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Volume 53, Issue 4
Displaying 1-14 of 14 articles from this issue
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Hiroshi TAKAHASHI, Kuniyo HIRATA, Susumu SAWADA, Kazuhito YOSHIMOTO, F ...2011 Volume 53 Issue 4 Pages 1229-1240
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSThe major aim of medical screening for gastric cancer is of course to lower disease mortality. Early detection of gastric cancer allows the option of less invasive endoscopic treatment as an alternative to conventional surgery. Since endoscopic treatment greatly benefits the patients' quality of life, endoscopists should aim at diagnosing a lesion at the endoscopically treatable stage. In providing information for diagnosis, endoscopic examinations offer the advantage of visualizing the color changes of the lesions. These color changes are key indicators in the diagnosis of flat-type lesions typical of 0-IIb early gastric cancer, with redness, discoloration, and heterogeneous color changes serving as important findings. In particular, in cases of minute gastric cancer, these color changes are crucial indicators that allow detection of the lesion. It is necessary to pay attention not only to morphological changes, such as depression and elevation, but also to color changes as the key mucosal alterations allowing diagnosis of minute gastric cancer. The use of narrow band imaging (NBI) is expected to allow for more accurate diagnoses of minute gastric cancer.View full abstractDownload PDF (2082K)
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Nei SOMA, Nobuyuki SUGIURA, Yuji HATTORI, Taro AKIIKE, Kenji ITO, Asam ...2011 Volume 53 Issue 4 Pages 1241-1251
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSA 37-year-old man, who had been diagnosed as having Henoch-Schönlein Purpura (HSP) based on the presence of purpura on his lower extremities, was admitted to our hospital for severe abdominal pain, especially in the epigastric area. He was treated with steroids after admission and the pain was swiftly alleviated. We endoscopically observed active lesions of the stomach, duodenum and followed-up these lesions during the course of the illness. The most severe change was found in the antrum and the angular region of the stomach including mucosal congestion, redness, petechia, multiple ulcers, hemorrhagic blebs and a hematoma -like protru-sion. The appearance of the gastrointestinal lesions correlated with the illness in this patient's case. Recognizing these typical lesions in the right clinical circumstances is crucial for the early diagnosis of HSP presenting with predominantly GI symptoms. Endoscopy can be useful in the diagnosis of HSP, especially for patients without the typical skin rash.View full abstractDownload PDF (3648K) -
Kohei FUKUMOTO, Koichiro YASUI, Tomohisa TAKAGI, Koichi SOGA, Mika YOS ...2011 Volume 53 Issue 4 Pages 1252-1257
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSA 60-year man was admitted to our hospital with recurrence of hepatocellular carcinoma. Upper gastrointestinal endoscopy revealed an irregular gastric ulcer on the greater curvature of the upper body. Histological examination of biopsies from the margin of the ulcer showed mucosal infiltrations with inflammatory cells and the presence of cells positively stained with anti-cytomegalovirus (CMV) antibody, suggesting that the lesion was associated with CMV infection. The lesion was treated with a proton pump inhibitor for twenty-eight months, but it remains untreated though it has been reduced.View full abstractDownload PDF (889K) -
Hiroaki TAKABAYASHI, Naoto MIYAKE, Toshiyuki MISHIMA, Masato NAKAHORI, ...2011 Volume 53 Issue 4 Pages 1258-1265
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSA seventy-five year-old Japanese woman, complaining chiefly of dizziness, was found to be severely anemic following blood chemistry performed elsewhere, and was referred to our hospital for further evaluation. Esophagogastroscopy revealed an early gastric cancer in the gastric antrum and showed diffuse antral vascular ectasia (DAVE) around the cancer. After ESD (Endoscopic submucosal dissection) was performed for the former, the DAVE remaining in the antrum was treated with APC (argon plasma coagulation). This paper reports on a rare case of a gastric cancer with DAVE, with only two cases having been previously reported.View full abstractDownload PDF (1650K) -
Akifumi FUKUI, Yuji NAITO, Osamu HANDA, Kazuhiko UCHIYAMA, Tomohisa TA ...2011 Volume 53 Issue 4 Pages 1266-1271
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSThe most serious complication of video capsule endoscopy (VCE) is retention of the capsule in the small intestine. Although the usefulness of balloon endoscopy to retrieve the retained capsule has been reported, the need for surgical intervention due to difficulty in retrieving the capsule has also frequently been reported in the clinical field. In the present study, we report on the usefulness of double-balloon endoscopy (DBE) combined with an ileus cannula (the triple balloon method) for retrieving the trapped capsule in the case of intestinal narrowing due to Crohn's disease.View full abstractDownload PDF (549K) -
Chise KODAIRA, Satoshi OSAWA, Masafumi NISHINO, Yasuhiro TAKAYANAGI, M ...2011 Volume 53 Issue 4 Pages 1272-1277
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSA 36-years old man was referred to our hospital with obscure gastrointestinal bleeding (OGIB). Capsule endoscopy (CE) was performed to investigate the existence of small bowel disease, and the capsule became entrapped at a stenosis in the ileum due to Crohn's disease which was diagnosed thereafter. It was difficult to retrieve the retained capsule by the conventional method of anterograde or retrograde double-balloon enteroscopy (DBE). We re-performed anterograde DBE combined with a nasogastric long tube that was inserted three days before the DBE procedure. By using the nasogastric long tube, shortening the small bowel and reducing an intraluminal pressure of the bowel helped DBE procedure and retained capsule was successfully retrieved. Our method, the “triple-balloon method”, using anterograde DBE combined with nasogastric long tube, is expected to improve the retrieval-rates of capsule retention.View full abstractDownload PDF (917K) -
Takaya YAMAGUCHI, Naoki INATSUGI, Shusaku YOSHIKAWA, Tsutomu MASUDA, H ...2011 Volume 53 Issue 4 Pages 1278-1287
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSIn patients with longstanding ulcerative colitis (UC), the risk of developing colorectal cancer (CRC) increases steadily and cancer surveillance is widely recommended. We herein report on four cases of early CRC associated with UC, and in every case we could detect the lesions endoscopically and perform the operation successfully. The type IV like pit pattern, called the neoplastic pit pattern of ulcerative colitis (NPUC), was a particularly important indicator to recognize CRC and dysplasia. However, in many cases, to detect flat neoplastic lesions is still difficult in spite of remarkable progress in endoscopic techniques : therefore, further studies are necessary for accurate diagnosis of the lesions. In surveillance colonoscopy, when we can acquire an exact method of finding the lesions, surveillance by targeted biopsies will be more efficient than by non-targeted random biopsies.View full abstractDownload PDF (1967K) -
Kiyoshi AZAKAMI, Masaaki NAMOTO, Yoshitaka HATA, Kouji MUKAI, Yousuke ...2011 Volume 53 Issue 4 Pages 1288-1294
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSA 63-year-old woman was referred to our hospital for further examination of a rectal submucosal tumor (SMT), which had been discovered by her family doctor. Colonoscopy revealed a solid tumor of 10 mm in diameter covered with normal mucosa at the Rb region of the rectum, indicating it was an SMT such as GIST or leiomyoma. In order to make a final diagnosis of the exact type of SMT, some portion of the SMT was exposed by incising the mucosa covering the lesion, which was followed by a direct vision biopsy using conventional biopsy forceps. The quality and quantity of the biopsy specimen was good enough for pathologists to make a final diagnosis of GIST.
A surgical procedure was subsequently carried out. Primary rectal GIST is considered to have a relatively worse prognosis compared to GIST observed in other area of the gastrointestinal tract. It is also very hard to complete a surgical procedure without affecting defecation function when GIST is advanced. It would be, therefore, very important to diagnose a rectal GIST as early as possible. We therefore propose that direct vision biopsy with an incision of the mucosa covering an SMT can be a very useful technique to make an early diagnosis of rectal GIST.View full abstractDownload PDF (890K) -
Toshihiko MATSUMOTO, Masahiro TAKATANI, Yousuke YAGI, Kou MIURA, Yuusa ...2011 Volume 53 Issue 4 Pages 1295-1302
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSWe present the case of a 72-year-old woman who was attending our hospital for hepatitis C virus-related cirrhosis. She developed fresh bloody stools in April 2007 and proctoscopy revealed a rectal varix from the rectosigmoid to the anal verge. Variceal bleeding was diagnosed and radiologic intervention was performed. We performed a mini-laparotomy under general anesthesia, and embolized the superior rectal vein. There was no recurrence of bleeding until the patient ultimately died from hepatic insufficiency. In conclusion, we report on a case of rectal variceal bleeding successfully controlled using intravascular embolization.View full abstractDownload PDF (1090K)
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Tomonori MATSUMOTO, Tetsuro INOKUMA, Naoto SHIMENO, Satoko INOUE, Naoy ...2011 Volume 53 Issue 4 Pages 1303-1309
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSTo investigate the influence of human immunodeficiency virus (HIV) infection on the clinical course of amebic colitis, we retrospectively examined a consecutive series of nineteen patients diagnosed as having amebic colitis in our hospital from 2005 until 2009. Colonoscopy revealed more wide-ranging erosions or ulcers in HIV infected patients than in HIV uninfected patients, and HIV infected patients also suffered from cytomegalovirus colitis at a higher rate. This study suggests that examination and selection of treatment considering HIV infection and cytomegalovirus colitis as complications are important in clinical practice for amebic colitis.View full abstractDownload PDF (736K)
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[in Japanese], [in Japanese], [in Japanese], [in Japanese]2011 Volume 53 Issue 4 Pages 1310-1311
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSDownload PDF (414K)
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Hirofumi KOGURE, Hiroyuki ISAYAMA, Takeshi TSUJINO, Suguru MIZUNO, Tak ...2011 Volume 53 Issue 4 Pages 1312-1319
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSAlthough endoscopic plastic stent placement is useful and safe for biliary strictures, the high stent occlusion rate and short stent patency remain important problems. Stent occlusion is caused by food impaction and sludge formation due to the reflux of duodenal contents into the bile duct. The inside stent, which is stent placement above the intact sphincter of Oddi, has been invented to retain the function of the sphincter of Oddi and to prevent the reflux of duodenal contents. In Japan, inside stents are employed for biliary strictures after living-donor liver transplantation and malignant biliary strictures, and favorable outcomes have been obtained. Although the design of the inside stent needs to be improved to reduce the risk of migration and to facilitate stent removal, the inside stent is expected to decrease the risk of ascending infection and to prolong the duration of stent patency. However, the development of more simplified, safer and dedicated devices is indispensable so that inside stents may become widespread. Moreover, a randomized, controlled trial of the inside stent compared with conventional stent placement is mandatory to evaluate the efficacy and safety of inside stents.View full abstractDownload PDF (762K)
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[in Japanese]2011 Volume 53 Issue 4 Pages 1320-1322
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSDownload PDF (225K)
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[in Japanese]2011 Volume 53 Issue 4 Pages 1323
Published: 2011
Released on J-STAGE: June 14, 2011
JOURNAL FREE ACCESSDownload PDF (144K)
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