Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 107, Issue 10
Displaying 1-13 of 13 articles from this issue
Review article
Monthly report; Physiology of digestive organs and Japanese herbal medicine
Round-table discussion; Physiology of digestive organs and Japanese herbal medicine
Review article
Case report
  • Masato MIYANO, Tomoaki YAMASAKI, Shinsuke HIRAMATSU, Eiji SASAKI, Kenj ...
    2010 Volume 107 Issue 10 Pages 1630-1634
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    A 20-year-old man had suffered from dysphagia since primary school. Upper gastrointestinal and endoscopy examinations revealed severe circumferential stenosis of the upper intra-thoracic esophagus. Secondary stenosis due to factors such as inflammation did not appear present, so congenital esophageal stenosis (CES) was diagnosed. Dysphagia improved after two endoscopic balloon dilatations. Almost all cases of CES are treated in babyhood, and individuals who remain untreated until adulthood are rare. Check ups and diagnoses should be made taking CES into consideration, even in adults.
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  • Yoshihiro YOKOI, Kazuhisa HIRAYAMA
    2010 Volume 107 Issue 10 Pages 1635-1640
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    Gastric emphysema encompasses a broad spectrum of diseases. A 31-year-old woman presented with severe vomiting and epigastric pain. She had lost body weight for several months, and was later diagnosed as having anorexia nervosa. A radiological study demonstrated intramural gas with huge gastric dilatation and portal venous gas. She underwent total gastrectomy and was rescued from extensive gastric necrosis. Her clinical findings suggest that extraordinary dilation of the stomach increased the intraluminal pressure, thereby resulting in perfusion disturbance and extensive gastric necrosis. There are five other case reports of gastric emphysema associated with eating disorders in the literature. All but one were young women, and one of 4 patients with massive gastric necrosis died due to septic shock. Eating disorders cause gastric emphysema through several unique mechanisms, including gastric muscular atrophy, occlusion of the gastroesophageal junction, and delayed gastric emptying. Gastric emphysema in relation to eating disorders carries a risk of life-threatening complications and requires urgent diagnosis and treatment.
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  • Toshifumi OZAWA, Eiko WACHI, Naoyuki YAMASHITA
    2010 Volume 107 Issue 10 Pages 1641-1650
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    A 48-year-old woman who had innumerable polyps in her stomach for 4 years visited our hospital to receive further examinations. Her younger brother had undergone gastrectomy because of cancer with gastric polyposis. Gastrography and gastroscopy showed numerous reddish polyps finger-like in form with much mucin in the antrum. On the other hand, polyposis in the corpus and fornix was nodular which formed giant folds. There was no polyps in other organs, therefore, we diagnosed juvenile polyposis limited to the stomach accompanied with Ménétrier disease. Double carcinoma were proved histologically after total gastrectomy. 55.8% of juvenile poplyposis limited to the stomach are accompanied with neoplasms, however, the rate of preoperatively correctly diagnosed neoplasms was 55%, so total gastrectomy was recommended.
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  • Atsushi TSUJI, Masahiro TAKAYANAGI, Toshifumi KASUGAI, Hiroyuki SUGIMO ...
    2010 Volume 107 Issue 10 Pages 1651-1660
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    The patient was a 52-year-old woman in whom CT revealed a huge tumor located mainly in the mesenterium. On the 5th day, clinical symptoms progressed rapidly and chemotherapy for malignant lymphoma was performed after percutaneous core needle biopsy. However, the patient died on the 9th day. After her death, the pathological diagnosis proved to be neuroblastoma based on the core needle biopsy. This disease is extremely rare in adults, but should be taken into consideration since rapid progression may sometimes occur.
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  • Takeshi CHIDA, Fujito KAGEYAMA, Masami YAMADA, Shigeto YOSHII, Yumiko ...
    2010 Volume 107 Issue 10 Pages 1661-1668
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    A 73-year-old woman was admitted with gastrointestinal bleeding. She had undergone pylorus-preserving pancreaticoduodenectomy, hepaticojejunostomy and pancreatojejunostomy for pancreatic cancer a year earlier. Gastrointestinal endoscopy revealed bleeding from varices in an interposed jejunum. Enhanced CT showed an extrahepatic portal venous obstruction and cavernous transformation of the portal vein, which were complications of these operations. We performed endoscopic injection using α-cyanoacrylate monomer for the varices. After 4 treatments, the bleeding stopped. We concluded that endoscopic injection using α-cyanoacrylate monomer was effective and useful treatment for bleeding from hepatopetal varices, including cavernous transformation of the portal vein. This method is also useful in emergency situations.
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  • Takayuki MIURA, Fuyuhiko MOTOI, Kei ITO, Hiromichi ITO, Atsushi KANNO, ...
    2010 Volume 107 Issue 10 Pages 1669-1675
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    A 50-year-old man with a cancer of the papilla of Vater underwent pylorus-preserving pancreatoduodenectomy reconstructed with pancreatogastrostomy in 2002. He began to complain of upper abdominal and back pain in April 2008. Abdominal CT scan revealed pancreatolithiasis with dilatation of the remnant main pancreatic duct. An upper intestinal endoscopy could not discern the orifice of the pancreatic duct. He was treated by transgastric EUS-guided drainage of the pancreatic duct several times, and ESWL for pancreatolithiasis. However, he had repeated pancreatitis.
    Surgical intervention was carried out to treat the obstructive pancreatitis in April 2009. Longitudinal pancreaticojejunostomy was performed without resection of the obstructive pancreatogastrostomy. The postoperative recovery was uneventful, and the patient remains asymptomatic after the second operation.
    We concluded that the longitudinal pancreaticojejunostomy is a safe and effective alternative for chronic pancreatitis after stenotic pancreatico-digestive tract anastomosis following pancreatoduodenectomy, especially for cases in which endoscopic stenting is ineffective.
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  • Masaki WATO, Tomoki INABA, Hisashi ISHIKAWA, Shigenao ISHIKAWA, Nobuyu ...
    2010 Volume 107 Issue 10 Pages 1676-1685
    Published: 2010
    Released on J-STAGE: October 05, 2010
    JOURNAL FREE ACCESS
    A 63-year-old man with Stage IVa pancreas tail cancer was admitted for a distal pancreatectomy and splenectomy; adjuvant chemotherapy with gemcitabine was also administered. The chemotherapy was terminated after 16 courses due to hemolytic anemia, thrombocytopenia and renal dysfunction. Plasma exchange was performed; however the patient's renal function was diminished, requiring chronic hemodialysis. Physicians should be cautious of hemolytic uremic syndrome as a possible adverse reaction to gemcitabine and be aware that tests are needed for its early detection.
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