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Volume 62 (2020)
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Volume 50 (2008)
- Issue 12 Pages 2987-
- Issue 11 Pages 2805-
- Issue 10 Pages 2665-
- Issue 9 Pages 2443-
- Issue 8 Pages 1699-
- Issue 7 Pages 1557-
- Issue 6 Pages 1427-
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Volume 50, Issue 2
Displaying 1-11 of 11 articles from this issue
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Hideki KOGA, Takayuki MATSUMOTO, Mitsuo IIDA2008 Volume 50 Issue 2 Pages 189-198
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe reviewed the literature regarding the epidemiology, diagnosis and treatments of nonsteroidal nti-inflammatory drug (NSAID)-induced enteropathy. The prevalence of NSAIDs-induced enteropathy is higher than had been expected . Recent studies showed more than 50% of patients taking NSAIDs had some mucosal changes in the small intestine. The gross appearance of NSAID-induced enteropathy varies ; diaphragm-like strictures, deep ulcers resulting in perforation, round or oval ulcers, circular ulcers, hemorrhagic ulcers or erosions and mucosal redness. Capsule endoscopy and double-balloon enteroscopy are helpful for making a diagnosis of NSAID-induced enteropathy. To investigate NSAID-induced enteropathy simply, and to rule out other specific enteropathies, such modalities as radiological examination of the small intestine, the permeability test, scintigraphy or the fecal excretion test using 111In-labelled white blood cells, and measurement of the fecal calprotectin concentration are also useful in addition to these enteroscopic examinations. Misoprostol, metronidazole and sulf asalazine are frequently used to treat NSAID-induced enteropathy, but have undesirable effects in some cases. Therefore, prevention of NSAID-induced enteropathy with selective COX-2 inhibitors may be also important . In the future, the development of new drugs based on the possible mechanisms of NSAID-induced mucosal inflammation is expected. Diaphragm-like strictures and bleeding from mucosal breaks may be treatable with interventional enteroscopy.View full abstractDownload PDF (17282K) -
Tsuyotoshi TSUJI, Tatsuya MIKAMI, Shinsaku FUKUDA, Hidezumi KIKUCHI, D ...2008 Volume 50 Issue 2 Pages 199-205
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSBackground : The most common complication with colonoscopic polypectomy is hemor rhage that occurs within 24 hours after polyp removal. We often use clips to stop or prevent bleeding after polypectomy. In our experience, most clips usually detach within a week. There are no previous reports dealing with the outcomes of clip use. Furthermore, it has been unclear whether clips are truly effective especially in preventing hemorrhage. Therefore, in the present study the risk factors associated with bleeding after polypectomy were identitied and correlation between hemorrhages and the use of clips was determined. Methods : One hundred and sixty five cases were enrolled in our study. Colonoscopy was done on the day after polypectomy to determine it bleeding had occurred from the ulcers or the area around the ulcers. The number of clips that were still present was noted. The association of bleeding with the polyp's clinicopathological features, type of removal, and the parameters related to the clips was determined. Results : No patient had hematochezia prior to colonoscopy ; however, on post-procedure colonoscopy, 9 (2.9%) had oozing from ulcers and 39 (12.7%) had oozing from around ulcers. Hemorrhage risk factors included a positive biopsy, polyps 710 mm in size, piecemeal EMR, and the presence of bleeding episode during EMR. 87% of the clips were still present on the day post-procedure, and in the cases in whom the clips had detached coagulated areas were seen. Conclusions : After colonoscopic polypectomy patients must be assessed for bleeding. When using clips, it is necessary to grasp the visible vessels or the mucosa that surrounds the ulcers tightly : the vessel should not be dropped, since this can induce bleeding.View full abstractDownload PDF (10522K) -
Sadatoshi SUGAE, Chikara KUNISAKI, Satoko KAMEDA, Roppei YAMADA, Shins ...2008 Volume 50 Issue 2 Pages 206-211
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSAn 80-year-old man was diagnosed with a gastric cancer by an upper gastrointestinal endoscopy. Immunostaining of the biopsy specimen revealed a small cell carcinoma. Distal gastrectomy with D2 lymph node dissection was performed. Histopathological examination showed a gastric small cell carcinoma in conjunction with squamous cell carcinoma ; pTypeO-IIa+ IIc, 25 mm, pT2 (MP), ly3, v3, pN1, pStage II. A small cell carcinoma is difficult to diagnose preoperatively by usual biopsy. This case may suggest that immunostaning of the biopsy specimen could allow us to diagnose a small cell carcinoma of the stomach preoperatively.Gastroenterological EndoscopyView full abstractDownload PDF (8711K) -
Masako FUJIOKA, Masaaki DEGUCHI, Kazuo HIROSE2008 Volume 50 Issue 2 Pages 212-216
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 80-year-old woman was admitted to hospital with appetite loss. She was diagnosed as unresectable type-4 gastric cancer with invasion to the duodenum and pancreas head . The chemotherapy using TS-1 and paclitaxcel was performed. The therapy was effective for the tumor, and she complained no symptoms and could eat the meal sufficiently. Sixteen month later, however, the gastric tumor relapsed and invaded the descending and transverse part of the duodenum, resulting in lumen stricture, and she could not eat the meal. To treat the malignant duodenal stricture, we tried to insert a self-expandable metallic stent (EMS), by endoscopy under fluoroscopy-aided method. We successfully inserted EMS by applying the long overtube of the ileus-aid-system. After the insertion of EMS, she could eat rice porridge enough, again. Her condition recovered markedly, and performance status improved from grade 3 to 1. Thereafter five months, the duodenal stricture did not occur, until when she died of sepsis resulting from biliary and urinary infection. A case of unresectable scirrhous gastric cancer with duodenal stricture who was successfully treated with intestinal stent, resulting in marked improvement of quality of life was presented.as successfully treated with intestinal stent, resulting in marked improvement of quality of life was presented.View full abstractDownload PDF (8877K) -
Atsuhiko MURATA, Kazuya AKAHOSHI, Kazuhiko NAKAMURA2008 Volume 50 Issue 2 Pages 217-222
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 77-year-old woman was admitted to our hospital because of a hemorrhagic duodenal ulcer that had difficulty with endoscopic hemostasis and hemorrhage from right subclavian vein in which was inserted a central venous catheter. Coagulation tests showed a great prolongation of activated partial thromboplastin time (APTT) on admission . After admission, severe bleeding from the ulcer appeared, we performed endoscopic therapy by hypertonic saline epinephrine injection. Hemorrhage from right subclavian vein was stopped by astriction. Laboratory studies showed an extremely low factor uG activity and the presence of a very high titer factor uG inhibitor. She was diagnosed as acquired hemophilia A, and treated with oral prednisone, cyclophosphamide and intravenous methylprednisolone pulse therapy. After treat ment, activated partial thromboplastin time normalized and factor uG inhibitor disappeared . In case of gastrointestinal bleeding that had difficulty with endoscopic hemostasis, we should pay attention to the possibility of acquired hemophilia A .View full abstractDownload PDF (10643K) -
Akira IMOTO, Eijiro MORITA, Mitsuyuki MURANO, Sadaharu NOUDA, Yosuke A ...2008 Volume 50 Issue 2 Pages 223-229
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA17 year-old female was referred to our hospital because of purpura of lower extremities and abdominal pain. A provisional diagnosis of Henoch-Schonlein purpura (HSP) was made, and oral predonisolone was started. The abdominal pain persisted despite treatment, whereas upper gastrointestinal endoscopy and colonoscopy failed to reveal significant findings. Video capsule endoscopy was then performed, which also revealed no significant findings ; the dosage of predonisolon could be reduced immediately. We conclude video cupsule endoscopy is useful to determine the therapeutic strategy in cases with HSP when clinical symptoms are inconsist ent with conventional endoscopic findings.View full abstractDownload PDF (11852K) -
Shinji YAMAMOTO, Akira KUSUYAMA, Katsuhiko YANAGA2008 Volume 50 Issue 2 Pages 230-233
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA40-year-old man who had undergone appendectomy for acute appendicitis developed fecal fistula 11 days after operation. Conservative therapy failed, and colonoscopic clipping of the fecal fistula was performed 37 days after the initial operation. The fistula was successfully closed and the patient was discharged 16 days after clipping. Although enterocutaneous fistula after appendectomy is uncommon, some fistulas are intractable and often require reoperation. We suggest that the endoscopic approach is a good option for the treatment of intractable fistula that develops after appendectomy.View full abstractDownload PDF (8503K) -
Toru ISHIKAWA, Hiroteru KAMIMURA, Atsunori TSUCHIYA, Tadayuki TOGASHI, ...2008 Volume 50 Issue 2 Pages 234-241
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old man complaining of left leg edema was admitted to our hospital. Computed tomography and magnetic resonance imaging revealed a pancreatic tumor and retroperitoneal fibrosis. Endoscopic retrograde cholangiopancreatography showed an obstruction of the main pancreatic duct in the pancreas tail. He underwent a distal pancreatectomy with splenectomy, cohich revealed a histological diagnosis of autoimmune pancreatitis combined with retroperitoneal fibrosis. Corticosteroid therapy was started following operation. Corticosteroid therapy was effective for the autoimmune pancreatitis as well as for the retroperitoneal fibrosis. At present, twenty eight months after operation, the patient is on 10mg/day of predonisolone without disease recurrence.View full abstractDownload PDF (15857K) -
[in Japanese], [in Japanese], [in Japanese]2008 Volume 50 Issue 2 Pages 242-243
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (2308K) -
Naohiro WASHIZAWA, Yoko OSHIMA, Masashi WATANABE2008 Volume 50 Issue 2 Pages 244-249
Published: February 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSPercutaneous Transesophageal Gastrotubing (PTEG) has been popularized since Oishi developed rupture-free balloon (RFB) what makes safe for puncturing to esophageal cavity in 1994. The most important tip is the precise puncture to the center of RFB after visualizing the location of thyroid gland, cervical vessels, and RFB. And next important tip is the procedure that the guide-wire, the sheath dilator, and the catheter are taken to straight positions for prevention of dislocation. The catheter what was put regularly should be used for enteral nutrition and intestinal decompression.View full abstractDownload PDF (11397K) -
[in Japanese]2008 Volume 50 Issue 2 Pages 250-252
Published: 2008
Released on J-STAGE: January 29, 2024
JOURNAL FREE ACCESSDownload PDF (480K)
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