Surgery today
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Hirschsprung's disease is almost always associated with newborns or infants; however, we report herein the unusual case of a 46-year-old woman in whom the symptoms of Hirschsprung's disease emerged late in adult life. The involved rectosigmoid region was successfully removed by performing Duhamel's operation with a diverting colostomy. After the colostomy was closed, she regained normal defecatory function. ⋯ Moreover, most papers on the familial occurrence of this disease have reported that siblings were affected. Our patient was unique for the definite occurrence of the disease in successive generations. The features of Hirschsprung's disease in adults and the familial occurrence are discussed with a review of the literature.
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Review Case Reports
Spontaneous rupture of the stomach in preschool age children: a report of two cases.
The cases of two preschool-age children who suffered spontaneous gastric ruptures are reported herein. The first was a 2-year-old girl with tetralogy of Fallot, transferred to our hospital due to shock. ⋯ An abdominal X-ray film revealed a pneumoperitoneum, and an emergency laparotomy was performed, confirming a round rupture in the posterior wall of the stomach. Both patients had a satisfactory postoperative course.
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We describe herein the case of a 52-year-old man found to have a solitary pulmonary lymphangioma. Computed tomography (CT) scan demonstrated a nodule with homogeneous density and a well-defined border in the lower lobe of the right lung. T2-Weighted magnetic resonance imaging (MRI) revealed a nodule with homogeneously high signal intensity. The tumor was removed by partial resection, and pathologic examination confirmed a diagnosis of primary lymphangioma of the lung.
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Case Reports
Retrograde cerebral perfusion exceeding 120 minutes in aortic arch reconstruction: a report of two cases.
The time limits for retrograde cerebral perfusion (RCP) during aortic arch reconstruction have yet to be clarified. We herein present two cases with periods of RCP exceeding 120 min during aortic reconstruction; both patients recovered uneventfully with no neurological deficits. These data suggest that RCP, as an adjunct to hypothermic circulatory arrest, may prolong the circulatory arrest time and thus prevent ischemic injury of the brain, even when RCP exceeds 120 min.