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Volume 45, Issue 2
Displaying 1-10 of 10 articles from this issue
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Kazuaki SASAKI, Kei OHNO, Keisuke OHNO, Tomomichi YOSHIKAWA, Hiroyuki ...2003 Volume 45 Issue 2 Pages 127-131
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSColonoscopy (CF) is fundamental to the one of follow-up programs in patients aftercolorectal cancer operated. The aim of this study is to determine the better bowel preparationfor CF in these patients. A prospective randomized trial to compare the smaller (Group A:1, 000ml) versus standard volumes of PEG preparation (Group B:2, 000ml) was conducted-Thecolonoscopists were unaware of the preparation volumes until the examinations were over.. Atotal of 59 patients were enrolled in the study. There were 32 patients in Group A and 27 inGroup B. Gnly 16 of 32 patients (50%) had an excellent and good preparation in Group A (vs. 78% Group B, p<0.05) . However, in the oral side colon cancer operated patients, 9 of 10patients (90%) had an excellent and good preparation in Grou.p A. In the anal side colon cancerand rectal cancer operated patients, only 7 of 22 patients (32%) had an excellent and goodpreparation in Group A. These results suggested that it is possible to reduce the PEG volume (1, 000ml) in the oral side colon cancer operated patients. Some anal side colon and rectal canceroperated patients had poor preparation with the standard preparation method(2, 000ml).View full abstractDownload PDF (3023K) -
Kunio TAKAGI, Yasuo TUKAHARA, Yukio FUKUSHIMA, Junya FUJITA, Kimimasa ...2003 Volume 45 Issue 2 Pages 132-137
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe encountered a patient with esophagobronchial fistula accompanying benign esophagealulcer in whom evident endoscopic findings could be obtained, and preservative treatmentachieved healing. The patient was a 73-year-old female. After partial hepatectomy, upperdigestive tract endoscopy revealed reflux esophagitis. Therefore, a protective factor-enhancingagent was administered at the outpatient clinic. However, about l year later, the patient wasadmitted for epigastric pain. Upper digestive tract endoscopy revealed esophageal ulcer. At theulcer base, a ffistula was detected. Endoscopy, esophageal fluoroscopy, and abdominal computedtomography (CT) suggested esophagobronchial fistula. Therefore, fasting and preservativetreatment, including drip infusion and administration of H2 blockers, proton pump inhibitors(PPI), and antibiotics, were performed for about l month. As a result, the u.lcer showedcicatrization, and the fistula Was completely closed. The present case suggests that esophago-bronchial fistula can be diagnosed by endascapy when the fistula is present in the loweresophagus and air bubbles spout from the site with respiration. Furthermore, surgery isconsidered the first-choice treatment for esophagobronchial fistula. However, in some patientswith benign ulcer-related esophagobronchial fistula, preservative treatment achieves healing.Initially, preservative treatment should be considered.View full abstractDownload PDF (5239K) -
Masao NISHIMOTO, Tetsuo AJIKI, Masaharu MATSUMORI, Tetsuhiro KOREEDA, ...2003 Volume 45 Issue 2 Pages 138-143
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-ald male devoloped hernatemesis due to vorniting following alcohol intake.Right pyopneumothorax was observed. Though this finding was not one of the conventionalindications for conservative therapy, he recovered after the thorough drainage using threeintrathoracic catheters and the nutritional management by intravenous hyperalimentation.Even in patients wzth severe spontaneous esophageal rupture, if goad drainage can be achieved, Conservative treatment may be possible.View full abstractDownload PDF (7056K) -
Natsuhiko KAMEDA, Shiro NAKAMURA, Naoto HIRATA, Masatsugu SHIBA, Kazut ...2003 Volume 45 Issue 2 Pages 144-150
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe experienced a case of incomplete type Behcet's disease with multiple intestinal lesions.A51-year old male with three major symptoms of Behcet's disease, folliculitis-like eruption, aphtous lesions of oral cavity and genital ulcer had admitted due to intractable duodenai ulcerand ileocecal ulcer. After ileocecal resection due to steposis, he developed complex fistulasbetween stomach, duodenurn and ileum near the anastomosis with abscess forrnation. As far aswe have examined, only five cases of intestinal type Behcet's disease patierlts with gastroduodenal lesions have been reported. Furthermore, this case had an interesting clinical courseof multiple fistula formation between upper and lower G-I tract.View full abstractDownload PDF (5538K) -
Kenya WATANABE, Mitsuru SAKA, Michio ONIZAWA, Ai SATE, Jyunko TAKIGUCH ...2003 Volume 45 Issue 2 Pages 151-156
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 60-year old woman consulted our hospital complaining abdominal pain, diarrhea andbloody stool. Colonoscopic findings showed protruding type polyps with white exudate on their top, located from the transverse to the sigmoid colon. Biopsy specimens and endoscopicalInucosal resection fragments showed fibromuscular obliterations. Thrus we could make adiagnosis of cap polyposis. Herpes simplex virus-1 infection was proved and may be one of thernodification to induce cap Polyposis.View full abstractDownload PDF (5083K) -
Takahiro KOGAWA, Tetsuji TAKAYAMA, Tamotu SAGAWA, Takatomi OKU, Minoru ...2003 Volume 45 Issue 2 Pages 157-161
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 68-year-old female suffered from cervical cancer(stage IIb)22-years ago. She wastreated by total uterectom.y and pelvic radiation therapy with total 55Gy. About 22 years later, she was admitted with a chief complaint of abdominal distension. Endoscopy revealededematous mucnsa, telagiectasia and wavy vascularization in the ileum end. Barium enemashowed stricture and serrated margin of anal portion of ileum, and the disease was diagnosedas radiational ileitis. After that, once she had been discharged, However, she was again admitted with com-plaints of abdominal pain and fullness. She Was diagnosed as intestinal perforation and receivedoperation. She was a very rare case of radiatianal ileitis wha underwent a perfalation by invaglnatlon.View full abstractDownload PDF (6603K) -
Tomoox WATANABE, Akira KIHARA, Hiraxnitsu KOMIYAMA, Hironobu SENGOKU, ...2003 Volume 45 Issue 2 Pages 162-167
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case of jejunal GIST with von Recklinghausen's disease. A 35-year-old womanwas admitted to our hospital with symptoms of melena and exertional dyspnea. She waspointed urith severe anemia on hematological examination. She had had multiple cafe au laitspots and papules in the whole body since her childhood. The shin lesion was neurofibromatosison histological diagnosis. Fluoroscopic and endoscopic examinations of the small intestinerevealed a submucosal jejunal tumor, 3×2cm in size, which located 7cm anal distal to Treitz'sligament. Partial resection of the jejunum was performed. Histologically, the tumor wascomposed of uniform spindle-shaped cells with fascicular pattern and no mitotic figures. While, on immunohistochernistry, tumor ce11s were positive for CD34 and c-kit, and negative for α-SNXA and Sloo protein. Therefore, the final histological diagnosis was an uncommitted type ofFIST with uncertain malignant potential. Most of non-epitherial tumors associated with vonRecklinghausen's disease are neurogenic tumors. Gn the Other hand, GIST is too rare as thecomplication of von Recklinghausen's disease. Only 10 GIST cases related to von Recklinghausen's disease has been reported in Japan including this one. However, this clinical experiences emphasize that GIST of the small intestine should be considered as an important possiblecomplication of von Recklinghausen's disease patients with anemia and/or melena.View full abstractDownload PDF (6657K) -
Yoshihisa SAIDA, Yoshinobu SUMIYAMA, Jiro NAGAO, Makoto TAKASE, Chidor ...2003 Volume 45 Issue 2 Pages 168-171
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis is a report of utilizing self-expandable metallic stent (EMS) for releasing benign obstruction caused by anastomotic torsion at colostomy closure. A 74-year-old male was detected to have a 5 mm flat polyp in the Rb region in September 2000, which was diagnosed as a recurrent tumor of sm2, having undergone polypectomy previously. In October 2000, low anterior resection was performed and covering loop colostomy was constructed at the descending colon. On February 22, 2001, the colostomy was closed. On the postoperative 11th day, ileus was observed and Gastrografin (amidotrizoic acid) enema demonstrated a stenosis at the anastomosis. where a contrast agent did not pass but colonos cope easily went through. SO, the ileus was defined as a bend at the. proximal side of the anastomosis and torsion. As the condition was not improved with conservative treatment, colonoscopy and introduction of EMS (Ultraflex, 8 mm in diameter and 80 mm in length Boston Science Go, Ltd.) under fluoroscopic guidance were performed on the postoperative 21st day, . Soon after EMS insertion, . flatus and watery diarrhea were observed, and flatulence was diminished. Mild tenderness around EMS site and fever were observed on the next day, but they disappeared a day after. The patient presented a good prognosis and was discharged on the 10th day after EMS introduction. In the 4th month after discharge, EMS fell off without patient's recognition. Neither ileus nor recurrent cancer has been observed for a year. EMS insertion for the large intestine is feasible not only for malignant stenosis but also for benign stenosis, in some cases, providing earlier improvement of QOL.View full abstractDownload PDF (5396K) -
Naohito UCHIDA, Kunihiko TSUTSUI, Hideki KOBARA, Tsutornu MASAKI, Hide ...2003 Volume 45 Issue 2 Pages 172-176
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPre-cutting improves the success rate of cannu.lation into the comrnon bile duct. However, this technique is not prevalent in Japan because of the postoperative complications such asbleeding, perforation and acute pancreatitis. We have reported the efficacy of the new typedpre-Dotting papillotome which was equipped not only with a lumen for contrast materials loutalso with an independent lumen for guide wires. This papillotorne has an advantage that theoperation of the guide wire and the injection of contrast materials can be carried out simultaneously. We made a few modifications to the previously reported pre-cutting papillotome. In thepresent study we estimated the modified pre-cutting papillotome that has a 20mm knife inlength(half of the proximal side being Clever cut coating)and does not have a leading tip. Weapplied the papilletome in 5 patients with commen bile duct stones and a patient with pancreatichead cancer in whom selective bile duct cannulation had failed. Selective cannulations into thebile ducts were succeeded in 50f 6 patients on the initial attempt of pre-cutting(success rate:83.3%)withou.t any complications. There was no significant difference in success rate of pre-cutting between two types of the papillotomes. However, the modified papillotome made notonly pre-cutting procedure easier but also EST fellewing pre-cutting easier. Although further studies with a large number of patients are needed to evaluate the efficacyof the papillotome, this papilleteme may help to increase the safety and the success rate of precuttlng.View full abstractDownload PDF (4808K) -
[in Japanese]2003 Volume 45 Issue 2 Pages 177
Published: February 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1589K)
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