[Resection of Lung Cancer with Chest Wall Invasion Using Posterior Paramedian Incision].

We report a case of lung cancer with chest wall invasion resected with the posterior paramedian incision. A man in his 60s exhibited hemosputum and cough. Chest X-ray revealed a large mass below the right hilum. A 6.3 cm soft tissue mass with central cavity invading to the lower posterior chest wall was found on chest computed tomography( CT). The tumor was diagnosed as squamous cell carcinoma by transcutaneous lung biopsy( TCLB). Thoracoscopic hilar dissection of the right lower lobe with dissection of the mediastinal lymph nodes were preceded to the en-bloc resection of the invaded chest wall with less invasive manner by the posterior paramedian incision.

A case of abdominal compartment syndrome derived from simple elongated sigmoid colon in an elderly man.

INTRODUCTION: Abdominal compartment syndrome or intra-abdominal hypertension may occur after intra-abdominal events, but their etiology and clinical signs remain unclear. We report a case of abdominal compartment syndrome in an elderly patient without other risk factors. PRESENTATION OF CASE: An 86-year-old man had been admitted to our hospital several times for a dilated sigmoid colon with elongation, and had complained about abdominal pain and abdominal fullness. At every admission we decompressed the sigmoid colon gas by colonoscopy, resulting in early discharge the following day. Recently, the patient developed dementia and experienced reduced activities of daily living that are common with aging. He frequently complained of severe abdominal distension with hypotension, tachycardia and tachypnea, and finally entered hospital twice a week. We decided to perform elective surgery, which showed abdominal compartment syndrome caused by elongated sigmoid colon without volvulus (the first reported case). DISCUSSION AND CONCLUSION: Considering the increase in the aging population, we must bear in mind that abdominal compartment syndrome may occur in simple elongated sigmoid colon without other risk factors.

Chronic necrotizing pulmonary aspergillosis following cryptococcal infection of the lung.

A 64-y-old male with steroid-induced diabetes mellitus was admitted to our hospital because of a nodular shadow found by chest radiography. Pathological examination revealed pulmonary cryptococcosis, and he was positive for serum Cryptococcus antigen. After oral treatment with fluconazole, he experienced clinical and radiographic improvement, but during ensuing observation without antifungal treatment his respiratory symptoms gradually worsened. Chest radiography showed progressive infiltration around the cavity, and Aspergillus mold was isolated by transbronchial lung biopsy from the lesion where previous cryptococcal infection was present. In addition, serum antibodies to Aspergillus antigens were demonstrated by immunodiffusion. Thus, pulmonary aspergillosis was found to complicate a case of pulmonary cryptococcal infection.