Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 104, Issue 4
Displaying 1-14 of 14 articles from this issue
Review article
Monthly report; Metabolic Syndrome and Digestive Disease in Clinics
Round-table discussion; Metabolic Syndrome and Digestive Disease in Clinics
Case Report
  • Seiji KAWANO, Ryusaku KUSUNOKI, Masahito AIMI, Reiji HIGASHI, Yasushi ...
    2007 Volume 104 Issue 4 Pages 535-541
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    A 82-year-old man was admitted into our hospital complaining of dysphagia. Endoscopic examination revealed an elevated tumor in the middle esophagus, and biopsy revealed carcinosarcoma. He underwent chemo-radiotherapy, and the size of tumor decreased remarkably and almost disappeared 7 months later. However, a metastatic lesion appeared 11 months later, and eventually he died. Autopsy revealed a sarcomatous element in the metastatic part, but the primary lesion showed no recurrence. We report herein this rare case of carcinosarcoma of the esophagus that was treated with chemo-radiotherapy.
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  • Rika MIYOSHI, Yuichi YASUNAGA, Takashi KIZU, Takuya INOUE, Chie WATANA ...
    2007 Volume 104 Issue 4 Pages 542-547
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    A 73-year-old woman without a history of allergic diseases visited our hospital complaining of sore throat and nocturnal cough. Blood tests showed marked eosinophilia (18000/mm3;WBC 21900/mm3, Eos 82.0%) with normal serum levels of C-reactive protein, non-specific and various allergen-specific IgE. Stool tests for protozoa or helminthic ova were negative. Chest X-ray films showed no pulmonary abnormalities. Endoscopic and histological examinations revealed reflux esophagitis (grade C according to the Los Angeles Classification System) with hiatal hernia with inflammatory infiltrates including eosinophils within the esophageal mucosa. A computed tomography showed the thickening of the esophageal wall. An administration of lansoprazole improved reflux esophagitis and also eosinophilia, and an alteration to famotidine caused heartburn with an increase in eosinophils. A re-alteration to omeprazole relieved the symptom and decreased eosinophils. It was shown that gastroesophageal reflux disease was one of the possible causes of eosinophilia.
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  • Atsufumi KASHIWA, Koichi TOMIKASHI, Yu NOMURA, Kiichiro MIYAWAKI, Dais ...
    2007 Volume 104 Issue 4 Pages 548-554
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    A 44 year-old man was admitted to our hospital because of severe left upper abdominal pain and high fever. Blood examinations revealed high levels of white blood cell count and CRP. An abdominal enhanced CT scan showed a low-density mass with an enhanced margin at the posterior side of the gastric body, and an irregular mass nearby at the transverse colon. We diagnosed a gastric wall abscess due to perforation from advanced colonic cancer and performed endoscopic drainage and endoprostesis by ERBD tube insertion into the abscess through the gastric wall. After the procedure, the clinical symptoms and laboratory data improved quickly, and we could continue further examinations and proceed safety with the treatment plan. To our knowledge, this is the first reported case of a gastric wall abscess due to penetration by gastrointestinal tract cancer which was treated with endoscopic endoprostesis.
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  • Takashi EGUCHI, Shoichiro KOIKE, Kazuma MAENO, Toshiyuki NAKAMURA, Tak ...
    2007 Volume 104 Issue 4 Pages 555-560
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    We report a case of nonocclusive mesenteric ischemia (NOMI) which occurred in a patient with torsion of gallbladder. A 91-year-old woman was admitted to the hospital and was diagnosed of acute cholecystitis. The next day, she went into shock. Then, we diagnosed her illness as torsion of gallbladder by computed tomography and ultrasonography, and performed an emergency operation. After cholecystectomy, it was recognized that the wide range of the small intestine had become necrotic sporadically. We diagnosed it as NOMI, and performed the wide resection of the small intestine followed by making double stomas. There is no previous report of NOMI associated with torsion of gallbladder. We guess the cause of NOMI in this case would be dehydration because of gallbladder torsion. NOMI has high mortality. Early diagnosis and early treatment are of great importance in NOMI.
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  • Masayuki MASHIMO, Junichi HARA, Atsunori NITTA, Mizuki OOHIRA, Seiko Y ...
    2007 Volume 104 Issue 4 Pages 561-567
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    The case was a 33-year-old woman with alcoholic liver cirrhosis. Her chief complaint was melena. She had undergone the abdominal operation in the past. Upper and lower gastrointestinal endoscopy did not reveal the bleeding point in the gastrointestinal tract. We diagnosed the bleeding from the ileocecum by the hemorrhage scintigraphy, the superior mesenteric artery angiography, and CT angiography. She had varices at the terminal ileum and adhesion between the ovary and the ileum end. The subtotal resection of the ileum was performed.
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  • Kyoko MONOE, Yukiko KANNO, Hironobu SAITO, Kazumichi ABE, Atsushi TAKA ...
    2007 Volume 104 Issue 4 Pages 568-572
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    A 79-year-old woman, who had been treated because of mixed connective tissue disease (MCTD), was admitted to the hospital for the intensive examination of a hepatic tumor that was unexpectedly found on computed tomography. The hepatic tumor was approximately 40mm in diameter. Her transaminase levels were slightly elevated but hepatic virus markers were negative. However, a liver aspiration biopsy revealed moderately differentiated hepatocellular carcinoma (HCC). In the surrounding non-tumor area, nonspecific reactive hepatitis was detected. MCTD associated with HCC has not yet been reported in the past. This case appears to be very interesting in terms of the etiology of HCC.
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  • Shinichi MORITA, Soichi SUGITANI, Yuka KOBAYASHI, Hiroko HARA, Masaya ...
    2007 Volume 104 Issue 4 Pages 573-578
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    A 51-year-old female previously diagnosed as primary amyloidosis suffered from recurrent abdominal pain. The result of thorough examination indicated that the main cause of the pain was severe hepatomegaly. Continuous venous administration of narcotics and other alternative therapies did not provide symptomatic relief, and thus the patient was treated with celiac plexus block, which resulted in effective pain control and improved ADL level. Though the procedure of celiac plexus block is simple and celiac plexus block is applicable without causing severe complication, it is not widely used. From this case, it is considered that celiac plexus block is one of the most effective means to relieve intractable pain associated with both benign malady and abdominal malignant tumor.
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  • Hiroaki SUDA, Sayo ITOH, Yoshihiro SAIGUSA, Kouich HIRAHATA, Yukako NE ...
    2007 Volume 104 Issue 4 Pages 579-583
    Published: 2007
    Released on J-STAGE: April 05, 2007
    JOURNAL FREE ACCESS
    A case was 23 years old woman. She came to our hospital with complain of continuing fever after common cold and mass like an egg was touched in right lower abdomen. No other surface lymph node was swelling. Abdominal US, CT and MRI showed that the mass was existed in the front of the psoas muscle and the maximum diameter of it was 6 cm in which necrotizing lesion was recognized. The size of the lymph node became smaller slowly but we could not perfectly exclude malignant disease, we examined needle biopsy for the diagnosis. The histopathological findings showed the histiocytic necrotizing lymphadenitis (HNL). HNL usually appears in the neck area, but in this case it was detected only in the abdomen. This case was very rare and we reported.
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