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The purpose of this study was to examine resistance dynamic stretch (RDS) using a stretch machine and static stretch (SS) with straight legs. The subjects of this study were 12 healthy male university judoka. The Subjects were divided into an SS group (n = 6) and an RDS group (n = 6). The period of stretching was 10 weeks and the frequency was twice a week in both groups. The measurement items were finger floor distance (FFD), straight leg raising (SLR) and heel buttock distanced (HBD). The results showed significant improvement in all items in the RDS group, however, the SS group did not show significant improvement in HBD before and after. HBD improved significantly in the RDS compared with the SS group. We conclude that RDS can improve the flexibility of the hamstrings as well as the quadriceps. [ABSTRACT FROM AUTHOR]

We encountered a 31-year old female 100-m hurdler with a depression in the affected region, which still remained after muscle strain of the rectus femoris muscle 13 years earlier. We discuss the case from morphological and functional viewpoints. The MRI and ultrasonic images showed scarring in the depression. Although no difference was found in muscle strength between the right and left sides, the muscle activity pattern obtained via electromyography differed from site to site on the injured side, unlike the healthy side. The results indicate the possibility that old muscle strains may affect performance in some athletic events. [ABSTRACT FROM AUTHOR]

Here we describe the case of a 69-year-old man who was found to have moderate thrombocytopenia and severe splenomegaly during a medical checkup at the age of 67. At the first visit, his white blood cell (WBC) count was 7,400/µl with 80% lymphocytes, and bone marrow aspiration showed 24% atypical lymphocytes. Flow cytometry of atypical lymphocytes was positive for mature T-cell markers, and T-cell clonality was revealed by T-cell receptor gene rearrangement. TCL1 was negative on immunohistochemistry. We diagnosed TCL1-family negative T-cell prolymphocytic leukemia (T-PLL) and employed watchful waiting. Thirty months after diagnosis, the patient developed urinary retention and right lower-limb paresis despite a normal WBC count, and an extradural tumor around the thoracic vertebrae and spinal cord compression were detected. The tumor was diagnosed as extranodal involvement of TCL1-family negative T-PLL, but the patient's general condition deteriorated rapidly, and no treatment was possible. T-PLL is a rare disease characterized by leukocytosis, and the WBC count generally increases with disease progression. Although blood counts are recommended for observation, it is important to keep in mind that the disease may worsen even if blood counts do not change.

Although a therapeutic response to neoadjuvant chemoradiotherapy(NACRT)is important to improve oncological outcomes after surgery in patients with locally advanced rectal cancer, there is no reliable predictor for this. The Wnt/β-catenin signal is known to be crucial for the tumorigenesis of colorectal cancer. This study aimed to investigate the association between Wnt/β-catenin signal activation and the response to NACRT in patients with locally advanced rectal cancer. We analyzed the expression of nuclear and membranous β-catenin in biopsy samples obtained from 60 patients who underwent curative surgery following NACRT. We found that patients with low nuclear β-catenin expression had a higher rate of good histological responses compared to those with high nuclear β-catenin expression. Additionally, patients with low nuclear/high membranous β-catenin expression tended to have better relapse-free survival. The activation of the Wnt/β- catenin signal pathway, represented by nuclear β-catenin accumulation, was significantly associated with a poor response to NACRT in patients with rectal cancer. The analysis of nuclear β-catenin accumulation before starting treatment could potentially predict the therapeutic response to NACRT.

Purpose: We have been using a paper-based hard copy print (paper print) system of X-ray images, in which digital imaging and communications in medicine (DICOM) data can be directly output on papers from medical imaging systems or from a picture archiving and communication system (PACS) server, and they are utilized as patient referral materials or for preoperative planning. The purpose of this study was to compare the display performance of X-ray images on the printed paper and that on the liquid crystal display (LCD)., Methods: We measured contrast response to verify consistency of image appearance on both display systems. The contrast resolution was assessed by a CDRAD phantom. The spatial resolution was assessed by an X-ray test chart., Results: The contrast response of the paper printer was not concordant with the grayscale standard display function (GSDF). The difference between the measured contrast response and the ideal GSDF on the paper was large in the high-density area. The low-contrast resolution on the paper was inferior to that on the LCD. The spatial resolving power on the paper was superior to that on the LCD., Conclusion: The display performance of the paper printer for X-ray images was clarified. X-ray images printed on the paper should be used carefully taking account of their characteristics of display performance.

Simultaneous administration of enteral formula and phenytoin in the clinical setting is known to reduce the plasma concentration of phenytoin. In this study, we examined the binding of phenytoin with enteral formulas and its components by quantifying the free phenytoin concentration. Furthermore, we investigated the effect of enteral formulas on gastrointestinal absorption of phenytoin in rats. The free phenytoin rate was reduced in vitro when phenytoin and enteral formula or pectin, a dietary fiber in enteral formulas, were co-administered. In vivo, when phenytoin and the enteral formula Mei Balance R ® were co-administered, the time to maximum plasma concentration (T max ) after oral administration was significantly increased. Moreover, the area under the phenytoin concentration-time curve from time zero to 6 h (AUC 0-6 h ) was significantly increased by co-administration of phenytoin with the enteral formula PG Soft EJ ® . These results showed the gastrointestinal absorption of phenytoin differs according to the type of enteral formula. In addition, we found the first time that plasma phenytoin levels increase when combined with enteral formula. Among the components of enteral formulas, in particular, milk protein delayed the absorption of phenytoin. Moreover, milk protein, casein and carrageenan tended to increase AUC 0-6 h . These results suggest the change in phenytoin concentration is due not only to the binding of enteral formula but also to the disintegration of components such as protein. Therefore, when co-administrated of phenytoin and enteral formula, phenytoin must be monitored frequently according to the enteral formula interaction.

Objectives: This study aimed to analyze and categorize the actual situation of employment consultation and support according to consultation times or employment status at the Consultation Support Center of the National Cancer Center Hospital of Japan., Methods: We retrospectively analyzed the patient backgrounds, consultation contents, and the number of employment consultation cases conducted at the Consultation Support Center of the National Cancer Center Hospital during a 6-month period from May to December 2018., Results: During the study period, 117 patients (male: female = 46:71) visited the Consultation Support Center. The median age of patients was 48 years old. The most common primary cancer site was the breast in 28 patients followed by the lung in 16 patients, and then gynecologic cancer in 10 patients. The most common cancer treatment was chemotherapy in 53 patients (45.3%), and 12 patients (10.2%) were recurrent patients. Fifty-two patients were in regular employment, 24 were unemployed, 17 were of unknown employment status, 16 were in non-regular employment, and 8 were classified/categorized as other. In terms of working status, 40 were on leave, 35 were working, 15 were seeking work, 8 were unemployed, and 19 were categorized as other. The median number of consultations was 1 (1,11). The content of consultations was the social security system in 44 cases (37.6%) job seeking in 24 cases (20.5%), how to inform the workplace in 14 cases (12%), and workplace environment adjustment in 13 cases (11.1%)., Conclusions: We conducted a survey on the actual status of employment consultation in a cancer center hospital. The majority of consultations were completed in one session. In terms of the content of consultations, there was a high need for consultations on the social security system and job seeking. Further study is needed on the characteristics of employment consultations according to employment status and other attributes.

Objective: We examined the applicability and safety of staging laparoscopy(SL)in the treatment of advanced gastric cancer., Methods: We retrospectively reviewed the gastric cancer cases that were examined using SL between January 2015 and December 2019 at our hospital., Results: Within this period, 59 gastric cancer patients underwent SL, of whom 53 were diagnosed with SL at first examination. The rare complications of SL were postoperative nausea and vomiting(1 case). In 47.5%(28/59)of patients, we observed peritoneal dissemination including positive lavage cytology. In 2 cases, peritoneal dissemination was found during curative resection despite not being detected by SL. Thus, the false negative rate of peritoneal dissemination discovery was 6.7%(2/30). Among the individuals who were diagnosed as P1 or CY1 at first, subsequent SLs were performed in 6 cases, and 5 patients were re-assigned as P0CY0, of whom 4 underwent conversion surgery., Conclusions: SL is an essential and safe examination method for defining the treatment strategy in advanced gastric cancer. However, further improvements are needed to reduce the false negative discovery rate and to advance gastric cancer treatment by increasing reliability of diagnosis.

Anti-doping (AD) education for athletes is mainly one-way and through passively attended lectures. As such, learning about prohibited substances and highly technical doping rules is often difficult for athletes. Therefore, having athletes passively attending lectures is not enough to prevent unintentional doping violations caused by medicines and supplements. Therefore, it is important for athletes to acquire knowledge about individual prohibited substances as well as active learning and practical knowledge about AD measures. "Doping Guardian" is an educational card game that has been developed to help prevent unintentional doping violations. Participants (pharmacists) of this game can learn how to use medicines and supplements from an AD perspective while simulating the life of an athlete. This presentation will provide an overview of this card game and how it has been used to date.

This report describes a 56-year-old man who was diagnosed with myeloid sarcoma (MS) of the testis and right shoulder after receiving allogenic stem cell transplantation (allo-SCT) at the age of 47 for acute myeloid leukemia (AML) with inv (16) (p13.1;q22). Nine years after allo-SCT, he complained of a painful right testicular mass. He underwent orchiectomy, and the pathologic diagnosis was MS. Inv (16) was identified by fluorescence in situ hybridization (FISH) using testicular tumor specimens. 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) revealed FDG accumulation in the right shoulder. FISH analysis of bone marrow aspirate revealed no increase in blasts and ruled out CBFB-MYH11 fusion. Reinduction chemotherapy, consolidation, and local radiation therapy for the left testis and right shoulder were administered to him. After that, he received a second allo-SCT from an unrelated donor who was HLA-matched. As of 2 years after the second allo-SCT, recurrence of neither AML nor myeloid sarcoma has been observed. The recurrence of MSs without bone marrow involvement is frequently reported in single, multiple single organs, or multiple single regions. Even if MSs recur in a distant location, combining systemic and local treatment may be a better treatment strategy.

This report describes a 69-year-old man with eosinophilia that was detected during a medical check-up. A review of his medical history revealed that his absolute eosinophil count was 990/µl at the age of 55 and increased to 5,380/µl at the age of 69. Electrocardiogram revealed first-degree atrioventricular block at the age of 58, followed by ST-segment depression and a negative T wave at the age of 65. The echocardiogram was normal at the age of 65. We diagnosed him with FIP1L1::PDGFRA-positive chronic eosinophilic leukemia by detecting the FIP1L1::PDGFRA fusion gene by fluorescence in situ hybridization. He had no symptoms at the first visit; however, echocardiography and contrast-enhanced computed tomography revealed an abnormal structure, considered a thrombus, within the left ventricular apex and apex wall thickening. We initiated imatinib (100 mg/day), and the eosinophilia disappeared in a month. However, his cardiac impairment worsened, and he gradually developed symptoms of heart failure. This case is valuable because it shows the long-term course of the disease, with 15 years of laboratory findings until diagnosis. Our findings suggest that in cases of eosinophilia with an abnormal electrocardiogram, contrast-enhanced cardiac magnetic resonance imaging should be considered earlier.

We report two cases of lesser omentum infarction with suggestive findings in esophagogastroduodenoscopy (EGD). Both patients were admitted to our hospital who presented with upper abdominal pain accompanied by signs of peritoneal irritation. EGD was performed to rule out gastroduodenal ulcer. No mucosal erythema and ulceration were observed, but we observed two signs suggesting lesser omentum infarction. First, EGD showed a submucosal tumor-like mass at the angular region of the lesser curvature of the stomach in both patients. Second, one of the patients exhibited great tenderness at the site of the tumor when this was depressed by biopsy forceps. We diagnosed the two patients with lesser omentum infarction from the results of abdominal computed tomography, abdominal ultrasonography, and EGD. Conservative management was applied;the patients received analgesic drugs and gradually became asymptomatic. Lesser omentum infarction presents with abdominal pain and sometimes signs of peritoneal irritation, and almost all cases can be successfully managed with conservative treatment. Diagnosing the disease carefully and precisely is essential. We report suggestive findings in EGD, which can assist in the diagnosis of lesser omentum infarction.

A calibration service using a medical accelerator has been launched to calibrate a radiotherapy dosimeter in terms of an absorbed dose to water. The radiotherapy dosimeter calibrated by the calibration service can measure the absorbed dose to water without a beam quality conversion factor. In this paper, an overview of the calibration service for a high-energy photon beam and a high-energy electron beam was described, as well as methods of absorbed dose measurement and cross-calibration using the calibrated radiotherapy dosimeter. And the development status of a dose standard for a particle beam was reported.

We retrospectively investigated the use of oral hydromorphone for cancer pain. Nineteen patients treated for cancer pain with oral hydromorphone were reviewed in this study. Cancers had occurred in the gastrointestinal (n=4), lung(n=3), breast(n=2), bone and soft tissue(n=2), hematological(n=2), and others(n=6). The administered opioids before switching to hydromorphone were morphine, oxycodone, and tapentadol. The mean oral morphine equivalent daily dose (OMEDD)was 89.3 mg. The average dose of hydromorphone administered was 16.4 mg/day, and average NRS 10(numerical rating scale: 0-10)scores of cancer pain before and after switching were 4.1 and 3.8, respectively, showing no significant differences. In this study, switching from other opioids to oral hydromorphone was feasible with an approved conversion ratio, ie, an oral hydromorphone-to-oral morphine ratio of 1:5. No severe adverse effects were observed. The oral hydromorphone extended-release formulation was administered every 24 h, as a tiny tablet formulation that is preferable owing to easy administration and adherence.

A 50-year-old woman developed gait disturbances and dysarthria since the past 2 years. She also presented with dystonia and hypokinesia of her left lower limb, and orthostatic hypotension. The dopamine transporter SPECT with 123 I ioflupane showed abnormal scans in bilateral striatum. Cerebral MRI revealed atrophy and signal changes in the medulla and spinal cord, from which Alexander disease (AxD) was suspected. Consequently, we checked the Glial fibrillary acidic protein (GFAP) gene. The analysis of the gene detected a heterozygous c.219G>T mutation, which was the first mutation reported in Japan, and finally she was diagnosed with AxD. Dystonia is relatively rare in AxD patients, but this case demonstrated that AxD should be listed in the differential diagnosis of extrapyramidal syndromes with abnormalities of the medulla and spinal cord on MRI.

A 72-year-old man developed dipeptidyl peptidase-4 inhibitor-associated bullous pemphigoid (BP) during treatment for type 2 diabetes mellitus and was administered prednisolone (PSL, 0.5 mg/kg). Despite PSL treatment at a daily dose of 19 mg/day, purpura appeared on his bilateral forearms 3 months later. He was diagnosed with acquired hemophilia A (AHA) based on a prolonged activated partial thromboplastin time, decrease in factor VIII activity, and the presence of factor VIII inhibitor. Immunosuppressive therapy (IST) comprising PSL (1 mg/kg) and cyclophosphamide (300 mg/week) did not reduce the inhibitor level, and he subsequently developed the complication of pneumonia caused by a fungal infection. Weekly rituximab (RTX) therapy (375 mg/m 2 ) for 4 weeks not only reduced the inhibitor level, but also enabled a rapid PSL dose reduction. Finally, a coagulative complete remission was achieved with improvements in pneumonia and BP. The prevention of adverse events of IST is particularly important in patients with AHA, who have a high median age. Therefore, RTX-based IST may be safer for AHA patients with complicating infections.

The patient was a 65-year-old man who developed dyspnea after 6 courses of S-1 and oxaliplatin(SOX)chemotherapy for advanced stomach cancer. The chemotherapy regimen consisted of SOX chemotherapy. The patient developed hypoxemia, and chest radiography revealed ground-glass opacity in both lungs. Bronchoscopy and DLST led to a diagnosis of druginduced lung injury caused by S-1. Although steroid pulse therapy was administered, the patient's condition deteriorated rapidly and was ultimately fatal. Based on the clinical course and histopathological findings, a DAD-type lung disorder was diagnosed. This description of a DAD-type drug-induced lung injury caused by S-1, for which histopathological findings were available in the early stages, is clinically valuable. We report this case along with a review of the relevant literature.

A 66-year-old man with malignant fibrous histiocytoma suffered from severe right arm and shoulder pain. Methadone 45 mg per day was effective in alleviating his pain, but he experienced severe drowsiness following trabectedin induced liver injury. We suspected that impaired methadone metabolism was responsible for the drowsiness. Reduction in methadone dosage and liver supporting therapy was effective in reducing the drowsiness.

With the standpoint ofref ining the chemotherapy regimen, we retrospectively reviewed adverse events encountered by the initial 10 cases during the first course of docetaxel plus ramucirumab for non-small-cell lung cancer that progressed after platinum-based chemotherapy. Febrile neutropenia(FN)was observed in 40% ofcases, and a halfofall patients experienced oral mucositis, including 2 Grade 3 cases. These results were concordant with a previous randomized phaseⅡstudy on Japanese patients. We amended the treatment regimen by adding the prophylactic use ofpegf ilgrastim. Post-amendment, FN was not observed in all 10 cases. However, the frequency and severity of chemotherapy-induced oral mucositis were not affected; Therefore, some patients discontinued treatment due to this toxicity as well as diarrhea. In conclusion, prophylactic granulocyte-colony stimulating factor is considered effective for reducing the risk of FN. Further intervention by an oral care team is required to validate our findings.

A 69-year-old man was brought to our hospital's emergency room with a chief complaint of hematemesis, which had been caused by advanced gastric cancer on the lesser curvature of the stomach's upper body. Subsequently, total gastrectomy with lymph node dissection (D2) was performed. A pathological diagnosis of gastric adenocarcinoma, U, Less, type 2, 100×70mm, tub2, pT3, int, INFb, ly0, v0, pN0 (0/24), pPM0 (30mm), pDM0 (30mm), fStage IIA, was then established. After discharge, the patient was treated with S-1 as adjuvant chemotherapy at a dose of 120mg per day. However, a decrease in the platelet count prompted termination of chemotherapy, which lasted for three courses. Ten months after surgery, serum CEA levels increased to 116.6ng/ml, with enhanced CT showing a solitary splenic tumor with a diameter of 48×52mm suggestive of gastric cancer recurrence. PET/CT revealed no other tumors suggestive of gastric cancer recurrence. Given that only a solitary splenic metastatic tumor was detected, splenectomy was performed eleven months after surgery. Histological findings were the same as the previous gastric cancer, with peritoneal washing cytology being suspicious. Chemotherapy with the SOX regimen (S-1 at a dose of 120mg per day and oxaliplatin at a dose of 100mg/m 2 ) was then started. The patient remained recurrence-free for a half year. Except during the terminal phase, only a few cases of a splenic metastasis from gastric cancer have been reported. We consider splenectomy to be potentially useful for patients with a solitary splenic metastasis from gastric cancer, through which prolonged prognosis could be expected.

A 30-year-old woman who was 14 weeks pregnant was admitted to our hospital due to purpura, nasal bleeding, and abdominal pain. She was diagnosed with acquired thrombotic thrombocytopenic purpura (TTP) based on the presence of hemolytic anemia, thrombocytopenia, decreased ADAMTS 13 activity (<0.01 IU/ml), and high ADAMTS 13 inhibitor levels (4.8 BU/ml). Plasma exchange (PE) and steroid therapy were immediately administered. However, because she did not respond to these therapeutic approaches, rituximab was additionally administered on the sixth day of treatment. The level of ADAMTS 13 inhibitor increased to 12.5 BU/ml on the seventh day. Renal insufficiency, disturbed consciousness, and genital bleeding did not improve in spite of daily PE, steroid therapy, and second dose of rituximab. She finally died after sudden convulsions on the 14th day. Although the treatment outcomes of TTP have remarkably improved, some cases are refractory to therapy. Establishment of adequate treatment strategies for acquired TTP in pregnant women is required.

At 37 years of age, the patient initially presented with symptoms of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) during her 1st pregnancy. She was treated with intravenous immunoglobulin (IVIg), and showed favorable recovery, becoming almost asymptomatic by the age of 38. At 39 years of age, during her puerperal period of her second pregnancy, she developed symmetrical muscle weakness and sensory disturbance of the upper and lower limbs. Nerve conduction studies revealed diffuse demyelination of peripheral nerves, and she was diagnosed with recurrence of CIDP. Once again, she showed remarkable improvement after IVIg therapy, and she has remained asymptomatic without the induction of preventative therapies. Recurrence of CIDP triggered in accordance with multiple pregnancies is extremely rare, and its clinical and electrophysiological features are presented in this report.

A 62-year-old woman was diagnosed with stage IV lung adenocarcinoma. After resection of a metastatic brain tumor, she had received first-line chemotherapy consisting of 6 courses of carboplatin and pemetrexed, then 14 courses of maintenance therapy of pemetrexed until disease progression. As second-line treatment, she was administered nanoparticle albuminbound paclitaxel(nab-paclitaxel)monotherapy. A nearly complete response(nearly CR)has been maintained for 3 years without any severe adverse events. Although there is insufficient evidence for the use of nab-paclitaxel monotherapy as second-line chemotherapy, it could be an effective treatment option for patients with recurrent advanced non-small cell lung cancer.

A 21-year-old man was admitted to our hospital in June 2015. He felt paresthesia of toes in April 2015, which had been spreading upward, and he became difficult to walk in June. Nerve conduction study showed peripheral demyelinating neuropathy that met the diagnostic criteria for chronic inflammatory demyelinating polyneuropathy (CIDP), and the cerebrospinal fluid (CSF) examination revealed the remarkably increased protein level. In addition, magnetic resonance imaging of his brain showed a few plaques in white matter, so he was finally diagnosed with combined central and peripheral demyelination (CCPD). Moreover, anti-neurofascin155 (NF155) antibodies assayed in his serum and CSF turned out to be positive. Although he was treated with intravenous immunoglobulin and intravenous methylprednisolone, his symptoms were not ameliorated. However, plasma exchange therapy was apparently effective, and the titer of anti-NF155 antibody was reduced. Recently, the number of case reports of CIDP with CNS lesions has gradually been increasing, while the information about the diagnosis and the treatment responses are not enough. Thus, we reported our case with CCPD who was successfully treated with plasma exchange.

A 66-year-old male underwent prednisolone (PSL) therapy of 13 mg/day for rheumatoid arthritis (RA). Antiphospholipid antibody syndrome, neutrophilic dermatosis (ND), and myelodysplastic syndrome (MDS) developed. Treatment of MDS required red cell concentrate transfusion, and second courses of azacitidine therapy (75 mg/m 2 daily, intravenous injection for 7 consecutive days) led to hematologic remission. Furthermore, ND improved early after the start of azacitidine therapy, making it possible to decrease the dose of PSL. After 12th courses of azacitidine therapy, treatment was discontinued and the long-term remission of MDS and ND has been maintained. During the course, the level of matrix metalloproteinase-3, as a marker of RA, also decreased. There are few case reports of MDS in which azacitidine was effective for autoimmune diseases, including ND. We report the present case.

In Japan and North America, different dosimetry protocols have been implemented to determine the absorbed dose to water: JSMP Standard Dosimetry 12 and AAPM TG-51 addendum. In this study, Japanese and Canadian reference dosimetries for high energy photon beams were compared theoretically, and then they were verified experimentally. We estimated the theoretical differences of the ion recombination correction factors, the leakage correction factors, the radial dose distribution correction factors, the calibration factors, the beam quality correction factors and the absorbed dose to water. When an influence of the radial dose distribution is negligible, the ratios of Canadian to Japanese absorbed dose in reference dosimetries ranged from 0.995 to 1.007 for all the reference-class-Farmer-type ionization chambers. This discrepancy was mainly caused by the wall correction factor included in the beam quality correction factor. Subsequently, to verify the theoretical approaches, we calibrated the same ionization chamber in 60 Co gamma ray of Japanese primary and secondary standard dosimetry laboratories (PSDL and SSDL) and measured the absorbed dose of a clinical linear accelerator. It followed that the ratios of Canadian to Japanese absorbed dose in reference dosimetries increased up to 1.015 for PTW 30013 reference-class-Farmer-type ionization chamber. This increase was mainly caused by a discrepancy in the calibration factors (N D,w ) observed between Japanese PSDL and SSDL. In conclusion, in order to improve the international consistency of the absorbed dose to water determined by JSMP Standard Dosimetry 12, we should reevaluate the accuracy of the wall correction factors and implement a periodic comparative test of the N D,w between Japanese PSDL and SSDL.

An 80-year-old man was examined with esophagogastroduodenoscopy and colonoscopy because of digestive tract hemorrhage;however, no specific cause was found. Small intestinal capsule endoscopy revealed a reddish elevated lesion in the ileum. This lesion was also detected using double-balloon endoscopy as a 5-cm reddish elevated lesion covered with normal villous architecture in the 95-cm part of the Bauhin valve on the oral side. The lesion was laparoscopically resected and diagnosed as inverted Meckel's diverticulum based on pathological examination. This was a rare case where Meckel's diverticulum was inverted, and the lesion was observed using capsule and double-balloon endoscopies before surgery. Although complications of Meckel's diverticulum are rare in the elderly, it is necessary to identify this disease as a cause of small intestinal bleeding, even in elderly patients.