HighlightsLaparoscopic extraction of a giant peritoneal loose body is a good adaption, even if with no symptom.

HighlightsAlthough sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion, it is very difficult for ruling out the malignancy in preoperative imaging studies.Even when accumulation of fluorodeoxyglucose increased slightly during the follow-up period and suggested the possibility of malignant diseases, it is necessary to make a diagnosis of splenic SANT comprehensively.

Purpose: Abdominal aortic calci cation (AAC) is a well-known risk marker for cardiovascular disease.However, its clinical effect on patients who underwent radical surgery for colorectal cancer (CRC) stages II-III is unclear. This study aimed to analyze the associations between AAC and prognosis of patients with stage II-III CRC. Methods: To evaluate the effect of AAC on clinical outcomes, prognosis, and metastatic patterns of CRC, we analyzed 362 patients who underwent radical surgery for stage II-III CRC between 2010 and 2018.Results: The high AAC group had signi cantly worse overall survival (OS), cancer-speci c survival (CSS), and recurrence-free survival (RFS) after propensity score matching to adjust for differences in baseline characteristics of patients and tumors. In the multivariate Cox regression analyses, a high AAC was an independent risk factor for poor OS (hazard ratio [HR], 2.38; 95% con dence interval [CI], 1.23-4.59; p=0.01), poor CSS (HR, 5.22; 95% CI, p<0.01), and poor RFS (HR, 1.83; 95% CI, 1.19-2.83; p<0.01). A high AAC was not associated with a risk of lung metastasis or local or peritoneal recurrence, but a risk for liver metastasis of CRC.Conclusion: A high AAC showed a strong relationship with poor OS, CSS, and RFS after curative resection for stage II-III CRC. A high AAC was also associated with a risk for liver metastasis, which may worsen the prognosis in stage II-III CRC. ACC could be a new clinical tool for predicting the prognosis for patients in stage II-III CRC.

Highlights Gastric heterotopic pancreas (HP) rarely expands due to inflammation or malignant transformation. Enlarged gastric HP caused by retention cysts is a rare case. Symptomatic enlarged gastric HP should be resected for histological diagnosis.

We present a case of preoperatively diagnosed gallbladder torsion (GT) that was successfully treated by single-incision laparoscopic cholecystectomy. An 80-year-old woman presented with sudden pain and a palpable mass in the right upper quadrant. Contrast-enhanced CT revealed ischemic changes, a swollen gallbladder with a V-shaped distortion of the extrahepatic ducts, and the gallbladder in an abnormal anatomical position; clinical findings indicated GT. We performed single-incision laparoscopic cholecystectomy and intraoperatively found that the floating gallbladder was twisted counterclockwise by 180° around the cystic duct. After an uneventful postoperative course, the patient was discharged on postoperative day 7. Laparoscopic cholecystectomy for a GT was first performed in 1994, and since then, 28 cases, including ours, have been treated laparoscopically. Laparoscopic cholecystectomy for GT could be the standard treatment for this condition, and single-incision laparoscopic cholecystectomy may be a good surgical option for patients with GT because of its anatomical characteristics.