Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
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Volume 111, Issue 6
Displaying 1-13 of 13 articles from this issue
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Review article
Monthly report; A coming view of functional dyspepsia (FD) in Japan
Case report
  • Two cases of dabigatran-induced esophageal ulcer indicating the usefulness of drug administration guidance
    Koichi IZUMIKAWA, Tomoki INABA, Shou MIZUKAWA, Yusuke KAWAI, Ichiro SA ...
    2014 Volume 111 Issue 6 Pages 1096-1104
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1096
    JOURNAL FREE ACCESS
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    Here we report two cases of dabigatran-induced esophageal ulcer. Case 1 was a 67-year-old man who presented with heartburn that developed a month after dabigatran administration. Case 2 was an 81-year-old woman who presented with epigastralgia that developed within a few days of dabigatran administration. Endoscopic findings were similar in both cases, including shallow esophageal ulcers covered with a thin whitish membrane. The patients were advised to consume the drug with plenty of water during meals and to remain in a sitting position for 30 min after consumption. This method successfully decreased their symptoms and ulcers, indicating that drug administration guidance is extremely effective in managing dabigatran-induced esophageal injury.
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  • A case of superficial esophageal basaloid squamous cell carcinoma resected by endoscopic submucosal dissection
    Takuto NOSAKA, Hiroyuki SUTO, Hidetaka MATSUDA, Kazuto TAKAHASHI, Masa ...
    2014 Volume 111 Issue 6 Pages 1105-1112
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1105
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    A woman in her 70s visited our hospital to undergo endoscopy. Esophagogastroduodenoscopy showed a white submucosal tumor-like lesion in the upper esophagus. Analysis of a biopsy specimen revealed that the tumor was a basaloid squamous cell carcinoma. A superficial squamous cell carcinoma was also revealed near the basaloid squamous cell carcinoma before endoscopic submucosal dissection. Curative en bloc resection was successfully performed. Histopathological examination revealed that the basaloid and superficial squamous cell carcinomas had invaded the lamina propria (pT1a-LPM) and epithelium (pT1a-EP), respectively. In addition, the basaloid squamous cell carcinoma had two different components in terms of malignancy and differentiation. Here we report a rare case of esophageal basaloid squamous cell carcinoma resected by endoscopic submucosal dissection.
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  • A case of advanced gastric cancer with an invasive micropapillary carcinoma component
    Youichirou BABA, Hiroki TANAKA, Yoshiaki ISONO, Tomonori SAITO, Katsum ...
    2014 Volume 111 Issue 6 Pages 1113-1119
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1113
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    A 62-year-old man was admitted for the evaluation of epigastric pain. Upper gastrointestinal endoscopy revealed a type 3 circumferential carcinoma in the gastric antrum. Distal gastrectomy was performed, and the lesion was histopathologically diagnosed as gastric cancer with an invasive micropapillary carcinoma component. Chemotherapy was administered after surgery; however, he died with multiple liver metastases after 39 months. Micropapillary carcinoma is a rare, high-grade, malignant histological subtype of gastric cancer that has not been described in detail till date. Here we describe this rare lesion and present a review of the relevant literature.
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  • A case of intraventricular dissemination arising from hepatocelullar carcinoma effectively treated with intrathecal administration of methotrexate
    Hikaru OGURI, Masaki MIYAZAWA, Tomoki NISHIKAWA, Shinichi HAYASHI
    2014 Volume 111 Issue 6 Pages 1120-1127
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1120
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    A 78-year-old man with hepatocellular carcinoma was admitted to our hospital for vertigo after transcatheter arterial chemoembolization. Contrast-enhanced magnetic resonance imaging revealed metastasis in the cerebellar vermis. Although the cerebellar metastasis decreased in size after cyberknife radiotherapy, multiple enhancing nodules appeared in the cerebral ventricles. A diagnosis of intraventricular dissemination from the cerebellar metastatic lesion originating from the hepatocellular carcinoma was made. Six intrathecal administrations of 20 mg of methotrexate through lumbar puncture resulted in a dramatic decrease in the intraventricular dissemination. Although intraventricular dissemination recurred 4 months later, these lesions disappeared after an additional 8 administrations of intrathecal methotrexate. Intraventricular dissemination arising from hepatocellular carcinoma is rare. Here we report a case that was successfully treated by intrathecal chemotherapy with methotrexate.
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  • A case of hepatocellular carcinoma complicated by pleural effusion mixed with bile after radiofrequency ablation
    Toshikazu KOBAYASHI, Shuichiro KATSUMI, Yoshiko WADA, Sohei HORIUCHI, ...
    2014 Volume 111 Issue 6 Pages 1128-1134
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1128
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    An 84-year-old Japanese man was admitted with hepatocellular carcinoma (HCC). He underwent transcatheter arterial chemoembolization and percutaneous radiofrequency ablation (RFA). Three weeks later, he developed sudden-onset right pleural effusion mixed with bile. Drip infusion cholangiography-computed tomography revealed leakage of the contrast agent, which passed from the HCC to the pleural cavity through a perforation in the diaphragm. The patient's condition improved after thoracic and endoscopic nasobiliary drainage. The occurrence of pleural effusion mixed with bile is a rare complication of RFA. This case provides important information about the morbidity, prevention, and treatment of this complication.
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  • Submucosal bacterial abscesses of the ascending colon and liver associated with portal and superior mesenteric vein thrombosis due to Enterococcus faecalis infection: a case report
    Daisuke NORIMURA, Fuminao TAKESHIMA, Yoshiaki SATOU, Tohru NAKAGOE, Ke ...
    2014 Volume 111 Issue 6 Pages 1135-1140
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1135
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    A 72-year-old woman with diabetes mellitus was admitted with fever and general fatigue. Blood biochemistry showed elevated hepatic and biliary enzyme levels, abdominal computed tomography showed multiple liver abscesses with portal and superior mesenteric vein thrombosis, and total colonoscopy revealed a submucosal bacterial abscess in the ascending colon. The abscesses were determined to be associated with Enterococcus faecalis infection. The patient was treated conservatively with antibiotics (meropenem) and anticoagulants (warfarin), which led to a gradual amelioration of symptoms and resolution of thrombosis.
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  • Acute hepatitis C infection with prolonged intrahepatic cholestasis and remarkable progression of fibrosis mimicking fibrosing cholestatic hepatitis
    Hideko AKAGI, Akira MIZUKI, Tomonari TOMINAGA, Yuki SEKI, Rokuro NAKAJ ...
    2014 Volume 111 Issue 6 Pages 1141-1148
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1141
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    We report the case of a 71-year-old woman with acute hepatitis C infection and persistent viremia since 2 years. Her clinical course was characterized by general fatigue and prolonged jaundice with unusually high serum bilirubin levels. Liver histology showed lymphocyte infiltration, marked fibrosis, and severe cholestasis in the periportal zone, findings mimicking fibrosing cholestatic hepatitis (FCH). Fibrosing cholestatic hepatitis is a life-threatening form of recurrent hepatitis C infection that typically occurs in immunosuppressed patients. Here we report the rare case of an immunocompetent patient who developed this condition.
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  • Liver injury and hepatic encephalopathy induced by the herbal medicine Hochuekkito
    Ryoju NEGISHI, Takeshi ICHIKAWA, Yoshiyuki TAWA, Akira FUJIMURA, Sayo ...
    2014 Volume 111 Issue 6 Pages 1149-1156
    Published: June 05, 2014
    Released on J-STAGE: June 05, 2014
    DOIhttps://doi.org/10.11405/nisshoshi.111.1149
    JOURNAL FREE ACCESS
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    A 57-year-old man was admitted with pruritus and jaundice following treatment for fatigue with the herbal medicine Hochuekkito. The patient was prescribed prednisolone and ursodeoxycholic acid, but he developed progressive cholestasis that required intravenous methylprednisolone pulse therapy. After treatment with plasma exchange for prolonged prothrombin time, the patient recovered; however, his liver function deteriorated because of liver injury induced by trimethoprim-sulfamethoxazole for pneumocystis pneumonia. After reduction of trimethoprim-sulfamethoxazole, his liver function almost returned to normal by day 130 of admission. It has remained normal for 10 months since then. Therefore, when prescribing Hochuekkito, the possibility of drug-induced liver injury should be taken in account.
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