Progress of Digestive Endoscopy
Online ISSN : 2187-4999
Print ISSN : 1348-9844
ISSN-L : 1348-9844
検索
詳細検索
OR
閲覧
検索
64 巻, 2 号
選択された号の論文の55件中1～50を表示しています
すべての抄録を表示する
掲載論文カラー写真集
臨床研究
  • 胃十二指腸潰瘍の除菌成功後に非NSAIDs十二指腸潰瘍再発を繰り返した1例
    植木 信江, 三宅 一昌, 濱本 達彦, 鈴木 健司, 楠 正典, 進士 陽子, 篠木 啓, 平塚 哲郎, 西垣 均, 二神 生爾, 和田 ...
    2004 年 64 巻 2 号 p. 28-31
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_28
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    　胃潰瘍に対するヘリコバクターピロリ（Helicobacter pylori ; 以下，H．pylori）除菌後に十二指腸潰瘍再発を繰り返した症例を経験した。症例は50歳男性，下血と心窩部痛を主訴に受診し内視鏡検査にて出血性胃潰瘍と診断された。除菌療法と8週間のプロトンポンプインヒビター（以下，PPI）投与を施行したが，その後受診せず放置された。除菌8カ月後，心窩部痛を主訴に来院，胃潰瘍は瘢痕化していたが，類円形の活動性十二指腸潰瘍の再発を認めた。その後，PPIにて一旦いずれの潰瘍も瘢痕化していたが，PPI中止後，十二指腸潰瘍を再度再発した。除菌後，尿素呼気試験を3回行うが，いずれもH．pylori陰性であった。
    　今回我々は，除菌成功後に極めて典型的な消化性潰瘍の形態を有する再発性十二指腸潰瘍を経験したので，若干の文献的考察を加え報告する。
    抄録全体を表示
    PDF形式でダウンロード (1077K)
  • ベトナムの二地域における上部消化管疾患，Helicobacter pylori感染，背景胃粘膜の検討―日本との比較観察を含めて―
    松久 威史, 富樫 晃祥, 松倉 則夫, 山田 宣孝
    2004 年 64 巻 2 号 p. 32-37
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_32
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    　我々は中国人，タイ人，ベトナム人（ホー・チ・ミン）の内視鏡検査を行い，胃十二指腸疾患，Helicobacter pylori（H．pylori）感染，背景胃粘膜の相違を調査してきた。今回は，ベトナム社会主義共和国中部の都市，フエでの成績をホー・チ・ミン，日本と比較検討した。その際，H．pylori感染の診断は病理診断法を用い，切片の採取は3点生検法に基づいた。年齢，性別のマッチにより得られたホー・チ・ミン，フエの108例における胃十二指腸疾患をみると，胃癌，消化性潰瘍，正常例の頻度に大きな相違はみられなかった。消化性潰瘍は胃潰瘍よりも十二指腸潰瘍の占める割合が高く（ホー・チ・ミン : 60.0％，フエ : 91.3％），日本人に胃潰瘍が多い成績（58.3％）とは大きく異なっていた。年齢，性別，内視鏡診断をマッチさせた76例のH．pylori感染率は，ホー・チ・ミンに比べフエでやや高いが有意差は認められなかった（各々48.7％，58.9％）。フエと日本の比較（85例）でも近似した値であった（各々50.6％，45.9％）。3点生検による切片＃3，すなわち胃体下部小彎側から採取した切片の腺萎縮，腸上皮化生スコアをH．pylori陽性例についてUpdated Sydney systemに従い0～3に判定すると，ホー・チ・ミン，フエの腺萎縮，腸上皮化生スコアはいずれも低値であった。一方，フエと日本のスコアを比較すると，日本人のそれは有意に高値を示した（腺萎縮スコア : 0.89，腸上皮化生スコア : 0.82）。これはH．pylori陽性日本人にのみみられる特有の変化であった。
    抄録全体を表示
    PDF形式でダウンロード (715K)
  • 十二指腸低悪性度リンパ腫に対するHelicobacter pylori（H．pylori）除菌療法
    滝沢 耕平, 小田 一郎, 鈴木 晴久, 江口 貴子, 濱中 久尚, 中島 健, 浦岡 俊夫, 小林 望, 後藤田 卓志, 松田 尚久, 斉 ...
    2004 年 64 巻 2 号 p. 38-41
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_38
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    　【目的】胃MALTリンパ腫に対するH．pylori除菌療法の効果はほぼ確立した感があるが，胃以外の低悪性度リンパ腫に対する治療方針は未だ統一されていない。そこで我々は十二指腸原発低悪性度リンパ腫に対する除菌療法について検討した。【対象】1998年1月より2003年7月までに生検によって診断された限局期・十二指腸原発低悪性度リンパ腫の11例。【結果】11例中，MALTリンパ腫は5例，男性3例 : 女性2例，年齢28～65歳（平均48.6歳），部位は球部1例 : 下行脚4例，臨床病期は全例stageⅠ，濾胞性リンパ腫は6例，男性1例 : 女性5例，年齢50～83歳（平均62.5歳），部位は全例下行脚で，臨床病期はstageⅠ5例 : stageⅡ11例であった。肉眼形態は，11例全例で白色顆粒状隆起の集簇あるいは散在した所見であった。MALTリンパ腫4例（3例に胃病変あり），濾胞性リンパ腫2例に対してH．pylori除菌を施行した。MALTリンパ腫では，胃病変3例中2例は消失したが十二指腸病変の消失は1例にのみ認められた。濾胞リンパ腫では1例も効果は認められなかった。【結論】十二指腸MALTリンパ腫に対する除菌療法は，その奏効率は胃MALTリンパ腫より低いものの，その低侵襲性よりまず試みてもよい治療法であると考えられた。一方，十二指腸濾胞性リンパ腫においては，除菌療法の効果は期待できないと考えられた。
    抄録全体を表示
    PDF形式でダウンロード (429K)
  • 内視鏡的大腸腫瘍摘除術後の後出血症例の検討
    鈴木 武志, 一志 公夫, 中村 靖幸, 斎藤 彰一, 松田 浩二, 荒川 廣志, 加藤 智弘, 野沢 博, 西野 晴夫, 成宮 徳親, 田 ...
    2004 年 64 巻 2 号 p. 42-45
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_42
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    　内視鏡的大腸腫瘍摘除術後の出血の明らかな要因は解明されてない。今回の検討では出血の要因と，止血法としてのクリッピングの有効性を検討した。東京慈恵会医科大学にて1999年1月から2003年7月の間に内視鏡的大腸腫瘍摘除術を施行した3,000例中，術後出血を認めた66例を対象とし，部位別，腫瘍径別，形態別，治療方法別の出血率を検討した。術後出血の要因として部位はS状結腸，腫瘍径別は10mm以下，形態はIpとIsp型であった。クリッピング施行の有無では出血率に明らかな差はなかったが，治療により生じた破綻血管を同定しそこに的確にクリッピングすれば出血を予防することが可能と思われ，そのためには破綻血管を同定する機器や方法の開発が望まれる。
    抄録全体を表示
    PDF形式でダウンロード (434K)
内視鏡の器械と技術
  • 2チャンネルスコープを用いたアルゴンプラズマ凝固法の有用性
    津田 朋子, 今枝 博之, 中下 学, 緒方 晴彦, 岩男 泰, 細江 直樹, 正岡 建洋, 鈴木 秀和, 中溝 裕雅, 相浦 浩一, 島津 ...
    2004 年 64 巻 2 号 p. 46-47
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_46
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    Argon plasma coagulation (APC) is useful for endoscopic therapy against gastrointestinal (GI) bleeding, GI malignant tumor and esophageal varices. An APC applicator spurts out argon gas, however the diameter of APC probe is so wide that the argon gas spurted out in the GI tract is not able to be absorbed while the applicator is inserted into a one channel endoscope. Therefore, patients often have fullnesss and vomit during APC. The aim of this study is to analyze usefulness of APC using a double channel endoscope against widespread gastric lesions. Subjectives were 14 sessions against 5 patients (radiation-induced gastropathy : 6 against 2 patients, diffuse antral vascular ectasia : 2 against a patient, gastric antral vascular ectasia : 1 against a patient, Oslar disease : 5 against a patient) . Argon gas spurted out in the stomach is absorbed more easily, while APC probe is inserted into a right channel in a double channel endoscope, therefore patients complained of neither fullness nor vomitting. Furthermore, it became easier to spew water and perform injection through a left channel. Operation time of APC using a double channel endoscope against widespread gastric lesions (11.7 minutes, 14 sessions) was significantly decreased compared with a one channel endoscope (21.0 minutes, 8 sessions) . Argon plasma coagulation using a double channel endoscope against widespread gastric lesions is thought to be easier and more useful, and less painful.
    抄録全体を表示
    PDF形式でダウンロード (562K)
症例
  • 経過観察中にdysplasiaが多発したBarrett食道の1例
    大森 順子, 三坂 亮一, 古市 有子, 竹内 英津子, 石川 尚之, 柳沢 明子, 荻原 正示, 加藤 純子, 古川 みどり, 土谷 まり ...
    2004 年 64 巻 2 号 p. 48-49
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_48
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 75-year-old man was pointed out Barrett's esophagus, reflex esophagitis and hiatal hernia by an annual check up upper gastrointestinal endoscopy from 1996. Severe dysplasia lesion was revealed in ulcer scar of lower Barrett's esophagus on March 2003. After them, multiple small occupied lesion of Barrett's esophagus was revealed moderate to severe dysplasia by biopsy. Middle and lower thoracic esophageal resection was performed on September 17. The pathological findings of the resected specimen revealed five lesions of well differentiated tubular adenocarcionma with a depth of invasion of m1, ly0, v0, n0, Stage I in 12cm in size Barrett's esophagus.
    抄録全体を表示
    PDF形式でダウンロード (799K)
  • 切開剥離法によるEMR，ならびにBRTOにより治療し得た胃食道静脈瘤に合併した食道癌の1例
    田代 淳, 為我井 芳郎, 小飯塚 仁彦, 小早川 雅男, 秋山 純一, 平賀 裕子, 今村 雅俊, 正木 尚彦, 村岡 亮, 正田 良介, ...
    2004 年 64 巻 2 号 p. 50-51
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_50
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A sixty-six year old man, who had alcoholic liver cirrhosis, was diagnosed as 0-IIb type superficial cancer of the lower esophagus 5cm in diameter and gastric varices (F3) , by follow-up endoscopy. The size of this varices had become larger than on the previous endoscopy. So he was admitted for EMR and BRTO.
    We could successfully perform EMR for the esophageal cancer, using hook knife method with repeating hemostasis and submucosal injection.
    The pathological findings showed well-differentiated scquamous cell carcinoma and depth of invasion was m1. After EMR, gastric varices were treated by BRTO. BRTO was effective and varices had had reduction in size gradually. 5months after these treatments, no recurrence and no complication such as esophageal stenosis and dysphagia, there were.
    We reported a case of the minimal invasive treatment for esophageal cancer with esophago-gastric varices by EMR and BRTO combined therapy.
    抄録全体を表示
    PDF形式でダウンロード (862K)
  • 内視鏡的粘膜切除術を施行し得た長軸方向に進展した0-Ⅱa型食道癌の1例
    若林 寛二, 小澤 壯治, 海老沼 浩利, 加藤 悠太郎, 栗原 直人, 菊池 潔, 露木 晃, 池田 栄二, 田久保 海誉, 日比 紀文, ...
    2004 年 64 巻 2 号 p. 52-53
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_52
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 71-year-old woman was detected to have an ulcer-like lesion in the gastric corpus during a health examination and was referred to the Tokyo Electrical Power Company hospital. Upper GI endoscopy revealed no ulcer-like lesions in the stomach, but a linear flat elevation along the longitudinal axis of the esophagus, appearing like leukoplakia. The lesion stained positively with iodine staining. It was diagnosed histopathologically as squamous cell carcinoma of the esophagus in situ, and could be resected completely via endoscopy and use of an EEMR tube. After EMR, a repeat upper GI endoscopy revealed an ulcer scar, but no stenosis of the esophagus. Esophageal carcinoma in situ developing in this shape only along the longitudinal axis of the esophagus is very rare. The patient was not a smoker and was not habituated to alcohol. There were no other risk factors, either, and the cause of formation of an esophageal carcinoma lesion of this shape is unknown. An association with reflex esophagitis may be possible.
    抄録全体を表示
    PDF形式でダウンロード (702K)
  • 経皮経食道胃管用チューブを用いて内視鏡的胸壁前胃管瘻造設術を施行した1例
    須田 康一, 北川 雄光, 才川 義朗, 小澤 壯治, 杉浦 功一, 矢野 和仁, 大山 隆史, 小熊 潤也, 田淵 悟, 北島 政樹
    2004 年 64 巻 2 号 p. 54-55
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_54
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    Percutaneous transesophageal gastro-tubing (PTEG) is known as a minimally invasive technique available for use in cases in which percutaneous endoscopic gastrostomy (PEG) is not indicated. We report a case in which percutaneous endoscopic antesternal gastric tube-stomy was performed with a PTEG kit.
    A 70-year-old male with a past history of cerebral infarction and esophagectomy with antesternal reconstruction was admitted to our ward with a chief complaint of dysphagia in May, 2003. Despite antibiotic therapy and swallowing rehabilitation, a high-grade fever persisted because of aspiration pneumonia. To improve the patient's general condition and control the aspiration pneumonia, percutaneous endoscopic gastric tube-stomy with a PTEG kit was performed in July. It was performed under local anesthesia, and the procedure took only 15 minutes. This technique is minimally invasive and can be used to treat high-risk cases, in which it would be difficult to perform surgery under general anesthesia.
    抄録全体を表示
    PDF形式でダウンロード (469K)
  • 食道バルーン拡張術が著効した食道アカラシアの1例
    下河辺 宏一, 溝上 裕士, 三浦 崇幣, 大坪 十四哉, 岩本 淳一, 奈良坂 俊明, 小又 孝之, 竹山 裕樹, 伊藤 真典, 竹原 央 ...
    2004 年 64 巻 2 号 p. 56-57
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_56
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 32-year-old man was diagnosed with esophageal achalasia and treated with Ca antagonist as an outpatient. A reflux symptom that developed after a meal sometime from November, 2002, was gradually worse, and he was admitted for treatment with balloon dilatation on July 4, 2003. We performed esophageal dilatation with a Rigiflex ABD Achalasia Balloon Dilator (Boston Scientific, Tokyo, Japan) , using a low-compliance balloon to achieve a 3cm-diameter of dilatation on the same day. According to the previous reports, this dilatation method and surgical method revealed equal efficacy in the treatment. We expanded the balloon in 10psi for three minutes and performed dilatation under the same condition twice. Marked improvement of clinical symptom was obtained on the next day. He had no serious complications such esophageal perforation and was discharged on July 7. At the time of this report the symptom had not recurred, and he continues to be followed-up as an outpatient. We suggest that balloon dilatation therapy should be treatment of choice next to medication in the management of esophageal achalasia.
    抄録全体を表示
    PDF形式でダウンロード (587K)
  • 高度な食道狭窄を呈したBarrett食道の1例
    小飯塚 仁彦, 平賀 裕子, 為我井 芳郎, 田尻 亮輔, 酒匂 赤人, 八坂 成暁, 平野 直樹, 島本 実香, 芹沢 浩子, 田代 淳, ...
    2004 年 64 巻 2 号 p. 58-59
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_58
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    We report a patient of Barrett's esophagus with sever stenosis.
    A 89 years old male was admitted to our department because of dysphagia on June 19th, 2003. Esophagoscopy revealed a sever middle esophagus stenosis at the level of 27cm from incisors. Esophagogram showed membranate esophageal stricture and sliding hiatal hernia. On June 28th, First balloon dilation was performed. Squamocolumnar junction was observed at the anal side of the stenosis and lower esophagus was lined by columnar epithelium almost 7cm length. Biopsy specimen revealed columnar epithelium with intestinal metaplasia. Therefore we diagnosed as Barrett's esophagus. After two times of balloon dilation he could ingest and discharged. Almost one week after his discharge, dysphagia was exacerbated again. Esophagoscopy revealed restenosis of esophagus, so further two times of esophageal dilation were added. After four times of balloon dilation, esophagogram showed good passege of the esophagus and esophagoscopy revealed improvement of stenosis and remaining of ulcer scar. Double stained by Methylene blue and iodine showed squamocolumnar junction cleary at the stricture point.
    We reported the case of Barrett's esophagus with a sever stenosis. Repeated endoscopic balloon dilation was seemed effective in benign esophagus stenosis.
    抄録全体を表示
    PDF形式でダウンロード (559K)
  • 扁平上皮癌を伴った食道非小細胞型未分化癌の1例
    早稲田 正博, 村上 雅彦, 五藤 哲, 澤谷 哲央, 佐藤 篤, 大塚 耕司, 町田 健, 牧田 英俊, 高野 裕, 成田 和広, 西野 ...
    2004 年 64 巻 2 号 p. 60-61
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_60
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 71-year-old man who was diagnosed a cancer of the esophagus was admitted to our hospital. Endoscopic examination revealed an elevated lesion covered with normal mucosa with a depressed lesion of the esophagus. The depressed lesion was not dyed by 2% iodine staining and pathological findings showed squamous cell carcinoma. And the elevated lesion was soft and gradual. Therefore, we diagnosed the lesion as a submucosal tumor (SMT) with early cancer of the esophagus. Then we performed endoscopic mucosal resection (EMR) .
    The pathological findings of the specimen showed the lesion size was 20×15mm and it was non-small cell type undifferentiated carcinoma with early moderately differentiated squamous cell carcinoma. The tumor was located in submucosal layer covered normal mucosa of esophagus. And the surgical margin was negative.
    After EMR, no additional therapy was done. He has no recurrence for 16 months.
    抄録全体を表示
    PDF形式でダウンロード (1129K)
  • ウイルス性肝硬変に合併し，胃悪性リンパ腫に対する放射線治療後の難治性Gastric vascular ectasiaの1例
    上田 研, 泉 並木, 小貫 優子, 井上 和成, 西村 幸, 土谷 薫, 中西 裕之, 朝比奈 靖浩, 黒崎 雅之, 内原 正勝, 三宅 ...
    2004 年 64 巻 2 号 p. 62-63
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_62
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A case of gastric vascular ectasia in a 66-year-old female with cirrhosis (type B and C) , and post-irradiated gastric malignant lymphoma was reported. Vascular ectasia was seen in the whole mucosa of the stomach. Inspite of refraining from foods as well as prescribing 30mg/day of lansoprazole, oozing was still observed by endoscopy and several blood transfusion was necessary. Argon plasma coagulation (APC) was carried out which showed decreasing hemorrhage. After 16 times coagulation, oozing from gastric mucosa stopped completely without any adverse events. APC seems to be a safe and effective therapy for gastric vascular ectasia especially in patients of cirrhosis.
    抄録全体を表示
    PDF形式でダウンロード (258K)
  • 摘出に工夫を要した胃内異物の1例
    佐藤 恵子, 宮谷 博幸, 川本 智章, 有山 茂和, 鈴木 剛, 三浦 教子, 黄 麗明, 山内 篤, 加藤 章, 山田 博文, 沖田 剛 ...
    2004 年 64 巻 2 号 p. 64-65
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_64
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 20-year-old female patient with mental disease intentionally swallowed a pair of nail clippers and was treated at our hospital. Abdominal X-ray showed the clippers in stomach and endoscopy was performed. The clippers were located in the body of the stomach. A gastric mucosal lesion with mild redness and hemorrhaging was observed. We were unable to grasp the nail clippers using grasping forceps, snare forceps or basket forceps. We therefore switched to a 2-channel endoscope. First, we inserted a guide wire through the hole in the handle of the clippers with a cannula used in ERCP. We then grasped the guide wire using the biopsy forceps, which were extended from the channel for forceps, and pulled the guide wire towards the channel for forceps. With the clippers suspended from the guide wire we removed the fiberoptic scope. Because an overtube was used, we were able to retrieve the nail clippers without damaging the esophagus or oral cavity. We have occasionally encountered cases of esophageal and gastric foreign bodies. It is important to utilize safe procedures for foreignbody removal in order to minimize damage to the intestinal mucosa.
    抄録全体を表示
    PDF形式でダウンロード (870K)
  • 十二指腸球部に陥頓し，止血に結紮装置法が有効であった胃穹窿部粘膜下腫瘍の1例
    山﨑 好喜, 外山 久太郎, 関川 三四郎, 建持 敦子, 櫻井 紀子, 宮澤 志朗, 酒井 太郎, 鎌田 一寿, 里道 哲彦, 村上 秩, ...
    2004 年 64 巻 2 号 p. 66-67
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_66
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A-83-year old female had epigastral discomfort since middle of May 2003. She visited our hospital becase of hematemesis on 29th May. Lavoratory data showed decreased hemoglobin. Emergency endoscopic examination revealed active bleeding from giant submucosal tumor (SMT) of the fornix and treated with injection of 1/5,000 Epinephrine. On Next day, SMT prolapsed into duodenal valve was revealed in the endoscopic examination and was returned to stomach from duodenal valve by endoscopic technique. However active re-bleeding from SMT was noted and treatment for bleeding was performed by hanging detachable snare based on the SMT. Suddenly bleeding was stopped and SMT was getting degenerated by necrotic change after treatment, and so histological diagnosis of SMT was failed out. Three months after treatment, endoscopic examination showed ulcer scar after endoscopic treatment for SMT and endoscopic ultrasonography was could not disclosed evidence of SMT.
    抄録全体を表示
    PDF形式でダウンロード (657K)
  • 内視鏡的食道異物摘出後に発症した胃破裂の1例
    坂本 正明, 村上 雅彦, 嘉悦 勉, 田嶋 勇介, 牧田 英俊, 五藤 哲, 草野 満夫
    2004 年 64 巻 2 号 p. 68-69
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_68
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 78-year-old woman vomited blood on the next day after endoscopic removal of esophageal foreign body (fish bone) . So, she was admitted emergency to our hospital.
    The Chest radiogram revealed massive free air in the abdominal cavity. We diagnosed a perforation of the gastrointestinal tract. Endoscopic examination revealed a laceration about 3 cm in diameter located from cardia to the upper body of the lesser curvature. So we performed operative treatment laparoscopically. The laceration was appeared at the same location as endoscopic findings. This wound was performed knotted suturing and covered by lesser omentum. The postoperative course was good.
    Here we present this case because spontaneous rupture of the stomach in an adult is rare. In our country, this disease was reported only 12 cases. The cause of the rupture was various, but in most case, dilatation of the stomach was existed before. Our case was speculated that excessive releasing air during endoscopic examination was the cause.
    抄録全体を表示
    PDF形式でダウンロード (552K)
  • 幽門輪にかかる早期胃癌EMRの1例
    今枝 博之, 岩男 泰, 緒方 晴彦, 細江 直樹, 梶原 幹生, 村井 彩乃, 上原 慶太, 鈴木 秀和, 相浦 浩一, 永田 博司, 熊 ...
    2004 年 64 巻 2 号 p. 70-71
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_70
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 65-year-old man with history of early stage gastric cancer resected endoscopically about 2 years ago presented another early stage gastric cancer (type 0-IIc) in the lesser curvature of the prepylorus spreading to the pyloric ring. 1 cm in diameter. It was difficult to invert a usual endoscope in the bulbus, therefore the duodenal side of the lesion was not able to be observed. The early gastric cancer lesion sprending in the bulbus was able to be observed by using a small caliber endoscope (XP260, Olympus Optical Co.) . He underwent endoscopic submucosal dissection (ESD) . At first, the duodenal mucosal layer of the lesion was able to be cut more easily and safely by inversion of the endoscope in the bulbus with a disposable attachment and a thinner knife. Next, the gastric mucosal layer was cut and finally, the lesion was resected en block with strip biopsy method by using a double channel endoscope. Neither bleeding nor perforation occurred during the procedure. Pathological findings revealed well-differentiated adenocarcinoma in the mucosal layer and the margin was negative for cancer cells. The resected site was scarred without recurrence and stenosis after 2 months. This case is the rare reported one of early stage gastric cancer spreading to the pyloric ring resected en block with ESD by using a small caliber endoscope.
    抄録全体を表示
    PDF形式でダウンロード (683K)
  • 十二指腸内に脱出した胃体部早期癌の1例
    桑山 隆志, 本橋 英明, 岡本 直子, 加藤 俊介, 森本 慎吾, 小畑 満, 石田 孝雄, 河野 辰幸, 杉原 健一
    2004 年 64 巻 2 号 p. 72-73
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_72
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    We experienced a case of early gastric carcinoma prolapsing into the duodenum. A 81 year-old woman was admitted to the hospital with vomiting and dizziness. Endoscopic examination revealed prolapse of the tumor through the pylorus to the duodenum, and the tumor replaced back to the stomach. Histlogical examination of the specimen biopsied from the tumor revealed Group IV, therefore we diagnosed it as an early gastric carcinoma. Distal gastrectomy with lymphadectomy was performed. A size of the tumor was 75×40mm. Histological diagnosis was well differentiated adenocarcinoma of stomach limiting within mucosa with lymph node metastasis. Post operative course was uneventful and she was discharged on postoperative day 21.
    抄録全体を表示
    PDF形式でダウンロード (916K)
  • リンパ管侵襲を認めたA型胃炎合併多発性胃カルチノイド腫瘍の1例
    梶原 幹生, 今枝 博之, 村井 綾乃, 緒方 晴彦, 岩男 泰, 木村 裕之, 加藤 眞三, 永田 博司, 熊井 浩一郎, 北島 政樹, ...
    2004 年 64 巻 2 号 p. 74-75
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_74
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    Multiple gastric carcinoid tumours are a well-recognised complication of hypergastrinaemia associated with chronic atrophic gastritis. However, the management of such tumours remains undetermined, with the decision either antrectomy or total gastrectomy being empirical, though the antrectomy has been preferred in recent reports because of the malignant potential of such carcinoids being putatively of modest concern. This report describes a case of multiple gastric carcinoid tumours (located in fornix to corpus, size＜5mm) arising in type A chronic gastritis. A total gastrectomy was performed because of the patient's strong request, after which the patient made an uneventful recovery. Histopathological findings revealed that a lymphoduct was infiltrated by chromogranin A-positive carcinoid cells (ly1) , although the carcinoid tumours themselves were relatively small and early in stage (sm1) . Lymphoduct infiltration may lead to future distant metastasis if preserved, and we conclude that the treatment for multiple gastric carcinoids should be of further discussion.
    抄録全体を表示
    PDF形式でダウンロード (906K)
  • 胃異所性膵囊胞腺癌の1例
    玉﨑 秀次, 伊藤 智彰, 根上 直樹, 佐藤 雅彦, 大久保 剛, 前川 勝治郎, 佐藤 英章
    2004 年 64 巻 2 号 p. 76-77
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_76
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 51-year-old male visited a clinic because of anorexia and decreased bodyweight that the patient had recognized since June 2003. He was referred to our hospital because a submucosal tumor of the stomach was detected by upper endoscopic examination performed in the clinic. Upper gastrointestinal endoscopy revealed a protruded lesion with smooth mucosal surfaces on the anterior wall of the stomach, which extended from the central body of the stomach to the antrum. Abdominal computed tomography revealed mural hypertrophy mainly on the anterior wall of the gastric antrum and a cystic tumor. On August 5, 2003, the patient underwent an operation because of a suspicious malignant submucosal tumor of the stomach. Intraoperative findings indicated a clear border between the tumor and the pancreas ; thus, the tumor was considered primary gastric and distal partial gastrectomy was performed Pathohistological examination revealed ectopic pancreatic cystadenocarcinoma.
    The reported incidence of ectopic pancreas in autopsy cases ranges from 0.55 to 13.7% ; it is rare to observe a tumor occurring from ectopic pancreas.
    We report a case of pancreatic cystadenocarcinoma that is considered to be developed from ectopic pancreas of the stomach.
    抄録全体を表示
    PDF形式でダウンロード (817K)
  • アルゴンプラズマ凝固（APC）が止血に有効であった重篤な合併症を有する胃sm癌の1例
    鈴木 剛, 佐藤 恵子, 川本 智章, 有山 茂和, 三浦 教子, 山内 篤, 黄 麗明, 加藤 章, 宮谷 博幸
    2004 年 64 巻 2 号 p. 78-79
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_78
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    Argon plasma coagulation (APC) is a method of non-contact electro-coagulation that may have a lower risk of complication. A 72-year-old woman developed edema, shortness of breath, and tarry stool. She admitted to the hospital. Laboratory findings on admission showed severe anemia. Hemoglobin was 8.6mg/dl. Gastroendoscopy showed bleeding from type IIc early gastric cancer at gastric angulus. Gastrectomy was contra-indication, since she had severe congestive heart failure with liver cirrhosis. Then, she transferred to our hospital. APC was performed in 2 sessions to obtain hemostasis. Complete hemostasis was finally achieved with APC. In conclusion, APC can obtain an effective coagulation for bleeding in case of gastric sm cancer, in which surgery is consider to be indication
    抄録全体を表示
    PDF形式でダウンロード (216K)
  • 診断的治療にて軽快した十二指腸及び回盲部結核の1例
    村上 恵子, 田辺 聡, 樋口 勝彦, 佐々木 徹, 中山 昇典, 佐田 美和, 小泉 和三郎, 勝又 伴栄, 西元寺 克禮, 田辺 由美, ...
    2004 年 64 巻 2 号 p. 80-81
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_80
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 40-year-old man sometimes complained of severe epigastric discomfort from one month ago. Duodenal ulcer was found by gastroduodenal endoscopy at the another clinic. So, he came to our hospital for detail examination.
    The gastroduodenal endoscopy showed irregular-shaped duodenal ulceration in the opposite side of the superior duodenal angle. The abdominal ultrasonography showed lymph node swelling around the hilus of the liver. The colonoscopy showed irregular-shaped ileocecal ulceration. The histological examination on biopsy specimen revealed epithelioid granuloma without caseous necrosis.
    Although the tubercle bacilli were not found by the culture examination, we suspected the duodenum and ileocecal tuberculosis. We started the antituberculotic therapy with isonicotinic acid hydrazide and rifampicin. After six months, the gastroduodenal endoscopy and colonoscopy revealed ulcer scar. The abdominal ultrasonography showed reduction of lymph node swelling.
    We report a case of duodenal and ileocecal tuberculosis successfully treated with diagnostic therapy using antituberculotic agent.
    抄録全体を表示
    PDF形式でダウンロード (921K)
  • 十二指腸内腔に穿破した空洞を伴うgastrointestinal stromal tumor（GIST）の1例
    粟井 俊成, 野津 史彦, 草間 一成, 石川 晶久, 石井 誠, 吉川 望海, 三田村 圭二, 井廻 道夫, 星野 光典, 草野 満夫, ...
    2004 年 64 巻 2 号 p. 82-83
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_82
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    We reported a case of gastrointestinal stromal tumor (GIST) with central cavity formation of the duodenum. A 70-year-old woman was admitted to our hospital because of anemia．Abdominal CT revealed a hyper vascular tumor (10 cm in diameter) with central cavity formation developed extramurally from the second portion of the duodenum. Endoscopic examination revealed a submucosal tumor with central cavity. We observed the inside of a central cavity of the GIST and biopsy specimens were obtained through the endoscope. Histopathorogical examination showed spindle cells arranged in interlacing-bundled pattern. Immunohistochemically, tumor cells were positive for KIT and Vimentin stains, but were negative for CD34, SMA, Desmin and S-100 stains. We diagnosed this case as a GIST of the duodenum, and pylorus preserving pancreaticoduodenectomy were performed. Recent reports indicate the usefulness of tyrosine kinase inhibitor, imatinib mesylate in the treatment of GIST. Additional studies are required to decide the strategy of therapy for GIST.
    抄録全体を表示
    PDF形式でダウンロード (377K)
  • 短期間で形態変化を呈した十二指腸Brunner腺過形成性ポリープの1例
    小金井 裕之, 税所 俊光, 齋藤 久美子, 松本 秀平, 森本 学, 池内 孝夫, 南 裕太, 國廣 理, 三邊 大介, 深野 雅彦, 池 ...
    2004 年 64 巻 2 号 p. 84-85
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_84
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 65-year-old male had been followed for diabetes mellitus and angina pectoris, and his stools were positive for occult blood at the annual physical examination. Upper GI endoscopy revealed a duodenal polyp greater than 3cm in diameter. Its shape was submucosal pedunculated type. After biopsy, he noted continuing tarry stools and was admitted because of dizziness. Reupper GI endoscopy revealed that the polyp had changed its shape in a short term. Its stalk was thick and twisted and its top was lobulated and ulcerated. The size was 3×4cm in diameter. We diagnosed that tarry stool was originated from bleeding of these erosions and performed endoscopic hemostasis with clips. Endoscopic polypectomy was difficult because of its large size and not confirming the diagnosis. Therefore surgical resection was performed. Histological findings of the resected specimen showed Brunner's gland hyperplasia.
    抄録全体を表示
    PDF形式でダウンロード (976K)
  • 上部消化管出血をきたし，内視鏡治療を行った十二指腸過形成性ポリープの1例
    瀬座 文香, 山口 武人, 尾高 健夫, 厳 俊, 相 正人, 三橋 佳苗, 宍戸 忠幸, 山口 和也, 税所 宏光, 服部 祐爾, 二階堂 ...
    2004 年 64 巻 2 号 p. 86-87
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_86
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 23-year-old man presented with tarry stool and severe anemia. Upper endosdopic examination revealed a pedunculated polyp protruding from the SDA of the duodenal bulb. Endoscopic ultrasonography showed a slightly hyperechoic mass connecting with the third layer of the duodenal wall and cystic structure in the tumor. Based on the examination, gastrointestinal bleeding was attributed to the polyp, and we performed endoscopic polypectomy without any complication. The resected specimen was 20mm in maximal length, and histopathological diagnosis was Brunner's gland hyperplasia. Endoscopic polypectomy is an useful treatment for the duodenal Brunner's gland hyperplasia causing gastrointestinal bleeding.
    抄録全体を表示
    PDF形式でダウンロード (737K)
  • いわゆる早期十二指腸癌と考えられた十二指腸隆起性病変の1例
    阿部 径和, 瀬座 勝志, 今田 浩史, 日野 眞一, 隆 元英, 近藤 英介, 林 伸一
    2004 年 64 巻 2 号 p. 88-89
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_88
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 66-year-old male was pointed out to have abnormalities at the stomach by a barium meal for medical checkup and visited our hospital for further examination. Endoscopic examination revealed an elevated lesion at the second portion of the duodenum.
    The biopsy specimen showed adenoma with severe dysplasia. Endoscopic mucosal resection was performed and the Histological examination revealed a well differentiated tubular adenocarcinoma limited within the mucosa.
    抄録全体を表示
    PDF形式でダウンロード (944K)
  • 出血を契機に発見された十二指腸下行脚多発性潰瘍の1例
    長沼 篤, 小島 明, 土田 浩之, 廣川 朋之, 白須 達也, 丸山 秀樹, 竹澤 二郎, 杉山 雅
    2004 年 64 巻 2 号 p. 90-91
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_90
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 73 years old male. It was under going to the nearby hospital for hypertension and hyperlipidemia. Moreover, it was under going to hospital regularly to the visitor of the department of this because of the reflux esophagitis. June 12, 2001, nausea, vomiting and diarrhea appeared and this department visitor was consulted on the following day, the 13th. The renal failure was accepted by dehydration and leukocytosis was also accepted. For this reason, he was sent to hospital on the same day. Afterhospitalization, although condition has improved gradually by intravenous drip, tarry stool and anemia appeared. For this reason, when upper endoscopy was performed on June 22, the multiple duodenal ulcers of the second portion were accepted, and they were judged as the cause of bleeding. In the biopsy of the circumference of an ulcer, it was no malignancy. During progress, although it lapsed into the bleeding shock, it has imploved under the medical treatment by transfusion, the hemostat, and H2-blocker, and the ulcer has improved. The recurrence of ulcers were not accepted after that. A case of the multiple duodenal ulcers of the second portion discovered ignited by bleeding was experienced. The part of ulcers, quality, etc. are rare and it reports this time.
    抄録全体を表示
    PDF形式でダウンロード (212K)
  • 内視鏡的に止血し得た多発性十二指腸憩室出血の1例
    岩崎 栄典, 岸川 浩, 長田 高志, 中村 健太郎, 平野 江利香, 中野 雅, 西田 次郎, 森下 鉄夫
    2004 年 64 巻 2 号 p. 92-93
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_92
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    An 84-year-old female was admitted to our hospital because of hematemesis and melena. At emergency gastrointestinal endoscopy, multiple diverticula with clot were visualized in the second portion of the duodenum. Since active bleeding from the diverticulum persisted, although a vessel was not visible, endoscopic hemostasis was performed using clipping. However, she developed massive melena 6 days after. Endoscopic examination revealed active bleeding from the diverticulum in the oral side of the papilla of Vater, and hemostasis using clipping was performed successfully. No hemorrhage occurred thereafter. The case in this study suggests that endoscopic clipping is a safe and effective method of hemostasis for the hemorrhage from the diverticulum.
    抄録全体を表示
    PDF形式でダウンロード (215K)
  • Warfarin potassium内服中に生じた十二指腸のDieulafoy潰瘍様病変を内視鏡的結紮療法で治療した1例
    木村 博之, 小池 雅美, 高 恵生, 斉藤 詠子, 柿沼 徹, 新井 晋, 今井 幸紀, 太田 慎一, 藤原 研司
    2004 年 64 巻 2 号 p. 94-95
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_94
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 74-year-old female underwent operation of dissecting aortic aneurysm 8 years ago and had been administrated warfarin potassium ever since. She was admitted to our hospital because of epigastralgia. Endoscopic examination revealed a clot of blood in the stomach and Dieulafoy-like lesion at posterior wall of the duodenal bulb. We treated the lesion with endoscopic band ligation (EBL) using endoscopic variceal ligation (EVL) kit and could achieve hemostasis. In recent years, EBL has been used to treat not only esophageal varix but also non-variceal upper gastrointestinal hemorrhage. We report EBL using EVL kit is a safe and effective therapy for Dieulafoy-like lesion at duodenal bulb in patient with severe coagulopathy.
    抄録全体を表示
    PDF形式でダウンロード (243K)
  • 術中内視鏡が診断に有用であった非特異性多発性小腸潰瘍の1例
    落合 康利, 後藤 庸子, 小松 英嗣, 渡邉 慶太, 長久保 秀一, 古宮 憲一, 金子 博, 箭頭 正徳, 鈴木 雅之, 小田 義英, ...
    2004 年 64 巻 2 号 p. 96-97
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_96
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    Nonspecific multiple ulcers of the small intestine (NMUS) is a clinical entity proposed in Japan with characteristic clinical features different from other inflammatory bowel disease such as Crohn's disease. A 57-year-old woman was admitted to our hospital because of refractory anemia and hypoproteinemia. She previously underwent ileocecal resection due to NMUS when she was 34 years old, but the detailed findings were not available. Then she was found to have multiple colonic ulcers and had been treated with salazosulfapyridine under the diagnosis of Crohn's disease. Laboratory data on admission showed severe anemia, hypoproteinemia. She didn't have the history of hematomesis nor melena, but fecal occult blood tests were always positive and the anemia was progressive requiring multiple blood transfusions. Colonoscopy revealed multiple colonic ulcerations and anastomotic stenosis, not inconsistent with Crohn's disease. Conventional investigations including gastroduodenoscopy and fluoroscopic small bowel examination failed to detect ulcer lesions in the small intestine. Our tentative diagnosis was Crohn's disease, but the possibility of NMUS could not be ruled out because of her past medical history. Then laparotomy was performed and an intraoperative enteroscopy revealed multiple shallow ulcers with bleeding along the whole small intestine. She was diagnosed as NMUS according to the endoscopic features characteristic of NMUS.
    抄録全体を表示
    PDF形式でダウンロード (495K)
  • 消化管出血を契機に診断された肺癌原発転移性小腸腫瘍の1例
    斎藤 淑子, 永原 章仁, 坂本 直治, 吉田 靖志, 礒沼 弘, 檀原 高, 松本 俊治, 林田 康男
    2004 年 64 巻 2 号 p. 98-99
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_98
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A case of adenocarcinoma in lung proceeding to metastasis in the small intestine is reported here. A 70-year-old woman was admitted to hospital with general fatigue, constipation and body weight loss. Laboratory data indicated anemia and a high level of CEA. From a chest X-ray and CT, we suspected lung tuberculosis, but results of cultures and a bronchoscopy were negative. Results of gastroduodenal endoscopy, colonoscopy and abdominal CT showed no reason for anemia or CEA elevation. Barium study of the small intestine showed a tumor about 200cm on the distal side of the ligament of Treitz. We performed partial resection of the small intestine, due to intestinal obstruction and procession of anemia. Histological examination of resected tissue suggested metastatic adenocarcinoma. Therefore we tried CT-guided biopsy of the lung tumor to find the primary lesion. Histological examinations of the biopsy tissue revealed primary lung adenocacinoma. Although metastasis of the small intestine progressing after lung cancer has a very poor prognosis, some patients still live long after the operation. Therefore it is essential to examine the digestive tract for the suspected small intestine metastasis, and operation as soon as possible.
    抄録全体を表示
    PDF形式でダウンロード (734K)
  • 盲腸粘膜下腫瘍様の形態をとった日本住血吸虫症の1例
    丸山 祥司, 安藤 昌之, 高場 恵美
    2004 年 64 巻 2 号 p. 100-101
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_100
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A case of Schistosomiasis Japonicum with a submucosal tumor in the cecum was experienced. The patient was 65-years old female, and had ever lived in the Kofu basin, Yamanashi prefecture. She was suffering from constipation, and had the colon scopy performed. A submucosal tumor in 2cm diameter was found in the cecum. With endoscopic ultorasonography, the thickening of the second layer with focal hyper echoic lesion was observed. The surface of the tumor got depressed in six months with endoscopic findings. To confirm the pathological diagnosis and for the therapy, laparoscopic local resection of the cecum was performed. Microscopically, the eggs of Schistosoma Japonica and the aggregation of lymphocytes and histiocytes around the eggs were observed. With immunohistochemical examination, diffuse spledding of the CD4, CD8, CD20, and CD45 positive lymphocytes were observed. The chronic inflammation of the cecum was observed as submucosal tumor.
    抄録全体を表示
    PDF形式でダウンロード (617K)
  • 内視鏡的治療を試みた大腸憩室出血の3例
    西川 尚子, 新村 和平, 羽原 隆, 中村 昭子, 森下 慎二, 佐藤 芳之, 松本 政雄, 井野元 勤, 池田 有成
    2004 年 64 巻 2 号 p. 102-103
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_102
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    We report on three cases of severe diverticular hemorrhage. Case 1 : A 83-year old man presented with acute lower gastrointestinal bleeding. Urgent colonoscopy was perfomed, which revealed a bleeding diverticulum in the ascendind colon. At the neck of the diverticulum, a bleeding vessel was identified. Hemostasis was achieved by clipping. Case 2 : A 68-year old man was admitted to our hospital with hematochezia. Colonoscopy revealed a bleeding diverticulum in the descending colon. Early hemostasis was achieved by clipping. Case 3 : A 43-year old man presented with severe acute lower gastrointestinal bleeding. Bleeing schintigraphy showed active bleeding from the ascending colon. Urgent angiography was performed, which revealed active bleeding from the ascending colon. Embolization was performed with autoclots and platinum microcoils. Colonoscopy showed a diverticulum in the ascending colon. Clipping was performed. The patient was free from rebleeging in the follow-up period. Endoscopic therapy is useful for acheiving early hemostasis in case of acute diverticular hemorrhage.
    抄録全体を表示
    PDF形式でダウンロード (872K)
  • 生理食塩水の粘膜下注入併用アルゴンプラズマ凝固療法が有効であった大腸多発血管拡張症の1例
    今川 敦, 橋本 拓平, 藤城 光弘, 角嶋 直美, 小林 克也, 大川 昭光, 三好 秀征, 森山 義和, 岡 政志, 山道 信毅, 矢作 ...
    2004 年 64 巻 2 号 p. 104-105
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_104
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 44 year-old man visited our hospital in January 2003, because of positive fecal occult blood test (FOB) . We detected multiple angioectasia in the transverse colon by total colonoscopy and diagnosed this lesion to be the cause of FOB positive. The lesions were treated by argon plasma coagulation with normal saline injection (NS-APC) . This technique is much safer than the usual APC procedure. The treatment was performed in the outpatient clinic without any complication, and no lesions were left 4 months later. APC-NS is useful treatment and safety technique for angioectasia of the colon.
    抄録全体を表示
    PDF形式でダウンロード (190K)
  • Schönlein-Henoch紫斑病に合併した大腸病変の1例
    倉形 秀則, 渡邊 利泰, 佐藤 直嗣, 五味 志奈, 高橋 敬二, 菊池 由宣, 北条 裕, 蜂矢 朗彦, 五十嵐 良典, 住野 泰清, ...
    2004 年 64 巻 2 号 p. 106-107
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_106
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 72-year-old male was admitted to our hospital, complaining melena, abdominal pain and purpuric rash appeared in the bilateral lower legs. The colonoscopy demonstrated multiple ulcers from the cecum through the rectum. Histological specimens taken from the margin of ulcers revealed non-specific inflammation. No pathogen was confirmed in physiological and immunochemical findings. Cutaneous biopsy showed leukocytoclastic vasculitis. He was treated with total parenteral nutrition and intravenous injection therapy of predonisolone under a diagnosis of Schönlein-Henoch purpura. The symptom and purpura improved in 3 days and in 2 weeks.
    We investigated 55 reports of adult patients with Schönlein-Henoch purpura with apparent digestive lesions during last 11 years. We confirmed that the colonic ulcers with edema were specific involvements of Schönlein-Henoch purpura.
    抄録全体を表示
    PDF形式でダウンロード (542K)
  • 特異な形態を呈した非腫瘍性大腸ポリープの1例
    岸本 洋輔, 鴨志田 敏郎, 石川 晶久, 堀田 総一, 平井 信二, 岡 裕爾, 下釜 達朗
    2004 年 64 巻 2 号 p. 108-109
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_108
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A case report of a 38-years-old male patient with a non-tumorous colonic polyp was described. This patient had a complaint of positive occult blood of stool in Sep 2002. Examinations of barium enema and colonoscopy showed a stalagmite-shaped polyp at the ceacum. Polypectomy was done in Nov 2002. Bizarre shape of this polyp was considered to be an inflammatory, however, pathological examination revealed lymphangiectasia, edema and telangiectasia in submucosa with no inflammatory cells. These findings were the same as those of mucosal polyp in the colon or colonic muco-submucosal elongated polyp (CMSEP) . We considered that inflammatory cells of this polyp disappeared over a long period of time and mimicked mucosal polyp or CMSEP.
    抄録全体を表示
    PDF形式でダウンロード (538K)
  • 右側大腸優位に発生した大腸ポリポーシスの1例
    福澤 誠克, 中村 哲夫, 高垣 信一, 額賀 健治, 川上 浩平, 萩原 恭史, 平良 悟, 宮岡 正明, 田村 和朗, 森安 史典
    2004 年 64 巻 2 号 p. 110-111
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_110
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    We descride a 63-year-old man, who turned out to be positive for fecal occult blood test on November, 2001. Colonoscopy was carried out on May 2002, and there were multiple polypoid lesions predominantly in proximal colon. On February 2003, Endscopic mucosal resection (EMR) of Isp'polyp (12mm in size) , LST (granular type ; 16mm in size) both located in ascending colon was perforemed. Pathological findings revealed carcinoma in adenoma in both resions. In recent years, attenuated familial adenomatous polyposis (AFAP) attract a great deal of attention. The mutations in APC and MYH gene are reported to be associated with AFAP. We analyzed mutation of APC and MYH gene. In this case, no mutation of both gene was detected. We report a rare case of colon poilyposis resembling AFAP.
    抄録全体を表示
    PDF形式でダウンロード (528K)
  • 小児若年性ポリープの2例
    宮﨑 栄治, 鈴木 貴久, 塚田 健次, 佐々木 森雄, 関根 正幸, 朝蔭 直樹, 後藤 達哉, 小林 滋, 平井 周
    2004 年 64 巻 2 号 p. 112-113
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_112
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    【Case 1】A previous healthy, 4-year-old boy was referred to our hospital because of acute onset of rectal bleeding with an evacuated polyp. Digital examination showed a fresh bleeding without any polyps. The bleeding from the stalk of the autoamputated polyp was suspected. Emergency colonoscopy under general anesthesia revealed an oozing stalk at the rectum. Clipping and spraying ALTO® was performed endoscopically. There were no other polyps in the proximal colon. Pathological findings showed a juvenile polyp.
    【Case 2】A 2-year-old girl, who had an episode of autoamputation of a polyp 6 months ago, was referred to our hospital because of a polyp in the stool. She was suspected to have the multiple polyps, and total colonoscopy was performed. No other polyps were detected in the colon. Pathological findings also showed a juvenile polyp.
    【Conclusion】A colonoscopy was needed to stop bleeding from the stalk of the autoamputated polyp at case 1, and to see the total colon whether the polyp was multiple or not at case 1 and 2. Juvenile polyp has been reported to have a malignant potential. We believe that total colonoscopy should be the initial procedure when evaluating a child with suspected juvenile polyp.
    抄録全体を表示
    PDF形式でダウンロード (516K)
  • 大腸原発Hodgkin's diseaseの1例
    宮永 禎子, 越川 淳也, 岩嶋 富美子, 床井 伸介, 藤本 秀明, 高橋 萌木, 吉永 治彦, 天川 孝則, 三浦 勝, 山中 研, 河 ...
    2004 年 64 巻 2 号 p. 114-115
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_114
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 79-year-old man was suffered from right upper abdominal pain and fever. Abdominal ultrasonogram showed multiple hypoechoic masses of the liver. Colonoscopic examination revealed one-half circumferential Type 2 like tumor in the ascending colon. Abdominal CT showed multiple low density nodules in the liver. A biopsy taken from the tumor of the ascending colon was histologically diagnosed as malignant lymphoma or poorly differentiated adenocarcinoma (cytokeratin, positive) . A right hemicolectomy was performed. The ulcerative tumor of the ascending colon was 8×7cm in size. The diagnosis histologically made was Hodgkin's disease of the ascending colon, mixed cellularity, infiltrating the subserosa. The Ann Arbor stage is IV B. Seven courses of ABVD therapy were performed. After the treatment, the liver tumors disappeared at all.
    抄録全体を表示
    PDF形式でダウンロード (914K)
  • 特異な形態を示した直腸カルチノイドの1例
    佐々木 廣仁, 倉橋 利徳, 樫田 博史, 大谷 響, 笹島 圭太, 木暮 悦子, 山村 冬彦, 深見 悟生, 竹内 司, 大塚 和朗, 永 ...
    2004 年 64 巻 2 号 p. 116-117
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_116
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 58-year-old woman was admitted to our hospital because of positive fecal occult blood which was pointed out by regular medical check-up. The patient underwent colonoscopic examination which revealed a protruded polyp with uneven surface, located in the rectum and measuring about 10mm in diameter. In magnifying colonoscopic view after dye spraying, most of the surface area was shown to be non-structural (Kudo's type VN pit pattern) , but only the periphery of the lesion was covered with the normal mucosa (type I pit pattern) . The lesion was excised with endoscopic mucosal resection (EMRtechnique) . The pathological diagnosis was a carcinoid tumor.
    The additional surgery including low anterior resection of the rectum and lymph node dissection was performed because the lesion showed rather large size, high grade atypia, 2.3% of Ki 67 index and uncertain cut margin. The case was peculiar in gross appearance, which made the diagnosis of carcinoid difficult.
    抄録全体を表示
    PDF形式でダウンロード (955K)
  • 内視鏡下粘膜細胞診で診断し得たアメーバ性大腸炎の4例
    服部 公昭, 権田 厚文, 藤井 佑二, 関 英一郎, 鵜瀞 条, 冨木 裕一, 櫻井 秀樹
    2004 年 64 巻 2 号 p. 118-119
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_118
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    Four cases of amebic colitis diagnosed immediately by cytological examination of biopsy specimen under colonoscopy. The patients were three men and a woman, 28-49 years old. They visited to our hospital with complaint of blood stool. Colonoscopy showed a round ulceration covered with the yellow-whitish exudates, surrounded by normal mucosa close to the orifice of the appendix, and multiple erosions and small ulcers in the rectum. Cytological examination of biopsy specimen from the ulcer revealed amebic organism. Ten days eradication therapy of Metronidazole successfully carried out. This cytological method is useful technique to facilitate early diagnosis of amebic colitis.
    抄録全体を表示
    PDF形式でダウンロード (186K)
  • インターフェロン療法中に虚血性腸炎を併発したC型慢性肝炎の1例
    福島 淑隆, 舩冨 等, 青柳 有司, 佐藤 貴也, 津保 勝郎, 小澤 達雄
    2004 年 64 巻 2 号 p. 120-121
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_120
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 35-year-old man with anti-HCV-antibody positive chronic hepatitis was treated with interferon (IFN) ‐α2b from December 27, 1999. On February 4, he complained of lower abdominal pain and melena, and was admitted as an emergency. Total colonoscopy revealed mucosal edema and erosions in the descending colon. The biopsied specimen showed interstitial edema with infiltration of inflammatory cells. IFN treatment was discontinued and patient was conservatively followed up. Colonoscopy performed 10 days after admission revealed improvement of erosions and mucosal edema. He had no past history of diabetes mellitus, hyperlipemia, or heart disease. Thus it appeared that ischemic colitis was associated with the IFN treatment. The mechanisms of ischemic colitis is thought to be related to an autoimmune phenomenon by IFN. Other mechanisms may be caused by cytokines associated with IFN. Only nine cases of ischemic colitis during IFN treatment had been reported. We reported a rare case of ischemic colitis complicated with IFN treatment.
    抄録全体を表示
    PDF形式でダウンロード (503K)
  • 初回内視鏡時に発見された潰瘍性大腸炎に合併した5型大腸癌の1例
    酒井 要, 西野 晴夫, 野沢 博, 井上 冬彦, 松生 恒夫, 野村 恭子, 土井 健一, 渡辺 豊, 池 秀之
    2004 年 64 巻 2 号 p. 122-123
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_122
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    The patient was a 46-year-old male. He was innately healthy, but noticed blood in stool and received a first colonoscopic examination in March, 2003. Colonoscopy showed almost normal mucosa in the rectum. It aolso exihibited almost normal mucosa in the sigmoid colon, only diffuse aphtha was seen. Severe fibrosis was markedly observed from the descending colon to the ileocecum, and relatively shallow ulcers of irregular shapes were scatterd in places. In addition, moderate stenosis was detected in the middle part of the transverse colon. It was difficult to make an endoscopic diagnosis because the stenosis was ill-demarcated with no appreciable elevated or depressed lesions. A biopsy of the stenosed segment revealed a well-differentiated adenocarcinoma. In contrast, the surrounding ulcerated part was found by biopsy to be ulcerative colitis.
    Subsequently, total colectomy was performed, and the final pathological diagnosis was type 5 large intestine cancer associated with ulcerative colitis. It has recently been reported that large intestine cancer in ulcerative colitis patients is detected frequently at 7 to 8 years or more on average after initial onset. This case was very rare since the advanced cancer was detected by the first endoscopic examination, while no symptoms suggestive of ulcerative colitis were noted during the course. Therefore, our experience is reported here with some discussion.
    抄録全体を表示
    PDF形式でダウンロード (224K)
  • 興味ある形態を示したⅡc＋Ⅰs型大腸sm癌の1例
    八坂 成暁, 為我井 芳郎, 斉藤 幸夫, 酒匂 赤人, 平野 直樹, 芹沢 浩子, 小飯塚 仁彦, 小早川 雅男, 平賀 裕子, 秋山 純 ...
    2004 年 64 巻 2 号 p. 124-125
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_124
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 55-year-old male complaining occult blood in stool underwent colonoscopy, colonic carcinoma was detected in the sigmoid colon.
    Endoscopic examination revealed an elevated lesion with a depression on the anal side. On magnifying endoscopic observation, type VN pit pattern was observed in the depressed area. A massively submucosal invasive carcinoma was highly suspected, and sigmoid colectomy was performed.
    The resected specimen showed a IIc＋Is lesion, measurihg 12×10mm in diameter includings showed well differentiated adenocarcinoma in the elevated area, and moderately differentiated adenocarcinoma in the depressed area, The depth of invasion was m in the elevated area, and sm2 in the depressed area. Neoplastic cells positive for p53 and Ki-67 were observed in depressed area, but these cells were sparsely seen in elevated area.
    We surmise that depression may be arised from a part of elevated lesion because these lesions had remarkable differences in their forms and biological characters.
    抄録全体を表示
    PDF形式でダウンロード (888K)
  • 術中大腸内視鏡が切除範囲決定に有効だった閉塞性大腸癌の1例
    米田 啓三, 林田 康治, 蓮江 健一郎, 小方 二郎, 和田 建彦, 宇田 治, 坂本 啓彰, 勝又 健次, 加藤 孝一郎, 土田 明彦, ...
    2004 年 64 巻 2 号 p. 126-127
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_126
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 59-year-old man visited a nearby clinic with the chief complaint of abdominal pain, and was diagnosed to have cancer of the sigmoid colon Colorectal endoscopy revealed a complete obstruction type in the sigmoid colon ; in addition, 9 polyps were also visualized distal to this tumor in the sigmoid colon. Considering the planned resection line, EMR was performed for the polyps in the rectum Within the area of observation, however, the presence of lesions on the proximal side of the intestine could not be ruled out, considering the presence of multiple lesions on the distal side. Intraoperative endoscopy was therefore performed, which revealed the presence of a type 2 tumor in the descending colon. We performed extended left hemicolectomy low anterior resection, partial cystectomy, and regional D3 lymph node dissection. Histopathologically, the tumors resected from the sigmoid and descending colon were rated as type 2 tumors. The tumor in the sigmoid colon was diagnosed as moderately differentiated adenocarcinoma, with an invasion level of Si (urinary-bladder) . The tumor in the descending colon was also diagnosed histopathologically as a moderately differentiated adenocarcinoma, with an invasion level of SE (stage IIIa) . Thus, intraoperative endoscopy was useful for determining the extent of resection in this case.
    抄録全体を表示
    PDF形式でダウンロード (394K)
  • 盲腸に発生した腺扁平上皮癌の1例
    草野 昌男, 森 菜緒子, 堤 康一郎, 遠藤 克哉, 阿部 靖彦, 小島 康弘, 境 吉孝, 野口 謙治, 小島 敏明, 鹿志村 純也, ...
    2004 年 64 巻 2 号 p. 128-129
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_128
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A case of adenosquamous carcinoma of the cecum was reported.
    A 71-year-old man complaining of constipation and admitted to our hospital for further investigation, because cecal tumor was pointed out by his home doctor. Barium enema examination revealed elevated lesion with central small ulcer. Abdominal computed tomography showed the wall thickness of cecum. Endoscopic examination revealed reddish flat elevated lesion with central small ulcer. Histological findings of biopsy specimen showed moderately differntiated adenocarcinoma. Operation was performed under the diagnosis of cecal cancer. The resected specimen demonstrated a type 2 tumor measurering 2.2×2.5cm in size. Histological findings of resected specimen showed adenosquamous carcinoma with no lymphnode metastasis. It was advanced carcinoma infiltrating into the excessserosal layer.
    Adenosquamous carcinoma of the cecum is considered to be a relatively rare disease and only 19 cases have been reported in Japan. In etiology of adenosquamous carcinoma, the theory of squamous cell metaplasis of colonic adenocarcinoma has been widely supported.
    抄録全体を表示
    PDF形式でダウンロード (480K)
  • 盲腸，上行結腸，横行結腸に多発した顆粒細胞腫の1例
    平塚 卓, 小山 雅章, 増井 朋子, 大楽 勝了, 木村 健, 藤本 武利, 平塚 秀雄, 松田 知己, 田村 知之, 小川 英風, 豊田 ...
    2004 年 64 巻 2 号 p. 130-131
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_130
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A case of multiple granular cell tumors of the colon is reported. A 48-year-old man visited to our hospital because of positive of fecal occult blood reaction. Colonoscopy revealed yellowish-white and hard 12 submucosal tumor (SMT) s, a 5-mm SMT in the cecum and 5-mm to 12-mm SMTs in the ascending colon closed to the hepatic flexure to the splenic flexure of the transverse colon. A few SMTs of the transverse colon was performed by biopsy. HE stainng showed acidophilic granules in the cytoplasm. Granules of cytoplasma were strongly positive with imunostaing for S-100 protein. The diagnosis of granular cell tumor was made. Two SMTs of the transverse colon was removed by endoscopic resection. In Japan, 55 cases including our case were reported for granular cell tumor of the colon, and this was the eighth case report of multiple granular cell tumors of the colon.
    抄録全体を表示
    PDF形式でダウンロード (304K)
  • 直腸癌に合併した虫垂重積を伴った虫垂粘液囊腫の1例
    田原 博貴, 星野 洋一, 町田 守也, 大木 一郎, 林 重之, 草野 元康, 森 昌朋
    2004 年 64 巻 2 号 p. 132-133
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_132
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 76-year-old man was admitted because of bloody stool. Colonoscopy revealed a protruding lesion in the rectum which was diagnosed as well differentiated adenocarcinoma by biopsy, and a mucocele of the appendix was also found. Anterior resection of the rectum and resection of the cecum were performed. Mucocele of appendix is rare and is difficult to be diagnosed preoperatively. The mucocele of the appendix is often complicated by pseudomyxoma peritonei, malignant alteration and invagination of large intestine. This case is rare because the mucocele of the appendix is accompanied by intussusception of the appendix and advanced rectal cancer.
    抄録全体を表示
    PDF形式でダウンロード (372K)
  • 内視鏡的粘膜下層剥離術（ESD）にて一括切除しえた生検に伴うnon-lifting sign陽性大腸腫瘍の1例
    大川 昭光, 矢作 直久, 藤城 光弘, 角嶋 直美, 今川 敦, 小林 克也, 橋本 拓平, 三好 秀征, 森山 義和, 岡 政志, 山道 ...
    2004 年 64 巻 2 号 p. 134-135
    発行日: 2004/06/10
    公開日: 2014/03/28
    DOIhttps://doi.org/10.11641/pde.64.2_134
    ジャーナル フリー
    抄録を表示する抄録を非表示にする
    A 69-year-old woman visited her local medical doctor with a chief complaint of diarrhea. As the facal occult blood test showed a positive result, she undertook a colonoscopy, which revealed 0-IIa typed tumor (superficial elevated lesion) with a diameter of 15mm. A histological examination of biopsy specimens from the lesion showed Group IV. In order to undertake an endoscopic resection of the tumor, she was introduced to this hospital. The colonoscopy at our outpatients clinic demonstrated remarkable converging folds. The tumor showed the non-lifting sign when we injected saline into the submucosal layer around the lesion. Endoscopic Ultrasound demonstrated a remarkable thickness of submucosal layer. Although we understood that a surgical operation should be one of the best options for its treatment, we performed an endoscopic submucosal dissection with informed consent because the histological diagnosis was Group IV, not Group V. En-bloc resection was achieved using of our newly devised flex knife and hyaluronate sodium solution without any complication. The size of resected specimen was 12mm in the greatest diameter. Histopathological examination revealed that the tumor was tubular adenoma with moderate to severe atypia, and the resected margin was negative. Colonoscopy two-month after the procedure showed a smooth ulcer scar with slight redness. She has been making good progress at the present time. We have learned a valuable lesson from this case. We demonstrated that a biopsy have to avoid before EMRs.
    抄録全体を表示
    PDF形式でダウンロード (194K)
feedback
 Top