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Volume 45, Issue 7
Displaying 1-8 of 8 articles from this issue
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Kiyotaka OKAWA, Tetsuya AOKI2003 Volume 45 Issue 7 Pages 1123-1129
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSOne of the recent topics on ulcerative colitis is the presence of the appendiceal lesion in patients with ulcerative colitis. On the basis of the results of many epidemiological studies, we may definitively say that appendectomy can suppress the onset of ulcerative colitis. Animal studies also demonstrated that the onset of enteritis was suppressed by appendectomy performed soon after birth. It seems highly likely that the appendix is closely involved in the etiology and pathophysiology of ulcerative colitis. Therefore, appendectomy may be used as a means of treating ulcerative colitis. Meanwhile, skipped lesions of the appendix have been endoscopically found in many cases. This kind of lesions of the appendix is endoscopically detected in about 30% of patients with active distal ulcerative colitis, particularly the proctitis type. These lesions are seen both at the onset and during the follow-up of the disease. The activity of the colitis is often in parallel to that of the appendix lesions. The presence of appendiceal lesion in patients with ulcerative colitis suggests : (1) it is not uncommon that ulcerative colitis involves skipped lesions, affecting the appendix as well ; (2) this disease does not always advance upwards and continuously from the rectum ; and (3) the disease can first develop at sites rich in lymph follicles including the appendix.View full abstractDownload PDF (11039K) -
Yukako HOSOKAWA, Shigehiro KIKUYAMA, Kimiyasu YONEYAMA, Hiroyuki TOEDA ...2003 Volume 45 Issue 7 Pages 1130-1134
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 74-year-old male was admitted to our hospital because of general fatigue. In his past history, he had chronic renal failure on HD and diabetes meritis. six yeare ago, he was pointed out to have an adenoma of the 4th portion of the duodenum, and followed up. Duodenography showed a sessile polypoid lesion of the 4th portion of the duodenum. Upper gastrointestinal endoscopy revealed a 40 × 30 mm polypoid lesion, suspected intramucosal lesion. The pathological finding was well differentiated adenocarcinoma. He was at poor risk, but we didn't choose endoscopic mucosal resection due to the location and size of the lesion. Partial resection of the duodenum was performed, which revealed intramucosal adenocarcinoma with adenoma component. After the operation, his condition was uneventful with no recurrence.View full abstractDownload PDF (7833K) -
Yoshihiro MORIWAKI, Shinju ARATA, Takehiko KITAMURA, Goro MATSUDA, Sat ...2003 Volume 45 Issue 7 Pages 1135-1139
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn a case of gastric tumor incarcerated into duodenum difficult to release, examination of the lesion cannot be performed and strategy of the treatment cannot he determined. We experienced a 69-year-old man of 4cm sized fundic leiomyosarcoma incarcerated into the duodenum and succeeded in release of the polyp endoscopically with the technique for bilaterally fixed foreign body. Under endoscopic examination, enteral feeding tube was inserted behind the neck of the polyp, then the end of the tube was grasped by endoscopic forceps and pulled out of his mouth. Both end of the tube was drawn, resulting in release of the incarceration.View full abstractDownload PDF (8955K) -
Hisayuki MATSUNAGA, Masuho HARAGUCHI, Hazime TANIOKA, Kenichi TAKAMORI ...2003 Volume 45 Issue 7 Pages 1140-1143
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThis case was a 61-year-old male with a duodenal ulcer in 1996. Since the ulcer recurred three times, Helicobacter pylori was eradicated in 2001. After that, H2 blocker was administrated continuously but he complained of sudden upper abdominal pain and had emergent operation for diffuse peritonitis. As the operation showed a perforated spot in the bulbus, omental filling was performed. We have to be careful for the fact that duodenal ulcer could be perforated even if the patients continue to take H2 blocker after eradication of H. pylori.View full abstractDownload PDF (6786K) -
Chuuichi SEKINE, Shigeru MATSUI, Hirosi IWAMATSU, Atsuto NAGOSHI, Yosh ...2003 Volume 45 Issue 7 Pages 1144-1149
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSThe patient was a 63-year-old woman. She became aware of her own exertional dyspnea from the summer 2001. She underwent colonoscopic examination because iron deficiency anemia and positive occult blood reaction in the feces were observed. In the examination, arteriovenous malformation (AVM) was suspected in the transverse colon, which was thought to be the source of the anemia. In addition, abdominal angiography of the patient revealed nidus and early venous return in the region of the transverse colon, leading to a diagnosis of colonic AVM. She was treated successfully by transcatheter arterial embolization (TAE). After TAE, AVM has almost disappeared and no progression of the anemia has been observed. We should take into consideration that TAE can be effective for the gastrointestinal bleeding due to AVM.View full abstractDownload PDF (8901K) -
Atsushi YAMADA, Takayuki NADA, Takefumi NAKAMURA, Tadayuki KOU, Keiich ...2003 Volume 45 Issue 7 Pages 1150-1156
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 82-year-old woman admitted to our hospital complaining of hematemesis. Endoscopy revealed a huge ulcer with a large exposed vessel at the lesser curvature of the mid-body of the stomach. As we could not treat the exposed vessel sufficiently with endoscopic treatment, we performed abdominal angiography. The celiac arteriography revealed the splenic artery as bleeding site. We embolized the main splenic artery using metallic coils. Follow-up endoscopy showed the metallic coil protruding from the ulcer bottom. Hemorrhage did not recur. In our patient, coil embolization was effective to prevent recurrent bleeding without severe complications, such as splenic infarction.View full abstractDownload PDF (11382K) -
Toyohiko YUKI, Tadasu SATO, Kazuhiko ISHIDA, Shigeharu SENOO, Takashi ...2003 Volume 45 Issue 7 Pages 1157-1163
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSMassive blood clots and food debris sometimes hamper emergency EGD for upper gastrointestinal hemorrhage by preventing clear endoscopic view resulting in difficulty in identification of the source of bleeding. Handling the difficulty with standard endoscopes by adjuvant techniques is often time consuming. We had an opportunity to use a new wide-channel endoscope (GIF XT-30, Olympus, Tokyo). GIF XT-30 has a wide forceps-channel with a diameter of 6 mm. The outer diameter at the distal end is 13.7 mm. A three-way stopcock connected to the channel enables the use of a double suction system with this scope. To clarify the efficacy and feasibility, we measured the time for suction of 500ml of distilled water and 100ml of plain yogurt with GIF XT-30 and GIF Q240 having a channel 2.8 mm in diameter (Olympus, Tokyo). The times required for sucking water and yogurt were signifficantly shorter by GIF XT-30 than those by GIF Q240. In clinical practice during six months period, GIF XT-30 was applied for 22 cases (11.3%) among 194 emergency EGDs. Suction of massive blood clots and food debris was successful and optimal endoscopic view was obtained in 19 of 22 cases. We conclued that GIF XT-30 is excellent in sucking massive clots and food debris and shortens the time of emergency EGD. This endoscope is an indispensable item for major endoscopic centers perfoming large volume emergency endoscopy.View full abstractDownload PDF (9862K) -
Tomoko TADA, Naotaka FUJITA, Go KOBAYASHI, Yutaka NODA, Katumi KIMURA, ...2003 Volume 45 Issue 7 Pages 1164-1169
Published: July 20, 2003
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESS[Purpose] The aim of this study was to evaluate the usefulness and limitations of endoscopic treatment of pancreatic pseudocysts. [Methods] Endoscopic transpapillary or transmural drainage was performed in 8 patients with pancreatic pseudocysts. Transpapillary drainage was attempted in patients with pseudocysts that communicated to the main pancreatic duct and transmural drainage was attempted in patients with noncommunicating cysts. External drainage was performed in patients with concurrent cystic infection and bleeding. Outcome and complications were assessed for each treatment method. [Results] Transpapillary drainage was successful in 5 of 6 patients and transgastric drainage was successful in 3 of 3 patients. External drainage was performed in 5 patients (63%). Improvement of symptoms, normalization of serum amylase levels, and disappearance of the cysts or reduction of cyst size were achieved in all cases. [Conclusion] Endoscopic treatment of pancreatic pseudocysts can be accomplished through both internal and external drainage techniques and is a useful treatment that can be considered before attempting surgical treatment.View full abstractDownload PDF (8676K)
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