointestinal Tract ; Humans ; Incidence ; Jejunum* ; Middle Aged ; Teratoma*

The authors present a case of intussusception of the vermiform appendix with ade nocarcinoma. A 35-year-old male with lower abdominal pain and anemia was found to have an intussusception of the appendix associated with an adenocarcino-ma. The preoperative diagnosis was cecal cancer but we detected the iutussuscept-ion of the appendix with an adenocarcinoma during operation. Patient was managed with right hemicolectomy and has been followed up.
Abdominal Pain ; Adenocarcinoma* ; Adult ; Anemia ; Appendix* ; Cecal Neoplasms ; Diagnosis ; Humans ; Intussusception* ; Male

Optimal goals of rectal cancer surgical treatment should include appropriate local control, higher survival rates, scrupulous operation procedures and good quality of life with maintained sexual and voiding function through the conservation of anal sphincter. Complete surgical removal of rectal cancer mass and adjacent lymph nodes in en-bloc package decreases the risk of local recurrence. Furthermore heightened awareness of better surgical techniques has created much interest in the anatomy involved in total mesorectal excision (TME), with particular focus on the fascial planes, nerve plexuses and their relationship to the surgical planes of excision. Total mesorectal excision focuses on several technical components and the quality of operated specimen. Sharp anatomic pelvic dissection along the visceral pelvic fascia must avoid any breach from the mesorectum haboring metastatic tumor deposits and lymph nodes. Also any coning down or blunt dissection should not be allowed. The rectal cancer mass and its surrounding mesorectum must be removed as one complete unit. Circumferential and distal resection margin must be also adequately obtained. Such sharp pelvic dissection instead of blunt dissection requires precised knowledge of the pelvic anatomy. Studying the hemisected cadevaric pelvis shows a clear relationship between the fascia and rectum. Also pelvic autonomic nerves can be saved to preserve the patient's sexual and voiding functions. Therefore the clincial importances of anatomical structures must be emphasized at each step of surgery. Upon such understanding of techniques, TME was performed in rectal cancer patients routinely and was able to obtain fair oncologic results and improved quality of life regarding sexual and voiding functions.
Anal Canal ; Autonomic Pathways* ; Fascia ; Humans ; Hypogastric Plexus ; Lymph Nodes ; Pelvis ; Quality of Life ; Rectal Neoplasms* ; Rectum ; Recurrence ; Survival Rate

Pseudomyxoma peritonei is a relatively rare and poorly understood condition in which mucus accumulate within the peritoneal cavity. The presence of cells in the mucin, either inflammatory or neoplastic, distinguishes it from simple acellular mucus ascites caused by mucinous spillage. There are widespread seedings on the peritoneal and omental surfaces with a heavy cancerous glaze. This is principally a complication of borderline or malignant neoplasm of the ovary and/or appendix. We report one female case with pseudomyxoma peritonei from mucinous adenocarcinoma of appendix which was diagnosed incidentally during laparoscopic cholecystectomy.
Adenocarcinoma, Mucinous* ; Appendix ; Ascites ; Cholecystectomy, Laparoscopic ; Female ; Humans ; Mucins* ; Mucus ; Ovary ; Peritoneal Cavity ; Pseudomyxoma Peritonei*

A gastrocolic fistula is a fistulous communication between a segment of colon and the stomach. It is a rare complication and is caused most commonly by a carcinoma of the colon or the stomach. Among the less common causes of a gastrocolic fistula are a benign gastric ulcer, chronic ulcerative colitis, Crohn's disease, a carcinoid tumor, syphillis, an intraabdominal abscess, a lymphoma, trauma, intestinal tuberculosis, and iatrogenic factors. Recently, the incidence of gastrocolic fistulas has decreased due to earlier diagnosis and treatment of stomach and colon cancer. The classic triad of symptoms are lienteric diarrhea, feculent vomiting, and foul eructations, but all patients do not necessarily present with these symptoms. A gastrocolic fistula is usually diagnosed by using a barium enema, but occasionally can be detected by using an upper gastrointestinal series or endoscopy. Here, we report experience with a fistula between a cancerous transverse colon and the stomach and give a review of the literature.
Abscess ; Barium ; Carcinoid Tumor ; Colitis, Ulcerative ; Colon* ; Colon, Transverse ; Colonic Neoplasms* ; Crohn Disease ; Diagnosis ; Diarrhea ; Endoscopy ; Enema ; Eructation ; Fistula* ; Humans ; Incidence ; Lymphoma ; Stomach ; Stomach Ulcer ; Tuberculosis ; Vomiting

An adenocarcinoma of the appendix is a rare tumor, and so far only 130 cases have been reported worldwide. We report one patient with peritoneal seeding of an adenocarcinoma. A 51-year-old man was admitted to our hospital with the impression of intestinal obstruction. He had undergone an appendectomy 5 years ago due to acute appendicitis. At that time, postoperative histopathological analysis had revealed an adenocarcinoid tumor in the appendix. The patient had been told to visit our hospital for follow-up but he hadn't visited. When he finally visited our hospital diagnostic laparoscopy revealed the peritoneal seeding of a recurrent adenocarcinoma. A palliative right hemicolectomy was done to relieve the bowel obstruction. After recovering from operation, the patient was treated with the 5-fluoruracil, leucovorin, and oxaloplatin (FOLFOX). The patient was discharged in improved general condition with a future plan for regular cyclic chemotherapy.
Adenocarcinoma ; Appendectomy ; Appendicitis ; Appendix* ; Carcinoid Tumor ; Drug Therapy ; Follow-Up Studies ; Humans ; Intestinal Obstruction ; Laparoscopy ; Leucovorin ; Middle Aged ; Neoplasm Metastasis*

Fournier's gangrene is a rare infection with high mortality rate. it consists of a mixed bacterial infectin of the skin, subcutaneous tissues and superficial fascia of the perinium and genitalia. Old patients especially with diabetes mellitus, alcoholism and maligancy are more affected. This disease requires prompt treatment: early diagnosis, broad spectrum antibiotic therapy, nutritional support and immediate extensive surgial debridement are necessary We report one case of Fournier's gangrene associated with diabetes mellitus.
Alcoholism ; Debridement ; Diabetes Mellitus ; Early Diagnosis ; Fournier Gangrene* ; Genitalia ; Humans ; Mortality ; Nutritional Support ; Skin ; Subcutaneous Tissue

Intestinal pseudo-obstruction is characterized by symptoms and signs of mechanical bowel obstruction in the abscence of an occluding lesion of the intestinal lumen. The chronic forms of intestinal pseudo-obstruction are separated into primary and secondary in according to the underlying disorders. primary or chronic idiopathic intestinal pseudo-obstruction(CIIP) is not associated with systemic illness and a progressive nature with relapses and remissions. Since Dyer described the rare histologic subtype of idiopathic pseudo-obstruction, the primary abnormality is in the myenteric plexus of the bowel at first in 1969, only few cases are reported. We report a case of CIIP caused by degeneration of myenteric plexus of the colon and he was successfully treated with surgical management.
Colon ; Intestinal Pseudo-Obstruction ; Myenteric Plexus ; Recurrence

Leiomyosarcoma is the most commonly nonepithelial gastrointestinal malignancy. It may arise from the smooth muscle of the muscularis propria, muscularis mucosa, or blood vessels. This malignant tumor is most common seen in the fifth and sixth decades, although it may occur in infants and children. Leiomyosarcoma of the large intestine are unusual neoplasms, comprising less than 0.1% of all malignancies of the colon and rectum. Leiomyosarcomas in gastrointestinal tract are mostly found 61% in the stomach, 24% in the small bowel, 7% in the rectum, and only 3% in the colon. The survival rates and therapeutic approaches to gastrointestinal leiomyosarcoma vary widely. We experienced a case of recurred rectal leiomyosarcoma in the abdominal wall and report with review of literatures.
Abdominal Wall* ; Blood Vessels ; Child ; Colon ; Gastrointestinal Tract ; Humans ; Infant ; Intestine, Large ; Leiomyosarcoma* ; Mucous Membrane ; Muscle, Smooth ; Rectum ; Stomach ; Survival Rate