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Volume 46, Issue 4
Displaying 1-11 of 11 articles from this issue
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Toru HIYAMA, Shinji TANAKA, Masaharu YOSHIHARA, Kazuaki CHAYAMA2004 Volume 46 Issue 4 Pages 911-918
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe analyzed 101udicial precedents associated with digestive endoscopy sentenced after 1981 in Japan, on the risk management point of view. By this analysis, we can clarifythe medical knowledge and skills that are required in staffs, and medical information and advisethat should be given to patients legally, at present. We hold weekly conferences of these judicialcases (one case per a time) at the Department of Endoscopy of the Hiroshima University Hospital. These conferences were very useful to confirm our obligation in endoscopic examination and treatment.View full abstractDownload PDF (7348K) -
Naoki SAJI, Tsutomu SAKAI, Takayuki KIMATA, Matahiko MURASE, Kazuo AMA ...2004 Volume 46 Issue 4 Pages 919-924
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 65-year-old man was admitted to our hospital because of hematemesis, epigastralgia a:ndback pain after he had eaten fish. Endoscopic finding showed a fishbone stuch into theesophageal wal1, so we removed it endoscopically. Chest X-ray and computed tomographyrevealed mediastinal emphysema and pleural effusion. The patient was cured by means of total parenteral nutriton and antibiotics strongly.Dyspnea had not been observed during the admission.4weeks Iater, mediastinal emphysernaand pleural effusion were disappeared and radiological examination showed the esophagealperfaratian had closed.500ral intake was restarted and the patient was discharged S weeksafter his admission. Fishbones sometimes cause esophageal perforations and severe complications such asmediastinal emphysema, pyothorax. Early diagnosis and treatment can be important.View full abstractDownload PDF (7307K) -
Takashi KATO, Yoshiyuki INOUE, Michiaki HIRAYAMA, Yutaka KAWANO, Shuji ...2004 Volume 46 Issue 4 Pages 925-931
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 74-year-old man, who had resection of an early gastric cancer at the age of 71, had a screening colonoscopy in February 1999. The colonoscopy revealed three polypoid lesions approximately 5mm in diameter in the cecum, ascending colon and rectum. The polypoid lesions had superficial erosion on the surface. The specimen of a polypoid lesion obtained by endoscopic mucosal resection revealed diffuse infiltration of signet ring cell carcinoma between the normal tubules. Therefore, colonic metastasis from the previous gastric cancer was suggested based on comparison with histologic findings of the resected gastric cancer. Colonic metastasis from gastric cancer usually presents as linitis plastica or an annular stricture and polypoid colonic metastasis from gastric cancer is very rare. Herein, the authors report a case of colonic metastasis presenting as polypoid lesions from a previous early gastric cancer.View full abstractDownload PDF (8562K) -
Wataru SANO, Sachiko OHUCHI, Shinji YASO2004 Volume 46 Issue 4 Pages 932-937
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe report a case of primary MALT lymphoma of the papilla of Vater. A 42-year-old woman was admitted to our hospital for further examination of icterus and elevated serum levels of hepatic, biliary and pancreatic enzyme with complaints of appetite loss and abdominal fullness. Abdominal ultrasonography, computed tomography, magnetic resonance cholan-giopancreatography and upper gastro-intestinal endoscopy demonstrated a tumor of the papilla of Vater. Low-grade MALT lymphoma was diagnosed by biopsied specimen and its immuno-histochemical study. She was given an eradication of Helicobacter pylori, CHOP therapy and Rituximab and achived a complete remission. Primary duodenal MALT lymphoma is rare and, therefore, a large number of cases should be evaluated for treatment. However, it is thought that eradication therapy, chemotherapy and immunotherapy should be the first choice tried prior to surgical resection for patient's quality of life.View full abstractDownload PDF (7646K) -
Kazuo TAJIRI, Goki SUDA, Kaoru YUI, Junichi SATE, Chikara YAMAMOTO, Da ...2004 Volume 46 Issue 4 Pages 938-942
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn 87-year old woman with chronic renal failure Was admitted because of aggravation ofanemia and renal dysfunction. The patient passed massive bloody stools and went into shock.Calanoscapic examinations performed after blood transfusion were unsuccessful because ofpoor preparation.4days later, the third colonoscopy was performed after preparation byosmotic purge. Bleeding Dieulafoy's ulcer was recognized in the rectum. Five hernoclips wereapplied so as to ligate the ulcer and hemostasis was obtained. Endoscopic clipping is safe andeffective measure for the treatment of rectal Dieulafoy's ulcer.View full abstractDownload PDF (4676K) -
Keiki ISOGAI, Norihiro KATO, Reine MORIUCHI, Isao TARASAWA, Takashi YA ...2004 Volume 46 Issue 4 Pages 943-948
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 77-year-old woman underwent radical hysterectomy for erldometrial carcinoma in 2001.The pathological diagnosis was endometrioid adenocarcinoma with squamous differentiation(Grade 2). Two years and six months after the primary surgery, she was admitted to ourhospital for lower abdominal pain. The colonoscopy revealed submucosal tumor accompaniedwith ulceration on the surface in the rectum. The biopsy specimen revealed poorly differentiat-ed adenocarcinoma. Distant metastasis was not recognized by the other examination. wediagnosed this case as primary carcinoma of the rectum, and the surgical operation wasperformed. The tumor was composed of mostly cancer cells with solid growth pattern by thepathological finding. The pathological diagnosis of the colonic tumor was identified withendometrial carcinoma. We concluded metastatic carcinoma, localized to the rectum, fromendometrial carcinoma.View full abstractDownload PDF (8540K) -
Nobuhiko YAMAMOTO, Yoshio HOSHIHARA, Katuyoshi SHIDA, Shu HOTEYA, Tosh ...2004 Volume 46 Issue 4 Pages 949-954
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old woman in hemodialysis was referred to our hospital with a complaint ofanemia. Colonoscopic examination showed a subpedunculated polypoid lesion with oozing inthe ileum at a distance of 10 cm from Bauhin's valve, which was 7 mm in size and like asubmucasal tumor without epithelium. we judged that endoscopic resection was possiblebecause of that mobility. A polypectomy was performed. Histologically it was a capillaryhemangioma which consisted of proliferated thin vessels with the endothelial cells in a singlelayer. Capillary hemangioma of the small intestine is very rare. And this patient is the firstcase with hemangiama of the small intestine that was diagnosed by endoscapic poiypectomy.View full abstractDownload PDF (7327K) -
Atsuhiro MOCHIDA, Hiroki TAKAHASHI, Masahiro IWABUCHI, Hiroshi YOKOYAM ...2004 Volume 46 Issue 4 Pages 955-959
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old male was referred to our hospital for the further treatment of rectal stenosis occurred after bloody stools. Colonoscopy and barium enema demonstrated a pin-hole stenosis of the lower rectum. Under the diagnosis of ischemic proctitis, he had been treated by several sessions of endoscopic balloon dilatation and transanal dilatation with Hegar's dilator. After the treatment, the stenosis was improved and no recurrence had been observed for 6 months. This case showed that endoscopic balloon dilatation therapy and the following transanal dilatation with Hegar's dilator were effective for the stricture type of ischemic proctitis.View full abstractDownload PDF (6976K) -
Yoshinobu OKABE, Osamu TSURUTA, Hideya SUGA, Naoki FUKUDA, Yuki WADA, ...2004 Volume 46 Issue 4 Pages 960-965
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 41-year-old man with a pancreatic pseudocyst measuring approximately 10 cm in diameter located in the pancreatic tail was referred to our hospital for further evaluation and treatment. Conservative treatment failed and then endoscopic cystogastrostomy was performed. At the end of the procedure, the drainage tube was migrated into the pancreatic pseudocyst. The cyst was re-punctured and the migrated pig tailed tube end was caught by wire snare through dilator cannula. Successful replacement of the tube at proper position was made. This technique was effective for replacement and retrieval of such migrated tube.View full abstractDownload PDF (7627K) -
Yuichi TOMIKI, Akinori HIGASHIYAMA, Tsuyoshi OKADA, Tomoo WATANABE, Hi ...2004 Volume 46 Issue 4 Pages 966-971
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground: Rubber band ligation of internal hemorrhoids is a well established office procedure. In the meantime, endoscopic rubber band ligation of esophageal varices has become widely accepted. Combining and modifying the ideas of these techniques, we have conducted endoscopic hemorrhoidal ligation (EHL) since 1993, and we feel that it would be appropriate now to evaluate the procedure. Methods: 119 patients who were subjected to EHL were followed and evaluated. Results: EHL was markedly effective in 67 cases (56.3%), effective in 41 cases (34.5%), and ineffective in 11 cases (9.2%). Of the 11 ineffective cases, 3 of them received surgical hemorroidectomy and 8 were treated by conservative measures with frequent or continuous use of suppositories. The most common complications after EHL were postoperative anal pain and slight bleeding. Of 92 patients followed for a long term, the 5-year non recurrence rate was 90. 4%. Persistent therapeutic effects were observed in 62 patients (67.4%), whereas 22 patients (23. 9%) had to be treated by suppositories and/or ointments as necessary, and 8 patients (8.7%) had a relapse. Of the 8 relapsed cases, 4 received repeated EHL with symptomatic remission, 2 received hemorroidectomy, and 2 were treated conservatively. Conclusion : Endoscopic hemorrhoidal ligation is an effective method for treating internal hemorrhoids. However, the indication for the treatment should be properly decided in each patient, by the patient's history, general and local conditions.View full abstractDownload PDF (7526K) -
[in Japanese], [in Japanese], [in Japanese]2004 Volume 46 Issue 4 Pages 972-973
Published: April 20, 2004
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1114K)
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