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Dermatomyositis is one of the auto-immune diseases and is associated with cancer at a high rate. In many cases, upon its detection the cancer is already advanced. Recently we have experienced two cases associated with carcinoma. The first case was associated with a duplicate cancer of the breast and stomach, and in both of them the cancer was early. After a radical operation, the symptoms were made less severe by prescribing steroid, and the prognosis was good. The second case was associated with an advanced cancer of the colon. About two months after the diagnosis of dermatomyosis, a radical operation had been performed and the symptoms had temporarily become less severe and the patient had left the hospital. But they soon recurred and the prognosis was not good. It seems that early detection is very important for improvement of the prognosis and the examination should be made with the possibility of duplicate cancer in mind.

Among various tumors of the small intestine which lack in specific clinical manifestations, myogenic tumors often present as melena and anemia as the chief complaints. In this paper, two cases of leiomyoma of small intestine in which angiography was useful for diagnosis are reported. These two patients were admitted to hospital because of anal bleeding. No lesions in the upper digestive tract and colon were revealed. To exlore the small intestine, angiography was carried out and valuable information about the location of the bleeding site was obtained in both cases. A close examination of the small intestine is needed for a patient with bleeding on the digestive tract from unknown lesion. Angiography is useful for diagnosis of myogenic tumors of the small intestine.

Recently sigmoid-visceral fistula which is a candidate for surgical treatment is increasingly encountered, with an increase in the frequency of sigmoidal diverticulitis. In patients complaining of bladder distress and intestinal dysfunction, the early diagnosis with barium enema and cystoscopic examination is important, bearing in mild a possible occurrence of sigmoid-visceral fistula. Careful attitude is mandatory to rule out probable association of malignant disease from the overlapping of the sigmoid colon in barium enema examination and the inflammatory changes in cystoscopic examination. As for the operation, an one stage procedure consisting of resection of the fistula with the bowel is recommended. Partical cystectomy was not necessary in two cases experienced. This paper reports a case of sigmoid-visceral fistula with a review of the literature.

Among various tumors of the small intestine which lack in specific clinical manifestations, leiomyomas or leiomyosarcomas often present as melena and anemia as the chief complaints. Six cases of leiomyoma or leiomyosarcoma of the small intestine, including 2 of leiomyosarcoma and 4 of leiomyoma, experienced at our department in a past 6-year period were clinically studied. A close examination of the small intestine is needed for a patient complaining of melena and anemia but revealing no lesion on the upper digestive tract or colon. Angiography can offer valuable informations of the size or site of a tumor; whether it is multiple; invasion into the surrounding tissues; and existence of liver metastasis. Moreover, it will enable to detect such tumors in early stages. When we must determine whether a tumor is benign or malignant, careful attention should be paid not only for a pattern of karyomitosis but also for other factors such as diameter of the tumor. A case having some factors indicating poor prognosis needs a careful follow-up, as well as aggressive treatments, especially for liver metastasis.

A 73-year-old woman was suspected to have gallstone ileus from abdominal simple X-ray film and ultrasonography. Preoperative alimentary examination revealed a cholecystoduodenal fistula, and freeing of the ilues was successfully performed. Gallstone ileus commonly occurs in aged people and we often have difficulties in diagnosis because its ileus condition prevent from sufficient preoperative diagnosing. Abdominal simple X-ray film and ultrasonographic examination are simple methods to offer some convincing holds suspecting the disease. For this disease conservative treatment is first selected, however, the majority of cases demaned surgical operation. Radical treatment for internal biliary fistula is not always necessary if biliary residual stones are not found. In this case which had no residual stones but had high risks, no biliary radical operation was carried out.