A 36-year-old woman without any relevant medical history was admitted to our hospital with an abdominal tumor that had caused recurrent right hypochondral and back pain for 3 months. Retroperitoneal cystic lymphangioma was diagnosed by abdominal ultrasonography and computed tomography. We suc-cessfully excised the tumor laparoscopically. Retroperitoneal cystic lymphangiomas are rare lesions that usually present in infancy, rather than in adulthood. Most patients experience chronic symptoms, necessitating therapeutic intervention. Excision is the treatment of choice, and can be performed laparoscopically in selected patients.

A 57-year-old woman underwent esophagectomy with three-field lymphadenectomy for lower esophageal cancer, followed by gastric roll reconstruction through the posterior mediastinum. A laparotomy and right thoracotomy with partial resection of the right fifth rib were performed. A purulent discharge requiring drainage developed postoperatively and continued for 3 months despite anastomotic integrity and the absence of a bronchopleural fistula. An empyema developed 3 months after drain removal, and a thoracostomy tube was reinserted. A displaced fragment of the right fifth rib was identified within the abscess cavity. Drainage and irrigation were not curative, and removal of the bone fragment was performed 18 months after the initial procedure. The patient has been symptom-free during 1 year of follow-up. We believe that the rib fragment functioned as a foreign body, which complicated treatment of the patient's postoperative infection.

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An Influence of Pregnancy and Delivery Experiences on Onset Age of Varicose Veins of the Lower LimbsPregnancy and delivery experiences were examined in regards to their impact towards the onset of varicose veins in the lower limbs, as it related to age.Subjects were patients with varicose veins in their lower limbs who visited a surgical clinic between Sep. 2004 and Mar. 2007. Data was derived through interviews and those three hundred seventy nine female patients who were aware of the onset age of their varicose veins were analyzed.The number of pregnancies/deliveries had significant influence for the onset age of varicose veins after the controlling effect from family history was considered. Patients who experienced more than two deliveries showed a younger onset age than one or no experience patients. However, minimum interval of deliveries and age at first/last delivery ages showed no significance for the onset age. An appropriate intervention, according to number of pregnancy or postpartum conditions, would decrease the risk of varicose veins and the hefty cost of beauty and health care over younger women.