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Volume 31, Issue 12
Displaying 1-22 of 22 articles from this issue
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Takashi ABE1989 Volume 31 Issue 12 Pages 3171-3179
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA clinical study was done to examine effectiveness and safety of sclerotherapy with low doses of 5% ethanolamine oleate. One hundred and seventy series of EIS were performed in 120 cases with cirrhosis for esophageal varices from December, 1980 through April 1988. Sclerosant, EO, was injected intravariceally. Among 118 series in which varices were eliminated by EIS, 91 secies were treated with low doses of EO, less than 5ml of EO per varix and less than 20ml per EIS (low-dose group), and 27 series with higher dose of EO (high-dose group). Recurrence rate of varices after EIS treatment in low dose group was 31% after one year and 53% after two years. There was no significant difference in recurrence between low-dose and high-dose groups. EIS with low dose was done for ruptured varices in 41 patients and satisfactory hemostasis was obtained in 92.7%. Complications were significantlyless and slighter in the low group. In conclusion, the low dose injection method of EIS for esophageal varices is more effective and safer than the high dose method.View full abstractDownload PDF (1005K) -
Toshihiro SHIZUKU, Shiro FUKUMOTO, Yoshihiro SHIMADA1989 Volume 31 Issue 12 Pages 3180-3193
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPrognostic survey on 5-years-survival rate and direct cause of death in 259 patients with liver cirrhosis, including 81 cases complicated by hepatoma, who have received the preventive endoscopic injection sclerotherapy for esophageal varices, was done. Age and each direct cause of death was also inventigated. Results : A 5-years-survival rate was 71.8%, and this result corresponded with those in some recent reports. As the direct causes of death, incidence of bleeding from the rupture of the esophageal varices was only 3.3%, and hepatic failure, 12.2%. On the other hand, hepatoma occupied very high percentage; 72.2%. The deaths caused by non-hepatic diseases relatively frequently encountered; incidence was 20.2%. The ages at death classified by direct causes of death : age at death by varices bleeding and hepatic failure was 60.3 years old, and that by non-hepatic diseases was 66.5 years old.View full abstractDownload PDF (1638K) -
Yoshimi SHIBATA, Kiyoshi OKAMURA, Shigeyuki OKANO, Shinichi OZAWA, Hir ...1989 Volume 31 Issue 12 Pages 3194-3206_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOur results of endoscopic treatment for advanced esophageal cancer and its usefulness were reported. Endoscopic therapies using a dilator, YAG-laser and prosthesis were performed in 16 patients with unresectable cancer of the esophagus. All patients were male and ranged from 60 to 70 with a mean age of 67.7 years. The major reasons for being inoperable were advanced stage of disease itself, old age, and distant metastasis to other organs. Some patients received previous radiotherapy and/or chemotherapy. Tumor length was 3 to 15cm in size, with a mean size of 8cm. Seven patients had a tracheoesophageal fistula. A mean survival rate after the initial endoscopic treatment was 7.1 months (ranged from 1 week to 38 months). Most patients died from respiratory failure. The performance status was improved in half of the patients. Four patients were able to be discharged from hospital, and 6 patients were free from intravenous hyper-alimentation. All patient except one could swallow soft meals and liquids after endoscopic treatment. These results suggest that endoscopic therapy is extremely effective from the point of improving the quality of life in patients with unresectable cancer of the esophagus. Importance of endoscopic treatment in patients with advanced esophageal cancer complaining of dysphagea should be emphasized although radiation or chemotherapy has been the treatment of choice. We proposed that decision making of indication and selection in use of dilation, prosthesis and laser irradiation should be adequately performed based on the degree and length of malignant stenosis and existence of tracheoesophageal fistula.View full abstractDownload PDF (1759K) -
Katsutoshi OBARA, Hiromasa OHIRA, Hiroaki SAKAMOTO, Katsutoshi IWASAKI ...1989 Volume 31 Issue 12 Pages 3209-3216_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSclerotherapy with α-cyanoacrylate monomer (CA) was performed on 3 cases of emergent bleeding from intractable isolated gastric varices (Lg) and successful hemostasis was obtained in all cases. A concentration of CA at 40% consisting of 0.4ml CA and 0.6ml Lipiodol was effectively used for 3 cases of the isolated gastric varices untreatable by 5% ethanolamine oleate (EO) sclerotherapy. The CA sclerotherapy seemed to be useful for the varices in the stomach, especially in the fornix, isolated or unconnected to the esophageal varices. One of them also had esophageal varices with no communication with the gastric varices, marking it impossible to treat by regurgitation of EO from the esophageal varices. Esophageal varices disappeared completely in the other 2 cases in which sclerotherapy had done previously. These 2 cases, which had been observed for morbid condition in the state of residual Lg, presented massive bleeding 6 and 52 months later, respectively. Injection of EO into the Lg for hemostasis were tried many times. However, they were failed. Preoperative varicerography with Iopamidol revealed its weak concentration, thick blood vessels and fast blood flow. Then, sclerotherapy with CA was successfully performed with immediate hemostasis. However, in view of CA remaining in situ as foreign body, the indication for the present sclerotherapy should be selected cautiously. Therefore, among cases of acute bleeding from isolated gastric varices, inoperatable or refused to undugo operation and, moreover, EO-ineffective cases are regarded as indicated.View full abstractDownload PDF (3308K) -
Hiroshi SAKAUE, Yuji MIZUKAMI, Yasushi HOSOKAWA, Shogo YAMASHITA, Tats ...1989 Volume 31 Issue 12 Pages 3217-3222_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn cases of esophageal varices in which surgery is not indicated, we studied long term effects of endoscopic injection sclerotherapy (EIS) in comparison with those in cases who were observed to follow their natural course. The criteria of indication for surgery at our clinic include: 1) sufficient possible control of ascites and hepatic encephalopathy, 2) serum bilirubin below 2.0mg/dl, KICG above 0.05, and 3) no evidence of liver cancer. The all subjects in this study were 110, who were regarded as not fulfilling these three criteria for surgery. In 42 cases EIS was carried out, and in 68 cases having esophageal varices with CBF2, 3RCsign (+) only conservative medical treatment was carried out and their course was observed. Eight of 42 cases (19.1%) in the EIS group developed variceal hemorrhages, five of which bled to death and in comparison with the untreated group both the hemorrhage rate and the mortality from hemorrhage was significantly lower. The survival rate at 1 and 2 years in EIS group was 74.9% and 47.0%, respectively. The survival rate was significantly superior to that of the group in which the natural course was only observed. The cause of death in the EIS group was most frequently due to liver cancer, and in the untreated group it was variceal hemorrhage. Based on the above results, EIS is thought to have reduced variceal hemorrhage and mortality from hemorrhage, and is considered to be a useful therapy for prolonging the survival rate in the long term prognosis of those cases unsuitable for surgery.View full abstractDownload PDF (1053K) -
Seiji SHIMIZU, Akitada ISO, Hirotomo OHTSUKA, Yoshihiro AOKI, Masahiro ...1989 Volume 31 Issue 12 Pages 3225-3232_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSHeater probe hemostasis was performed in 50 cases of peptic ulcer bleeding during the past three and a half years. The cases included 31 patients with gastric ulcer, 14 with duodenal ulcer, and 5 with stomal ulcer. In gastric ulcer patients, permanent hemostasis (PH) was obtained in 28 (90.3%), temporary hemostasis (TH) in 2 (6.5%), and hemostasis was unsuccessful in only one (3.2%). In duodenal ulcer patients, PH was achieved in 13 (92.9%), and TH in one (7.1%). In stomal ulcer patients, PH was achieved in all cases. In a total of 50 cases, PH was obtained in 46 (92.0%), TH in 3 (6.0%); hemostasis was unsuccessful in one case only. The effectiveness of heater probe method was statistically irrelavant to the site of ulcer, or the severity of bleeding. No accidents were encountered with the therapy. Heater probe method is not only highly effective in hemostasis, but also technically easy; it is evaluated as the most useful hemostatic measures. Furthermore, ulcer recurrence has not been experienced after the heater probe hemostasis; cauterization of the ulcer may alter the natural course of peptic ulcer disease.View full abstractDownload PDF (1147K) -
Teruya ITANO, Yosihiro DAIMON, Hidenori SAKAMOTO, Hideyuki KOMIDORI, Y ...1989 Volume 31 Issue 12 Pages 3233-3237_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSSystemic amyloidosis has a poor prognosis, complicating with nephropathy, enteropathyand/or cardiomyopathy. Eleven autopsied cases with systemic amyloidosis involving the lower gastrointestinal tract were studied as for histological characteristics vs clinical symptoms. Amyloid deposition was diffusely seen at the vascular walls of each layer of the intestinal wall mainly in the submucosa of the small intestine and the muscular layer of the large intestine. Gastrointestinal hemorrhage or paralytic ileus has developed in cases with severe amyloid deposition and long time being suffered from primary diseases. Amyloid deposition in cases with severe gastrointestinal complications was statistically significant at the mucosa, muscularis propria, serosa in the small intestine and the submucosa in the large intestine. Amyloid deposition in intramural neurofibers was variable. This study showed that there was severe amyloid deposition at each layer of the intestinal wall in cases developing serious complications such as gastrointestinal bleeding or intestinal pseudo-obstruction.View full abstractDownload PDF (678K) -
Tatsuya KIYOHARA, Hideki ISHIKAWA, Kiyoshi IMANISHI, Masaharu TATSUTA, ...1989 Volume 31 Issue 12 Pages 3238-3247
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic findings and computed tomography (CT) images in three cases with lipohyperplasia and one case with lipoma of the ileocecal valve were studied. Typical colonoscopic finding of lipohyperplasia is a symmetrical enlargement of the ileocecal valve, whereas lipoma is observed as a localized submucosal tumor. Diagnoses of these conditions were possible by characteristic colonoscopic findings and histologically shown submucosal adipose tissue. However, it is offes difficult to obtein submucosal tissue by endoscopic biopsy. CT scan after distending the colonic lumen by water or olive oil is a useful technique for evaluating and confirming the fatty density of the tumor or the enlarged ileocecal valve. For the patients with lipohyperplasia and lipoma, clinical follow-up was sufficient without surgical intervention when they had no severe ileocecal valve syndrome such as right-sided abdominal pain or tenderness.View full abstractDownload PDF (4902K) -
Hideki ISHIKAWA, Kiyoshi IMANISHI, Masaharu TATSUTA, Tooru OTANI, Shig ...1989 Volume 31 Issue 12 Pages 3248-3252_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe developed an new intraluminal ultrasonography under romanoscopy. This instrument consisted of romanoscopy and the pistol type of intraluminal ultrasonograph (7.5MHz). The procedures were as follows : (1) romanoscope was inserted intrarectally, and the lesion of the colon was observed, (2) romanoscope was placed oral to the lesion and, then, ultrasonograph was inserted through romanoscope with airtight, (3) 150ml water was injected into the lumen through the romanoscope, and (4) lesion was observed through pulling out. The rectal wall was ultrasonographically recognized as five layers in its structure. This method can be performed satisfactorily even for twisted colon, because volume of the water could be easily controlable in a short period of time. The depth of involvement can be evaluated by assessing the destroyed layers of the wall structure. Correct diagnosis could be obtained in 21(80.8%) of the 26 patients with rectal cancers.View full abstractDownload PDF (769K) -
—DIFFERENTIAL DIAGNOSIS BETWEEN NEUROFIBROMA AND SCHWANNOMA—Tamotsu SAGAI, Yukari CHIBA, Kazuo TAKAYAMA, Atsushi KANO, Hideaki MUK ...1989 Volume 31 Issue 12 Pages 3253-3258_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 43-years-old woman visited a clinic because of epigastric dyscomfort. Physical examination and laboratory data were normal. An upper gastrointestinal series and endoscopic examination revealed a polypoid tumor on the greater curvature of the lower gastric body. Biopsy speciemens obtained from this polyp were normal mucosa. We performed ethanol injection method, but could not obtain the tumor tissue. At lapalatory, a 1.0×1.0cm tumor was found at the submucosa and muscularis of the stomach. There was no capsule but the lesion was well cicumscribed. Microscopically, the tumor cells were fusiform and are arranged in this cords. The intercellular component of a tumor was composed of numerous collagen fibrils and a nonorganized matrix which stained with alcian blue for monopolysaccharides. The tumor cells showed immunoreactivity to S-100 protein and neuron-specific enolase (NSE). The gross and microscopic features of neurofibroma as well as its natural history are distinct from those of schwannoma. In some instances, the differential diagnosis may be difficult. It is nesessary to differentiate between neurofibroma and schwannoma.View full abstractDownload PDF (1129K) -
Naoki HINO, Hiroshi YAMAMOTO, Shigeki SENZAKI, Isao WAKIYA, Kazufumi H ...1989 Volume 31 Issue 12 Pages 3259-3263_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 82 year-old man with a chief complaint of hematemesis. The emergency endoscopy showed a tumor accompanying with a irregular ulcer and coagula at the gastric fornix. A malignant submucosal tumor was strongly suspected. However, histological finding revealed the inflammatory change in several biopsized tissue. After one month, the lesion disappeared on video-endoscopic examination. Recently, there have been a number of reports concering vanishing tumor of the stomach caused by gastric anisakiasis. In this case, anisakis antibody was detected by immunoelectrophoresis, however neither eosinophlic infiltration nor anisakis bodies were histologically observed. Cases with hematemesis caused by vanishing tumor of the stomach were extremely rare in Japan.View full abstractDownload PDF (769K) -
Zentaro SHIRAI, Hiroshi KOKAWA, Yohichi OYAMA, Hideo TOKUMITSU, Kohich ...1989 Volume 31 Issue 12 Pages 3264-3273
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTrans-ileocolic obliteration (TIO), performed urgently to control bleeding from ruptured gastric varices (GV) locating in the fornix in two patients, achieved complete hemostasis. The common features in two, demonstrated on trans-ileocolic portography, were as follows; a) marked dialatation of the left and/or short gastric veins in diameter, suggesting increase in blood flow of the gastric varices, and b) presence of the gastro-renal shunt as a solitary drainage vein of the gastric varices. Therefore, endoscopic injection sclerotheraphy (EIS) with a ordinary dosage of sclerosant expected to have little effect on hemorrhage. In addition, application of EIS for the gastric varices might lead obliteration of the shunt and an elevation of the venous pressure in the left and short gastric veins. Consequently, bleeding would persist after EIS. On the other land, application of TIO for the patients with the hemodynamic changes descrebed above was reasonable because the inflow collateral veins, i, e. the left and short gastric veins, were obliterated by the procedure. Actually, the gastric varices in two patients desappeared following TIO. We conclude that TIO for the patients with ruptured gastric varices locating in the fornix is safe and accurate as an emergent therapeutic modality.View full abstractDownload PDF (1250K) -
Minoru SHIBATA, Yukihisa UENO, Yasukiyo SUMINO, Naoya YOSHIDA, Shigeki ...1989 Volume 31 Issue 12 Pages 3274-3279_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 55-year-old woman was admitted to our hospital in 1981 because of itching and liver dysfunction. Laboratory Batas had shown high level of serum ALP, γ-GTP, ALP, IgM and slight liver dysfunction. On the basis of clinical symptoms and laboratory data, although anti-mitochondrialantibody (AMA) was negative, we suspected primary biliary cirrhosis (PBC). Laparoscopic examination was performed and diagnosed as PBC stage II according to Scheuer's classification and following up thereafter for 8 years until present. In the clinical course, esophageal varices were revealed in 1985, and RC sign was appeared in 1987. Then, sclerotherapy for esophageal varices were performed several times. But no therapeutic effect was obtained and pancytopenia due to hypersplenism was advanced. Therefore resection of esophageal varices and splenectomy and wedge biopsy of the liver were performed in 1988. Histological examination revealed PBC stage III according to Scheuer's classification. In patient with PBC, esophageal varices may appear even though the liver morphology and function are not advanced to cirrhosis. We suggest upper GI endoscopy should be performed even in the patient of early stage of PBC to exclude the possibility of variceral bleeding.View full abstractDownload PDF (1002K) -
—REVIEW OF 60 CASES REPORTED IN JAPANEASE LITERATURES—Hiroyuki SAITOH, Hisato HARA, Takeshi OBARA, Toshifumi ASHIDA, Yoshimi ...1989 Volume 31 Issue 12 Pages 3280-3289_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 78-year-old female with a serous cystadenoma of the pancreas was reported. US and CT revealed a isoechoic solid mass and a low density mass, respectively, in the tail of the pancreas. ERP demonstrated displacement of the dorsal pancreatic duct in addition to pancreas divism. Celiac angiography demonstrated a hypervascular tumor. Surgical resection was performed and the tumor was macroscopically consisted of multiple small cysts containing serous content. The tumor was histologically diagnosed as serous cystadenoma of the pancreas. Japanease literatures of 60 cases of serous cystadenoma of the pancreas reported so far were reviewed and characteristic features revealed by US, CT and angiography in the diagnosis of serous cystadenoma of the pancreas were discussed.View full abstractDownload PDF (1512K) -
Tokuya SUZUKI, Masaru Furube, Motonobu SUGIMOTO1989 Volume 31 Issue 12 Pages 3290-3297
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 65-year-old woman was admitted to our hospital for further examination of recurrent consciousness disturbance with an elevation of blood ammonia level which had first occurred 8 years ago. She had noticed telangiectasias and subcutaneous vascular dilatation of the skin at the right upper chest from an early age. Her laboratory data showed pancytopenia, hypoalbuminemia and retention of plasma ICG. Celiac arteriography suggested a shunt between hepatic artery branches and hepatic vein branches. Superior mesenteric arteriography suggested an extrahepatic shunt between artery and portal vein and also an intrahepatic shunt between portal vein branches and hepatic vein branches. Gastrofiberscopy showed a cherry-red like capillary dilatation on the posterior wall of the anglulus. On laparoscopy, a marked scattering vascular dilatation was observed on the atrophied right lobe surface. Microscopic findings of the biopsy specimen taken from the left lobe showed no fibrotic nor cirrhotic changes. Because of these systemic vascular abnormalities involving the skin, the stomach and the liver, diagnosis of Rendu-Osler-Weber's disease was made, although the heredity was not proved. The cause of encephalopathy was thought to be a portal-systemic shunting due to hepatic vascular anomalies.View full abstractDownload PDF (878K) -
Kouichi SEKI, Yasuhiro SHIRAI, Kousaku KITAGAWA, Yukiko IZUMI, Osamu K ...1989 Volume 31 Issue 12 Pages 3298-3303_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 13-year-old male with unicteric stage of primary sclerosing cholangitis (PSC) manifesting purpura and hepatosplenomegaly was reported. ERC shown features of the biliary system compatible with those of type II of intrahepatic PSC described by Li Yeng et al. Laparoscopy was helpful for the diagnosis of PSC in this case. A deep longitudinal trench-like depression was observed on the surface of the left lobe. Liver surface showed macronodular cirrhosis with a number of lymph cysts mainly on depressed areas. The right hepatic lobe was swollen with regenerative findings. The second laparoscopy carried out ten months later demonstrated a hemispherical regenerative mass on the inferior surface of the medial portion of the right lobe. These laparoscopic features are compatible with those reported as characteristics in an adult type of PSC. Liver consistence was hard when the biopsy was done. Histological examination of the biopsy specimen revealed periductal fibrosis, being compatible with the findings in PSC. It is noted that this case without jaundice had completed cirrhosis. From the laparoscopic observation in this case, a deep longitudinal trench-like depression and formation of regenerative mass seem to be characteristic of PSC.View full abstractDownload PDF (982K) -
Hiroya TAKIUCHI, Osamu SAITOH, Hogen TEI, Kiyoshi ASHIDA, Ichiro HIRAT ...1989 Volume 31 Issue 12 Pages 3304-3311
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 52year-old female, who has been followed for the last 6 years under the diagnosis of CLL, was admitted because of nausea and vomiting. Double contrast barium radiography of the small intestine showed a solitary ulceration and stenosis near the Treitz's ligament. Small intestinal endoscopy revealed a shallow ulceration at the most strictured region near the Treitz's ligament. Tuberculosis of the small intestine was suspected. Because antituberculous therapy and hyperalimentation were not effective, the partial resection of the stenotic portion of the small intestine was done. The microscopic findings of the resected jejunum was mostly consistent of nonspecific ulcer of the small intestine. However, the histological changes similar to aberrant pancreas were partially noted in the resected specimen. There are many causes in the pathogenesis of the nonspecific ulcer of the small intestine and we studied the cause of them in this case.View full abstractDownload PDF (892K) -
Shinichi NAKAMURA, Kurato YASHIRO, Kou NAGASAKO, Shuichi SATO, Bunei I ...1989 Volume 31 Issue 12 Pages 3312-3315_1
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTwo cases of colonic tuberculosis diagnosed by smearing the biopsy specimens were reported. Case 1 was a 29-year-old female. This patient was admitted to our hospital because of chronic diarrhea. Colonoscopy showed swelling of the ileocecal valve and an ulcer with smooth margin adjacent to the valve. Biopsy was performed from the margin of this ulcer. Case 2 was a 54-year-old man. He was admitted to our hospital because of persistent right lower abdominal pain. Colonoscopy showed the reddish area with fissure in the cecum. We performed biopsy of this area. Ziehl-Neelsen method of smearing the biopsy specimens revealed mycobacterium tuberculosis in these specimens, the diagnosis of colonic tuberculosis was established. As the therapy of tuberculosis is different from other inflammatory conditions such as Crohn's disease, the differential diagnosis is very important. In the diagnosis of tuberculosis with non-specific colonoscopic picture, smear study proved essential.View full abstractDownload PDF (674K) -
Ei SASAKI, Atsushi TOYONAGA, Yutaka NAKASHIMA, Tetsuharu ORIISHI, Kazu ...1989 Volume 31 Issue 12 Pages 3316-3323
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 53 year-old female was admitted to our clinical service because of pain at right lower quadrant of the abdomen. She had appendectomy in 1967. X-ray and colonof iberscopic examinations revealed serpigious, longitudinal folds and narrowing of the ascending colon. Computer tomogry aphy showed the wall thickness of involved ascending colon. The superior mesenteric arterial angiography showed hypervascular area at the arcade of the right colic and ileocolic artery. Subsequently inflammatory mesenteric disease such as a mesenteric panniculitis was initially considered. However the surgical operation revealed mucins scattered in the abdominal cavity and the tumor formation at the posterior aspect of the cecum being compatible with the location of the past appendicular removal. Histological examination showed mutinous adenocarcinoma occuring from the residual appendix or from the cecal mucosa very adjacent to the appendicular orifice associated with inflammatory fistula from the appendicular orifice to the mid ascending colon and to the terminal ileum.View full abstractDownload PDF (1104K) -
Isao TAKEDA, Satoshi NAKANO, Takashi KUMADA, Keiichi SUGIYAMA, Toshima ...1989 Volume 31 Issue 12 Pages 3324-3331
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSTo evaluate the efficacy of endoscopic topical injection therapy, 630 patients with hemorrhagic gastric ulcers were analyzed. These patients were divided into three groups according to following periods. A period (1978.1-1980.10), when endoscopy was adopted for diagnosis but not for treatment. B period (1980.11-1983.12), when endoscopic therapy using hypertonic saline including with epinephrine solution (HSE) was performed for initial hemostasis in emergency. C period (1984.1.`1988.12), when endoscopic therapy using HSE and/or absolute ethanol (E) was performed repeatedly to prevent re-bleeding. Operative rate was significantly lower in C period (15/359, 4.2%) than in A period (48/132, 36.4%) and B period (20/139, 14.4%) (p<0.01 respectively), Operative rates in cases treated by endoscopic topical injection therapy was significantly lower in C periods (13/262, 5.0%) than in B period (20/92, 21.7%) (p<0.01), too. As for hemostasis rates for hemorrhagic gastric ulcers in C period, temporary and permanent hemostasis rate were 98.9% (259/262) and 94.3% (247/262), respectively. To evaluate the limitation of this therapeutic method, we examined the features of 13 gastric ulcers which were operated due to hemorrhage in C period. These were a) Dieulafoy's ulcers (30.8%), or b) large ulcers over 3.1 cm in diameter (53.8%) and c) deep ulcers with Ul-IV (30.8%). Endoscopic topical injection therapy is very effective hemostatic method for hemorrhage from gastric ulcers, but this method also has some limitations.View full abstractDownload PDF (1135K) -
1989 Volume 31 Issue 12 Pages 3332-3424
Published: December 20, 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (14815K) -
1989 Volume 31 Issue 12 Pages 3442
Published: 1989
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (66K)
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