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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 8
Displaying 1-11 of 11 articles from this issue
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Hisao FUJII2008 Volume 50 Issue 8 Pages 1699-1710
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSIn western countries, it has been well known that inflammatory bowel disease is a high risk group for colorectal cancer. In Japan, it has become a major clinical problem as the number of patients with ulcerative colitis (UC) increased gradually and the long-standing cases in-creased. In order to detect early colitis cancer dysplasia, several surveillance programs for patients with long-standing extensive UC have been proposed. Because it is endoscopically difficult to find out the "flat" dysplasia against the inflammatory mucosa, a series of more than 30 random biopsies is recommended. However, because magnifying chromoendoscopy has enhanced the ability to visually identify dysplasia/cancer, targeted biopsy, an alternate method of sampling doubtful lesions selectively has been discussed. Although colectomy is generally recommended in case that high-grade dysplasia or DALM (dysplasia associated lesion or mass) is detected as a result of the surveillance, controversy exists as to the proper management of low-grade dysplasia, and gastroenterologists may not fully understand the ramifications involved. Restorative proctocolectomies, subtotal colectomy and ileal-pouch anal anastomoses (IPAA) are widely each performed on surgery-candidates, and operative results are satisfac-tory. However, a few cases of dysplasia/cancer after IPAA were reported and, therefore, annual follow-up should be continued after colectomy. Prognosis of the early colitic cancer seems to be as good as ordinary colorectal cancer, hence enlightenment of the physicians as well as the patients may be a key to bringing the surveillance to successful completion.View full abstractDownload PDF (3843K) -
Youichi MIYAOKA, Erina KAKUTA, Yasumasa TADA, Kousuke HUKAZAWA, Goichi ...2008 Volume 50 Issue 8 Pages 1711-1717
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 74-year-old man was admitted to our hospital because of fever, general fatigue and epigastralgia. On admission, the patient presented with obstructive jaundice, cholangitis and pancreatitis. Endoscopic retrograde cholangiopancreatography (ERCP) was performed and showed a swelling of the papilla Vater with a partial erosion, an irregular filling of the distal common bile duct (CBD), and dilatation of CBD. Endoscopic retrograde bilirary drainage was performed. The biopsy spiecemen of the erosion on papilla showed well differentiated adenocarcinoma. A pyloric preserving pancreatduodenectomy (PPPD) was performed. His-tological diagnosis was adenosquamous cell carcinoma of the papilla Vater that was rare histological type. Pathological stage was III, pPancO, pDu3, pNO. Although adenosquamous cell carcinoma of the papilla Vater, in general, has a poor prognosis compared with other types of cancers of the papilla Vater. Our case, however, has had no recurrence for about four years after operation.View full abstractDownload PDF (7685K) -
Taishi HATA, Masayuki OHUE, Kimimasa IKEDA, Shinichi NAKATSUKA, Yasuo ...2008 Volume 50 Issue 8 Pages 1718-1722
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 28-year-old man was diagnosed with ulcerative colitis at 16-years-old and has been followed by a general practitioner. Right hypochondoralgia developed, and he was diagnosed with appendix cancer with multiple liver metastases. Surveillance of ulcerative colitis is important to indentity colitic cancer. However, detecting changes of the appendix is difficult. We recommend taking into account appendix cancer to identity early-stage tumors using colonoscopy.View full abstractDownload PDF (6929K) -
Ryosaku AZEMOTO, Takashi INKYO, Yu YOSHIDA, Sachio HATA, Akiyuki TAWAD ...2008 Volume 50 Issue 8 Pages 1723-1728
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 90-year-old woman was admitted with chest pain and vomiting. She had developed a gastric outlet obstruction (Bouveret's syndrome). On computed tomography and gastrointestinal endoscopy, a gallstone was found to be impacted in the duodenal bulb. The patient was successfully treated by a single session of electrohydraulic lithotripsy used with water-jet endoscopy. Since water-jet endoscopy provides a clear view during electrohydraulic lithotripsy of a gallstone impacted in the gastrointestinal tract, so it facilitates the procedure.View full abstractDownload PDF (8749K) -
Tomoaki YAMASAKI, Yukie KOHATA, Kennichi MORIMOTO, Eiji SASAKI, Osamu ...2008 Volume 50 Issue 8 Pages 1729-1735
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSWe describe a 19-year-old man who presented with epigastric pain and nausea. Laboratory data showed elevated liver enzymes and bilirubin. Abdominal X-rays revealed radio-opacity near the common bile duct and CT showed radio-opaque material in the gallbladder and common bile duct. The radio-opaque material presented with niveau. We diagnosed obstructive jaundice caused by limy bile in the common bile duct. Endoscopic sphincterotomy (EST) was performed and the limy bile was completely removed from the common bile duct. Limy bile in a young man is very rare, and EST was useful for removing this calcified sludge from the common bile duct.View full abstractDownload PDF (7193K) -
Hideyuki CHIBA, Kensuke KUBOTA, Masato YONEDA, Yasunobu ABE, Masahiko ...2008 Volume 50 Issue 8 Pages 1736-1742
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 75-year-old man was admitted to hospital due to epigastralgia and abnormal liver function tests. The serum IgG4 level was 601 mg/dl. The patient was f indlly diagnosed as having gastric cancer associated with autoimmune pancreatitis (AIP). The patient had gastric cancer surgery. Subseguently corticosteroid was given to treat the AIP. After the start of steroid therapy, move than 15 months ago, the patient is doing well on maintenance therapy. Furthermore, the infiltration of IgG4-positive plasma cells present in this patient's swollen duodenal papilla improved with corticosteroids therapy. This response supports the diagnosis of AIP.View full abstractDownload PDF (9763K) -
Makoto ABUE, Masaki SUZUKI, Hiroyoshi ONODERA, Shinichi SUZUKI, Yoshir ...2008 Volume 50 Issue 8 Pages 1743-1751
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSA 57-year-old male developed a serous cystadenoma (SCT) and an intracystic hemor-rhage. During 33 months of follow-up CT, MRI, and endosonographic images of the cyst showed that the cyst became smaller and the cyst wall became thicker. Since a cystic tumor could not be ruled out, a pylorus-preserving pancreatoduodenectomy was done. On histology the cyst wall of the resected specimen was found to consist of thick fibrous tissue, the mural nodules were identified as the cholesterin granuloma, and each cyst showed evidence of previous hemorrhage.View full abstractDownload PDF (12962K) -
[in Japanese], [in Japanese]2008 Volume 50 Issue 8 Pages 1752-1753
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDownload PDF (1401K) -
Shoichi SAITO, Hisao TAJIRI, Masahiro IKEGAMI2008 Volume 50 Issue 8 Pages 1754-1763
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSEndoscopic Imaging is divided into five categories by object-oriented classification. Narrow Band Imaging (NBI) and Auto-Fluorescence Imaging (AFT) are fit for the field of "Image-enhanced endoscopy". The new system for NBI and AFT is very easy to use, because these two modes of observation can be switched by pushing one button without complicated works and the image is displayed in real-time. In order to obtain clear findings, it is important to wash out the mucous covered on the mucosa. NBI makes it possible to emphasize the imaging of mucosal micro-vessels in superficial layer of colon tumors. As one of the benefits using NBI observation, it is thought to recognize easily neoplasia as a brownish area. In addition, it is useful to differentiate neoplasia from non -neoplasia. However, it is in the middle of a discussion on the diagnosis of depth of invasion to submucosal layer by observation of micro-vascular patterns. Meanwhile, a research on auto-fluorescence for neoplasms has been continued since more than 40 years ago. New AFT videoscope system (CF: FH260AZI) has equipped with two charged-coupled devices (CCD) ; one is for conventional observation by white light (WL) and the other for autof luorescence. Neoplasia or inflamed mucosa is shown as a magenta color by AFT observation. Our study suggested that AFT might be easily possible to distinguish neoplasia from non-neoplasia in the colon. In particular, it has a potential use for identifying small or flat tumors and tumor margins. However, further large studies should be performed to clarify the clinical impact of AF endoscopy, in addition to the basic analysis of fluorescent characteristics.View full abstractDownload PDF (13826K) -
Terumi KAMISAWA2008 Volume 50 Issue 8 Pages 1764-1768
Published: August 20, 2008
Released on J-STAGE: May 09, 2011
JOURNAL FREE ACCESSDiagnostic and therapeutic approach to the minor duodenal papilla including standardized technique was reviewed. In cases in which a pancreatogram is not achieved or those in which only a small portion of the ductal anatomy is visualized via the major duodenal papilla, cannulation of the minor papilla provides a second route of access to the ductal system. Successful minor papilla cannulation requires meticulous attention to technique. As the orifice of the minor papilla is usually of pinpoint size, needle-tipped catheters are useful. As minor papilla cannulation in pancreas divisum carries the risk of severe pancreatitis, the procedure should be performed with more caution. In some patients with pancreas divisum, an increased resistance to flow across the small orifice results in dorsal pancreatic duct hypertension and clinical symptoms including acute recurrent pancreatitis, chronic pancreatitis, and pancreatic-type pain. Pancreas divisum patients with acute recurrent pancreatitis are the best candidates for endoscopic management for dorsal-duct decompression including endoscopic minor papilla sphincterotomy and stenting.View full abstractDownload PDF (6145K) -
[in Japanese]2008 Volume 50 Issue 8 Pages 1769-1771
Published: 2008
Released on J-STAGE: January 29, 2024
JOURNAL FREE ACCESSDownload PDF (683K)
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