Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
Volume 114 , Issue 6
Showing 1-11 articles out of 11 articles from the selected issue
Special contribution
Review article
Monthly report; Current status of ESD for gastrointestinal cancer
Case report
  • Yutaka OKAGAWA, Kohichi TAKADA, Hiroki SAKAMOTO, Takumi MIURA, Shigeki ...
    2017 Volume 114 Issue 6 Pages 1001-1007
    Published: June 05, 2017
    Released: June 05, 2017
    JOURNALS FREE ACCESS

    An 87-year-old woman was admitted to our hospital for paralytic ileus, and she was treated using an ileus tube. Although her symptoms improved, abdominal fullness developed again on day 3 after ileus tube insertion. Abdominal computed tomography indicated intussusceptions at the ileum and the terminal part of the ileum;therefore, an emergency surgery was performed. During the surgery, antegrade intussusceptions were found in the ileum 60cm from the ileocecal valve and the terminal part of the ileum into the ascending colon. The intussusception of the anal side was resolved by manual reduction, but the oral side needed a partial resection of small bowel because of the presence of necrosis. There were no lesions, such as tumors, at the intussusceptions sites. Therefore, the two intussusceptions were thought to be caused by the ileus tube. We diagnosed a rare case of intussusceptions in the two parts of the ileum as a complication of the placement of an ileus tube.

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  • Takuya SEIKE, Takashi KAGAYA, Takuya KOMURA, Ryotaro NAKAI, Yoshiaki S ...
    2017 Volume 114 Issue 6 Pages 1008-1014
    Published: June 05, 2017
    Released: June 05, 2017
    JOURNALS FREE ACCESS

    A 40-year-old man complaining of abdominal distention was referred to our hospital. Computed tomography of the abdomen demonstrated a very large abdominal mass with fat and calcification. The size of the mass rapidly increased from 30cm to 40cm over two weeks. The tumor was removed and diagnosed by pathological examination to be a retroperitoneal mature cystic teratoma that contained a 40-cm long, mature intestinal tract-like cyst, together with bone marrow and fat. The rapid growth of the tumor may have been caused by an increased secretion in the cyst.

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  • Shigeo MANABE, Takayuki YASUOKA, Yuki ENDO, Fumitaka USUI, Taku YAMAGU ...
    2017 Volume 114 Issue 6 Pages 1015-1022
    Published: June 05, 2017
    Released: June 05, 2017
    JOURNALS FREE ACCESS

    A 52-year-old man was referred to our hospital complaining of right lower abdominal pain. He was diagnosed with appendicitis complicated with a liver abscess and underwent an appendectomy. After antibiotic treatment following surgery, the liver abscess penetrated the right lung, which was considered to be drained from a hepatobronchial fistula. Due to the effect of drainage, the liver abscess immediately improved and the patient was subsequently discharged.

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  • Yasuharu KAKIZAKI, Naohiko MAKINO, Yoshiaki ANDO, Akiko MATSUDA, Tetsu ...
    2017 Volume 114 Issue 6 Pages 1023-1030
    Published: June 05, 2017
    Released: June 05, 2017
    JOURNALS FREE ACCESS

    We report a case of pancreatic intraepithelial neoplasia-3 (PanIN-3) with autoimmune pancreatitis (AIP). The patient, a 75-year-old man, had been diagnosed to have AIP with stenosis of the main pancreatic duct. After six years, computed tomography demonstrated dilatation of the main pancreatic duct in the mid-pancreas. Although we could not confirm the presence of any pancreatic tumor on the basis of imaging modalities alone, cytological examination of the pancreatic juice obtained by endoscopic retrograde pancreatography revealed atypical cells. Therefore, we performed pancreatoduodenectomy and obtained a pathologic diagnosis of PanIN-3 with AIP. The present case is informative in the context of pancreatic carcinogenesis in AIP.

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  • Masatoshi YAMATO, Kuniaki ARAI, Hajime TAKATORI, Tetsuro SHIMAKAMI, Ta ...
    2017 Volume 114 Issue 6 Pages 1031-1038
    Published: June 05, 2017
    Released: June 05, 2017
    JOURNALS FREE ACCESS

    A 74-year-old man with hepatitis C virus (HCV)-related cirrhosis was admitted because of dyspnea. Laboratory investigations revealed severe proteinuria (4.0g/day), low serum albumin level, and cryoglobulinemia. Computed tomography showed massive pleural effusion and ascites. Because these effusions were leaky and the hepatic reserve was relatively intact, we thought these were mainly caused by nephrotic syndrome. Renal biopsy revealed membranoproliferative glomerulonephritis with mesangial proliferation and excessive matrix deposition. Based on these histopathological findings and the presence of cryoglobulinemia, a diagnosis of HCV-related nephropathy was performed. Therefore, antiviral therapy was initiated with direct-acting antiviral (DAA) agents (daclatasvir+asunaprevir). Serum HCV-RNA level was observed to be negative at week 8, which was followed by an alleviation of proteinuria and a gradual decrease in the pleural effusion and ascites. HCV-related nephropathy should be considered in the differential diagnosis of patients with chronic hepatitis C and refractory ascites. DAA agents are effective in the treatment of these patients.

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  • Tsuyoshi SUDA, Hikaru OGURI
    2017 Volume 114 Issue 6 Pages 1039-1045
    Published: June 05, 2017
    Released: June 05, 2017
    JOURNALS FREE ACCESS

    A 79-year-old man was diagnosed to have primary amyloid light-chain (AL) amyloidosis with associated liver damage and prominent hepatomegaly. He was followed up without any treatment. One year after the diagnosis, he was taken to the hospital with a sudden onset of features of shock. Computed tomography revealed hepatic rupture, and he was treated by emergent transcutaneous arterial embolization. However, the procedure was unable to save his life. AL amyloidosis with prominent hepatomegaly is considered to be a risk factor for spontaneous liver rupture and intra-abdominal hemorrhage.

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