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Volume 52, Issue 8
Displaying 1-12 of 12 articles from this issue
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Tetsuya MINE2010 Volume 52 Issue 8 Pages 1843-1848
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSPreviously, the numbers of pancreatic cystic lesions were apparently low. Recently, however, the numbers of pancreatic cystic lesions have been increasing. One of the reasons for this phenomenon is the development and prevalent use of new equipment. Pancreatic cystic lesions are divided into pseudocysts and true cysts. The majority of pseudocysts are pseudocysts with tumors and these are called “cystic degeneration”. In contrast, congenital true cysts are relatively few in number. In this paper, based on an explanation of IPMN (Intraductal papillary mucinous neoplasm), MCN (Mucinous cystic neoplasm) and SCN (Serous cystic neoplasm), the diagnosis of pancreatic cystic lesions is discussed.View full abstractDownload PDF (462K)
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Yasuhiro OONO, Hisashi NAKAMURA, Yosuke IRIGUCHI, Akihiko YAMAMURA, Mi ...2010 Volume 52 Issue 8 Pages 1849-1856
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSBased on the "Treatment Guidelines for Colorectal Cancer 2005 Edition", a new criterion for curative endoscopic treatment of submucosal cancer is "the submucosal invasion depth of the lesion is less than 1,000 μm". This study was designed to clarify the feature of the adaptation lesions, to examine the clinicopathological factor according to tumor distance, and the presence of vascular invasion (ly or v) by the submucosal invasion depth. As a result, (1) Lesions larger than 20 mm in diameter had a low EMR resection rate ; (2) As to the lesions with submucosal invasion of 300 to 1,000 μm, there was a high positive ratio of vascular invasion (28.9%). From this result, based on the new criterion for endoscopic treatment, it is important that the lump resection rate of lesions larger than 20 mm in diameter should be improved by endoscopic treatment, and the excision specimen is handled carefully to ensure an accurate histopathological diagnosis.View full abstractDownload PDF (1210K)
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Yutaka OKAMOTO, Yoshio SASAKI, Norito YAGIHASHI, Kiyonori YAMAI, Kazun ...2010 Volume 52 Issue 8 Pages 1857-1865
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSA 59-year-old man was admitted for examination of an esophageal polyp. Endoscopy revealed a 12mm light yellowish protrusion in the middle thoracic esophagus. Histopathological examination of the biopsy specimens taken from the lesion revealed a granular cell tumor. Endoscopic ultrasonography disclosed that the tumor was located in the lamina propria mucosae and extended into the submucosal superficial layer. We safely performed an endoscopic submucosal dissection, and the tumor was free from the vertical margins of the resected specimen. We report herein on the usefulness of endoscopic submucosal dissection for removal of an esophageal granular cell tumor.View full abstractDownload PDF (1136K) -
Jun TAGUCHI, Yoko ISHIBASHI, Nozomu SUGAI, Hideyuki SEKI, Atsuhiko MIU ...2010 Volume 52 Issue 8 Pages 1866-1873
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSA 75-year-old woman was hospitalized with dysphasia, appetite loss and sialorrhea. The chief complaint persisted despite treatment, and upper gastrointestinal endoscopy had not revealed significant findings. Endoscopic examination at our hospital showed erosion and ulceration of the esophagus and the stomach, which we treated as reflux esophagitis and gastritis. However, the symptoms were not alleviated, thus we suspected esophagus pemphigus. Later biopsy specimens of the esophagus revealed suprabasal acantholysis and immunofluorescent studies demonstrated IgG, IgA and C3 deposits. Serum levels of antidesmoglein 3 antibodies were elevated. Her skin and oral cavity were normal, but the above findings indicated a provisional diagnosis of esophagus pemphigus, and oral prednisolone (PSL) 30 mg per day was prescribed. The symptoms disappeared within a few days and the endoscopic findings also improved, so the PSL dosage was gradually reduced. The patient remains on 5.5 mg/day of PSL without disease recurrence. This condition was very difficult to diagnose because the symptoms indicated only esophagitis and gastritis. As far as we know, gastric pemphigus has not been described. However, we postulate that the gastritis was associated with the esophagus pemphigus in this patient because both of these conditions improved in parallel.View full abstractDownload PDF (1022K) -
Shin KUNII, Naoyuki ARAKAWA, Kota AOKI, Koichi ACHIWA, Minoru KUBOTA, ...2010 Volume 52 Issue 8 Pages 1874-1880
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSA 31-year old woman was admitted to our hospital with vomiting and backache. which had started within a week after her birth. After upper gastrointestinal endoscopy and upper gastrointestinal contrast study. she was diagnosed as having congenital duodenal web. Endoscopic membranectomy was performed successfully using a snare for polypectomy under general anesthesia. The only complication was bleeding from the site of the membranectomy observed on the 2nd postoperative day. which was successfully managed by electrocoagulation and clipping. The patient's symptoms such as vomiting and backache disappeared soon after the membranectomy. Although congenital duodenal web is rare in adults. it should be considered in the differential diagnosis for the patients with complaints of repeated vomiting. Endoscopic membranectomy seems to be safe. harmless. and most effective treatment. and can be expected to become the most common treatment for congenital duodenal web.View full abstractDownload PDF (876K) -
Kuniaki SASAKI, Rikiya SATO, Tomohiro HOSONO, Tadaaki NOGUCHI, Takahir ...2010 Volume 52 Issue 8 Pages 1881-1887
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSA 79-year-old woman who had been treated for gastric ulcer for a month was admitted to our hospital with sudden hypochondralgia. Emergency upper GI endoscopy revealed a fish bone which had penetrated the second portion of the duodenum. Abdominal computed tomography (CT) confirmed that the fish bone had penetrated to the retroperitoneum around the head of the pancreas, but no finding of peritonitis or abscess formation was detected. The fish bone was removed endoscopically. The fish bone was 36 mm long, and the patient's postoperative recovery was fortunately good. We report on this case together with a review of similar cases in the Japanese literature.View full abstractDownload PDF (858K) -
Nana NAKAYAMA, Shinji NAGATA, Mayumi KANEKO, Kenjirou SHIGITA, Mieko O ...2010 Volume 52 Issue 8 Pages 1888-1894
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSAn 82-year-old male suffered from long term watery diarrhea after taking lansoprazole. At first, there were no finding on colonoscopic examination, but one year later, colonoscopic findings showed a mucosal appearance with redness, and in the year after that, granulation and edema, at the proximal colon with indistinct vascular transparency. A colonic mucosal biopsy showed prominent subepithelial collagen band thickening, and so this case was diagnosed as collagenous colitis. The patient got relief from his diarrhea after only one week after changing lansoprazole to omeprazole. Colonoscopic and pathological findings were also improved after four months.View full abstractDownload PDF (1582K) -
Atsuhiro MASUDA, Hidetaka TSUMURA, Hiromu KUTSUMI, Toshio TANAKA, Hide ...2010 Volume 52 Issue 8 Pages 1895-1900
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSA huge pancreatic mass was seen on CT in a 55-year-old male, with a diameter of about 7 centimeters, and which was associated with abdominal and back pain after radiotherapy for a plasmacytoma of the left upper jaw. ERCP revealed narrowing of the main pancreatic duct and high levels of serum IgG were seen in this patient. An open biopsy was done, because it is necessary to distinguish pancreatic plasmacytoma from malignant lymphoma and autoimmune pancreatitis. Although pancreatic plasmacytoma is a rare disease, it should be considered as one of the differential diagnoses when there is a huge mass at the pancreas.View full abstractDownload PDF (1111K) -
Kazunari NAKAHARA, Yoshiki KATAKURA, Chiaki OKUSE, Minako KOBAYASHI, S ...2010 Volume 52 Issue 8 Pages 1901-1907
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSA 70-year old man visited our hospital with chief complaints of hematemesis and melena. His upper gastrointestinal endoscopic examination indicated an elevated lesion, which was considered to be formed by compression from outside the gastric wall, with a hemorrhagic ulcer in the posterior wall of the upper gastric body. Endoscopic hemostasis was successfully performed. Enhanced computed tomography of the abdomen showed a neoplastic lesion, which was approximately 90 mm in diameter and had invaded the stomach, in both the pancreas body and tail. A relationship between the elevated lesion with the hemorrhagic ulcer in stomach and the pancreatic neoplastic lesion was strongly suspected. Subsequently, an endoscopic biopsy of the tissues surrounding the ulcerous stomach lesion was performed, the specimens from which, on histopathological testing, showed anaplastic ductal carcinoma (pleomorphic type) of the pancreas. Anaplastic ductal carcinoma of the pancreas is known as a rare type of pancreatic ductal carcinoma. We report an interesting case of anaplastic ductal carcinoma of the pancreas diagnosed with an endoscopic biopsy of the perforated tissues into the stomach, the initial symptoms of which were hematemesis and melena.View full abstractDownload PDF (1176K)
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[in Japanese], [in Japanese], [in Japanese]2010 Volume 52 Issue 8 Pages 1908-1909
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSDownload PDF (390K)
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Satoru NONAKA, Yutaka SAITO, Ichiro ODA2010 Volume 52 Issue 8 Pages 1910-1918
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSIt is well known that carbon dioxide (CO2) is absorbed faster in the body than air and also rapidly excreted through respiration. With the relatively recent development and increasingly widespread use of endoscopic submucosal dissection (ESD) as a minimally invasive treatment, ESD for early gastrointestinal (GI) neoplasms in the esophagus, stomach and colorectum has risen dramatically. Quite naturally, the number of complications including perforations as well as procedure times have also increased during the technically more difficult ESD. CO2 insufflation can reduce abdominal pain and patient discomfort caused by bowel hyperextension, perforation-related subcutaneous/mediastinal emphysema and pneumoperitoneum. Although CO2 insufflation has been used in colonoscopy from the mid-1980s in Western countries, its use is still limited in Japan. We have recently reported that CO2 insufflation can be used as safely as air insufflation in ESD procedures in the esophagus, stomach and colorectum. Based on our results, we fully expect that CO2 insufflation will become a standard method for GI endoscopy.View full abstractDownload PDF (693K)
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[in Japanese]2010 Volume 52 Issue 8 Pages 1919
Published: 2010
Released on J-STAGE: March 03, 2011
JOURNAL FREE ACCESSDownload PDF (147K)
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