All issues
Volume 52 (2019)
- Issue 12 Pages 695-
- Issue 11 Pages 611-
- Issue 10 Pages 551-
- Issue 9 Pages 485-
- Issue 8 Pages 405-
- Issue 7 Pages 345-
- Issue 6 Pages 281-
- Issue 5 Pages 239-
- Issue 4 Pages 191-
- Issue 3 Pages 137-
- Issue 2 Pages 83-
- Issue 1 Pages 1-
- Issue Special_Issue P･･･
- Issue Supplement2 Pag･･･
- Issue Supplement1 Pag･･･
Volume 48, Issue 10
Displaying 1-11 of 11 articles from this issue
- |<
- <
- 1
- >
- >|
CASE REPORT
-
Tomohiko Sasaki, Satoru Motoyama, Yusuke Sato, Kei Yoshino, Akiyuki Wa ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 811-816
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLSalvage esophagectomy following definitive chemo-radiotherapy and additional chemotherapy was performed in a 37-year-old man with a diagnosis of advanced thoracic middle esophageal cancer. At 3 postoperative months, he was infected with Trichosporon fungemia and developed acute respiratory distress syndrome. He underwent intensive treatment with respiratory management. Early administration of AmBisome and Voriconazole as anti-fungal agents was effective and his trichosporonosis was cured. Deep-seated trichosporonosis is rare and lethal and opportunistic infections are occasionally present in immunocompromised patients. There have been many reports about trichosporonosis developing during treatment of hematologic malignant diseases. In the future, expansion of multidisciplinary therapy will likely increase the incidence of trichosporonosis among gastrointestinal cancer patients. It is necessary for us to take precautions against lethal trichosporonosis and important to diagnose this rapidly by blood culture so that it can be treated with appropriate anti-fungal agents.View full abstractDownload PDF (1337K) Full view HTML -
Shigeya Hayashi, Takashi Oshima, Amane Kanazawa, Nobuhiro Sugano, Taka ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 817-824
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLA 69-year-old man presented with dyspnea on exertion, persisting for 1 month. Pulmonary thromboembolism was suspected, but enhanced CT and lung perfusion imaging showed no evidence of pulmonary artery thromboembolism. There was swelling of the paragastric and para-aortic lymph nodes, and gastric cancer was diagnosed on upper gastrointestinal endoscopy. We performed right cardiac catheterization and withdrew some blood from a pulmonary artery catheter in the wedge position. We confirmed the presence of adenocarcinoma malignant cells in the aspirated blood. Pulmonary tumor thrombotic microangiopathy (PTTM) associated with gastric cancer was diagnosed. The patient received noninvasive positive-pressure ventilation, and the symptoms improved. He was then given an anticancer drug (S-1) for 3 months on an outpatient basis. Exertional dyspnea developed, and the patient was admitted to the emergency department of our hospital. He died of respiratory failure on hospital day 1. To the best of our knowledge, preterminal diagnosis of PTTM has rarely been reported in Japan.View full abstractDownload PDF (2464K) Full view HTML -
Hirotsugu Morioka, Shinichiro Yoshitani, Takahito Minami, Akihiro Miki ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 825-833
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLA 63-year-old man was admitted. During hospitalization in our cardiovascular internal medicine department, anemia was identified. Abdominal CT showed a large tumor mass from the gastric fundus, centered on the posterior wall of the gastric corpus, and invasion of a tumor from the tail of the pancreas body 10 cm in size was suspected. On upper gastrointestinal endoscopy, a large Borrmann 1 tumor measuring 10 cm in diameter was observed on the greater curvature side of the cardiac portion, and the result of the biopsy was a diagnosis of poorly differentiated adenocarcinoma. Surgically, from the diagnosis of advanced gastric carcinoma, a D2 dissection, with total gastrectomy and pancreatosplenectomy, was performed. The histopathological findings were UM, Borrmann 1, T4, N3, H0, P0, CY0, pStage IIIC, and upon performing an immunohistological examination, it was shown that vimentin, Ki-67, CD3, CD5, CD68 (KP-1) and CD99 were positive, so a diagnosis of primary gastric undifferentiated pleomorphic sarcoma was reached. Primary gastric undifferentiated pleomorphic sarcoma is an extremely rare condition, and we herein report this case, with pertinent bibliographic considerations.View full abstractDownload PDF (2606K) Full view HTML -
Shuntaro Tsukamoto, Hideo Terashima, Sugiru Pak, Yoritaka Nakano, Fumi ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 834-839
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLA 69-year-old woman with dorsal pain visited our hospital, and underwent upper gastrointenstinal endoscopy, leading to the discovery of a submucosal tumor (SMT) measuring about 10 mm in diameter, which was located at the anterior wall of the duodenal bulb adjacent to the pyloric ring. The biopsy specimen showed positive expressions for neuroendocrine markers on immunostaining, resulting in a diagnosis of neuroendocrine tumor (NET). Based on assessment of the proliferative activity (mitotic count, <2 per 10 high power fields (HPF) and/or ≤2% Ki-67 index), the SMT was finally diagnosed as Grade 1 (G1). This case was considered an indication for limited surgery because NET-G1 that is not greater than 10 mm and not proliferating beyond the submucosal layer is generally estimated to be unlikely to metastasize to a lymph node. Thus, the patient underwent distal gastrectomy including the duodenal bulb. Histopathological findings showed a well-circumscribed tumor measuring 8 mm located in the submucosal layer．The presence of metastasis was confirmed in one of the subpyloric lymph nodes. Unexpectedly, an analysis of 21 duodenal NETs gathered from Japanese case reports showed that 3 cases had nodal metastasis in the case of either G1 or tumors with a diameter up to 10 mm. The potential risk of nodal metastasis should be recognized when treating duodenal NETs, even in cases of fulfilling all the condition of low-risk factors for nodal metastasis.View full abstractDownload PDF (1485K) Full view HTML -
Mariko Ogino, Satoshi Hirano, Yoshinori Suzuki, Hironori Tanaka, Daisu ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 840-846
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLA 73-year-old man with lower bile duct cancer underwent pancreaticoduodenectomy. A stent tube 8 cm in length made of polyvinyl chloride for retrograde transhepatic biliary drainage (RTBD) known as the “lost tube” was placed at the anastomosis and fixed with an absorbable suture. A space-occupying lesion which was judged to be a calculus in the bile duct at the anastomotic site was detected by CT at 18 months after surgery. The patient was hospitalized 2.5 months later due to obstructive cholangitis. Endoscopic examination revealed that a stone adhered around the stent tube caused obstruction of the bile duct. Just after withdrawing the stent tube with the stone, many biliary stones flowed from the intrahepatic ducts. Theoretically, this type of stent would have dropped out naturally and have been discharged through the gastrointestinal tract. In the present case, the stent had lodged at the anastomotic site and formed a calculus around it. Although this seems to be a very rare complication of internal stent for bilioenteric anastomosis, it could be a possible cause for obstructive cholangitis as an example of a late complication.View full abstractDownload PDF (1581K) Full view HTML -
Akefumi Sato, Hirofumi Ichikawa, Kazuaki Hatsugai, Masato Oohara, Sige ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 847-854
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLA 75-year-old man was initially admitted for cholangitis. CT scan revealed the patient had situs inversus totalis and a tumor in the transpositioned gallbladder. Gallbladder cancer was suspected and extended cholecystectomy was performed. Serosal invasion was unclear and the cystic duct margin was negative in frozen sections. Pathological examination indicated gallbladder adenocarcinoma with subserosal invasion. Both the external and cystic duct margins were negative and no metastasis was detected in the cystic duct lymph node. Situs inversus totalis can cause difficulty in surgical maneuvers as most surgeons are unfamiliar with mirror-image transposition of the viscera. In addition, it is necessary to carefully examine all features of the patient with situs inversus because coexisting anomalies are often found. We report a rare case of carcinoma in the transpositioned gallbladder with a review of the literature.View full abstractDownload PDF (1550K) Full view HTML -
Toshihiro Misumi, Masahiro Nishihara, Naoki Tanimine, Keizo SuginoArticle type: CASE REPORT
2015 Volume 48 Issue 10 Pages 855-861
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLBoth appendiceal diverticulum and appendiceal serrated adenoma are extremely rare. We report a case of appendiceal serrated adenoma with appendiceal diverticulum. A 73-year-old man was admitted to our hospital because of right lower abdominal pain. Abdominal enhanced CT revealed swelling of the appendix with fat tissue thickening, and with appendiceal diverticulum. We performed an appendectomy under the diagnosis of acute appendiceal diverticulitis. A moderate amount of pus-like fluid was observed around the appendix. The swollen appendix possessed three diverticula, one of which was perforated. Histological findings demonstrated that the diverticula were pseudo-diverticula and that a serrated adenoma existed at the base of the appendix. Appendiceal serrated adenoma with appendiceal diverticulum is extremely rare, and to the best of our knowledge, this case is the first to be reported in Japan.View full abstractDownload PDF (1421K) Full view HTML -
Masayuki Tsutsuyama, Koji Komori, Kenya Kimura, Takashi Kinoshita, Yas ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 862-868
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLFournier’s gangrene is a rapidly progressing necrotizing fasciitis of the perineum and external genital organs. The disease is life-threatening and has a high mortality rate. Therefore, prompt diagnosis and treatment is needed. The present case was a 61-year-old man who complained of gluteal pain. The gluteal region and scrotum were swollen and partially necrotized, and a whole-circumference tumor was palpable on digital examination of the rectum. CT scans revealed rectal wall thickening, widespread gas filling the area from the gluteal region to the scrotum, and extravasation of contrast media from the stomach. We diagnosed Fournier’s gangrene caused by penetration of rectal cancer and upper gastrointestinal bleeding. For treatment, we first tried endoscopic hemostasis, but this proved troublesome because of the limited working area caused by a clot. We then used laparotomy to perform gastrectomy, transverse colostomy, and debridement of the perineal area. Here, we report this case, along with a review of the literature.View full abstractDownload PDF (1878K) Full view HTML -
Saki Nagashima, Shigeru Fujisaki, Motoi Takashina, Kenichi Sakurai, Ry ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 869-876
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLWe report a rare case of small-bowel obstruction due to hernia bursae omentalis. A 61-year-old man was admitted because of upper abdominal pain. Abdominal CT images revealed a dilated small intestine loop on the side of the lesser curvature of the stomach. Intestinal obstruction was diagnosed, and to relieve his symptoms, we placed a long tube. However, his symptoms did not improve. Thus, an open surgery was performed on the next day. We found that the ileum was herniated into the omental bursa through the gastrocolic ligament. Because intestinal necrosis had developed, the necrotic intestine was removed and the intestine was reconstructed. The patient had an uneventful postoperative course and was discharged on postoperative day 14. This case was similar to that of a transomental hernia, however, there was no hiatus of the greater omentum. Hernia bursa without hiatus is rare. In particular, our case is one of the very few cases of hernia bursae omentalis with dysplasia of the gastrocolic ligament.View full abstractDownload PDF (1944K) Full view HTML -
Kenji Yoshino, Dai Manaka, Ryo Kudou, Syunpei Kanai, Eisei Mitsuoka, S ...Article type: CASE REPORT
2015 Volume 48 Issue 10 Pages 877-882
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLA 57-year-old woman with ovarian cancer underwent sigmoid colostomy because of rectovaginal fistula 4 years after primary surgery. Four days postoperatively, the discharge from the midline incision increased. Skin redness around the stoma and ulceration was found which lead to the diagnosis of pyoderma gangrenosum (PG). The necrosis spread widely around the wound, but the epithelization was finally restored by corticosteroid ointments on postoperative day 44. The characteristic ulcers were detected at the site of the central venous port on the left upper arm and the site of the peripheral intravenous feeding, and were both diagnosed as PG. PG is a rare disease which presents a characteristic ulcer as a cardinal symptom, and is often combined with inflammatory bowel diseases, autoimmune diseases and malignant tumors. It sometimes occurs around the stoma, but there have been no reports about consecutive PG occurrence at other sites such as the venous port and the peripheral intravenous puncture. We report this rare case with a review of the literature.View full abstractDownload PDF (1304K) Full view HTML
EDITOR'S NOTE
-
Eigo OtsujiArticle type: EDITOR'S NOTE
2015 Volume 48 Issue 10 Pages en10-
Published: October 01, 2015
Released on J-STAGE: October 15, 2015
JOURNAL FREE ACCESS FULL-TEXT HTMLDownload PDF (669K) Full view HTML
- |<
- <
- 1
- >
- >|