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4. Albumin-Lymphocyte-Globulin-C-Reactive Protein Index as a Novel Prognostic Biomarker for Hepatocellular Carcinoma after Hepatectomy.

Author

Utsumi, Masashi, Inagaki, Masaru, Kitada, Koji, Tokunaga, Naoyuki, Yunoki, Kosuke, Sakurai, Yuya, Okabayashi, Hiroki, Hamano, Ryosuke, Miyaso, Hideaki, Tsunemitsu, Yosuke, and Otsuka, Shinya

Abstract

Introduction: This study evaluated the performance of the albumin-lymphocyte-globulin-C-reactive protein (CRP) (ALGC) index as a novel prognostic biomarker for hepatocellular carcinoma (HCC) after hepatectomy. Methods: Patients (n = 178) who underwent hepatectomy for HCC (July 2010–December 2021) were analyzed. The ALGC index was calculated as ([albumin × lymphocyte]/[CRP × globulin × 104]). Patients were divided into a low ALGC group (<1.82; n = 81) and a high ALGC group (≥1.82; n = 97). The association of the ALGC index with survival was assessed by univariate and multivariate analyses. Results: The median overall survival (OS) was 100 (range: 1–149) months with 1-, 3-, and 5-year OS rates of 91.6%, 81.2%, and 64.2%, respectively. In univariate analysis, ALGC index (<1.82), alpha-fetoprotein (≥25 ng/mL), tumor size (≥3.5 cm), microvascular invasion, and multiple tumors were associated with shorter OS. ALGC index (<1.82) (hazard ratio [95% confidence interval]) (2.48 [1.407–4.513]; p = 0.001) and multiple tumors (1.92 [1.070–3.356]; p = 0.029) were independent predictors of OS in multivariate analysis. Conclusion: ALGC index is a novel prognostic biomarker for HCC after hepatectomy. It may assist in treatment stratification and better management of patients with HCC. [ABSTRACT FROM AUTHOR]

Published
2024
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5. Preoperative Myosteatosis and Prognostic Nutritional Index Predict Survival in Older Patients With Resected Biliary Tract Cancer

Author

UTSUMI, MASASHI, primary, INAGAKI, MASARU, additional, KITADA, KOJI, additional, TOKUNAGA, NAOYUKI, additional, YUNOKI, KOSUKE, additional, SAKURAI, YUYA, additional, OKABAYASHI, HIROKI, additional, HAMANO, RYOSUKE, additional, MIYASOU, HIDEAKI, additional, TSUNEMITSU, YOUSUKE, additional, and OTSUKA, SHINYA, additional

Published
2024
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6. Combination of sarcopenia and systemic inflammation-based markers for predicting the prognosis of patients undergoing pancreaticoduodenectomy for pancreatic cancer.

Author

Utsumi, Masashi, Inagaki, Masaru, Kitada, Koji, Tokunaga, Naoyuki, Yunoki, Kosuke, Okabayashi, Hiroki, Hamano, Ryosuke, Miyasou, Hideaki, Tsunemitsu, Yousuke, and Otsuka, Shinya

Subjects
SARCOPENIA, PSOAS muscles, PANCREATIC cancer, PROGRESSION-free survival, PANCREATICODUODENECTOMY, CANCER prognosis, PLATELET lymphocyte ratio, PROGNOSIS
Abstract

Background: This study aimed to evaluate the effects of sarcopenia and inflammation on the prognosis of patients with pancreatic cancer after pancreaticoduodenectomy. Methods: Eighty patients who had undergone pancreaticoduodenectomy for pancreatic cancer between July 2010 and December 2023 were included in this study. The psoas muscle index was used to assess sarcopenia. The C-reactive protein-to-albumin ratio, prognostic nutritional index, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were used to calculate the preoperative inflammatory marker levels. The prognostic factors for overall survival were determined using Cox regression analysis. Results: Twenty-four patients were diagnosed with sarcopenia. Sarcopenia showed a significant association with advanced tumor stage. Univariate analysis revealed a significant reduction in overall survival in patients with a prognostic nutritional index of <45, C-reactive protein-to-albumin ratio of ≥0.047, cancer antigen 19–9 levels of ≥130 U/mL, sarcopenia, lymph node metastasis, and vascular invasion. Multivariate analysis revealed that a C-reactive protein-to-albumin ratio of ≥0.047 (hazards ratio, 3.383; 95% confidence interval: 1.384–8.689; p< 0.001), cancer antigen 19–9 levels of ≥130 U/mL (hazards ratio, 2.720; 95% confidence interval: 1.291–6.060; p = 0.008), sarcopenia (hazards ratio, 3.256; 95% confidence interval: 1.535–7.072; p = 0.002) and vascular invasion (hazards ratio, 2.092; 95% confidence interval: 1.057–4.170; p = 0.034) were independent predictors of overall survival. Overall survival in the sarcopenia and high C-reactive protein-to-albumin ratio groups was significantly poorer than that in the non-sarcopenia and low C-reactive protein-to-albumin ratio and sarcopenia or high C-reactive protein-to-albumin ratio groups. Conclusion: Sarcopenia and a high C-reactive protein-to-albumin ratio are independent prognostic factors in patients with pancreatic cancer after pancreaticoduodenectomy. Thus, sarcopenia may have a better prognostic value when combined with the C-reactive protein-to-albumin ratio. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Random Z(2) Higgs Lattice Gauge Theory in Three Dimensions and its Phase Structure

Author

Doi, Shunsuke, Hamano, Ryosuke, Kakisako, Teppei, Takada, Keiko, and Matsui, Tetsuo

Subjects
Condensed Matter - Statistical Mechanics, Condensed Matter - Disordered Systems and Neural Networks
Abstract

We study the three-dimensional random Z(2) lattice gauge theory with Higgs field, which has the link Higgs coupling $c_1 SUS$ and the plaquette gauge coupling $c_2 UUUU$. The randomness is introduced by replacing $c_1 \to -c_1$ for each link with the probability $p_1$ and $c_2 \to -c_2$ for each plaquette with the probability $p_2$. We calculate the phase diagram by a new kind of mean field theory that does not assume the replica symmetry and also by Monte Carlo simulations. For the case $p_1=p_2(\equiv p)$, the Monte Carlo simulations exhibit that (i) the region of the Higgs phase in the Coulomb-Higgs transition diminishes as $p$ increases, and (ii) the first-order phase transition between the Higgs and the confinement phases disappear for $p \ge p_c \simeq 0.01$. We discuss the implications of the results to the quantum memory studied by Kitaev et al. and the Z(2) gauge neural network on a lattice., Comment: 18 pages, 10 figures

Published
2009

10. Preoperative myosteatosis and prognostic nutritional index predict overall survival in older patients (aged ≥ 80 years) with resected biliary tract cancer: a retrospective cohort study

Author

Utsumi, Masashi, primary, Inagaki, Masaru, additional, Kitada, Koji, additional, Tokunaga, Naoyuki, additional, Yunoki, Kosuke, additional, Sakurai, Yuya, additional, Okabayashi, Hiroki, additional, Hamano, Ryosuke, additional, Miyasou, Hideaki, additional, Tsunemitsu, Yousuke, additional, and Otsuka, Shinya, additional

Published
2023
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11. C-reactive Protein-to-Albumin Ratio Predicts Conversion from Laparoscopic to Open Cholecystectomy in Acute Cholecystitis

Author

UTSUMI, MASASHI, INAGAKI, MASARU, KITADA, KOJI, TOKUNAGA, NAOYUKI, YUNOKI, KOSUKE, SAKURAI, YUYA, HAMANO, RYOSUKE, TSUNEMITSU, YOUSUKE, MIYASOU, HIDEAKI, and OTSUKA, SHINYA

Subjects
Pharmacology, Cancer Research, General Biochemistry, Genetics and Molecular Biology, Research Article
Abstract

Background/Aim: The aim of this study was to identify predictors of conversion from laparoscopic to open cholecystectomy, and to determine whether pre-operative C-reactive protein-to-albumin ratio (CAR) can predict conversion from laparoscopic to open cholecystectomy, in patients with acute cholecystitis diagnosed according to the Tokyo Guidelines 2018. Patients and Methods: We retrospectively analysed 231 patients who underwent laparoscopic cholecystectomy for acute cholecystitis between January 2012 and March 2022. Two hundred and fifteen (93.1%) patients were included in the laparoscopic cholecystectomy group; sixteen (6.9%) patients were included in the conversion from laparoscopic to open cholecystectomy group. Results: In univariate analysis, significant predictors of conversion from laparoscopic to open cholecystectomy included the interval between symptom onset and surgery (>72 h), C-reactive protein (≥15.0 mg/l) and albumin (72 h) were independent predictors of conversion from laparoscopic to open cholecystectomy. Conclusion: Pre-operative CAR as a predictor of conversion from laparoscopic to open cholecystectomy may be useful for pre-operative risk assessment and treatment planning.

Published
2023

13. Lymphocyte-to-C-Reactive Protein Ratio Predicts Prognosis in Patients With Colorectal Liver Metastases Post-hepatic Resection: A Retrospective Study

Author

UTSUMI, MASASHI, primary, INAGAKI, MASARU, additional, KITADA, KOJI, additional, TOKUNAGA, NAOYUKI, additional, KONDO, MIDORI, additional, YUNOKI, KOSUKE, additional, SAKURAI, YUYA, additional, HAMANO, RYOSUKE, additional, MIYASOU, HIDEAKI, additional, TSUNEMITSU, YOUSUKE, additional, and OTSUKA, SHINYA, additional

Published
2022
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14. Lymphocyte-to-C-reactive protein ratio predicts prognosis in patients with colorectal liver metastases after hepatic resection: a retrospective study

Author

Utsumi, Masashi, primary, Inagaki, Masaru, additional, Kitada, Koji, additional, Tokunaga, Naoyuki, additional, Kondo, Midori, additional, Yunoki, Kosuke, additional, Sakurai, Yuya, additional, Hamano, Ryosuke, additional, Miyasou, Hideaki, additional, Tsunemitsu, Yousuke, additional, and Otsuka, Shinya, additional

Published
2022
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15. C‐reactive protein to albumin ratio predicts difficult laparoscopic cholecystectomy in patients with acute cholecystitis diagnosed according to the Tokyo Guidelines 2018

Author

Utsumi, Masashi, primary, Sakurai, Yuya, additional, Narusaka, Toru, additional, Tokunaga, Naoyuki, additional, Kitada, Koji, additional, Hamano, Ryosuke, additional, Tsunemitsu, Yousuke, additional, Miyasou, Hideaki, additional, Otsuka, Shinya, additional, and Inagaki, Masaru, additional

Published
2022
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17. A Combined Prediction Model for Biliary Tract Cancer using the Prognostic Nutritional Index and Pathological Findings: A Single-center Retrospective Study

Author

Kitada, Koji, primary, Tokunaga, Naoyuki, additional, Kato, Takamitsu, additional, Narusaka, Toru, additional, Hamano, Ryosuke, additional, Miyasou, Hideaki, additional, Tsunemitsu, Yousuke, additional, Otsuka, Shinya, additional, Inagaki, Masaru, additional, and Utsumi, Masashi, additional

Published
2021
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24. Ming Dynasty Religious Ritual Policy Toward Neglected Spirits : The Jili (祭厲) System and the Jiangshan (蔣山) Ritual

Author

HAMANO, Ryosuke

Abstract

This paper considers the religious ritual system called the Jili (祭厲) system founded in the early Ming dynasty, and its relationship with Buddhist rituals conducted at Jiangshan (蔣山). Both were rituals conducted for neglected spirits, and were developed and performed from 1368 to 1372. The Jili (祭厲) invoked the content of the Daoist Huang lu zhai (黃籙齋), removing the Daoist priest and taking on the structure of being managed by the Chenghuang shen (城隍神) at the request of regional government officials. The ritual was carried out three times, in 1368, 1369, and 1372. The ritual of 1372 was the largest, and the idea that rituals had already been performed for the neglected spirits at the time of the previous two occasions can be detected. Ming dynasty religious policy was that the Jili (祭厲) was the most fundamental ritual, and institutionalized it as a matter of state policy for regular and nationwide practice. Provisional rituals were conducted in place of it until it could be fully established. After the Jili (祭厲) was established, it was conducted in 1372 as a compilation of the rituals for neglected spirits.

Published
2016

25. Hyperbilirubinemia as a predictor of severity of acute appendicitis

Author

Akai, Masaaki, primary, Iwakawa, Kazuhide, additional, Yasui, Yuichi, additional, Yoshida, Yusuke, additional, Kato, Takuya, additional, Kitada, Koji, additional, Hamano, Ryosuke, additional, Tokunaga, Naoyuki, additional, Miyaso, Hideaki, additional, Tsunemitsu, Yosuke, additional, Otsuka, Shinya, additional, Inagaki, Masaru, additional, and Iwagaki, Hiromi, additional

Published
2019
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26. Ten Cases of Colovesical Fistula due to Sigmoid Diverticulitis

Author

Miyaso, Hideaki, Iwakawa, Kazuhide, Hamada, Yuki, Yasui, Nanako, Nishii, Gou, Akai, Masaaki, Kawada, Kengo, Nonoshita, Takashi, Kajioka, Hiroki, Isoda, Kenta, Kitada, Kouji, Nishie, Manabu, Hamano, Ryosuke, Tokunaga, Naoyuki, Tsunemitsu, Yosuke, Otsuka, Shinya, Inagaki, Masaru, and Iwagaki, Hiromi

Subjects
Colovesical fistula, Diverticulitis
Abstract

Colovesical fistula (CVF) resulting from colon diverticulosis is a comparatively rare disease, and neither the diagnosis nor treatment has been established. Our experience with CVF due to sigmoid diverticulitis over a 9-year period was reviewed to clarify the clinical presentation and diagnostic confirmation. Ten patients with CVF were identified in this period, and chief complaints, laboratory findings, presenting symptoms, diagnostic investigations, and subsequent treatments were reviewed. Preoperative urinalysis showing bacteriuria (100%) was the most common presentation, followed by fecaluria (40%), abdominal pain (40%), pneumaturia (30%), hematuria (30%), pain on urination (30%), pollakiuria (10%), and dysuria (10%). The abilities of various preoperative investigations to identify CVF were: computed tomography (CT), 88.9%; magnetic resonance imaging, 40%; cystoscopy, 30%, and gastrografin irrigoscopy, 22.2%. Colonoscopy (0%) was not diagnostic. Bowel resection was performed in nine of ten patients. When inflammation was intense, covering ileostomy was performed, and an omental plasty was placed between the bowel anastomosis and bladder. When CVF is suspected, we recommend CT followed by colonoscopy and cystoscopy as a first-line investigation to rule out malignancy as a cause. Other modalities should only be used if the diagnosis is in doubt or additional information is needed to plan operative management. Primary colic anastomosis appears to be safely performed by applying omental plasty and covering ileostomy.

Published
2015

27. A Report of Four Cases of Intestinal Endometriosis

Author

Iwakawa, Kazuhide, Nonoshita, Takashi, Hamada, Yuki, Yasui, Nanako, Akai, Masaaki, Isoda, Kenta, Kitada, Kouji, Hamano, Ryosuke, Tokunaga, Naoyuki, Miyaso, Hideaki, Tsunemitsu, Yosuke, Otsuka, Shinya, Inagaki, Masaru, and Iwagaki, Hiromi

Subjects
Ileus, Endometriosis, Menstruating woman
Abstract

Four cases of intestinal endometriosis seen at our hospital are presented. The patients ranged in age from 35 to 43 years and developed abdominal pain, vomiting, and dyschezia due to stenotic lesions of the intestine. The sites of the lesions were the ileum in 2 cases, and the sigmoid colon and rectum in 1 case each. All cases had no history of bowel disease or laparotomy, and were not diagnosed preoperatively. These results suggested that evaluations of symptoms and clinical examinations are inadequate for an accurate diagnosis of intestinal endometriosis. The patients’ postoperative courses were uneventful, and there have been no recurrences. In conclusion, intestinal endometriosis should be considered in women of childbearing age who present with bowel obstruction, especially in women without a history of laparotomy.

Published
2017

31. A multi-institution phase II study of docetaxel and S-1 in combination with trastuzumab for HER2-positive advanced gastric cancer (DASH study).

Author

Kagawa, Shunsuke, Muraoka, Atsushi, Kambara, Takeshi, Nakayama, Hiroshi, Hamano, Ryosuke, Tanaka, Norimitsu, Noma, Kazuhiro, Tanakaya, Kohji, Kishimoto, Hiroyuki, Shigeyasu, Kunitoshi, Kuroda, Shinji, Kikuchi, Satoru, Kuwada, Kazuya, Nishizaki, Masahiko, Shirakawa, Yasuhiro, and Fujiwara, Toshiyoshi

Subjects
STOMACH cancer treatment, DOCETAXEL, HER2 protein, CANCER chemotherapy, PROGRESSION-free survival, TRASTUZUMAB, THERAPEUTICS
Abstract

Background: Trastuzumab when combined with fluoropyrimidine and cisplatin was proven to improve survival in patients with human epidermal growth factor receptor 2 (HER2)-positive gastric cancer (GC) in the ToGA study. The safety and efficacy of trastuzumab in combination with docetaxel and S-1 have not yet been evaluated.Methods: This study was a multicenter, phase II study. Patients with chemotherapy-naïve HER2-positive advanced or metastatic GC were eligible. Trastuzumab was administered intravenously on day 1 of the first cycle at 8 and 6 mg/kg in subsequent cycles. Docetaxel was administered intravenously at 40 mg/m2 on day 1 of each cycle. S-1 was administered at a dosage based on body surface area for 14 days in a 3-weekly cycle. The primary endpoint was progression-free survival (PFS).Results: A total of 23 patients were enrolled. Median PFS was 6.7 months (95% CI 4.1-10.1). The response rate (RR) was 39.1%. Median overall survival (OS) and time to treatment failure (TTF) were 17.5 and 4.4 months, respectively. Major grade 3-4 adverse events were neutropenia (39.1%), leukopenia (30.4%), and febrile neutropenia (8.7%).Conclusion: Trastuzumab in combination with docetaxel and S-1 showed effective antitumor activity and manageable toxicities as first-line treatment for patients with HER2-positive GC. [ABSTRACT FROM AUTHOR]

Published
2018
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33. Analysis of surgical outcomes of diverticular disease of the colon

Author

Miyaso, Hideaki, Iwakawa, Kazuhide, Kitada, Koji, Kimura, Yuji, Isoda, Kenta, Nishie, Manabu, Hamano, Ryosuke, Tokunaga, Naoyuki, Tsunemitsu, Yosuke, Ohtsuka, Shinya, Inagaki, Masaru, and Iwagaki, Hiromi

Subjects
Adult, Aged, 80 and over, Male, Laparotomy, emergent operation, Colon, diverticular disease, Length of Stay, Middle Aged, laparoscopic surgery, elective surgery, Postoperative Complications, Treatment Outcome, Elective Surgical Procedures, Multivariate Analysis, Diverticulosis, Colonic, Humans, Female, Laparoscopy, Colectomy, Aged, Retrospective Studies
Abstract

We analyzed retrospectively the surgical outcomes of diverticular diseases of the colon at the surgical division of Fukuyama Medical Center. Data were collected from 39 patients who underwent surgery for diverticular disease at Fukuyama Medical Center. Thirty-nine patients were admitted between 2005 and 2010. The mean age of the 39 patients was 63.6 years. The collected data included patient demographics, patient history, type of surgery and complications. Patients were divided into 2 groups, Elective vs. Emergent group, right vs. left colon group and laparotomy vs. laparoscopic approach. Multivariate analysis of the logistic model of morbidity revealed a significantly higher rate in the left colon and the Cox proportional hazards model clearly showed fewer postoperative hospital days with the laparoscopic approach. Surgical procedures should be decided in reference to the particular clinical and pathological features of diverticular disease to gain an acceptable morbidity and mortality rates.

Published
2012

35. Two cases of lymphoepithelial cyst of the pancreas

Author

Hamano, Ryosuke, primary, Inagaki, Masaru, additional, Kimura, Yuuji, additional, Isoda, Kenta, additional, Kitada, Koji, additional, Nishie, Manabu, additional, Nomura, Nagahisa, additional, Tokunaga, Naoyuki, additional, Takahashi, Kenji, additional, Miyasou, Hideaki, additional, Tsunemitsu, Yosuke, additional, Ohtsuka, Shinya, additional, Miyoshi, Kazuya, additional, Iwakawa, Kazuhide, additional, Takahashi, Masahiko, additional, and Iwagaki, Hiromi, additional

Published
2012
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48. STIMULATION OF ADENOSINE A2A RECEPTOR INHIBITS LPS-INDUCED EXPRESSION OF INTERCELLULAR ADHESION MOLECULE 1 AND PRODUCTION OF TNF- IN HUMAN PERIPHERAL BLOOD MONONUCLEAR CELLS

Author

Hamano, Ryosuke, Takahashi, Hideo Kohka, Iwagaki, Hiromi, Kanke, Toru, Liu, Keyue, Yoshino, Tadashi, Sendo, Toshiaki, Nishibori, Masahiro, and Tanaka, Noriaki

Abstract

LPS stimulates CD14/Toll-like receptor (TLR) 4, leading to induce TNF- production. Cell-to-cell interaction through the engagement between intercellular adhesion molecule (ICAM) 1 on monocytes and its ligand on T cells has been suggested to play a role in the TNF- production by LPS-treated human peripheral blood mononuclear cells (PBMCs). Adenosine is reported to inhibit LPS-induced TNF- production. However, little is known about the mechanism of the inhibitory effects induced by adenosine on the LPS-induced immune responses. We found that adenosine inhibited the expression of ICAM-1 and the production of TNF- by human PBMC via adenosine A2A receptor in the presence of LPS. However, the stimulation of A1R or A3R enhanced the actions of adenosine. Adenosine had no effect on the expression of CD14 and TLR-4, suggesting that the inhibitory effects of adenosine on the LPS actions might be independent of the expression of CD14 and TLR-4. Thus, adenosine differentially regulates the expression of ICAM-1 and the production of TNF- through plural subtypes of receptors.

Published
2008
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49. STIMULATION OF 7 NICOTINIC ACETYLCHOLINE RECEPTOR INHIBITS CD14 AND THE TOLL-LIKE RECEPTOR 4 EXPRESSION IN HUMAN MONOCYTES

Author

Hamano, Ryosuke, Takahashi, Hideo Kohka, Iwagaki, Hiromi, Yoshino, Tadashi, Nishibori, Masahiro, and Tanaka, Noriaki

Abstract

The lipopolysaccharide (LPS)-receptor complex, CD14/toll-like receptor 4, is known to play a role in the immune responses during sepsis. Excessive inflammation and tumor necrosis factor (TNF)- synthesis have been reported to cause morbidity and mortality in endotoxemia and sepsis. Cell-to-cell interaction through the engagement between intercellular adhesion molecule 1, B7.1, and CD40 on monocytes and their ligands on T cells has been suggested to play a role in the inflammatory response such as TNF- and interleukin 10 production. Nicotine, with the stimulation of the nicotinic acetylcholine receptor 7 subunit (7-nAChR), has now become the focus of attention because of its anti-inflammatory effects. However, little is known about the mechanism of the inhibitory effects induced by nicotine on the LPS-induced immune responses. In the present study, we found that nicotine suppressed the expression of CD14, toll-like receptor 4, intercellular adhesion molecule 1, B7.1, and CD40 on monocytes and the production of TNF-, but not interleukin 10, in human peripheral blood mononuclear cells in the presence of LPS. The actions of nicotine were reversed by a nonselective and a selective 7-nAChR antagonist, mecamylamine and -bungarotoxin, respectively. Therefore, nicotine might inhibit the LPS receptor complex expression via 7-nAChR, thus leading to a decrease in the adhesion molecule expression and TNF- production. Moreover, we demonstrated that a nuclear factor-B and a p38 mitogen-activated protein kinase inhibitor mimicked the actions of nicotine in the presence of LPS. These results suggested that the nuclear factor-B and p38 mitogen-activated protein kinase might be involved in the actions of nicotine.

Published
2006
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50. A Report of Four Cases of Intestinal Endometriosis

Author

Iwakawa, Kazuhide, Nonoshita, Takashi, Hamada, Yuki, Yasui, Nanako, Akai, Masaaki, Isoda, Kenta, Kitada, Kouji, Hamano, Ryosuke, Tokunaga, Naoyuki, Miyaso, Hideaki, Tsunemitsu, Yosuke, Otsuka, Shinya, Inagaki, Masaru, Iwagaki, Hiromi, Iwakawa, Kazuhide, Nonoshita, Takashi, Hamada, Yuki, Yasui, Nanako, Akai, Masaaki, Isoda, Kenta, Kitada, Kouji, Hamano, Ryosuke, Tokunaga, Naoyuki, Miyaso, Hideaki, Tsunemitsu, Yosuke, Otsuka, Shinya, Inagaki, Masaru, and Iwagaki, Hiromi

Abstract

Four cases of intestinal endometriosis seen at our hospital are presented. The patients ranged in age from 35 to 43 years and developed abdominal pain, vomiting, and dyschezia due to stenotic lesions of the intestine. The sites of the lesions were the ileum in 2 cases, and the sigmoid colon and rectum in 1 case each. All cases had no history of bowel disease or laparotomy, and were not diagnosed preoperatively. These results suggested that evaluations of symptoms and clinical examinations are inadequate for an accurate diagnosis of intestinal endometriosis. The patients’ postoperative courses were uneventful, and there have been no recurrences. In conclusion, intestinal endometriosis should be considered in women of childbearing age who present with bowel obstruction, especially in women without a history of laparotomy.

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