GASTROENTEROLOGICAL ENDOSCOPY
Online ISSN : 1884-5738
Print ISSN : 0387-1207
ISSN-L : 0387-1207
Search
Advanced search
OR
Browse
Search
Volume 57, Issue 11
Displaying 1-12 of 12 articles from this issue
Show all abstracts
    • |<
    • <
    • 1
    • >
    • >|
  • ENDOSCOPIC FINDINGS OF ESOPHAGEAL MOTILITY ABNORMALITIES
    Shiko KURIBAYASHI, Hiroko HOSAKA, Akiyo KAWADA, Junichi AKIYAMA, Yasuy ...
    2015 Volume 57 Issue 11 Pages 2503-2512
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2503
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Esophageal manometry is necessary for diagnosing esophageal motility disorders ; however, the number of hospitals in which esophageal manometry is performed is limited in Japan. Endoscopy is important for ruling out organic diseases, such as esophageal carcinoma, during the diagnostic process of esophageal motility disorders in which the endoscopic procedure is performed as the first step. Since there are some cases in which esophageal motility abnormalities can be detected by endoscopy, endoscopic findings of esophageal motility abnormalities should be noted.
    View full abstract
    Download PDF (2388K)
  • PYOPNEUMOTHORAX AFTER ENDOSCOPIC SUBMUCOSAL DISSECTION PERFORMED WITH THE PATIENT IN THE RIGHT LATERAL POSITION FOR EARLY GASTRIC CANCER OF THE FORNIX
    Yasuhiro MITSUI, Shinji KITAMURA, Koichi OKAMOTO, Naoki MUGURUMA, Jins ...
    2015 Volume 57 Issue 11 Pages 2513-2518
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2513
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    An 80-year-old man consulted a primary care physician for medical checkup. Esophagogastroduodenoscopy (EGD) demonstrated an elevated lesion at the fornix of the stomach and he was referred to our hospital for further investigation. The lesion was diagnosed as early gastric cancer and endoscopic submucosal dissection (ESD) was performed. While the patient was in the left lateral position, it was difficult to approach the lesion tangentially with the endoscope. Therefore, we performed ESD with the patient in the right lateral position with an over-tube. On the first postoperative day, the patient developed a high-grade fever and respiratory failure. Computed tomography (CT) demonstrated a right pyopneumothorax and aspiration pneumonia. He recovered with antibiotics, steroids and thoracic drainage. We reported the efficacy of ESD with the patient in the right lateral position for early gastric cancer at the fornix. However, this position may induce severe respiratory infections.
    View full abstract
    Download PDF (4451K)
  • RUPTURE OF SMALL INTESTINAL VARICES TREATED BY ENDOSCOPY
    Kazuhiro MATSUMOTO, Masashi FUKUSHIMA, Yohei TANIGUCHI, Masaya WADA, S ...
    2015 Volume 57 Issue 11 Pages 2519-2523
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2519
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 56-year-old man was admitted to our hospital because of passage of tarry stools. He had undergone gastrectomy for a duodenal ulcer previously and he had had repeated exacerbation of chronic pancreatitis. Gastrointestinal endoscopy and colonoscopy were performed, but the source of bleeding could not be identified. Computed tomography demonstrated splenic vein emboli and small intestinal varices. We thought that the varices were the source of bleeding. The drainage vein of the varices was not identified. We could not perform interventional radiography. Therefore, we performed capsule endoscopy and double balloon endoscopy, but we could not detect the varices. For diagnosis and treatment, we performed gastrointestinal endoscopy again. We detected small varices near the anastomosis site and carried out endoscopic band ligation and injection of polydocanol. Symptomatic remission was attained, and no recurrence of gastrointestinal hemorrhage has occurred over the past one year. We consider that endoscopic therapy may be a good treatment modality for small intestinal varices.
    View full abstract
    Download PDF (1569K)
  • AN ELDERLY CASE OF CROHN'S DISEASE PRESENTING AS HEPATIC PORTAL VENOUS GAS
    Wataru JOMEN, Hiroyuki KURODA, Shigeyuki FUJII, Masahiro MAEDA, Masano ...
    2015 Volume 57 Issue 11 Pages 2524-2530
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2524
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    A 72-year-old man was admitted to our hospital with the complaint of abdominal pain. CT showed inflammation in the ileocecum and hepatic portal venous gas ; neither intestinal necrosis nor perforation was observed. Therefore, he was admitted to our hospital for conservative treatment. Since his clinical course was satisfactory after admission, he was discharged. However, he returned to visit our hospital one week later with the main complaint of abdominal pain. Since CT showed a small intestinal obstruction starting from the ileocecum, he was readmitted to our hospital. After insertion of an ileus tube to reduce intestinal pressure, he underwent colonoscopy which revealed a longitudinal ulcer and obstruction at the terminal ileum. Upon examination of biopsy samples obtained from the ulcer, he was diagnosed as having Crohn's disease. There have been few reports on elderly-onset Crohn's disease, and hepatic portal venous gas in patients with Crohn's disease is rare.
    View full abstract
    Download PDF (3849K)
  • ENDOSCOPIC FEATURES OF THREE CASES OF NON-OCCLUSIVE MESENTERIC ISCHEMIA
    Yutaro IHARA, Kazuoki HIZAWA, Kouhei FUJITA, Tomoki NITAHATA, Kozue HI ...
    2015 Volume 57 Issue 11 Pages 2531-2536
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2531
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    We herein describe endoscopic features of three patients with non-occlusive mesenteric ischemia (NOMI). A 79-year-old man underwent a right hemi-colectomy because of the development of NOMI, despite normal findings on colonoscopy 31 hours earlier. The second patient was an 89-year-old man who presented with bloody diarrhea 10 hours after respiratory shock due to aspiration pneumonia. Colonoscopy revealed congested purple-colored or hyperemic edematous mucosa from the transverse colon to the ileum. The third patient was an 89-year-old woman who recovered from NOMI with conservative therapy although abdominal CT images had depicted extended thickening of the right colon with portal vein gas. On colonoscopy performed 15 days after presentation, multiple longitudinal or various-shaped ulcers with edematous mucosa were scattered from the ascending to descending colon, and the ulcers were not completely scarred six months later.
    View full abstract
    Download PDF (5877K)
  • A CASE OF DEPRESSED-TYPE (O-IIC) SQUAMOUS CELL CARCINOMA IN SITU AT THE ANAL CANAL RESECTED BY ENDOSCOPIC SUBMUCOSAL DISSECTION AS EXCISIONAL BIOPSY
    Shun-ichiro OZAWA, Hiroshi YASUDA, Yoshinori SATO, Shinya ISHIGOOKA, K ...
    2015 Volume 57 Issue 11 Pages 2537-2542
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2537
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    An 81-year-old woman presented to our hospital with positive fecal occult blood test. Colonoscopy (CS) detected a small polyp at the sigmoid colon. Follow-up CS performed one year later revealed an irregular flat depressed lesion of 25mm in diameter at the anal canal. Endoscopic biopsy revealed squamous cell carcinoma. The depressed lesion became more evident with indigo carmine spraying, and was depicted by narrow band imaging (NBI) as a brownish area. Magnifying endoscopy (ME) with NBI of the depressed area revealed irregular blood vessels, which resembled irregular intra-epithelial papillary capillary loop (IPCL) in the esophagus squamous cell carcinoma lesion. These tumor vessels were generally equivalent to B type vessel in the Japan Esophageal Society ME Classification. The anal border, which was close to the dentate line, was well demarcated on NBI. The lesion showed no apparent rigidity endoscopically, and its shape changed smoothly by air inflation. These observations indicated that the lesion was a mucosal carcinoma ; therefore, we performed en bloc resection of the tumor by endoscopic submucosal dissection (ESD). The tumor was 0-IIc type and 24mm in diameter. The pathological diagnosis was squamous cell carcinoma, pTis, ly0, v0, VM (-), HM (-).
    The frequency of anal canal cancer among colon cancers is 0.8% according to past literatures. Most of them are adenocarcinomas ; squamous cell carcinoma is relatively rare. To our knowledge, this is the first report of depressed-type squamous cell carcinoma at the anal canal, which was treated by ESD.
    View full abstract
    Download PDF (4508K)
  • KEY POINTS OF THE TECHNIQUE OF THE ENDOSCOPIC HEALING METHOD USING POLYGLYCOLIC ACID SHEET AND FIBRIN GLUE FOR ARTIFICIAL GASTRO-INTESTINAL ULCER DUE TO ESD
    Kengo TAKIMOTO, Hiroaki YAMAUCHI, Kiichi MATSUYAMA
    2015 Volume 57 Issue 11 Pages 2543-2550
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2543
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Recently, endoscopic treatments have markedly advanced. In Japan, endoscopic submucosal dissection (ESD) has become the standard treatment for early digestive tract cancers, such as esophageal, gastric, and colorectal cancers. The importance of methods of preventing and managing various intra-and postoperative complications has been emphasized. A method of covering the ulcer base with a polyglycolic acid sheet and fibrin adhesive, which we previously reported as a method of preventing perforation after duodenal ESD, is a safe, simple procedure in which the ulcer base is covered with the sheet, which is then fixed with the adhesive. In this method, a polyglycolic acid sheet and fibrin adhesive are used. As instruments, only biopsy forceps and two spraying tubes are required. When attaching the polyglycolic acid sheet, examining the ulcer base after ESD, pretreatment, and the patient's position are important. In this article, we review sheet delivery, sheet-attaching methods, and techniques of adhering the sheet using the fibrin adhesive, and introduce a safe procedure to prevent sheet detachment.
    View full abstract
    Download PDF (3958K)
  • PATIENT PREPARATION, SEDATION, AND EQUIPMENT USED IN PEDIATRIC GASTROINTESTINAL ENDOSCOPY IN JAPAN
    Takashi ISHIGE, Katsuhiro ARAI, Takao ITOI, Mikihiro INOUE, Manari OIK ...
    2015 Volume 57 Issue 11 Pages 2551-2559
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2551
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Specifications for patient preparation, sedation, and equipment used in pediatric gastrointestinal endoscopy in Japan are not well documented. Thus, the aim of this study was to investigate how Japanese pediatric endoscopy specialists perform gastrointestinal endoscopy in children.
    A questionnaire requesting information regarding patient preparation, sedation, and decisions regarding scope size used in esophagogastroduodenoscopy, colonoscopy, balloon enteroscopy, or endoscopic retrograde cholangiopancreatography, was sent to all 17 members of the Japanese Pediatric Gastrointestinal Endoscopy Guideline Committee.
    As a result, we received a response from all 17 members. General anesthesia was most frequently used as sedation in infants undergoing esophagogastroduodenoscopy ; midazolam or general anesthesia was used at equivalent frequencies among infants undergoing colonoscopy. Peroral balloon enteroscopy was generally performed under general anesthesia even in adolescents ; however, peranal balloon enteroscopy was performed under general anesthesia or midazolam sedation at equivalent frequencies. For preparation prior to esophagogastroduodenoscopy, topical lidocaine was used in adolescents, who did not receive general anesthesia. As preparation for colonoscopy, magnesium citrate and polyethylene glycol were widely used, often in combination with picosulfate sodium. These specialists decided the size of the scope to use according to the patient's age, purpose of endoscopy, and body weight.
    View full abstract
    Download PDF (1092K)
  • DEXMEDETOMIDINE VERSUS MIDAZOLAM FOR GASTROINTESTINAL ENDOSCOPY : A META-ANALYSIS
    Toshihiro NISHIZAWA, Hidekazu SUZUKI, Seiji SAGARA, Takanori KANAI, Na ...
    2015 Volume 57 Issue 11 Pages 2560-2568
    Published: 2015
    Released on J-STAGE: November 28, 2015
    DOIhttps://doi.org/10.11280/gee.57.2560
    JOURNAL FREE ACCESS
    Show abstractHide abstract
    Background and Aim : Patients who undergo gastrointestinal endoscopy often require sedatives such as midazolam and the more recently developed alpha-2 agonist, dexmedetomidine. To assess the efficacy and safety of dexmedetomidine sedation for gastrointestinal endoscopy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing dexmedetomidine with midazolam.
    Methods : We searched PubMed, the Cochrane library, and the Igaku-chuo-zasshi database in order to identify randomized trials eligible for inclusion in our meta-analysis. Data from the eligible studies were combined to calculate pooled odds ratios (OR) or weighted mean differences (WMD).
    Results : We identified nine randomized trials from the database search. Compared to that of midazolam, the pooled OR for restlessness of dexmedetomidine was 0.078 (95% confidence interval [CI] : 0.013-0.453, P < 0.0001), and there was no significant heterogeneity among the trial results. Dexmedetomidine significantly increased Ramsay sedation score compared with midazolam (WMD : 0.401, 95% CI : 0.110-0.692, P = 0.0069), without significant heterogeneity. Compared with midazolam, the pooled OR for hypoxia, hypotension, and bradycardia with dexmedetomidine sedation were 0.454 (95% CI : 0.098-2.11), 1.370 (95% CI : 0.516-3.637), and 2.575 (95% CI : 0.978-6.785), respectively, with no significant differences detected between the groups.
    Conclusion : This meta-analysis shows that dexmedetomidine is a safe and effective sedative agent for gastrointestinal endoscopy, especially endoscopic retrograde cholangiopancreatography and endoscopic submucosal dissection.
    View full abstract
    Download PDF (1154K)
    • |<
    • <
    • 1
    • >
    • >|
feedback
 Top