Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 105 , Issue 4
Showing 1-13 articles out of 13 articles from the selected issue
Review article
Monthly report; New horizons of autoimmune pancreatitis
Round-table discussion; New horizons of autoimmune pancreatitis
Case Report
  • Shunsuke YAMAMOTO, Noriya UEDO, Hiroyasu IISHI, Sachiko YAMAMOTO, Yoji ...
    2008 Volume 105 Issue 4 Pages 529-534
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A 40-year-old man was admitted to our hospital for treatment of gastric carcinoid of 7-mm in diameter associated with type A gastritis. Endoscopic mucosal resection was performed and histological examination revealed a gastric carcinoid with submucosal invasion (2500μm). Three months after the resection, the other carcinoid of 3-mm lesion was found, but no recurrence of resected portion. Neither local recurrence nor distant metastasis has been observed during 1-year follow-up period. These findings revealed that gastric carcinoid with type A gastritis, when smaller than 1-cm in diameter, could be cured with endoscopic procedure.
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  • Makiko MATSUMURA, Eigo KOJIMA, Takehiro TAJIMA, Susumu TSUMAHARA, Shin ...
    2008 Volume 105 Issue 4 Pages 535-542
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A 69-year-old man tarry stools received emergency endoscopy. Which revealed a solitary submucosal tumor about 15mm in diameter with a central ulcer, exhibiting woozing bleeding in the duodenal second portion. Endoscopic hemostasis was unsuccessful so emergency surgery was performed. Histological examination revealed amyloid with A-lambda immunoreactivity. Usually, this type of amyloidosis appears multiple submucosal masses. However this case presented as a single nodule at initial examination. We should keep in mind the potential of encountering this atypical form of amyloidosis.
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  • Toshifumi OZAWA
    2008 Volume 105 Issue 4 Pages 543-549
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A 32-year-old woman came to our hospital with purpose of careful examination for anemia. Colonoscopy was revealed a solitary protrusion with irregular shape covered with red and discolored mucosa of the descending colon. Surface of this lesion was smooth, which had flexibility in dynamic study with infusion of the air and water. Additionally, multiple ulcer scars was recognized on this lesion. After dye-spraying using by crystal-violet, no neoplastic pits was detected on the lesion except for asteroidal pits and pattern of pinecone on reddish protrusions. Endoscopic ultrasonography demonstrated a thickened low echoic layer (from 2nd to upper half of the 3rd layer) and anechoic structure in higher reddish part of the lesion. Diagnostic EMR was performed with no complication. Histological examination was revealed a spindle cells and ganglion cells in much fiber which was positive for immunostaining of S-100 ptotein. Hyperplastic glands were seen with no neoplastic change in reddish protrusion. Therefore, Diagnosis of polypoid ganglioneuroma of the descending colon was made. To a rare thing, our case was the 16th reported case of ganglioneuroma in large intestine without neurofibroma-1 or multiple endocrine neoplasm.
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  • Ryuichi KITA, Masato NAKATSUJI, Norihiro NISHIJIMA, Hisato KAWAKAMI, K ...
    2008 Volume 105 Issue 4 Pages 550-557
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A hepatic nodule was detected in segment 5/6 on abdominal US study in a 28 year-old male. The nodule was 7cm in diameter and the early phase of contrasted US, CT and MRI images showed spoke-wheel like vessels radiating from the center. No defect images were observed on postvascular phase contrasted US and SPIO MRI, which indicated the presence of Kupffer cells in the nodule. The nodule was diagnosed as a focal nodular hyperplasia (FNH) based on histological findings. The late phase of single level dynamic CT during hepatic arteriography (CTHA) showed corona enhancement of the nodule, which is considered to be characteristic of hypervascular metastatic liver tumors, hyperplastic nodules and HCCs. In our case, the drainage flow from the nodule may have been visualized as corona enhancement via the pathway from the sinusoid in the nodular periphery to the one in the adjacent and contiguous parenchyma.
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  • Hirotoshi FUKUDA, Yohei MIZUTA, Kazuo OHBA, Kohki IKEDA, Hidetoshi ODA ...
    2008 Volume 105 Issue 4 Pages 558-565
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A 51-year-old man visited the Sasebo General Hospital because of a niche and a ductal lesion with reflux of barium in the lesser curvature of the gastric body in the upper gastrointestinal series of an annual medical checkup. Endoscopic examination showed an ulcer and a depressed lesion draining yellowish serous liquid in the stomach. Abdominal CT scan and MRCP revealed the ductal structure reached from the lesser curvature of the gastric body to the left lobe of the liver besides the ordinary pancreatobiliary system. ERCP showed normal common bile duct, gall bladder, and right intrahepatic bile duct, while the fistulography using cannula through the gastric depressed lesion revealed an accessory bile duct communicating to the left intrahepatic bile duct. The both biliary systems were completely separated, resulting in the diagnosis of double common bile duct of type IIIa.
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  • Miwako TANAKA, Yasuhiko KITADAI, Michiyo KODAMA, Tomonori SUMIDA, Kei ...
    2008 Volume 105 Issue 4 Pages 566-571
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A 17-year-old man was admitted to our hospital with multiple fractures resulting from traffic accident. After treatment of fractures, his general status was improved. However, one month after traffic accident, he suffered severe pain in the epigastrium. Ultrasonography and computed tomography showed thickening of the intestinal wall in the duodenum, ileum, and ascending colon. Nineteen days after the onset of abdominal pain, small hemorrhagic spots appeared on both of the lower legs. Subsequently, he developed proteinuria and hematuria. Purpura nephritis was diagnosed in biopsy specimens of the kidney. Anaphylactoid purpura associated with traffic accident is very rare and it is difficult to diagnose without skin and renal symptoms.
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  • Tadashi FUJISAKI, Takaaki IKARI, Akira KAMEI, Kouichi TAKANO, Kensuke ...
    2008 Volume 105 Issue 4 Pages 572-577
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    A 51-year-old woman who had undergone gastrectomy for advanced gastric cancer was found to have a splenic tumor during the postoperative clinical observation. Abdominal computed tomography (CT) demonstrated solitary splenic tumor 15mm in diameter with delayed contrast enhancement. Abdominal ultrasonography (US) revealed low echoic mass with enhancement at vascular and perfusion image. We performed splenectomy to exclude the possibility of the metastatic tumor. The tumor was histopathologically diagnosed as inflammatory pseudotumor because of the presence of acidophilic fiber proliferation, hyalinized tissue and infiltration of lymphocytes and plasma cells.
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  • Akiko TAIRA, Masami YAMADA, Yasunori TAKEHIRA, Fujito KAGEYAMA, Shiget ...
    2008 Volume 105 Issue 4 Pages 578-582
    Published: 2008
    Released: April 04, 2008
    JOURNALS FREE ACCESS
    Gallstone ileus is a rare but important cause of small bowel obstruction in the geriatric population. A 65-year-old man with a twenty year history of cholecystolithiasis was admitted to our hospital with abdominal pain and vomiting. Physical exams showed abdominal defence and rebound tenderness. A plain abdominal X-ray suggested a small bowel obstruction and pneumobilia. CT scan revealed a 2.5-cm gallstone at the jejunum and air in the biliary tree. The patient underwent a emergency laparotomy based on a diagnosis of panperitonitis with a perforation associated with gallstone ileus. Operative findings revealed a jejunal perforation and a impacted stone on the anal side of perforation. Enterolithotomy and jejunal resection were performed with cholecystectomy and repairment of the cholecystoduodenal fistula.
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