Objective: To evaluate outcomes of palliative surgery for malignant bowel obstruction (MBO) and identify factors associated with postoperative survival. Methods: We retrospectively reviewed 27 patients who underwent palliative surgery for MBO between April 2014 and March 2023. Clinical data including symptom relief, oral intake, discharge status, and overall survival (OS) were analyzed. Results: Median age was 70 years; 23 patients were Stage IV. Primary tumors included colon-rectum (15), stomach (6), pancreas (2), and others (4). Peritoneal dissemination was present in 18 cases. Median preoperative Palliative Prognostic Index (PPI) was 3.0. Postoperative symptom relief was achieved in 96.3%, oral intake in 81.5%, and discharge in 51.9%. Median OS was 118 days. Peritoneal dissemination and oral intake status were significantly associated with OS; sex, age, and PPI were not. Conclusion: Palliative surgery may improve outcomes such as symptom relief, oral intake, discharge to preferred care settings, and survival. These findings support its role in advance care planning and enhancing quality of life in patients with terminal cancer.

A 78-year-old woman who had a history of left deep venous thrombosis was referred to our hospital with a sudden hemoptysis. Thoracic computed tomography showed a solitary pulmonary nodule in the right lower lobe. Based on her medical history of deep venous thrombosis, she was tentatively diagnosed as having pulmonary embolism and successfully treated by inserting an inferior vena cava filter and anticoagulant therapy with warfarin [Please confirm whether previous sentence is correct]. However, the lung nodule on thoracic computed tomography was still depicted four months later. With suspicion of a malignant tumor, including possible lung cancer, a right segmentectomy was performed. Pathological assessment of the resected specimen showed the tumor was derived from the right bronchial wall, but was not ruptured into the intratracheal lumen, as well as coexistence with intraalveolar hemorrhage near the tumor. The lung nodule was diagnosed as bronchial schwannoma. Thus, the origin of the hemoptysis was found to be pulmonary embolism due to deep vein thrombosis, and not by bronchial schwannoma, which was also present in the lung.

Tuberculous spondylitis, or so-called Pott's disease, seems to be overlooked because of a lack of severe inflammation in the insidious generating process and tends to cause non-specific symptoms, such as back pain, fever, weakness, and weight loss. Diagnostic delay is common and the results can be disastrous. Discriminating between Pott's disease and other diseases, such as malignancy and pyogenic infection, is difficult. However, the inflammatory process in Pott's disease tends to spare the disk space, while that of pyogenic infection typically affects the area. Herein, we present a patient with Pott's disease who showed the characteristic clinical and radiological findings.