Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 111 , Issue 5
Showing 1-12 articles out of 12 articles from the selected issue
Review article
Monthly report; Expansion and limitation of indication criteria for liver transplantation in patients with hepatocellular carcinoma
Original article
  • Yoshihisa FUKUDA, Kanae SHINOZAKI, Takahide SASAKI, Kanefumi YAMASHITA ...
    2014 Volume 111 Issue 5 Pages 899-908
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    We analyzed the ratio of positive test results in various diagnostic methods for Helicobacter pylori infection and the clinical presentations in six cases of acute gastric mucosal lesions (AGML) caused by acute H. pylori. At onset, five cases tested negative for serum antibodies; one had a positive result, but the antibody titer increased with time. Some false negative results were obtained with the following tests: urea breath test, rapid urease test, microscopy, culture, and immunostaining; however, the feces antigen test gave positive results in all five cases. These data suggest that feces antigen test should be performed in all cases suspected of acute H. pylori infection. Where progress was monitored without eradication therapy, subjective symptoms were exacerbated in some patients, and one patient developed a persistent infection. Consequently, eradication therapy should be performed at an early stage of AGML.
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Case report
  • Shunsuke AKIMOTO, Fumiaki YANO, Kazuto TSUBOI, Masato HOSHINO, Nobuo O ...
    2014 Volume 111 Issue 5 Pages 909-914
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    A middle school girl started a diet; she developed an eating disorder, and was diagnosed with anorexia nervosa. Endoscopic examination revealed no esophagitis due to gastric reflux, but slackness was seen in the cardiac region. Multichannel intraluminal impedance pH monitoring revealed marked non-acidic reflux. On the basis of positive symptom index (SI) and symptom association probability (SAP) values, the patient was diagnosed with non-erosive gastroesophageal reflux. The patient was afraid to eat because of the reflux; therefore, laparoscopic reflux prevention surgery was performed. The symptoms completely disappeared after surgery, and normal oral ingestion was possible.
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  • Kiyonori KUSUMOTO, Yoshinori MIZUMOTO, Akihiko HAMADA
    2014 Volume 111 Issue 5 Pages 915-923
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    We experienced two cases of shock secondary to colonic diverticular bleeding. Both patients showed signs of shock after each episode of melena; however, the bleeding site could not be initially identified because multiple diverticula were present and the bleeding spontaneously ceased during each examination. Therefore, we subsequently performed planned clipping and dynamic computed tomography scanning of the area surrounding the potential bleeding sites to look for signs of vascular leakage and to determine the clip location. The use of this method enabled us to successfully identify the bleeding site in both cases. Thus, this method can be useful in identifying the site of colonic diverticular bleeding that may cause shock.
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  • Tomoya MASUDA, Masao YOSHIOKA, Shuhei ISHIYAMA, Mitsuhiro KANETO, Hiro ...
    2014 Volume 111 Issue 5 Pages 924-930
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    A man in his twenties had intermittent abdominal pain in the right lower quadrant for more than 4 years. The abdominal pain persisted after a meal, and he visited our hospital emergency department. We performed an emergency colonoscopy and found a 3-cm mobile polypoid lesion located on the antimesenteric side of the ileum 40 cm from the ileocecal valve and was 85×26×23 mm in size. On the basis of characteristic ultrasound and contrast-enhanced CT findings, our preoperative diagnosis was intussusception due to Meckel's diverticulum translation and performed a laparoscopic ileocecal resection. The pathological diagnosis was Meckel's diverticulum translation with ectopic pancreatic and gastric tissue. Furthermore, we aggregated the cases of adult intussusception due to Meckel's diverticulum translation reported in Japan, and investigated preoperative diagnoses and treatment plans.
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  • Naoki ASAYAMA, Tamito SASAKI, Masahiro SERIKAWA, Tomoyuki MINAMI, Akih ...
    2014 Volume 111 Issue 5 Pages 931-939
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    A man in his sixties presented to our hospital with obstructive jaundice and was diagnosed with inoperable pancreatic cancer. Chemoradiotherapy was initiated, and an expandable metallic stent was inserted endoscopically to drain the biliary system. Six months later, he was referred to our hospital with 1-week history of epigastric pain and obstructive jaundice. On admission for further evaluation, he experienced hematemesis and went into severe shock. Upper gastrointestinal endoscopy and endoscopic retrograde cholangiopancreatography showed active bleeding from the duodenal papilla. Therefore, we performed endoscopic nasobiliary drainage (ENBD). On day 4, blood was detected in the ENBD tube, and the patient again experienced hematemesis. Emergent enhanced computed tomography revealed a right hepatic arterial aneurysm that had likely ruptured and caused the hemobilia. The aneurysm was successfully embolized, and the patient was discharged on hospital day 21.
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  • Ryuichi KITA, Azusa SAKAMOTO, Eriko IGUCHI, Haruhiko TAKEDA, Yoshiaki ...
    2014 Volume 111 Issue 5 Pages 940-947
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    We report three cases of resected hepatocellular carcinomas with nodules showing different signal intensities in the hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI (EOB-MRI). One case involved a nodule-in-nodule type hepatocellular carcinoma that showed high signal intensity for the outer tumor and low intensity for the inner tumor in the hepatobiliary phase of EOB-MRI. The inner tumor was more dedifferentiated than the outer. The other two cases involved similar nodules, which showed different signal intensities in the hepatobiliary phase of EOB-MRI. In all three cases, the expression of OATP8 showed good correlation with high signal intensity in the hepatobiliary phase of EOB-MRI, whereas MRP2, MRP3, or both were also highly expressed. However, in the two nodules showing low intensities, the expression of one excreting transporter was independently high even though that of OATP8 was not high. The expression of excreting transporters is usually characterized by passive correspondence to OATP8 expression levels; nevertheless, it sometimes shows expression independent of OATP8.
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  • Tomoaki IWATA, Yasuteru KONDO, Osamu KIMURA, Fumiyoshi FUJISHIMA, Tats ...
    2014 Volume 111 Issue 5 Pages 948-955
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    A 66-year-old male was referred to our hospital because of a high CRP level. CT and MRI revealed cord-like contrast effects along the periphery of the liver, and peripheral portal vein occlusion was suspected. Histopathological analysis revealed fibrotic occlusion and eosinophil and histiocytic infiltration of the portal vein. Taking into account various clinical imaging tests, blood tests, and histopathological tests and of his current clinical history, he was diagnosed with previous infection of schistosomiasis japonica. We believe that this case illustrates the importance of a comprehensive diagnosis; in addition, we implemented real-time virtual sonography and EOB-MRI that provided useful visual information.
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  • Yoshito KIMURA, Yukimasa YAMASHITA, Ryosuke ITAI, Masayuki MARUO, Eiki ...
    2014 Volume 111 Issue 5 Pages 956-965
    Published: May 05, 2014
    Released: May 05, 2014
    JOURNALS FREE ACCESS
    A 79-year-old woman with pneumobilia and liver dysfunction was admitted to our hospital. ERCP and gastrointestinal endoscopy revealed choledochal stones and a cholecystogastric fistula at the greater curvature of the gastric antrum. The risk of cholecystectomy and fistulectomy appeared to be extremely high for this patient because of her advanced age and low respiratory function due to interstitial pneumonia. Therefore, only an endoscopic lithotomy was performed, and the cholecystogastric fistula remained. However, after 2 years of follow-up, she developed an advanced gallbladder carcinoma. This finding suggests that cholecystogastric fistula is a risk factor for gallbladder carcinoma. Because of the difficulty of early detection of gallbladder carcinoma associated with cholecystogastric fistula, both fistulectomy and cholecystectomy are necessary when cholecystogastric fistula is diagnosed.
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