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Gastroesophageal submucosal hematoma is a disease in which blood vessels in the gastroesophageal submucosa rupture and form a hematoma. In this report, we describe a case of gastroesophageal submucosal hematoma that developed due to vomiting in a patient with no history of bleeding and resolved with conservative treatment. A 69-year-old man presented with precordial pain and hematemesis after vomiting. A diagnosis of idiopathic gastroesophageal submucosal hematoma was made by computed tomography scan, magnetic resonance imaging, and esophagogastroduodenoscopy. Healing was achieved by conservative treatment with fasting, rehydration, and acid suppression. When a patient presents with sudden chest pain, hematemesis, and dysphagia, the possibility of this disease should be considered., Competing Interests: None., (© 2023 The Authors. DEN Open published by John Wiley & Sons Australia, Ltd on behalf of Japan Gastroenterological Endoscopy Society.)

Neat 1-phenyl- and 1-(p-tolyl)-2-propyn-1-ones (1 and 1', respectively) were heated in water without any additive at 150 °C for 2 h to give 1,3,5-tribenzoyl- and 1,3,5-tri-(p-toluoyl)benzenes (2 and 2', respectively) in 74 and 52% yields, respectively. The crossed reactions of 1 with the enolate of p-toluoylacetaldehyde (3') and 1' with the enolate of benzoylacetaldehyde (3) were carried out to give unsymmetrically substituted 1-toluoyl-3,5-dibenzoylbenzene (Ph2Tol) and 1,3-ditoluoyl-5-benzoylbenzene (PhTol2), respectively, corroborating the previously proposed reaction mechanism in which 3 and 3' that are formed by rate-determining nucleophilic attack of HO(-) on 1 and 1' or its conjugate acids formed by subsequent protonation would serve as a common intermediate for the formation of 2, 2' and the acetophenone derivatives as byproducts. When 4-methoxy-3-buten-2-one (4) was heated in hot pure water without any additive at 150 °C for 30 min, 1,3,5-triacetylbenzene (5) was obtained in an isolated yield of 77% just by removing water by filtering the crystalline product from the cooled reaction mixture. The reaction did not take place in the absence of water. Slow decompositions of 5 in water set in at the temperature of 300 °C for 30 min.

Cyclotrimerization of 1-phenyl-2-propyn-1-one in pressurized hot water gave 1,3,5-tribenzoylbenzene in one pot in 65 % yield after 7 min at 200 °C, or in 74 % yield after 60 min at 150 °C. The reaction did not take place in the absence of water, and added base promoted the reaction at 250 °C, suggesting a mechanism of three-consecutive Michael addition reactions. The reaction rates increased with temperature, but the yield of 1,3,5-tribenzoylbenzene decreased at the expense of formation of acetophenone as a side product at higher temperatures. p-Methyl and p-chloro-substituents on the phenyl ring retarded and enhanced the reaction, respectively. A mechanism involving the enol of benzoylacetaldehyde at a branching point of the pathway leading to 1,3,5-tribenzoylbenzene and acetophenone was suggested., (Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

We report here a case of torsion of the gallbladder in a 73-year-old woman. The patient was admitted to our hospital with right hypochondralgia. Ultrasonography and computed tomography demonstrated a distended gallbladder, with a multilayered wall, which contained no stones. Since the symptoms did not respond to antibiotics, laparotomy was performed. The gallbladder was found to be twisted around its pedicle and to be gangrenous. Cholecystectomy was performed, and the patient had an uneventful postoperative course. We also reviewed 245 cases reported in the Japanese literature. The clinical features of gallbladder torsion, which include low frequency of fever and jaundice, poor response to antibiotic therapy, and acute onset of abdominal pain, may be helpful in the differential diagnosis from acute cholecystitis. Moreover, a highly suggestive sign of gallbladder torsion observed by ultrasonography or computed tomography is a markedly enlarged "floating" gallbladder with a continuous hypoechoic line indicating edematous change in the wall.

A 53-year-old woman with polycystic disease was admitted because of abdominal distention and dyspnea. Percutaneous puncture was performed and adenocarcinomatous cells were seen in the contents of the main liver cyst. A right hepatic lobectomy was carried out, and a hard nodule was found to arise from the wall of the main liver cyst. Microscopically the nodule was poorly differentiated adenocarcinoma and CEA was seen both in the epithelium of the liver cyst and in the tumor cells by the PAP method. We consider that the tumor originated in the cyst of the polycystic liver. Five similar cases were reported up to 1984.