岡山医学会Acta Medica Okayama0030-155812412012膵炎を伴った胃異所性膵の1切除例5962ENSusumuShinouraTakahitoYagiHiroshiSadamoriHiroakiMatsudaYuzoUmedaRyuichiYoshidaDaisukeSatohMasashiUtsumiNaosukeYokomichiTakashiKuiseToshiyoshiFujiwaraWe experienced a case of gastric aberrant pancreas with acute pancreatitis. The patient was a 42-year-old man. He was referred to our hospital because of epigastric pain. A CT scan and endoscopic examination revealed a gastric submucosal tumor with inflammation. His serum amylase level was high at 222 IU/l. Endoscopic ultrasonography revealed a hypoechoic mass lesion, 3 cm in diameter, at the body of his stomach. Endoscopic ultrasoundscopy-guided fine needle aspiration was performed. Pathological examination showed pancreatic tissue. So, he underwent partial gastrectomy due to gastric aberrant pancreas with pancreatitis. There are very few cases of gastric aberrant pancreas with pancreatitis on record.No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155812332011脾動脈結紮を伴う生体肝移植後に脾動脈症候群を呈した一例207211ENDaisukeSatohTakahitoYagiHiroshiSadamoriHiroakiMatsudaSusumuShinouraYuzoUmedaRyuichiYoshidaTakashiUtsumiToshiyoshiFujiwaraAfter orthotopic liver transplantation, splenic artery syndrome (SAS), a phenomenon by which the main blood flow of the impaired hepatic artery is shifted to the splenic artery or gastroduodenal artery despite the absence of a structural lesion involving the anastomosis, has occasionally been observed. We report a 20-year-old women who developed SAS with pancytopenia and refractory ascites after living donor liver transplantation despite intraoperative ligation of the splenic artery as a prophylactic treatment for SAS. In this case SAS was diagnosed by digital subtraction angiography (DSA). A celiac trunk angiogram showed relative hypoperfusion of the hepatic artery together with augmentation of the blood flow toward the spleen with the unique collateral circulation through the left gastric artery, stomach and short gastric artery, and distal splenic artery. Embolization of one of the two left gastric arteries was performed. After embolization the hepatic artery perfusion showed significant improvement, but reduced again the next day. We ultimately conducted splenectomy. This case showed portal hyperperfusion and portal hypertension, consistent with previous reports that have described an association of SAS with portal hyperperfusion. After splenectomy, there was significant improvement in the hepatic artery perfusion, ascites disappeared promptly, and pancytopenia was significantly improved.No potential conflict of interest relevant to this article was reported.Okayama University Medical SchoolActa Medica Okayama0386-300X5422000Creation and use of a composite polyurethane-expanded polytetrafluoroethylene graft for hemodialysis access.9194ENAtsunoriNakaoMasashiMiyazakiYoshinariOkaHiroakiMatsudaMasahiroOishiYoshiakiKokumaiKeiichiKunitomoHiroshiIsozakiNoriakiTanakaArticle10.18926/AMO/32285<p>The Thoratec (Vectra) polyurethane vascular access graft (TPVA) is among the most recent additions to the list of materials used to construct prosthetic grafts for vascular access during hemodialysis. We give the TPVA very high marks, and recognize the utility of such a graft for use in hemodialysis. However, the strong elasticity of this graft can lead to unexpected complications after suturing. We devised a new surgical method using a TPVA-ePTFE (expanded polytetrafluoroethylene) composite graft, substituting the anastomosis section of the TPVA with a portion of ePTFE graft material, and have been able to overcome most of the TPVA's potential problems. We herein describe the technique.</p>
No potential conflict of interest relevant to this article was reported.岡山医学会Acta Medica Okayama0030-155811322001多発性肝嚢胞の1例159164ENYutakaNakanishiKohsakuSakaguchiYoshiakiIwasakiKazuhiroNousoHiroyukiShimomuraHiroakiMatsudaTakahitoYagiNoriakiTanakaTakaoTsujiA 45-year-old female was admitted to our hospital with sever abdominal fullness, and was diagnosed as polycystic liver disease with ultrasonography, abdominal CT and abdominal angiography. Almost all part of the right lobe of the liver was replaced with a lot of cysts. The liver obviously swelled up. We thought her symptom came from oppression of the digestive tract by the liver. Liver function is good. Right lobe resection, deroofing and fenestration were performed, and after operation the volume of the liver was reduced and the symptom got better. We report a case of polycystic liver disease improved with surgical therapy, adding some study with reference.No potential conflict of interest relevant to this article was reported.Acta Medica Okayama1999SUBZERO NONFREEZING STORAGE OF ISOLATED RAT HEPATOCYTES IN UNIVERSITY OF WISCONSIN SOLUTIONENNo potential conflict of interest relevant to this article was reported.