An inferior mesenteric artery (IMA) aneurysm is the rarest among visceral artery aneurysms. A 69-yearold man was referred to our hospital with an asymptomatic IMA aneurysm associated with occlusion of the superior mesenteric artery (SMA) and celiac artery (CA). After revascularization of the SMA with an 8-mm expanded polytetrafluoroethylene (ePTFE) graft, the aneurysm was resected, and the IMA was reconstructed. The "jet disorder" phenomenon has been thought to cause an IMA aneurysm in the case of CA and SMA obstruction. We consider it better to revascularize not only an IMA but also an SMA or CA for preventing that phenomenon.

Pilonidal sinus is known to be common among soldiers but not among Asian individuals. Few reports have discussed the occurrence of pilonidal sinus in the navy. We analyzed the incidence and etiological factors of 12 cases (11 patients, with 1 recurrence) of pilonidal sinus diagnosed between 1998 and 2004 in Japan Self-Defense Force Hospital Yokosuka. All patients were male, and all lesions were in the sacral area. The patients' average age and body mass index were 29.1 years and 27.4, respectively. The surgical procedures used were primary closures (10 cases, 83.3%) and flaps (two cases, 16.7%), and the number of postoperative hospital days averaged 11.8. Pilonidal sinus was not found to be significantly common among Japan Self-Defense Force personnel in general (7 of 11 patients with pilonidal sinus; not significant); however, it was significantly more common among the crew members of Japan Self-Defense Force ships (seven of seven patients; p < 0.05), which suggests that the on-board lifestyle contributes to the occurrence of pilonidal sinus.

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Objective: We evaluated the outcomes of bypass surgery for revascularization in cases of critical limb ischemia with the distal anastomotic site at or below the ankle; we focused on the differences in outcomes between 2 groups having different proximal anastomotic sites. Patients and Methods: Out of 270 cases diagnosed with critical limb ischemia from January 2003 to October 2009, bypass surgeries with the distal anastomotic site at or below the ankle were performed on the limbs of 69 patients (75 limbs). These cases were classified on the basis of the proximal anastomotic sites: group F (n = 50) where the common femoral artery was the proximal anastomotic site and group P (n = 25) where the below-knee popliteal artery was the site. Results:The 5-year cumulative primary/secondary patency rates were 69.3%/81.8% for group F and 68.7%/84.9% for group P. The 5-year cumulative limb salvage rate was 97.9% in group F and 80.3% in group P. Conclusion: Among the cases reviewed, results were comparable between cases with the proximal anastomotic site at the below-knee popliteal artery and those with the site at the common femoral artery.

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