Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 103 , Issue 12
Showing 1-14 articles out of 14 articles from the selected issue
Review article
Monthly report; Progress of imaging diagnosis in pancreatic diseases
Original article
  • Kazutaka KOGANEI, Hideaki KIMURA, Akira SUGITA, Katsuhiko ARAI, Tsuneo ...
    2006 Volume 103 Issue 12 Pages 1355-1360
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    Clinical aspectsC treatment and outcome of five patients with ulcerative colitis recto- or anovaginal fistula and were studied retrospectively. All patients had total colitis (relapse and remission type) and more than a 5 year history of ulcerative colitis. They all had anorectal complications, such as periproctal abscessC stenosis of fistula. Four patients had total colectomy with an ileal pouch anal canal anastomosis for intractability or dysplasia. One was treated conservatively. Complete closure of fistula was obtained in two patients;in one patient rectum was resected below the fistula and in one patient defect of the vaginal posterior wall was reconstructed by using a gluteal fold flap following colectomy. Recto- or anovaginal fistula complicating ulcerative colitis is rare but may occur in the patients with severe rectal inflammation and they can be managed by restorative proctocolectomy with an ileal pouch anal or anal canal anastomosis.
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Case Report
  • Masashi KAWAMURA, Kouichi SUGIYAMA, Shu ABE, Masaki KITAGAWA, Toyohiko ...
    2006 Volume 103 Issue 12 Pages 1361-1365
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    A 75-year-old man, in whom upper gastrointestinal endoscopy revealed a submucosal tumor in the greater curvature of the gastric angle, was hospitalized for further investigations. Since the tumor was shown to be located in the submucosal layer by endoscopic ultrasonography, we performed endoscopic mucosal resection. Pathological studies of the resected specimen revealed a gastrointestinal stromal tumor of the stomach. It was also formed that the tumor was connected not to muscularis propria, but to the muscularis mucosae. There has been no previous report about a case of gastrointestinal stromal tumor of the stomach arising from the muscularis mucosae in Japan.
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  • Keisuke OKUDAIRA, Atsushi KAWAGUCHI, Ryota HOKARI, Kazuyuki NARIMATSU, ...
    2006 Volume 103 Issue 12 Pages 1366-1371
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    A 68-years-old Japanese woman was hospitalized emergently because of hemorrhagic gastric ulcer. For the hospitalization periodC elevated levels of white blood cell countC eosinophilic leucocyte countC serum IgE and positive MPO-ANCA were recognized. With considering clinical course and these laboratory findingsC we diagnosed Churg-Strauss syndrome (CSS). Steroid therapy in combination with cyclophosphamide was effective. CSS is a rare diseaseC but we should discriminate this disease when we encounter gastrointestinal bleeding of unknown etiologyC especially PPI-resistant gastric ulcer.
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  • Yuki ASADA, Kazuaki KANDA, Kazuyuki OZEKI, Toshiro TANAKA, Yohei MIZUT ...
    2006 Volume 103 Issue 12 Pages 1372-1376
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    Two patients with mesenteric panniculitis are presented. In the first patientC a provisional diagnosis of ileus was made, based on the clinical features and imaging data. Laparotomic findings showed that the ileum was bound tightly by a fibrous strip and dilated, with thickened and swollen mesentery. Incision of the fibrous strip was performed, and the clinical symptoms were improved. The second patient was strongly suspected to have mesenteric panniculitisC from characteristic features on abdominal computed tomography and barium enema. Conservative therapy was effective in this case. We emphasize the variety of clinical courses in mesenteric panniculitisC requiring selection of the most suitable treatment.
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  • Yoshio SUMIDA, Kazuyuki KANEMASA, Kohei FUKUMOTO, Naho KATOH, Shigeyos ...
    2006 Volume 103 Issue 12 Pages 1377-1383
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    A 73-year-old man was admitted with fever and abnormal liver function test. After admission, his fever persisted in spite of administrating a variety of antibiotics. He was diagnosed as acute Q fever on the basis of a high titer of IgM antibodies against phase II Coxiella burneti. His fever resolved after starting minocycline, but biliary enzymes continued to be elevated. Transbronchial lung biopsy and percutaneous liver biopsy revealed caseating granulomas and Mycobacterium tuberculosis was detected by culture. Miliary tuberculosis was diagnosed and his biliary enzymes declined after starting therapy with antituberculous drugs. This report of miliary tuberculosis complicating acute Q fever is a valuable and unprecedented case.
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  • Masami MIYAGAWA, Hidetoshi KANEMASA, Toshiyuki NITAN, Masafumi MATSUMO ...
    2006 Volume 103 Issue 12 Pages 1384-1390
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    A 69-year-old man was referred to our hospital for epigastralgia. He was found to have elevation of serum amylase and CA19-9. Ultrasonography, abdominal CT, MRCP, ERCP and EUS showed the cystic lesion and a possibility of an other tumor. There was a stenosis of the main pancreatic duct (MPD) at the pancreas head and dilatation of the MPD from the body to the tail. Intraductal papillary mucinous neoplasm (IPMN) of the branch pancreatic duct was diagnosed, and there was a likelihood of ductal carcinoma of the pancreas. We therefore performed pancreatoduodenectomy. Pathological finding showed invasive carcinoma from an intraductal papillary mucinous neoplasm with invasive ductal carcinoma of the pancreas.
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  • Naohisa KURIYAMA, Tsutomu SEKOGUCHI, Shotaro SAEGUSA, Hiroyuki YUASA, ...
    2006 Volume 103 Issue 12 Pages 1391-1396
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    A 59-year old woman was admitted to our hospital for further examination of a cystic lesion detected in the tail of the pancreas. Imaging studies showed a 35-mm-diameter cystic lesion with septa and mural nodule at the same site. The mural nodule of the cyst was thick and was enhanced. Partial resection of the tail pancreas was performed with a preoperative diagnosis of pancreatic cystic tumor. The resected specimen showed mulitlobular cyst. HistologicallyC the internal surface of the cyst was covered with stratified squamous cells and the mural nodule of the cyst was spleen tissue. The final diagnosis was an epithelial cyst derived from an accessory spleen in the pancreas.
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  • Ippei MATSUMOTO, Takashi UEDA, Tetsuo AJIKI, Takeo YASUDA, Tsunenori F ...
    2006 Volume 103 Issue 12 Pages 1397-1402
    Published: 2006
    Released: December 06, 2006
    JOURNALS FREE ACCESS
    A 55-year-old male heavy drinker was taken to another hospital because of loss of consciousness. Laboratory data showed anemia and endoscopy of the upper gastrointestinal tract disclosed intraduodenal bleeding from the ampulla of Vater. Further examinations were scheduled. However, three days later, he was given emergency admission to our hospital because of massive rectal bleeding and circulatory shock. Abdominal contrast-enhanced CT showed a pseudoaneurysm in a pseudocyst in the head of the pancreas. Emergency angiography revealed a ruptured pseudoaneurysm of the gastroduodenal artery 15 mm in diameter. He was successfully treated with transcatheter arterial embolization. ERCP demonstrated the pseudocyst communicating from the main pancreatic duct in the pancreatic head. The final diagnosis was ruptured pseudoaneurysm of the gastroduodenal artery into a pseudocyst, presenting with hemosuccus pancreaticus, secondary to chronic pancreatitis.
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