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A 64-year-old woman was admitted to our hospital with abdominal pain and vomiting. She had no history of abdominal surgery or injury. Abdominal contrast CT scan revealed expansion of the small intestine, and stenosis of the pelvic intestinal tract. The patient underwent conservative therapy by an ileus tube to decompress the small intestine, but there was no obvious improvement. Intramesosigmoid hernia was suspected with angiography from an ileus tube and abdominal contrast CT, laparoscopic surgery was performed on the 9th day after admission. The postoperative course was uneventful and she was discharged from the hospital on the 10th post operative day. Intestinal hernia without history of abdominal surgery, particularly associated with intramesosigmoid hernia, is rare. Herein, we describe our experience with a case of intramesosigmoid hernia and present a discussion of intramesosigmoid hernia with a review of the literature.

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We report a case of a huge splenic cyst with a high concentration of carbohydrate antigen (CA) 19-9 in the cystic fluid. A 35-year-old woman, who first noticed an abdominal mass 5 months prior, was referred to our hospital due to anemia and an enlarged spleen that were observed during routine physical examination. All laboratory results were normal, except for the presence of anemia (hemoglobin, 5.6 g/dl) that was noted during her initial visit. Serum levels of carcinoembryonic antigen and CA19-9 were within the normal range. Abdominal computed tomography revealed a huge cystic lesion (20 × 17 × 14 cm) in the spleen. The patient underwent splenectomy. The spleen weighed 1.4 kg, and 2670 ml of cystic fluid was recovered. The CA19-9 concentration in the cystic fluid was markedly elevated to 34751.0 U/ml. The cystic lesion was histopathologically diagnosed as a true cyst with no evidence of malignancy. True cysts account for approximately 20% of all splenic cysts and are usually idiopathic. Herein, we report a case of a true cyst, with a brief review of the literature.Key words: splenic cyst, CA19-9, splenectomy CA19-9 (J. Nihon Univ. Med. Ass., 2013; 72 (2): 108-112) CA19-9 35 22 7