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Clinical Journal of Gastroenterology

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https://www.readbyqxmd.com/read/30003469/rare-case-of-a-gallbladder-neuroendocrine-carcinoma
#1
Masakuni Fujii, Hiroaki Saito, Junji Shiode
There are no neuroectodermal cells in the gallbladder mucosa. Therefore, gallbladder neuroendocrine carcinoma (NEC) is extremely rare and has a poor prognosis. We report a case of a Japanese man in his 60s with this disease. The patient visited a family doctor for epigastralgia. Blood tests showed no abnormalities, including tumor markers, such as CEA and CA19-9. Abdominal ultrasonography (US) showed a low-echoic mass, 39 × 30 mm, with clear boundaries to the liver from the fundus of the gallbladder. Contrast-enhanced computed tomography showed that the tumor was enhanced early and washed out...
July 12, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29995231/three-renal-failure-cases-successfully-treated-with-ombitasvir-paritaprevir-ritonavir-for-genotype-1b-hepatitis-c-virus-reinfection-after-liver-transplantation
#2
Noriaki Orita, Tetsuro Shimakami, Hajime Sunagozaka, Rika Horii, Kouki Nio, Tekeshi Terashima, Noriho Iida, Masaaki Kitahara, Hajime Takatori, Kazunori Kawaguchi, Kazuya Kitamura, Kuniaki Arai, Taro Yamashita, Yoshio Sakai, Tatsuya Yamashita, Eishiro Mizukoshi, Masao Honda, Shuichi Kaneko
We report three cases of genotype 1b hepatitis C virus (HCV) reinfection after liver transplantation. When antiviral treatment was considered, all three patients had renal dysfunction and had been treated with immunosuppressive agents for a long time; one with tacrolimus (TAC) and the others with cyclosporine A (CyA). Therefore, the possible antiviral regimens among direct-acting antivirals (DAA) were limited and so we treated all three patients with ombitasvir/paritaprevir/ritonavir (OBV/PTV/r). Because ritonavir is known to markedly increase the blood concentration of TAC and CyA through drug-drug interactions, close monitoring of blood concentrations of TAC or CyA and dose adjustments of immunosuppressive agents were needed...
July 11, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29951849/author-s-reply-to-the-letter-to-the-editor-for-efficacy-and-safety-of-metallic-stents-in-comparison-to-plastic-stents-for-endoscopic-drainage-of-peripancreatic-fluid-collections-a-meta-analysis-and-trial-sequential-analysis
#3
LETTER
https://www.readbyqxmd.com/read/29931440/utility-of-contrast-enhanced-ultrasonography-with-perflubutane-in-evaluating-indications-for-diagnostic-percutaneous-tumor-biopsy-in-a-case-of-hepatic-sclerosed-hemangioma
#4
Yusuke Ando, Masatoshi Ishigami, Yoji Ishizu, Teiji Kuzuya, Takashi Honda, Yoshiki Hirooka
Sclerosed hemangioma is difficult to distinguish from intrahepatic cholangiocarcinoma or liver metastasis due to their imaging resemblance, thus pathological diagnosis is often required; however, percutaneous biopsy entails a risk of dissemination if the tumor is malignant. Perflubutane, a contrast agent of ultrasonography, has a characteristic feature of being phagocytosed by Kupffer cells. Hepatic malignant lesions contain few or no Kupffer cells, therefore, they are shown as a contrast defect. We report a case in which contrast enhanced ultrasonography (CEUS) with perflubutane was useful to evaluate indications for percutaneous tumor biopsy...
June 21, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29923164/a-case-of-portal-vein-thrombosis-caused-by-blunt-abdominal-trauma-in-a-patient-with-low-protein-c-activity
#5
Erica Nishimura, Takeyuki Misawa, Hiroaki Kitamura, Shuichi Fujioka, Tadashi Akiba, Katsuhiko Yanaga
Portal vein thrombosis (PVT) is caused by several conditions including infection, malignancies, surgery, medications, and coagulation disorders. However, PVT caused by low-energy injury is very rare. A 51-year-old man visited a clinic with a 2-day history of abdominal pain following blunt abdominal trauma. Contrast-enhanced computed tomography (CT) revealed thrombosis in both the portal vein and splenic vein, and he was transferred to our hospital with a diagnosis of PVT. Anticoagulant therapy was initiated using unfractionated heparin...
June 19, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29923163/hypertriglyceridemia-induced-pancreatitis-updated-review-of-current-treatment-and-preventive-strategies
#6
REVIEW
Prashanth Rawla, Tagore Sunkara, Krishna Chaitanya Thandra, Vinaya Gaduputi
Hypertriglyceridemia (HTG) is an uncommon but well-established cause of acute pancreatitis (AP) comprising up to 7% of the cases. The clinical course of HTG-induced pancreatitis (HTGP) is highly similar to that of AP of other etiologies with HTG being the only distinguishing clinical feature. However, HTGP is often correlated with higher severity and elevated complication rate. At present, no approved treatment guideline for the management of HTGP is available, although different treatment modalities such as insulin, heparin, fibric acids, and omega 3 fatty acids have been successfully implemented to reduce serum triglycerides (TG)...
June 19, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29915984/laparoscopic-treatment-of-a-vesicointestinal-fistula-due-to-a-meckel-s-diverticulum-a-case-report-and-review-of-the-literature
#7
Hiroyuki Hakoda, Hideyuki Mishima, Takumi Habu, Shin Murai, Ryohei Maeno, Yuriko Yokomizo, Yuki Inagaki, Takehito Maruyama, Yuichi Matsui, Akihiro Sako
While there have been numerous reports about colovesical fistulas and ruptured intestinal diverticula, there have been far fewer reports about vesicointestinal fistulas caused by Meckel's diverticula. Most Meckel's diverticula are asymptomatic. Furthermore, they seldom cause vesicointestinal fistulas, and the associated complications are non-specific. Thus, their preoperative diagnosis is difficult. We experienced a case in which a vesicointestinal fistula was caused by a Meckel's diverticulum and was treated with laparoscopic surgery...
June 18, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29909559/a-successful-treatment-for-hepatocellular-carcinoma-with-osler-rendu-weber-disease-using-radiofrequency-ablation-under-laparoscopy
#8
Yoshinari Takaoka, Naoki Morimoto, Kouichi Miura, Hiroaki Nomoto, Kozue Murayama, Takuya Hirosawa, Shunji Watanabe, Takeshi Fujieda, Mamiko Ttsukui, Hirotoshi Kawata, Toshiro Niki, Norio Isoda, Makoto Iijima, Hironori Yamamoto
Hepatocellular carcinoma (HCC) can be difficult to diagnose and treat in patients with Osler-Rendu-Weber disease due to vascular malformation and regenerative nodular hyperplasia. In addition, percutaneous liver puncture should be avoided for the diagnosis and treatment as the procedure carries a high risk of bleeding. We herein report the successful treatment of HCC in a patient with Osler-Rendu-Weber disease using radiofrequency ablation (RFA) under laparoscopy. A 71-year-old man with Osler-Rendu-Weber disease was admitted to our hospital for the treatment of HCC...
June 16, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29948819/esophagogastric-varices-were-diagnosed-in-a-non-cirrhotic-liver-case-during-long-term-follow-up-after-oxaliplatin-based-chemotherapy
#9
Ryuta Shigefuku, Tsunamasa Watanabe, Takuro Mizukami, Kotaro Matsunaga, Nobuhiro Hattori, Takuya Ehira, Tatsuya Suzuki, Hiroyasu Nakano, Yoshinori Sato, Yasumasa Matsuo, Kazunari Nakahara, Hiroki Ikeda, Nobuyuki Matsumoto, Takashi Tsuda, Masafumi Katayama, Satoshi Koizumi, Chiaki Okuse, Michihiro Suzuki, Takehito Otsubo, Takako Eguchi Nakajima, Hiroshi Yasuda, Fumio Itoh
Oxaliplatin, a chemotherapeutic agent for colorectal cancer, has been associated with pathological evidence of sinusoidal endothelial injury in the liver. However, esophagogastric varices are a poorly recognized outcome of oxaliplatin-based chemotherapy. We report a 78-year-old man, whose past history of colon cancer was resection and treatment with mFOLFOX6 for 20 weeks, as adjuvant chemotherapy. After 3.5-year follow-up of the oxaliplatin-based chemotherapy, he was diagnosed with esophageal varices without liver dysfunction, indicating that the hepatotoxicity caused by oxaliplatin could be prolonged after its administration...
June 11, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29948818/rapidly-growing-hepatocellular-carcinoma-recurrence-during-direct-acting-antiviral-treatment-for-chronic-hepatitis-c
#10
Nobuyuki Yamashita, Hironori Tanimoto, Shinji Shimoda, Atsumasa Komori, Hideyuki Nomura
We herein report the case of a woman in her 80s with a recurrent hepatocellular carcinoma (HCC) tumor that rapidly increased in size during direct-acting antiviral (DAA) treatment. She suffered from HCC at her initial visit to our department and underwent hepatectomy. Thereafter, she underwent DAA treatment for chronic hepatitis C; however, her alpha-fetoprotein (AFP) level rapidly increased, and a liver tumor of > 1 cm in diameter was observed that had not been seen immediately before DAA treatment. She underwent hepatectomy again and moderate to poorly differentiated HCC was diagnosed...
June 11, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29948817/pancreatic-metastasis-of-papillary-thyroid-carcinoma-preoperatively-diagnosed-by-endoscopic-ultrasound-guided-fine-needle-aspiration-biopsy-a-case-report-with-review-of-literatures
#11
Yuko Murakami, Tatsuo Shimura, Ryo Okada, Yasuhide Kofunato, Teruhide Ishigame, Rei Yashima, Keiichi Nakano, Shinichi Suzuki, Seiichi Takenoshita
Pancreatic metastatic tumors from thyroid carcinoma are extremely rare. We report a case of an 80-year-old female with a pancreatic metastatic tumor derived from papillary thyroid carcinoma which was initially resected 158 months prior to detection of the metastatic pancreatic tumor. The patient has encountered cervical lymph-node metastasis on three occasions following the initial operation. Metastatic pancreatic lesions and cervical lymph nodes were first detected using 18-fluorodeoxyglucose positron-emission tomography/computed tomography, and she was preoperatively diagnosed using endoscopic ultrasound-guided fine-needle aspiration biopsy...
June 8, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29948816/cholangitis-complicated-by-infection-of-a-simple-hepatic-cyst
#12
Yui Mizumoto, Suguru Mizuno, Yousuke Nakai, Eri Tanaka, Tatsunori Suzuki, Kensaku Noguchi, Tomoka Nakamura, Tatsuya Sato, Kazunaga Ishigaki, Tsuyoshi Takeda, Ryunosuke Hakuta, Kei Saito, Rie Uchino, Naminatsu Takahara, Hirofumi Kogure, Minoru Tada, Kazuhiko Koike
An 87-year-old man was admitted to our hospital due to fever and elevated liver enzymes. Computed tomography (CT) scan revealed bile duct stones with a dilated biliary system, which confirmed the diagnosis of cholangitis. A 12-cm simple hepatic cyst was also seen in the right liver, which had been detected on CT scan 5 years before, and did not change in size. Fever did not subside even after endoscopic biliary drainage and a repeated CT scan showed an enlarged cyst up to 14 cm, suggesting cyst infection...
June 8, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29881954/rapid-reversal-of-colonic-pneumatosis-with-restoration-of-mesenteric-arterial-supply
#13
Hussein Abidali, Lauren Cole, Anil Bellur Seetharam
Pneumatosis cystoides intestinalis (PCI) is characterized by gas-filled cystic lesions within the wall of the large intestine and presents along a spectrum of clinical severity ranging from benign to life threatening. Etiopathogenesis is multifactorial and postulated to result from either mechanical or bacterial causes. In this report, we present a patient with chronic abdominal pain evaluated with colonoscopy revealing segmental PCI isolated to the distal colon. Further investigation revealed an abdominal aortic aneurysm (AAA) compromising the inferior mesenteric artery takeoff...
June 7, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29845554/a-case-of-an-elderly-female-with-diffuse-hepatic-hemangiomatosis-complicated-with-multiple-organic-dysfunction-and-kasabach-merritt-syndrome
#14
Yoshiaki Shimizu, Takuya Komura, Takuya Seike, Hitoshi Omura, Tatsuo Kumai, Takashi Kagaya, Hajime Ohta, Atsuhiro Kawashima, Kenichi Harada, Shuichi Kaneko, Masashi Unoura
Since diffuse hepatic hemangiomatosis (DHH) is an extremely rare disease especially in adults, the etiology and natural course of adult-onset DHH has not been well understood. We report a case of DHH complicated with multiple organic dysfunction and Kasabach-Merritt syndrome (KMS) in an 83-year-old female. She presented with mild abdominal distension and laboratory findings revealed thrombocytopenia and abnormal coagulation, indicating disseminated intravascular coagulation (DIC). Enhanced computed tomography revealed diffuse, hypodense hepatic nodules with delayed enhancement involving the whole liver, and multiple hypodense splenic legions...
May 29, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29790076/a-case-of-jackhammer-esophagus-caused-by-eosinophilic-esophagitis-in-which-per-oral-endoscopic-myotomy-resulted-in-symptom-improvement
#15
Shinwa Tanaka, Takashi Toyonaga, Fumiaki Kawara, Daisuke Watanabe, Namiko Hoshi, Hirohumi Abe, Ryusuke Ariyoshi, Yoshiko Ohara, Tsukasa Ishida, Toshitatsu Takao, Yoshinori Morita, Eiji Umegaki
A 73-year-old female with a 6-month history of progressive dysphagia and chest pain was referred to our hospital. She underwent esophagogastroduodenoscopy, which revealed abnormally strong contractions in the distal esophagus. Esophageal biopsy specimens showed massive eosinophil infiltration into the epithelium, and high-resolution manometry (HRM) also demonstrated abnormally strong contractions in the distal esophagus. Based on these results, she was diagnosed with Jackhammer esophagus (JHE) due to eosinophilic esophagitis (EoE)...
May 22, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29766398/hepatosplenic-t-cell-lymphoma-a-unifying-entity-in-a-patient-with-hemolytic-anemia-massive-splenomegaly-and-liver-dysfunction
#16
Marianna Mavilia, Agnes McAuliffe, Safina Hafeez, Haleh Vaziri
Hepatosplenic T cell lymphoma (HSTCL) is a rare subtype of peripheral non-Hodgkin lymphoma, of which 20% of cases are associated with chronic immunosuppression. It often occurs in patients with inflammatory bowel disease treated with immunomodulating medications such a thiopurines or TNF-alpha inhibitors. Cytopenias are commonly seen but autoimmune hemolytic anemia (AIHA) is rare. Here we present a young male with longstanding ulcerative colitis on chronic azathioprine, exhibiting several rare features of HSTCL...
May 15, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29766397/novel-variant-of-unknown-significance-in-mutyh-in-a-patient-with-mutyh-associated-polyposis-a-case-to-reclassify
#17
Trilokesh D Kidambi, Dena Goldberg, Robert Nussbaum, Amie Blanco, Sarah E Umetsu, Jonathan P Terdiman, Jeffrey K Lee
MUTYH-associated polyposis (MAP) is a hereditary cancer syndrome that is caused by biallelic pathogenic variants in the MUTYH gene and should be evaluated for in patients with an attenuated colonic polyposis phenotype. Monoallelic pathogenic variants in MUTYH are associated with a moderate increased risk of colorectal cancer but not with the polyposis phenotype. We present a case of a patient presenting with multiple colonic adenomatous polyps, whose germline testing revealed a heterozygous pathogenic variant in MUTYH in exon 13, c...
May 15, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29737481/a-case-of-ischemic-gastroduodenal-disease-in-a-patient-who-was-receiving-hemodialysis-treatment-that-was-managed-by-conservative-treatment
#18
Ko Tomishima, Sho Sato, Nozomi Amano, Ayato Murata, Hironori Tsuzura, Shunsuke Sato, Yoshio Kanemitsu, Yuji Shimada, Katsuyori Iijima, Takuya Genda, Ryo Wada, Akihito Nagahara
A 69-year-old man was under maintenance dialysis due to diabetic renal failure. He had a drop in blood pressure during dialysis, developed hematemesis, and was transported to our hospital. Emergency upper gastrointestinal endoscopy revealed diffuse erosion, mucosal sloughing, and edematous mucosa in the upper body of the stomach to the posterior wall of the antrum and to the greater curvature, which were considered to be an ischemic change. His underlying diseases included diabetic renal failure, chronic arteriosclerosis obliterans, cerebral infarction, internal carotid artery stenosis, hypertension, and myocardial infarction...
May 8, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29730811/phlegmonous-gastritis-associated-with-advanced-esophageal-cancer
#19
Nobutoshi Hagiwara, Takeshi Matsutani, Hiroki Umezawa, Munenaga Nakamizo, Kazuhiko Yokoshima, Eriko Shinozuka, Tsutomu Nomura, Eiji Uchida
Phlegmonous gastritis is a rapidly progressive bacterial infection of the stomach wall. It has a high mortality rate and aggressive treatment, either with antibiotics or surgical resection, is required. Here, we report an extremely rare case of phlegmonous gastritis associated with advanced esophageal cancer. A 65-year-old Japanese man was urgently admitted to the hospital due to pyrexia and gastrointestinal symptoms. Abdominal computed tomography revealed widespread diffuse thickening of the gastric wall. On endoscopic examination, an ulcerative mass was detected at the lower thoracic esophagus, and a markedly elevated submucosal lesion was present in the middle of the stomach body...
May 5, 2018: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/29730810/superiority-of-metal-stents-in-the-endoscopic-management-of-pancreatic-walled-off-necrosis-inferences-from-recent-systematic-reviews-and-meta-analyses-of-the-literature
#20
LETTER
Fateh Bazerbachi, Tarek Sawas, M Hassan Murad, Barham K Abu Dayyeh
No abstract text is available yet for this article.
May 5, 2018: Clinical Journal of Gastroenterology
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