A 33-year-old male was admitted to Takano Hospital with fainting spell and diaphoresis due to massive terry stool. He had been working and in good health until 2 days before admission. Urgent duodenal endoscopy disclosed hemorrhage from an angiomatous lesion of the duodenum. A duodenal resection with duodenojejunostomy was performed. Pathologic examination revealed a cavernous hemangiomatosis of the duodenum. The patient had a good postoperative course. Hemangioma of the intestinal tract is rare. To our knowledge, the present case is the first case in which urgent endoscopy has succeeded in establishing the preoperative diagnosis of this lesion and ascertaining the bleeding point.

SUMMARYA 65-year-old Japanese woman was admitted to hospital because of exertional dyspnea. Transthoracic echocardiography showed diffuse hypokinesis of the left-sided ventricular wall, but was not clear enough to provide useful information because of the rotation of the cardiac apex and the presence of lung tissue. Systemic ventriculography showed that the left-sided ventricle with heavy trabeculations was morphologically similar to a normal right ventricle. Magnetic resonance imaging (MRI) clearly revealed corrected transposition of the great arteries. Because this patient had no severe associated cardiac anomalies, systemic ventricular dysfunction is thought to be the major cause of exertional dyspnea. MRI is a useful non-invasive method for the rapid evaluation of cardiac morphology. ( CONGENITALLY corrected transposition of the great arteries (CCTGA) is a rare cardiac anomaly 1) characterized by atrioventricular (AV) and ventriculoarterial discordance. However, few patients with this anomaly survive past 50 years of age because of associated congenital intracardiac anomalies such as pulmonary stenosis and ventricular septal defect, or systemic AV valve (anatomical tricuspid) regurgitation and subsequent development of systemic (morphological right) ventricular dysfunction or heart block. [2][3][4] In this paper, we describe a 65-year-old woman who had CCTGA with AV valve regurgitation. Magnetic resonance imaging (MRI) was useful for diagnosis.

A few guidelines for surgical dissection at the porta hepatis in hepatic portoenterostomy for congenital biliary atresia as evolved from our experiences on 52 cases are suggested. Indication for revision is also shown. Supplementary procedures in case of complications, such as ascending cholangitis and the onset of portal hypertension, are also described. An early primary operation as well as a positive revision and supplementary procedures for ascending cholangitis and oesophageal varices have resulted in an improvement of the therapeutic results.

Two cases of seromuscular laceration of the stomach associated with infantile hypertrophic pyloric stenosis are reported. The diagnosis and treatment of this lesion is uncertain due to a paucity of clinical experience. The first patient was treated by mucosal resection. Early decompression therapy of the stomach is essential for the neonate with upper gastrointestinal obstruction or stenosis.