GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Volume 24, Issue 3
Displaying 1-12 of 12 articles from this issue
  • YOJI HIRAYAMA
    1982 Volume 24 Issue 3 Pages 405-421
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Gastrointestinal manifestations were studied in 83 cases with systemic lupus erythematosus. Gastrointestinal symptoms were found in 50 cases (60.2%) in the course of the disease. Abdominal pain was complained by the most mumber of cases, followed by various abdominal discomforts. In fact 23 out of 54 examined cases revealed abnormal findings in the gastrointestinal tract. But, gastric ulcers and duodenal ulcers had not particular features endoscopically. There was no evidence that these ulcers were induced by cortico-steroid. Angitis was not seen in biopsy specimens. The author experienced 2 cases having perforations of small intestine and a case having multiple colonic ulcers. One of the cases showed severe angitis in the resected intestine. Colonic ulcers resembled closely to that of Behcet disease. The author found hypotonic findings of esophagus and of small intestine radiologically. There were some cases which showed severe angitis or severe gastrointestinal lesions. But many of the cases showed only minor gastrointestinal symptoms or minor gastrointestinal lesions. The author concluted that the cause of the minor symptoms were mainly functional disorders such as hypotonic tendency of gastrointestinal tract.
    Download PDF (21547K)
  • SHIGERU HARASAWA, HARUMICHI SHIBATA, TAKASHI MAKINO, KAZUHIRO KIKUCHI, ...
    1982 Volume 24 Issue 3 Pages 422-430_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Relationship of the esophagogastric junction (Z-line pattern) and the functions of the esophagus was studied in the patients with reflux esophagitis. We classified Z-line pattern Z0-type to Z4-type, on a point of view of the shape and the level of the Z-line. Lower esophageal sphincter pressure (LESP) was messured by open-tip infusion method and acid clearing test was messured by Booth's method (0.1 N HCl 15 ml). Z-line classification endoscopically was as following: Z0-type is normal Z-line pattern and no evidence of esophagitis and hiatus hernia, Z1-type to Z3-type of the Z-line pattern were classified in proportion to the shape of the Z-line, Z1-type is slihtly indented on those Z-line changes, Z2-type is mild and Z3-type is severe, and Z-line of Z4-type is a way from the esophageal hiatus, but is straightly on the shape, no evidence of esophagitis. Following results were obtained: 1. LESP was 15.5±5.6 cmH2O (M + SD) in normal subjects (Z0-type), it was 10.3±2.9 cmH2O in Z1-type, 9.5±4.9 cmH2O in Z2-type, 9.4±4.1 cmH2O in Z3-type and 7.6+3.4 cmH2O in Z4-type. There were statistically significant difference between 4-type and the other Z-line patterns (p<0.05, p<0.05, p<0.025 and p<0.025 respectively). 2. Acid clearance was shown as the time until the pH returned to 5.0 due to swallowing at one-minute intervals. The result of acid clearing test was 11.4±3.0 min in 4-type, 18.3±7.0 min in Z1-type, 20.3±5.6 min in 4-type, 24.1±5.7 min in Z3-type and 24.5±7.4 min in Z4-type. Acid clearance were signicantlly delayed along with Z-line pattern (p<0.025, p<0.025, p<0.005 and p<0.005 respectively) 3. The patients with hiatus hernia were 5 cases of Z3-type and 6 cases of Z4-type. They had low LESP and delayed acid clearance.As above mentioned, the results of LESP and acid clearing test were well related to Z-line patterns in patients with reflux esophagitis.
    Download PDF (4819K)
  • TAKASUKE YOSHIDA, ATSUO SAKAMOTO, SHYUICHI HIGASHI, HIKARU KANBE, YASU ...
    1982 Volume 24 Issue 3 Pages 431-439
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Nine cases of benign gastric submucosal tumor (BGST) obtained a pathological diagnosis by electrocoagulation biopsy were analysed in terms of tumor mass development and mucosal change over the tumor during the follow-up period. These tumors consisted of 3 leiomyomas, 2 leiomyoblastomas, 3 lipomas and an aberrant pancreas. An annual increasing rate of tumor volume were 0/yr in lipoma, 0.17-0.44/yr in leiomyoma, and 0.73, 0.6/yr in two cases of leiomyoblastoma. There was no obvious enlargement observed of the tumor mass in aberrant pancreas. Estimated doubling time was from 3yr. lmon to 5yr. 10mon in leiomyomas, and 1yr. 6mon and 2yr. 3mon respectively in two leiomyoblastomas. Three of the nine cases showed ulcer formation over the tumor during the follow-up period. These ulcerations tended to heal very quickly within a month or two. We would like to propose a periodic examination program using x-ray or endoscopy at least once in every other year in case of a small asymptomatic benign submucosal tumor of the stomach. Leiomyoblastoma or aberrant pancreas with ulcer formation regardless of its size should be treated surgically once a pathological diagnosis has been reached.
    Download PDF (5345K)
  • KIMIYA TAKESHITA, AKIRA NAKAJIMA, SHIGEO MORI, HIDEKI YAMAUCHI, HIROSH ...
    1982 Volume 24 Issue 3 Pages 440-447
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A retrospective study was made in the 243 patients with early gastric carcinoma resected during thr last 12 years as to if there were any endoscopic characteristics closely related to the types of histology. I. Protruded and/or elevated type (77 lesions). Predominant type of histology in the polypoid cancer (I, ha, I+IIa, IIa+I) was well differentiated tubular adenocarcinoma, while in the particular type of polyps associated with IIc at the base were poorly differentiated. In the circularly or hemicircularly protruded types (IIa+IIc), the types of histology depended on the steepness of protrusion and the depth of depression at the center. II. Depressed and/or excavated type (168 lesions).Close relationships were found between histological differentiations and endoscopic findings (characteristics of the margin, the floor of depression and/or excavation and shapes of the surrounding mucosal folds). III. Flat type (7 lesions). There were no endoscopic characteristics corresponding to the histological differatiaions. Further efforts must be made to obtain endoscopic and histological correlations in this particular type of early gastric carcinoma.
    Download PDF (5123K)
  • MUTSUO UECHI, IZUMI YOKOYAMA, TEIKO NAKAI, AKIRA KURIHARA, YOKO MIWA, ...
    1982 Volume 24 Issue 3 Pages 449-454
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    This study presents protective mechanism of the mucous membrane with our main emphasis on mucopolysaccharides within the mucous membrane at varying stages of gastric ulcer. If we look at the findings based on 35SO4 autoradiography, an increase in uptake of 35SO4 by the epithelial cells of the active stage (A2) and a peak is exhibited during the initial half of the healing stage (H1). If the amount of hexosamine within the mucous membrane is determined, a movement similar to the 35SO4 autoradiographic findings is exhibited with a peak occourring from the A2 to the H1 stage. In summary, it is conceivable that based on the mucopolysaccharide metabolism during the varying stages of gastric ulcer, formation of a mucous barrier is quite rapidly initiated after ulceration and the importance of a protective facter in healing process of gastric ulcer is suggested.
    Download PDF (5193K)
  • YOSHINORI NUMA, TAKAHIRO KODAMA, MASATAKA ODA, TAKARO ESAKI, KEIJIRO A ...
    1982 Volume 24 Issue 3 Pages 455-459_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    The non-operated cases shown adhesion to the liver capsule were examined. The incidence of cases shown adhesion was 7.4 % (43 cases) in total numbers having laparoscopic examination (584 cases). Of the 43 cases analyzed, 14 cases were diagnosed of chronic active hepatitis, 10 cases of liver cirrhosis, 4 cases of chronic inactive hepatitis, 4 cases of intrahepatic cholestasis, 4 cases of hepatocellular carcinoma, 2 cases of metastatic liver cancer and 5 cases of others. The incidence of alcoholic history in these cases was higher (34.9 %). Moreover, the history of appendectomy or pulmonary Tbc was more often seen except hepatitis in previous history. The incidence of cases with adhesion seen in miscellaneous liver diseases was 11.0 % in metastatic liver cancer (19 cases), 8.0 % in hepatocellular carcinoma (50 cases), 6.4 % in chronic active hepatitis (218 cases), 5.4 % in chronic inactive hepatitis (74 cases) and 5.1 % in liver cirrhosis (196 cases). According to our criteria about the adhesion, the cases showing moderate to severe adhesion were highly seen in chronic liver diseases.
    Download PDF (3064K)
  • MASAHIRO TADA, YOSHINORI TANAKA, MINORU YAMAMOTO, MINORU HARADA, YUZO ...
    1982 Volume 24 Issue 3 Pages 460-464_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Since intussusception is a common complication of Peutz-Jeghers polyps, laparotomy should be recommended to remove them. However, many of them will not be palpable or discernible during laparotomy. Operative endoscopy was employed for removing polyps of the small intestine in a 22-year-old female who was previously diagnosed to have Peutz-Jeghers syndrome. Using a newly designed enteroscope with two channels (SIF-2C, Olympus), four large polyps over 1 cm in size were romoved from the ileum and jejunum with safety. Endoscopic polypectomy has become one of the rapidly advancing fields and widely employing methods in gastrointestinal endoscopy since the introduction of endoscopic electrosurgical techniques. Although the endoscopic removal of polys arising from the esophagus, stomach, duodenum, colon and rectum can be performed with ease and safety, polypectomy for polyps of the small intestine has never been performed because of technical difficulties in handling an endoscope in the small intestine. Two-channel enteroscope resolved this problem. Therefore, it is emphasized that double channel enteroscope makes the polypectomy in the small intestine possible and the indication of enteroscopy will be extended more widely.
    Download PDF (7069K)
  • YASUYUKI YAZAKI, CHIHIRO SEKIYA, TAKASHI KITAGAWA, YOSHIHARU TOMINAGA, ...
    1982 Volume 24 Issue 3 Pages 467-472_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    An unfused pancreatic duct system is the condition in which the dorsal and ventral pancreatic ducts are unfused embriologically, so pancreatic drainage is mainly through the accessory papilla. In endoscopic retrograde pancreatography, it is easy to demonstrate short ventral duct by cannulation of main papilla usually. But cannulation of the accessory papilla is technically so difficult that success rate of cannulating accessory papilla have been reported to be still very low (0-51%). We devised a narrowed tip ERCP cannula (diameter of the tip is about 0.1-0.2 mm) to improve success rate of cannulating accessory papilla because usually ordinary ERCP cannula is too big to make cannulation of accessory papilla. Success rate of cannulating accessory papilla using this narrowed tip ERCP cannula was 100% in six patients with an unfused pancreatic duct system, and dorsal pancreatic duct have been all clearly demonstrated within 5 minutes after insertion of duodeno-fiberscope. Techneque of cannulating accessory papilla by this cannula is very easy, and no complication was experienced. We think this new device is very useful for cannulation of accessory papilla especially those in ERP of an unfused pancreatic duct system. Success rate of cannulating accessory papilla in ERP of an unfused pancreatic duct system will be improved very much by this method.
    Download PDF (5773K)
  • YOSHINORI FUJIKAWA, MASATOSHI WATANABE, KIYOSHI FUJITA, TAKASHI HARIMA ...
    1982 Volume 24 Issue 3 Pages 473-481
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    We have performed colonoscopic examination after glycerin enema or without any premedication within a week from the onset of symptoms in the cases complaining of melena and/or acute diarrhea. We defined this as "early colonoscopy" and investigated about the usefulness of this for the bleeding of the lower gastrointestinal tract. 68 patients underwent early colonoscopy. In 74% of of them, the causes were confirmed. Many of the causes confirmed were acute inflammatory colonic diseases, for example, ischemic colitis or drug induced colitis. Most of the lesions were seen at the rectum or sigmoid colon. But, in the acute inflammatory colonic diseases, a part of lesions were seen at the right side colon. In the majority of cases in early colonoscopy, the scope was introduced into the rectum and sigmoid colon, though it might be possibble to introduce it into the cecum. As a week passed from the onset, acute inflammatory colonic diseases showed the tendency to cure. No complication occurred. From the results desults described above, we concluded that early colonoscopy was safe and useful for the bleeding of lower gastrointestinal tract, especially for acute inflammatory colonic diseases.
    Download PDF (1102K)
  • TAKASHI SUZUKI, TADASHI SHIGEMATSU, TOMOYO YUASA, FUMIO TACHINO, TAKAS ...
    1982 Volume 24 Issue 3 Pages 482-487_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    Using a panendoscope, esophago-gastro-duodenobulboscopy was achieved in 2, 744 consecutive patients during the past 5 years. Among the detected disoriers, 10 cases of esophageal carcinoma and 144 cases of gastric carcinoma were included. Of these patients with malignancy, 5 cases (50%) of esophageal and 37 cases (25.6%) of gastric carcinoma were found at early stages. In all of 5 early esophageal carcinoma, endoscopy and biopsy were essential in establishing the diagnosis, while radiology was effective in only 2 of the 5 patients in detecting the lesions. Two of the 5 patients with early esophageal carcinoma was coincidentally associated with gastric carcinoma, one with early carcinoma and the other with advanced one. Another case of early esophageal carcinoma had a history of gastrectomy due to early gastric carcinoma ten years ago. Prognosis of these patients with early esophageal carcinoma were not good despite of surgical operation because of their old age and other malignacy. Routine performance of UGI tract endoscopy with a f orwardviewing instrument is essential in detecting early esophageal carcinoma.
    Download PDF (11347K)
  • ISSEI SENOUE, SOTARO SUZUKI, MASAFUMI HARA, TAKASHI MAKINO, HARUMICHI ...
    1982 Volume 24 Issue 3 Pages 488-493_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    A 17-year-old male was admitted to our hospital because of severe bronchial asthma attack. He had been suffering from bronchial asthma for last 15 years. Within a week, the attack was improved by theophyllin infusion, steroid hormone and antibiotics (CTZ) administration. Stool occult blood test was slightly positive on admission. The dose of steroid hormone was gradually decreased, the grade of stool occult blood, however, became stronger. No bleeding source was detected in the upper alimentary tract examination. Barium enema examination was performed and "thumbprinting sign" was noted in the trasverse colon without any lower G. I. symptoms for 5 weeks since admission. One week after the barium enema, he complained of increasing abdominal pain and bloody diarrhea. On the 7th hospital week, ulcerative colitis was strongly suspected by second barium enema examination which showed numerous "spiculations" and marked mucosal edema from the ascending through the descending colon. Rectosigmoidoscopy showed multiple ulcers on the friable mucosa and the biopsied specimens revealed "crypt abscess" formation. Finally, the patient was diagnosed to have ulcerative colitis. No report of ulcerative colitis observing the onset and course has been seen in the literatures.
    Download PDF (8698K)
  • KAZUHIKO IWAKOSHI, ICHIRO HIRATA, OSAMU MASAMUNE, SABURO OHSHIBA, FUMI ...
    1982 Volume 24 Issue 3 Pages 494-498_1
    Published: March 20, 1982
    Released on J-STAGE: May 09, 2011
    JOURNAL FREE ACCESS
    This report is a presentation of a case of colonic carcinoma complicated with tuberculous scar. The patient was 69-year-old female who was admitted to our hospital complaining of swelling of a lymph node in the left neck. Resected specimen of the lymph node revealed adenocarcinoma. Therefore, examination of G-I tract was performed in order to detect the primary lesion. Upper G-I series showed no abnormalities. In the barium enema examination, marked shortening of he ascending colon was noted. Haustra was absent in the ascending colon and the proximal transverse colon. Convergence of the mucosal folds owing to the ulcer scar was scattered. In addition, stenosis of the lumen and irregular form of excavation were found in the hepatic flexure. In the colonofiberscopic examination, convergence of the mucosal folds in the ascending colon and incompetent ileocecal valve were obrerved. Irregular form of ulceration with dirty whitish coating was found in the hepatic flexure. Biopsied specimen taken from the ulcerated area revealed adenocarcinoma. Macroscopic finding of the resected specimen was type 2 of colonic carcinoma. Ascending colon was shortened and convergence of the mucosal folds was scattered. Histologically, well differentiated adenocarcinoma was found in the hepatic flexure. In the ascending colon, mild atrophy of the mucosa, interruption of the muscularis mucosa, and fibrosis in the submucosa were present. From these findings, diagnosis of colonic carcinoma complicated with tuberculous scar was made though typical tuberculous tubercle was not found.
    Download PDF (6706K)
feedback
Top