GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Search
Advanced search
OR
Browse
Search
Volume 54, Issue 4
Displaying 1-13 of 13 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
  • LAPAROSCOPIC FINDINGS FOR NASH (Non Alcoholic Steato-Hepatitis)
    Naohide TANAKA, Mitsuhiko MORIYAMA
    2012 Volume 54 Issue 4 Pages 1435-1442
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1435
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Currently, as a cause of liver cirrhosis and hepatocellular carcinoma, Non Alcoholic Steato-Hepatitis, NASH) is close behind hepatitis B or C. As necessary criteria in a diagnosis of NASH the patient must not be an alcohol drinker as that would cause alcoholic liver injury and pathological findings from in liver biopsies should show severe fatty change, inflammatory cell infiltration, ballooning of liver cell, Mallory bodies, and fibrosis resembling alcoholic liver injury. NASH presents various disease states according to the progression of the disease, which can be observed via the laparoscope. In the early stage of NASH, the liver surface appears flat with marginal dullness and a few depressed lesions, and lymphatic microcysts or reddish marking are absent. However, as inflammation increases, the reddish marking becomes apparent. In the cirrhosis stage, micronodules can be observed on the liver surface, and as the disease develops, lymphatic microcysts appear. It would appear that laparoscopy is a useful tool to obtain a more precise diagnosis and assess the progression of NASH.
    View full abstract
    Download PDF (4117K)
  • EXAMINATION ABOUT THE MALLORY-WEISS TEAR AS THE ACCIDENT OF ESD
    Koichiro KAWANO, Yoshitaka NAWATA, Koichi HAMADA, Hiroko TAJIMA, Noriy ...
    2012 Volume 54 Issue 4 Pages 1443-1450
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1443
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Recently, endoscopic submucosal dissection (ESD) has become established as a curative standard treatment for early gastric carcinoma without metastasis. As bleeding and perforation are well known as complications, the Mallory-Weiss tear is also one of the serious complications that accidentally occurs during the procedure. However, there has been no clear evidence of that so far. In the presents study, we investigated the features of Mallory-Weiss tears that occurred during gastric ESD procedures at our hospital. We performed 207 cases of gastric ESD for early gastric carcinoma and Mallory-Weiss tears occurred in 7 cases (3.4%). We could not complete the treatment in 2 cases, because the lacerated wound extended to the cancerous lesion in one case (14.3%) and the lacerated wound caused perforation of the gastric wall in the other case (14.3%). Retrospectively, we did push the endoscope during the procedure in all 7 cases. In these 7 cases, the patient's body mass index (BMI) was significantly lower than that of other cases, and this suggested that a lower BMI (below 18.5) could be a risk factor for Mallory-Weiss tears during gastric ESD. As the Mallory-Weiss tear sometimes can be a serious complication associated with gastric ESD, it is important to handle the endoscope gently especially for patients at high risk for this complication, such as those with a low BMI.
    View full abstract
    Download PDF (3112K)
  • AN ADULT CASE OF CONGENITAL ESOPHAGEAL STENOSIS MARKEDLY IMPROVED WITH ENDOSCOPIC BALLOON DILATATION THERAPY
    Tsutomu IWASA, Kazuhiko NAKAMURA, Akira ASO, Hiroyuki MURAO, Yoichiro ...
    2012 Volume 54 Issue 4 Pages 1451-1456
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1451
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 67-year-old man was admitted to our hospital with dysphagia. A barium meal examination revealed lower esophageal stenosis and endoscopic ultrasonography revealed circumferential esophageal mucosal hypertrophy. He had had symptoms of dysphagia from his babyhood, therefore, we diagnosed congenital esophageal stenosis. Endoscopic balloon dilatation therapy was performed and his symptoms improved markedly. Although most of cases of congenital esophageal stenosis are diagnosed in childhood, there are some cases which have been diagnosed in adult. We therefore need to pay attention to the possibility of this disease during examination of patients with dysphagia.
    View full abstract
    Download PDF (3348K)
  • A CASE OF GASTROINTESTINAL LESIONS PRODUCED BY SULFUR TUFT POISONING WHEREIN GASTROINTESTINAL CHANGES WERE ALSO FOLLOWED UP ENDOSCOPICALLY
    Renma ITO, Yoshibumi KANEKO, Hiroyoshi NAKANISHI, Kunihiro TSUJI, Naoh ...
    2012 Volume 54 Issue 4 Pages 1457-1463
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1457
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 60-year-old man developed vomiting and abdominal pain 30 min after eating sulfur tuft mushrooms (Hypholoma fasciculare) and was brought to our hospital. The symptoms resolved on hospital day 2, but he again developed vomiting and abdominal pain together with tarry stools on hospital day 3. Upper gastrointestinal endoscopy on hospital day 4 showed continuous and circumferential redness, edema, erosions, and hemorrhage from the superior duodenal angle to the descending part of the duodenum. The symptoms resolved over time with conservative treatment. Endoscopy on hospital day 9 showed no evidence of hemorrhage, but a granular mucosa and linear ulcers were found in the descending part of the duodenum. The patient was discharged from the hospital on hospital day 14 after his symptoms had resolved. Endoscopy after hospital discharge showed only linear scars. There are few reports of gastrointestinal lesions produced by mushroom poisoning. Therefore, we believe that our case, in which the gastrointestinal changes were also followed up endoscopically, is noteworthy.
    View full abstract
    Download PDF (3155K)
  • A CASE OF PRIMARY RECTAL FOLLICULAR LYMPHOMA
    Takeshi TOMODA, Atushi IMAGAWA, Yuki MORITO, Ichiro SAKAKIHARA, Tsuyos ...
    2012 Volume 54 Issue 4 Pages 1464-1469
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1464
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    We report a case of follicular lymphoma in the rectum. A 77-year-old man was referred to our hospital for further examination following a positive fecal occult blood test. Colonoscopy showed a flat elevated lesion 15 mm in diameter at the rectum. Histological examination of the specimen obtained by forceps biopsy led to the suspicion of follicular lymphoma. Intraluminal ultrasonography revealed a mass having a hypoechoic area in the 3rd layer of the wall. The tumor was limited to the rectum without any metastasis. We performed endoscopic submucosal dissection (ESD) for both diagnosis and treatment. Histopathological assessment of the resected specimens revealed that the tumor was a follicular lymphoma.
    View full abstract
    Download PDF (4258K)
  • TREATMENT OF A COMPLETE ANASTOMOTIC OBSTRUCTION AFTER HIGH ANTERIOR RESECTION WITH ENDOSCOPIC INCISION AND BALLOON CATHETER DILATATION WITH HYPOTONIC DUODENOGRAPHY CATHETER
    Yoki FURUTA, Hiroyuki EGUCHI, Syuji TADA, Yuji YAMAGUCHI, Kazuaki SUGI ...
    2012 Volume 54 Issue 4 Pages 1470-1476
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1470
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    An 84-year-old man underwent a colostomy for an intestinal obstruction arising from sigmoid colon cancer. As the second phase, he underwent high anterior resection, and the artificial anus was not closed. Nine months after the surgery when closure of the artificial anus was considered, complete obstruction of the anastomotic site was observed and an endoscopic incision and dilatation were conducted. Intestinal perforation was considered as a potential complication, however, linear visualization of the proximal and distal intestinal tract at the site of obstruction was possible using a balloon catheter for hypotonic duodenography during the procedure. The obstructed site was incised using a flex knife, followed by endoscopic balloon dilatation, which achieved good patency. Accordingly, the artificial anus was closed and the patient demonstrated appropriate defecation following the operation. This case is an example in which endoscopic incision and dilatation were safely and successfully conducted for a complete anastomotic obstruction.
    View full abstract
    Download PDF (3926K)
  • A CASE OF AN ACUTE HEMORRHAGIC RECTAL ULCER WITH SYSTEMIC LUPUS ERYTHEMATOSUS TREATED WITH ETHANOL INJECTION AND AETHOXYSKLEROL SCLEROTHERAPY
    Taku TABATA, Kouichi KOIZUMI, Go KUWATA, Takashi FUJIWARA, Hideto EGAS ...
    2012 Volume 54 Issue 4 Pages 1477-1484
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1477
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 46-year-old female with systemic lupus erythematosus was referred to our hospital for the investigation of hematochezia. Colonoscopy revealed an acute hemorrhagic rectal ulcer, which was thought to be due to long-term recumbency, chronic renal failure, diabetes and constipation. Although the usual endoscopic treatment was not effective, ethanol injection and endoscopic sclerotherapy with aethoxysklerol® was effective. Ethanol and aethoxysklerol injection can be a good treatment for cases of intractable acute hemorrhagic rectal ulcer.
    View full abstract
    Download PDF (3983K)
  • A CASE OF TUBERCULOUS PERITONITIS DIAGNOSED BY QUANTIFERON®TB-2G, EXPLORATORY LAPAROSCOPY, AND BIOPSY
    Shinsuke HIRAMATSU, Kiyohide KIOKA, Hirotsugu MARUYAMA, Takehisa SUEKA ...
    2012 Volume 54 Issue 4 Pages 1485-1489
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1485
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 70-year-old man with dysuria was suspected of having ascites and was referred to our hospital for further examinations. The patient had no history of ascites-related symptoms. Blood test results were normal, with slight elevation of C-reactive protein (CRP) and cancer antigen 125 (CA125) levels. Abdominal echocardiography and computed tomography showed no focal lesions except low to moderate rates of ascites. Upper gastrointestinal endoscopy and colonoscopy also revealed no causative lesion. The levels of adenosine deaminase (ADA) and CA125 in the ascites were high and the tuberculin and QuantiFERON®TB-2G (QFT) tests were positive. Thus tuberculous peritonitis was suspected. The final diagnosis of tuberculous peritonitis was made on the basis of laparoscopic biopsy findings. Tuberculous peritonitis is rare ; hence, it is difficult to diagnosis this condition on the basis of clinical findings and examinations. We found that the combination of QFT and exploratory laparoscopy was useful in diagnosing tuberculous peritonitis.
    View full abstract
    Download PDF (2242K)
  • SELF-LIMITING RISK OF METACHRONOUS GASTRIC CANCERS AFTER ENDOSCOPIC RESECTION
    Masaaki KOBAYASHI, Rintaro NARISAWA, Yuichi SATO, Manabu TAKEUCHI, Yut ...
    2012 Volume 54 Issue 4 Pages 1498-1505
    Published: 2012
    Released on J-STAGE: May 28, 2012
    DOIhttps://doi.org/10.11280/gee.54.1498
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Background : Since endoscopic resection (ER) has been established as a treatment for early gastric cancer, metachronous multiple cancers have become a problem. It is unclear whether the risk of metachronous cancer is self-limiting or permanent. The aim of this study was to evaluate the incidence of multiple cancers after ER during a long-term follow-up study.
    Patients and Methods : A total of 234 patients who received initial ER for early gastric cancers were evaluated retrospectively. ER included endoscopic mucosal resection and endoscopic submucosal dissection. Patients were followed up with endoscopy for 3.0-19.6 years (median, 5.0 years), including 40 patients surveyed for more than 10 years. Accessory cancers detected after ER, but which could be retrospectively viewed in pre-ER pictures, were evaluated in the metachronous group.
    Results : Thirty patients (12.8%) developed 36 metachronous multiple cancers. The median interval between the discovery of metachronous cancer and the initial ER was 3.2 years ; the longest interval was 9.7 years. Eight (22.2%) of the 36 metachronous cancers could be detected retrospectively in the picture record from pre-ER. The Kaplan-Meier curve of cumulative incidence of metachronous cancers stopped increasing after 10 years of follow up.
    Conclusions : Although the residual gastric mucosa after ER is thought to be a high-risk environment, the high risk may only be the result of occult synchronous cancers. It is probable that the high risk of metachronous cancers is not continuous after 10 years.
    View full abstract
    Download PDF (2313K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top