Adhesive strapping represents a promising treatment for umbilical hernia. To achieve the best results, adhesive strapping should be initiated as early as possible.

This is a case presentation of a unique cause of intestinal bleeding. A duodenal ulcer eroded into the superficial branch of the cystic artery, causing massive intestinal hemorrhage. The patient, a 76-year-old woman, presented with left upper abdominal and left back pain secondary to cystic lesions in the pancreas body and tail. Stress after operation and complication of leakage of pancreatic juice after distal pancreatectomy with splenectomy and diclofenac sodium administration may have caused a deep peptic ulcer to erode the cystic artery. We performed a transfixing ligation of the bleeding vessel, serosal suture of ulcer of the gallbladder, and simple closure of the duodenal ulcer with covering greater omentum. There were no serious complications after the operation, and the patient made an uneventful recovery.

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日臨外会誌 78(５) ，1035-1040，2017 Departments of Surgery 1) and Pathology 2) , Miyazaki Prefectural Miyazaki Hospital Clear cell adenocarcinoma generally develops in the kidneys, ovaries, extraovarian endometriosis, uterine cervix, upper vagina, and lower genital tract. A 62-year-old woman was referred to our hospital because of lower abdominal pain and a high fever. Enhanced computed tomography showed a huge intrapelvic mass, 7 cm in diameter, with abscess formation. After antibiotic therapy, the patient underwent en bloc resection with sigmoid colectomy, hysterectomy, left oophorectomy, and left ureterectomy. Histological examination of the resected specimen showed a clear cell adenocarcinoma. Immunohistochemical stains showed the tumor cells to be strongly positive for cytokeratin (CK)20 and CDX4, partially positive for CK7 and CD10, and negative for ER, PgR, and NapsinA. Because the positive staining for CK20 and CDX4 demonstrated a typical adenocarcinoma of the colon, metastatic clear cell carcinoma from kidney or ovarian tissue was ruled out. Since magnetic resonance imaging and positron emission tomography showed no other tumors, the patient was diagnosed with primary clear cell adenocarcinoma of the sigmoid colon. The patient's postoperative course was uneventful, and, one year later, the patient had no unusual clinical features and no evidence of recurrence. Surgical resection is the generally recommended treatment for primary clear cell adenocarcinoma of the colon.