Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
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Volume 112, Issue 3
Displaying 1-13 of 13 articles from this issue
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Review article
Monthly report; Diagnosis and Treatment of the gallbladder elevated lesions
Round-table discussion
Original article
  • Clinical characteristics of patients with pneumatosis cystoides intestinalis
    Daisuke SAITO, Mari HAYASHIDA, Miki MIURA, Kengo TOKUNAGA, Shin'ichi T ...
    2015 Volume 112 Issue 3 Pages 494-499
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.494
    JOURNAL FREE ACCESS
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    Pneumatosis cystoides intestinalis (PCI) is a relatively rare disease in which multilocular or linear pneumatic cysts develop under the mucosa or serosa of the intestinal wall. We conducted a retrospective analysis to investigate the clinical characteristics of 68 patients with PCI. Hepatic portal venous gas (HPVG) was present in 9 patients, 8 of which had underlying intestinal tract necrosis. In most patients, PCI was mild and asymptomatic and resolved spontaneously. The main treatment strategy for PCI is conservative therapy. However, in cases complicated by HPVG, the presence of underlying intestinal tract necrosis must be considered in order to promptly determine whether emergency surgery is required.
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Case report
  • A case report of food-induced ileus requiring two emergency laparotomies in one year
    Daisuke KUBOTA, Yukino KUBOTA
    2015 Volume 112 Issue 3 Pages 500-507
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.500
    JOURNAL FREE ACCESS
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    A 58-year-old woman completely edentulous man was transported to our hospital by ambulance with complaints of abdominal pain and vomiting. Abdominal computed tomography revealed multiple objects in the dilated ileum. An emergency laparotomy was performed and a diagnosis of ileus caused by ingestion of lotus root was established. We advised the patient to obtain and wear dentures. However, she did not comply and continued to swallow food without chewing. After 11 months, she was readmitted with the same symptoms. A second emergency laparotomy also revealed food-induced ileus. No recurrence of food-induced ileus has occurred after the patient agreed to wearing dentures. When encountering patients presenting with ileus, the patient's diet and eating habits should be verified, and the condition of the teeth at the time of diagnosis should be evaluated. Encouragement of patients to improve eating habits, along with adequate dental care, sufficiently prevents food-induced ileus.
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  • Three cases of enteroenteric intussusception examined by three-dimensional computed tomography enteroclysis
    Toshiyuki YOSHIKAWA, Tomoyo YAMADA, Takafumi KUROKAMI, Shinsuke SATO, ...
    2015 Volume 112 Issue 3 Pages 508-514
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.508
    JOURNAL FREE ACCESS
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    Three-dimensional computed tomography (3D CT) enteroclysis or virtual enteroscopy is a novel technique to explore the entire small bowel using a modified protocol of virtual colonoscopy by inflating the small bowel with air. In our hospital, the procedure is performed routinely for cases with suspected gross lesions. We performed 3D CT enteroclysis for three cases with enteroenteric intussusception bowel. The lesions associated with intussusception were identified, single-incision laparoscopic surgery was performed, and diagnoses of lipoma and Peutz-Jeghers polyp were made in two cases. 3D CT enteroclysis did not reveal any associated lesion in the third case. This was followed by an intraoperative exploration during gastrectomy for stomach cancer, but no intestinal lesion was found. A diagnosis of idiopathic intussusception and its spontaneous release was made, and no recurrence was observed during the follow-up period. 3D CT enteroclysis seems to be an appropriate modality for the evaluation of enteroenteric intussusception.
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  • Successful resection of a gastric aberrant pancreas causing gastrointestinal bleeding by laparoscopy and endoscopy cooperative surgery
    Kohei KURODA, Masatoshi FUJII, Daisuke SHIRASAKA, Takashi HIRAYAMA, Yu ...
    2015 Volume 112 Issue 3 Pages 515-521
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.515
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    A man in his 50s was admitted to our hospital for treatment of hematemesis. Endoscopy revealed arterial bleeding from a gastric submucosal tumor and endoscopic hemostasis was successful. However, surgical resection was contemplated to prevent recurrent bleeding and for making a definitive diagnosis. Surgical resection was eventually performed by laparoscopy and endoscopy cooperative surgery (LECS), and the tumor was pathologically diagnosed to be a gastric aberrant pancreas. We think that LECS is suitable for a gastric aberrant pancreas causing gastrointestinal bleeding, because the procedure is effective for tumor resection with minimal removal of the stomach wall.
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  • A case of primary micropapillary carcinoma of the jejunum
    Anna SEKI, Masao YOSHIOKA, Shunsuke SAITO, Masakuni FUJII, Mamoru ITO, ...
    2015 Volume 112 Issue 3 Pages 522-527
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.522
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    Micropapillary carcinoma (MPC) has been recently reported as a variant of invasive breast carcinoma. MPC is also known to be an aggressive variant of adenocarcinoma, and it is associated with poor prognosis and a high propensity for lymphovascular invasion and lymph node metastases. MPC of the breast, urinary bladder, and lung has been reported relatively frequently; however, there have been few reports on gastrointestinal MPC. Furthermore, MPC of the small bowel has not been reported yet. Here we report a case of MPC of the jejunum. A female septuagenarian was admitted because of anorexia and weight loss. We established a diagnosis of primary jejunal cancer and resected the duodenum and a part of the jejunum. Histologically, the tumor consisted of adenocarcinoma with moderate to poor differentiation. Among the carcinoma cells, approximately 10% formed small papillary neoplastic cell clusters surrounded by clear spaces, suggesting a diagnosis of MPC. We present the details of the case along with a review of relevant literature.
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  • A case of skeletal muscle metastasis on the left thigh after esophagectomy for esophageal adenocarcinoma in Barrett' s esophagus
    Shogo MARUZEN, Koichi OKAMOTO, Itasu NINOMIYA, Isamu MAKINO, Keishi NA ...
    2015 Volume 112 Issue 3 Pages 528-536
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.528
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    We report the case of a 45-year-old man with advanced esophageal adenocarcinoma in Barrett's esophagus. After neoadjuvant chemotherapy using S-1, docetaxel, and cisplatin, the patient underwent thoracoscopic esophagectomy with a two-field lymph node dissection and reconstruction with a gastric tube through the posterior mediastinal route. The pathological stage was CT-pT4 (diaphragm), ly2, v1, CT-pN1, CT-pStage IVa. Fourteen months after the operation, the patient complained of pain in his left thigh with a palpable indurated mass that was increasing in size. Needle biopsy specimens revealed skeletal muscle metastasis of the adenocarcinoma. The metastastic lesion was resected and local control was achieved successfully for 13 months, after which the patient died because of intrabronchial bleeding.
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  • Subcutaneous continuous injection of octreotide decreased the tumor marker levels and induced cystic necrosis of the tumors in a case of pancreatic neuroendocrine tumor with multiple hepatic metastases
    Masahiro MIURA, Hiroaki SHIBAHARA, Kiyoshi MORITA, Kenichi MATSUI, Yuy ...
    2015 Volume 112 Issue 3 Pages 537-546
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.537
    JOURNAL FREE ACCESS
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    For symptom alleviation, subcutaneous continuous injection of octreotide was administered to a patient with pancreatic neuroendocrine tumor (NET) accompanied by multiple hepatic metastases and ascites. The level of the tumor marker neuron-specific enolase decreased to the normal range and cystic necrosis of the tumors was confirmed. There have been some reports on the antineoplastic effects of octreotide on pancreatic NET; therefore, octreotide appears to be a valid option as a therapeutic agent in patients with highly advanced pancreatic NET, in whom administration of molecular targeted or anticancer agents is difficult because of a poor general status.
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  • Use of dexmedetomidine hydrochloride as a sedative during local therapy for hepatocellular carcinoma
    Shunsuke TSUBATA, Yukio ARUGA, Masaaki HIRANO, Akira SAKAMAKI, Masashi ...
    2015 Volume 112 Issue 3 Pages 547-554
    Published: March 05, 2015
    Released on J-STAGE: March 05, 2015
    DOIhttps://doi.org/10.11405/nisshoshi.112.547
    JOURNAL FREE ACCESS
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    Sedation using dexmedetomidine hydrochloride (DEX) was administered to patients with hepatocellular carcinoma (HCC) prior to local therapy. Case 1 was a 58-year-old man undergoing radiofrequency ablation in combination with transcatheter arterial chemoembolization for HCC in S3. In accordance with the package insert, the initial loading dose was set at 6 μg/kg/hour. Although a favorable sedative effect was achieved, his blood pressure and pulse rate decreased. Case 2 was a 79-year-old woman undergoing percutaneous ethanol injection therapy for HCC in S6. Half the initial loading dose indicated in the package insert (3 μg/kg/hour) was administered, but the sedative effect was appreciable. No marked blood pressure or pulse rate decreases were observed. We believe that the use of DEX as a sedative agent in local therapy for HCC can be expected to increase. However, the optimal dose setting for DEX requires further examination.
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