GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
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Volume 53, Issue 6
Displaying 1-12 of 12 articles from this issue
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  • CURRENT STATUS OF ENDOSCOPIC AND LAPAROSCOPIC TREATMENTS FOR MORBID OBESITY
    Masayuki OHTA, Teijiro HIRASHITA, Seigo KITANO
    2011 Volume 53 Issue 6 Pages 1591-1599
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1591
    JOURNAL FREE ACCESS
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    Currently, endoscopic and laparoscopic bariatric treatments for morbid obesity have been performed worldwide. The general indication is ≥ 40 kg/m2 BMI or ≥ 35kg/m2 BMI with severe comorbidities, but Asian bariatric surgeons have recently attempted to enlarge this indication. Nowadays, one endoscopic bariatric treatment which has been mainly performed is endoscopic intragastric balloon placement, and more recently, endoscopic duodenal-jejunal bypass sleeve (liner) and gastroplasty have been developed and the results reported. In Japan, about 100 patients with morbid obesity have annually undergone endoscopic and laparoscopic bariatric treatments. Although the endoscopic treatments are currently not equivalent to laparoscopic bariatric surgery in terms of the efficacy and continuity, they are expected to replace the surgery through the future development and innovation of new devices and technologies.
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  • MUCOSAL FINDINGS OF THE SMALL INTESTINE IN PATIENTS WITH PORTAL HYPERTENSION DUE TO LIVER CIRROSIS : A CAPSULE ENDOSCOPY STUDY
    Hideki MIZUNO, Takashi KAGAYA, Naoki OOISHI, Hajime TAKATORI, Tatsuya ...
    2011 Volume 53 Issue 6 Pages 1600-1608
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1600
    JOURNAL FREE ACCESS
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    Background : Video Capsule endoscopy (VCE) and double-balloon enteroscopy have made it possible to examine most parts of the small intestine. However the mucosal findings of the small intestine in patients with portal hypertension are unknown. The aim of this study was to evaluate the endoscopic features of the small intestine in patients with liver cirrhosis (LC) with VCE. Methods : Between July 2007 and October 2008, 30 patients (LC group ; 15 patients, control group ; 15 patients) were examined with VCE. The relation between endoscopic findings and clinical parameters was compared. Results : Edema, erythema, telangiectasias and angioectasia like lesions were significantly more frequent in the LC group (p<0.05). Lesions classified as vascular lesions were observed in 13 patients (86.7%). In 6 of 15 patients (40.0%), multiple lesions were detected all around the small intestine. The presence of these vascular lesions was not related to esophageal varices, gastric varices, portal hypertensive gastropathy, portal hypertensive colopathy, Child-Pugh class, or combined hepatocellular carcinoma. More patients with this endoscopic pattern had a previous history of varix bleeding (p<0.05). Conclusions : VCE is a safe and useful examination for patients with LC. It is necessary to establish the classification and the clinical significance of the portal hypertensive enteropathy through the accumulation of case data.
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  • A CASE OF GASTRIC INVOLVEMENT OF MULTIPLE MYELOMA OBSERVED BY MAGNIFYING ENDOSCOPY USING A NARROW-BAND IMAGING SYSTEM
    Hiroyoshi NAKANISHI, Yoshibumi KANEKO, Shinya YAMADA, Kazuyoshi KATAYA ...
    2011 Volume 53 Issue 6 Pages 1609-1616
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1609
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    Multiple myeloma(MM) is a neoplastic proliferation of monoclonal plasma cells that can result in osteolytic bone lesions, hypercalcemia, renal impairment, bone marrow failure, and the production of monoclonal gammopathy. When the plasma cells infiltrate outside the bone marrow it is known as extramedullary progression, which usually involves the reticuloendothelial system such as the liver, lymph nodes and the spleen. Involvement of the gastrointestinal tract is rare. There have been only a few endoscopic descriptions of gastric involvement of MM and there are no reports describing the findings of magnifying endoscopy using a narrow-band imaging system. We present a case of MM with gastric involvement observed using NBI endoscopy with magnification in addition to conventional white light endoscopy.
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  • A CASE OF IGG4 RELATED DISEASE SHOWING MORPHOLOGICAL AND HISTOLOGICAL CHANGE OF MAJOR DUODENAL PAPILLA AFTER STEROID THERAPY
    Akitoshi DOUHARA, Yoshio SUMIDA, Tasuku HARA, Yutaka INADA, Naohisa YO ...
    2011 Volume 53 Issue 6 Pages 1617-1625
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1617
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    A 77-year-old man with jaundice was referred to our hospital. We found elevated level of serum hepatobiliary enzymes, IgG, and IgG4. Imaging studies demonstrated a pancreas head mass, segmental narrowing of the main pancreatic duct with an irregular wall in the pancreas head, and strictures of the intrahepatic and extrahepatic bile duct. His major duodenal papilla was swollen on duodenoscopy during endoscopic retrograde cholangiopancreatography, and infiltration of abundant IgG4-positive plasma cells was detected in the biopsy specimens taken from the swollen papilla. We diagnosed IgG4-related sclerosing cholangitis with autoimmune pancreatitis. After steroid therapy, his jaundice and the swelling of the pancreatic head were relieved and the swollen papilla with the abundant infiltration of IgG4-positive plasma cells disappeared.
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  • GASTROINTESTINAL HEMORRHAGE DUE TO SORAFENIB IN TWO PATIENTS WITH ADVANCED HEPATOCELLULAR CARCINOMA
    Takao WATANABE, Yoichi HIASA, Masashi HIROOKA, Yoshiyasu KISAKA, Shiny ...
    2011 Volume 53 Issue 6 Pages 1626-1633
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1626
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    Two patients who had gastrointestinal hemorrhage due to Sorafenib are presented. In case 1, bloody stools occurred within 1 week after the Sorafenib treatment. The endoscopic findings revealed edematous and reddish changes in the duodenal mucosa. In case 2, bloody stools occurred 1 month after the Sorafenib treatment. Colonoscopic findings indicated similar mucosal change in the colon. The hemorrhagic points were difficult to detect in both cases. However, a quick improvement in the bloody stools after stopping Sorafenib intake suggested that the gastrointestinal hemorrhage was associated with Sorafenib treatment. The endoscopic mucosal findings in both cases would probably be characteristic of patients with gastrointestinal hemorrhage due to Sorafenib.
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  • A ROLE OF TRANSNASAL ENDOSCOPY IN DIAGNOSIS OF GASTRIC CANCER—A STUDY OF 3-YEAR EXPERIENCE—
    Hidenori KONDO, Ken HARUMA
    2011 Volume 53 Issue 6 Pages 1634-1639
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1634
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    Purpose : This study sought to elucidate the usefulness of transnasal endoscopy in the diagnosis of gastric cancer. Method : In order to examine the effectiveness, we used transnasal endoscopy with the Olympus GIF-N260 and GIF-XP260N in gastric cancer examinations, thorough medical checkups, and a general digestive disease clinic. Results : A total of 2085 cases of transnasal endoscopy was assessed from January 2006 to December 2008. We experienced 15 cases of early gastric cancer : male, 10 ; female, 5 ; mean age, 77.3 years ; M cancer, 12 cases ; and SM cancer, 3 cases. Conclusion : Our results suggested that transnasal endoscopy was useful in screening for gastric cancer.
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  • USEFULNESS OF PORTABLE ULTRATHIN ENDOSCOPY THROUGH THE PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TUBE (PART 1)
    Satoru ADACHI
    2011 Volume 53 Issue 6 Pages 1640-1645
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1640
    JOURNAL FREE ACCESS
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    Purpose : Percutaneous endoscopic gastrostomy (PEG) is widely used. However, there are concerns with adverse effects caused by improper PEG tube replacement. The usefulness of a portable ultrathin endoscope through the PEG tube was evaluated. Method : Ten outpatients (males 7, females 3 ; mean age of 61 years), who were treated with PEG tube feeding, were examined with the portable ultrathin endoscope. The tube sizes used included 20 to 24 Fr (Bumper-Button type). After an air injection adaptor (FUJI systems Co., Tokyo, japan) was connected to the PEG tube, the portable ultrathin endoscope (portable multiscope FP-7RBS2, PENTAX, Tokyo, Japan) was inserted into the tubes and observations were performed in the stomach. Result : In all the patients, it was easily recognizable that the PEG tube and internal bumper were in the stomach. There were no complications caused by this examination. Conclusion : This examination using the portable ultrathin endoscope may be useful in patients requiring PEG tube replacement. It can be easily and safely performed even at the bedside.
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  • TROUBLESHOOTING COMPLICATIONS ASSOCIATED WITH THE PERCUTANEOUS ENDOSCOPIC GASTROSTOMY TECHNIQUE
    Yoshihiro NAKATANI, Masami MATSUMOTO, Kiminori TSURO, Hiroto MORIYASU
    2011 Volume 53 Issue 6 Pages 1650-1663
    Published: 2011
    Released on J-STAGE: July 02, 2011
    DOIhttps://doi.org/10.11280/gee.53.1650
    JOURNAL FREE ACCESS
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    Percutaneous Endoscopic Gastrostomy (PEG) is one of the useful tools to perform enteral nutrition, and is now becoming a more popular procedure because of its ease of use and safety compared to other operative enteral nutrition techniques. However, complications associated with PEG is not so mild and problems during PEG can sometimes be fatal, because the patients needing PEG are tend to be elderly and many of them are suffering from several severe diseases. Therefore the establishment of appropriate troubleshooting techniques is eagerly anticipated. On the other hand, development of new devices improves the convenience and safety in PEG procedures, and so endoscopists who perform PEG must completely understand complications and accidental events in PEG and manage each patient with some special problems in the best possible way with the appropriate device in order to minimize PEG-associated troubles. It is quite natural that endoscopists should accept responsibility for all problems during PEG. In this review, we describe a concrete treatment technique and prevention strategies for major intraoperative PEG-associated problems.
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