Nippon Shokakibyo Gakkai Zasshi
Online ISSN : 1349-7693
Print ISSN : 0446-6586
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Monthly report (General review article); Usefulness and issues on immunomodulators in inflammatory bowel disease
Monthly report; Usefulness and issues on immunomodulators in inflammatory bowel disease
Case report
  • Yu WATAHIKI, Tomohiro SUZUKI, Yudai KOYA, Naoki MATSUOKA, Nobuo MATSUH ...
    2020 Volume 117 Issue 3 Pages 237-244
    Published: March 10, 2020
    Released: March 10, 2020
    JOURNALS RESTRICTED ACCESS

    A 77-year-old woman was referred for severe constipation and abdominal distension which had lasted for 1 month. A computed tomography (CT) scan and a colonoscopy revealed segmental stricture in the transverse and descending colons. After no improvement in her symptoms was observed with conservative therapy, we performed a left hemicolectomy. Histopathological examination revealed a reduction in ganglion cells in the Meissner's and Auerbach's plexuses and hypoganglionosis was diagnosed. In addition, a diagnosis of acquired hypoganglionosis was made because this case was adult onset, and there has been no recurrence.

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  • Narihiro SHIBUKAWA, Shohei OUCHI, Shuji WAKAMATSU, Yuhei WAKAHARA, Aki ...
    2020 Volume 117 Issue 3 Pages 245-251
    Published: March 10, 2020
    Released: March 10, 2020
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    A 70-year-old woman received H. pylori eradication therapy in March, 201X-12. She was admitted to our department because early gastric cancer was detected on esophagogastroduodenoscopy, and we performed endoscopic submucosal dissection (ESD) in June, 201X-2. The final diagnosis was well-differentiated tubular adenocarcinoma. Afterwards, we performed ESD two times (in November, 201X-1, and in March, 201X), and final diagnoses were both adenocarcinoma of fundic gland type.

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  • Hidenori TANAKA, Yusuke JIMBO, Kousuke IWANE, Ryohei TAKATA, Atsushi I ...
    2020 Volume 117 Issue 3 Pages 252-260
    Published: March 10, 2020
    Released: March 10, 2020
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    A 57-year-old female presented with a chief complaint of odynophagia during medical treatment for systemic lupus erythematosus (SLE). Endoscopy revealed sloughed mucosa along the entire esophageal length, and normal mucosa was easily stripped by withdrawal of the biopsy forceps. Blistering eruptions subsequently appeared on her upper extremities, trunk, and oral cavity. Direct immunofluorescence of a skin biopsy specimen demonstrated linear deposits of IgG, IgM, and complement at the dermoepidermal junction. On the basis of these findings, a diagnosis of bullous SLE was made. This autoimmune blistering disease can occur in the course of SLE and is rarely accompanied by sloughing of the esophageal mucosa.

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  • Miho DOI, Hideki MIYATA, Shogo KITAHATA, Hirofumi IZUMOTO, Hidetaro UE ...
    2020 Volume 117 Issue 3 Pages 261-269
    Published: March 10, 2020
    Released: March 10, 2020
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    A man in his 40s visited a facility with the chief complaint of abdominal pain;liver dysfunction was detected, and consequently, he was referred to our hospital for further examinations. His medical history was unremarkable. He used to drink alcohol (beer, 1500mL) every day. Magnetic resonance imaging and computed tomography showed stenosis of the distal bile duct and slight dilation of the upstream bile duct. Common bile duct stones and gallbladder stones were not detected. Malignant tumors in the bile duct biopsy were not discovered. The patient underwent subtotal stomach preserving pancreatoduodenectomy. The pathological diagnosis was chronic pancreatitis with amputation neuroma-like neurogenesis of the bile duct.

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  • Hiroki FUKUYA, Masayuki MIYAZAKI, Yusuke MORITA, Kosuke TANAKA, Masayo ...
    2020 Volume 117 Issue 3 Pages 270-276
    Published: March 10, 2020
    Released: March 10, 2020
    JOURNALS RESTRICTED ACCESS

    A 49-year-old man with chronic hepatitis B receiving treatment with entecavir visited a hospital with a complaint of abdominal pain. Computed tomography (CT) showed 2 liver tumors, each measuring 1cm in diameter, 1 in segment 7 and 1 in segment 4. Magnetic resonance imaging (MRI) showed a hypervascular tumor in segment 7 that appeared in a site different from that seen on CT. The liver tumor in segment 4 was not detected by MRI. Two months later, MRI showed a new liver tumor in segment 7/6 and that the liver tumor in segment 7 had increased to 2cm in diameter;blood tests showed eosinophilia. Enzyme-linked immunosorbent assay showed a high serum Toxocara antibody. The patient was diagnosed as having hepatic toxocariasis and was treated with albendazole for 8 weeks. After treatment, MRI showed that the liver tumors disappeared. Eosinophilia, multiple lesions, and the disappearance of the tumors were characteristic findings of visceral larva migrans.

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