Publications by authors named "Shota Fukai"

6 Publications

  • Page 1 of 1

Perforation of intestinal leiomyosarcoma: A case report.

Int J Surg Case Rep 2021 Feb 19;79:327-330. Epub 2021 Jan 19.

Department of Surgery, Tokyo Bay Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, 279-0001, Japan. Electronic address:

Introduction And Importance: The majority of gastrointestinal sarcoma is gastrointestinal stromal tumors and intestinal leiomyosarcoma is rare. Small intestinal mesenchymal tumors are often large at diagnosis, and they commonly present with bleeding or intussusception. We report a perforation associated with intestinal leiomyosarcoma.

Case Presentation: A 66-year-old man presented with severe epigastric pain. A physical examination showed tachycardia and a diffusely tender and rigid abdomen. Computed tomography showed a massive tumor and free air. A laparotomy was performed to treat lower digestive perforation. Massive tumor, which invaded surrounding intestine, was 20 cm in size at the ileum. The involved intestine was perforated. We confirmed that feeding artery was superior mesenteric artery and performed partial intestinal resection. His clinical course was uneventful and discharged 10 days postoperatively. The pathological findings showed spindle shaped and the tumor invaded the mucosa at the perforated site. Immunohistochemical spectrum resulted c-kit negative, S-100 negative, Desmin positive, alpha smooth muscle actin(αSMA) positive and Ki-67 30-40 %. The pathological findings were leiomyosarcoma.

Discussion: Gastrointestinal sarcoma is sometimes found by bleeding. In our patient, leiomyosarcoma invaded surrounding intestine, it made the intestine wall frail and caused perforation. The intestinal perforation which was involved by leiomyosarcoma has been rarely reported to the best of our knowledge since WHO refined leiomyosarcoma.

Conclusions: Although intestinal leiomyosarcoma is rare, we should know that it can involve surrounding intestines and make them perforated.
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http://dx.doi.org/10.1016/j.ijscr.2021.01.062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7840855PMC
February 2021

Use of a stent to treat colonic stenosis secondary to acute pancreatitis: A case report.

Int J Surg Case Rep 2019 8;61:26-29. Epub 2019 Jul 8.

Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan. Electronic address:

Introduction: We report a patient for whom a colonic stent was successfully used to treat colonic stenosis secondary to acute pancreatitis.

Presentation Of Case: A 70-year-old male presented with epigastric pain. A choledocholith and bile duct dilatation were found on abdominal computed tomography scan. Endoscopic retrograde cholangiopancreatography was performed and a common bile duct stent was placed. Ten hours after stent placement, severe epigastric pain developed. Contrast enhanced abdominal computed tomography scan revealed increased density of fat tissue around the pancreas. He was diagnosed with severe acute pancreatitis and treated in the intensive care unit. On the twenty-eighth hospital day, he vomited. His abdomen was distended and tender to palpation. Contrast enhanced abdominal computed tomography scan revealed stenosis of the descending colon and proximally dilated colon and small bowel. He was diagnosed with colonic stenosis secondary to acute pancreatitis. A colonic stent was placed in the descending colon. Eight months after this episode, elective subtotal colectomy was performed. The postoperative course was unremarkable.

Discussion: The overall documented leak rate for segmental colectomy with or without on-table lavage following large bowel obstruction is about 4%. In addition, in the acute phase of severe acute pancreatitis, inflammation makes surgery difficult. Use of enteric stents in patients with pancreatitis could be used as a temporizing measure until the inflammation and obstruction improve.

Conclusion: Colonic stenting is useful as a bridge to surgery in the management of large bowel obstruction.
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http://dx.doi.org/10.1016/j.ijscr.2019.06.065DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6626977PMC
July 2019

Gastric perforation secondary to an incarcerated paraesophageal hernia.

Surg Case Rep 2019 Jun 10;5(1):94. Epub 2019 Jun 10.

Department of Surgery, Tokyo Bay Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, Japan.

Background: Paraesophageal hernias are usually asymptomatic; however, they can cause serious complications such as necrosis or incarceration-induced perforation. Necrosis usually occurs in the incarcerated portion of the hernia. Here, we report the case of a patient with gastric necrosis secondary to an incarcerated paraesophageal hernia in which the necrotic lesion was outside the hernia sac.

Case Presentation: A 91-year-old woman presented with severe abdominal pain and vomiting. A physical examination showed hypotension and a diffusely tender and rigid abdomen. Computed tomography showed a paraesophageal hernia, massive ascites, and free air around the stomach. A laparotomy was performed to treat the upper gastrointestinal perforation. The stomach was incarcerated within the paraesophageal hernia sac. After reducing the stomach, we identified a large perforation on the posterior wall of the gastric fundus. Full-thickness necrosis involving part of the stomach necessitated total gastrectomy. She remained physiologically unstable and her condition deteriorated; she died 2 days postoperatively.

Conclusions: A hiatal hernia can be associated with an ischemic gastric perforation outside the hernia sac.
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http://dx.doi.org/10.1186/s40792-019-0653-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557949PMC
June 2019

Metastatic colon cancer derived from a diverticulum incidentally found at herniorrhaphy: a case report.

Surg Case Rep 2018 May 15;4(1):47. Epub 2018 May 15.

Department of Surgery, Juntendo Urayasu Hospital, Juntendo University, Chiba, Japan.

Background: There are few reports of metastases from colon cancer to an inguinal hernia sac, and few reports of colon cancer originating in diverticula. We report a patient with carcinoma of the sigmoid colon arising in two diverticula, who presented with peritoneal seeding to an inguinal hernia sac, and a review of the literature.

Case Presentation: A 55-year-old male underwent open herniorrhaphy for a left inguinal hernia. At operation, a nodule in the inguinal hernia sac was resected and histologic examination revealed adenocarcinoma, which was suspected to be a metastasis from a distant primary lesion. Postoperative evaluation included colonoscopy and positron emission tomography which showed two suspected lesions in sigmoid diverticula. Laparoscopic subtotal colectomy was performed, and pathology revealed adenocarcinoma in two sigmoid diverticula.

Conclusions: If a nodule is found in an inguinal hernia sac, especially in older patients, peritoneal metastases should be considered. Resection of the nodule with histopathologic evaluation is essential. Colon cancer arising in a diverticulum should be considered as a possible site of the primary lesion.
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http://dx.doi.org/10.1186/s40792-018-0455-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5953913PMC
May 2018

Ductal Carcinoma in situ of the breast in sclerosing adenosis encapsulated by a hamartoma: A case report.

Int J Surg Case Rep 2018 7;45:9-12. Epub 2018 Mar 7.

Department of Surgery, Tokyo Bay Medical Center, 3-4-32 Todaijima, Urayasu, Chiba, 279-0001, Japan. Electronic address:

Introduction: Ductal Carcinoma in situ (DCIS) of the breast can develop in areas of sclerosing adenosis. The radiographic finding of sclerosing adenosis is a spiculated mass and can look like invasive ductal carcinoma. We report a patient with DCIS in sclerosing adenosis encapsulated by a hamartoma, with imaging findings quite different from the typical findings of sclerosing adenosis.

Presentation Of Case: A 73-year old woman, with no previous mammography, presented with a palpable mass in the left breast. Mammography showed a 36 mm well-defined mass with fat density in the middle outer quadrant of the left breast. Ultrasonography showed a well-defined mass in the same area which was composed of hypoechoic and hyperechoic areas. The histological diagnosis by core needle biopsy was sclerosing adenosis. We considered the patient's age and tumor size and performed a partial mastectomy for both diagnosis and treatment. Final pathology showed DCIS in sclerosing adenosis in a hamartoma.

Discussion: This patient had DCIS in an area of sclerosing adenosis, encapsulated by a hamartoma. DCIS can develop in areas of sclerosing adenosis, and can appear similar to invasive ductal carcinoma, so we must avoid misdiagnosis or over-treatment. Malignant transformation of a hamartoma is rare, but can occur since it contains epithelial tissue. Definitive biopsy should be performed due to the possibility of a malignancy inside the hamartoma.

Conclusions: When diagnosing a hamartoma, the presence of atypical findings on imaging studies, should suggest the possibility of malignancy. Although rare, a malignant tumor may be present inside the hamartoma.
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http://dx.doi.org/10.1016/j.ijscr.2018.03.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6000998PMC
March 2018

Pseudoaneurysm of an ileal mesenteric artery after a stapled anastomosis.

Surgery 2018 04 13;163(4):968-969. Epub 2017 Dec 13.

Department of Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Chiba, Japan.

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http://dx.doi.org/10.1016/j.surg.2017.10.037DOI Listing
April 2018