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Faculty of Medicine College Hospital A |
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Assistant Professor |
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Related SDGs |
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MUNAKATA Shun
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Papers 【 display / non-display 】
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A Case of Esophageal Penetration of a Fish Bone into the Left Atrium Rescued by Urgent Surgery
Sakamoto Norihiko, Takeno Shinsuke, Ikenoue Makoto, Kawano Fumiaki, Munakata Shun, Shimizu Ikko, Kojima Risako, Meiri Risa, Iwasaki Ayaka, Mori Kousuke, Sakaguchi Shuhei, Ishii Hirohito, Furukawa Koji, Nanashima Atsushi
Surgical Case Reports 11 ( 1 ) n/a 2025.8
Language：English Publishing type：Case report Publisher：一般社団法人 日本外科学会
<b>INTRODUCTION:</b> Esophageal penetration due to accidental foreign body ingestion is relatively rare but has a poor prognosis. Penetration into the left atrium is extremely rare, and only a few cases have been reported. A case of foreign body penetration into the left atrium is reported.<b>CASE PRESENTATION:</b> The patient was a 75-year-old woman who was transferred to our hospital for surgery due to fish bone perforation from the lower esophagus into the left atrium on CT. Urgent surgery was performed with the diagnosis of sepsis due to a mediastinal abscess and esophageal penetration into the left atrium caused by accidental fish bone ingestion. At surgery, only the fistula of the penetration wound in the esophagus and the left atrium could be detected, but not the fish bone. On CT after surgery, a folded fish bone was seen at the pericardium close to the left atrium. It was considered unlikely that the heart would again be perforated due to the fish bone’s length, and it was decided to follow up with continued antimicrobial therapy.<b>CONCLUSIONS:</b> A rare, successfully rescued case of esophageal penetration of an accidentally ingested fish bone into the left atrium by urgent surgery, with collaboration between gastrointestinal and cardiovascular surgeons, is reported.
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SHIMIZU Ikko, KAWANO Fumiaki, IKENOUE Makoto, MUNAKATA Shun, TAKENO Shinsuke, NANASHIMA Atushi
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) 86 ( 8 ) 1095 - 1101 2025.8
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：Japan Surgical Association
We encountered a case of extensive necrotizing soft tissue infection following a complicated perineal trauma with a pelvic fracture. The patient, a 59-year-old man, was urgently transported to a local hospital after sustaining a crush injury to the pelvic region from a crane truck accident during work. He was hospitalized with a pubic ramus and sciatic fracture and contusions in the right temple and perineum. On the fourth day post-injury, the patient developed a high fever and foul-smelling purulent discharge from the perineal wound, along with extensive erythema and swelling of the back and thighs. Clinical evaluation confirmed necrotizing soft tissue infection secondary to perineal trauma. Emergency open-wound drainage, debridement of necrotic tissue, and colostomy were performed. The patient was managed in the intensive care unit for approximately two weeks and the infection was treated for more than one month. He underwent four debridement procedures, followed by a successful segmental skin graft. One year post-surgery, the colostomy was closed, and the patient resumed work. Optimal management of traumatic injuries to the buttocks, particularly open perineal wounds with pelvic fractures close to the anus, is crucial.
DOI： 10.3919/jjsa.86.1095
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Kawano Fumiaki, Chiyotanda Teru, Nakame Kazuhiko, Meiri Satoru, Fukushima Tsuyoshi, Shirahama Kousei, Sato Yuichiro, Yamaguchi Hideki, Ikenoue Makoto, Munakata Shun, Higuchi Kazuhiro, Takeno Shinsuke, Nanashima Atsushi
Endocrinology Diabetes and Metabolism Case Reports 2025 ( 2 ) e250014 2025.5
Language：English Publishing type：Research paper (scientific journal) Publisher：Bioscientifica
Summary
Spindle epithelial tumor with thymic-like elements (SETTLE) is an extremely rare tumor that occurs primarily in the thyroid gland. Histologically, SETTLE is characterized by the presence of spindle-shaped epithelial cells and glandular structures. However, it is known that diagnosis via fine-needle aspiration cytology can be challenging. SETTLE predominantly occurs in younger individuals and has a less favorable prognosis compared to differentiated thyroid carcinoma. Therefore, ensuring accurate diagnosis and appropriate treatment is crucial. We encountered a case of spindle epithelial tumor with thymus-like differentiation in a 10-year-old patient for whom the preoperative diagnosis was successfully established through fine-needle aspiration cytology, which facilitated appropriate surgical resection. Comprehensive histopathological examination and immunohistochemical analysis are essential to ensure appropriate management and surveillance of SETTLE.
Learning points
A rare thyroid tumor, spindle epithelial tumor with thymic-like elements (SETTLE), was diagnosed preoperatively and treated surgically.
SETTLE presents with characteristic histological features that must be recognized for accurate diagnosis. In addition, diagnosis through cytology is often challenging.
The primary treatment for SETTLE is surgical intervention as radiotherapy and pharmacological treatments are generally not expected to be highly effective.
Radical resection is the only effective treatment, making the selection of the surgical procedure according to the stage of the disease essential.DOI： 10.1530/EDM-25-0014
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What should acute care surgery be like in regional facilities? Reviewed
Kawano Fumiaki, Tashiro Kousei, Ikenoue Makoto, Munakata Shun, Suzuki Yasuto, Takeno Shinsuke, Furukawa Kouji, Ochiai Hidenobu, Nanashima Atsushi
Japanese Journal of Acute Care Surgery 15 ( 0 ) 97 - 100 2025.4
Language：Japanese Publishing type：Research paper (scientific journal) Publisher：The Japanese Society for the Acute Care Surgery
We looked back on the 10 years of acute care surgery 〈ACS） at our department and discussed what type of ACS is required in facilities in regional cities. In our department, the emergency and critical care unit started in 2012, which required major changes in the surgical emergency treatment system. At the regional level, we focused on maintaining the existing emergency system, and we established a system in which severe injuries and trauma cases were concentrated in our department. At the facility level, ACS team was formed with existing surgeons to facilitate trauma care and actively intervene in trauma care. In addition, to maintain the team, we improved the on-call system and implemented complete division of labor in perioperative management. At the individual level, we performed daily surgical tasks with a specialty to maintain surgical skills and motivation. In addition, we made efforts to encourage young surgeons and residents to intervene in the practice in order to foster the Acute care surgeons. In this way, we believe that ACS in regional cities can be established by maintaining the existing emergency system and having existing surgeons create a system that is suited to the facilities.
DOI： 10.50840/jjacs.15-1
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Spindle epithelial tumor with thymus-like elements (SETTLE): a surgical case diagnosed preoperatively using fine-needle aspiration cytology. Reviewed
Kawano F, Chiyotanda T, Nakame K, Meiri S, Fukushima T, Shirahama K, Sato Y, Yamaguchi H, Ikenoue M, Munakata S, Higuchi K, Takeno S, Nanashima A
Endocrinology, diabetes & metabolism case reports 2025 ( 2 ) 2025.4
Language：English Publishing type：Research paper (scientific journal)
DOI： 10.1530/EDM-25-0014
Presentations 【 display / non-display 】
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術前CTにて脾静脈の走行異常を認識し、安全に腹腔鏡下胃切除術を施行した胃癌の１例．
樋口和宏，宗像 駿，千代反田顕，池ノ上実，河野文彰，武野慎祐，七島篤志
第38回日本内視鏡外科学会総
Event date： 2025.12.11 - 2025.12.13
Language：Japanese Presentation type：Oral presentation (general)
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陰圧閉鎖療法により治療し得た鼠径部術後難治性リンパ漏の1例.
千代反田顕，樋口和宏，宗像 駿，池ノ上実，河野文彰，武野慎祐，七島篤志，藤田 環，伊東憲子，鬼頭雄也，伊東 大
第38回日本外科感染症学会
Event date： 2025.11.7 - 2025.11.8
Language：Japanese Presentation type：Oral presentation (general)
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右鎖骨下動脈基始部異常を伴う胸部食道癌に対して根治切除を行った一例.
西田脩通，池ノ上実，宗像 駿，樋口和宏，千代反田顕，中田恭真，河野文彰，市原明子，山田和之介，濵田朗子，原 大介，岩本和樹，内勢由佳子，武野慎祐，七島篤志
第78回日本胸部外科学会定期学術集会
Event date： 2025.10.23 - 2025.10.25
Language：Japanese Presentation type：Oral presentation (general)
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食道癌の術後1年目および6年目に孤立性腎転移を左右腎臓に認め腎摘出術を行った1症例.
鈴木康人，武野慎祐，田代耕盛，池ノ上実，河野文彰，宗像 駿，樋口和宏，千代反田顕，七島篤志，阿部純也，澤田篤郎，賀本敏行，盛口淸香，山下 篤
第78回日本胸部外科学会定期学術集会
Event date： 2025.10.23 - 2025.10.25
Language：Japanese Presentation type：Oral presentation (general)
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cStageIV食道癌に対して術前に免疫チェックポイント阻害薬を導入した3例の経験.
荒木裕介，池ノ上実，中田恭真，千代反田顕，樋口和宏，宗像 駿，河野文彰，武野慎祐，七島篤志
第78回日本胸部外科学会定期学術集会
Event date： 2025.10.23 - 2025.10.25
Language：Japanese Presentation type：Oral presentation (general)