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Clinical Journal of Gastroenterology

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https://www.readbyqxmd.com/read/28364316/a-case-of-annular-pancreas-with-wirsung-s-duct-encircling-the-duodenum-embryological-hypothesis-based-on-cholangiopancreatographic-and-immunohistochemical-findings
#1
Manami Fukai, Terumi Kamisawa, Shin-Ichirou Horiguchi, Tsunekazu Hishima, Sawako Kuruma, Kazuro Chiba, Satomi Koizumi, Taku Tabata, Sayaka Nagao, Masataka Kikuyama, Goro Honda, Masanao Kurata
We present a resected case of annular pancreas in which Wirsung's duct encircled the duodenum and continued directly to the main pancreatic duct in the body and tail. Furthermore, Wirsung's duct coursed along the right side of the lower bile duct near the major duodenal papilla. Histologically, the islets of Langerhans in the annular pancreas were irregular in shape and were characterized by a striking abundance of pancreatic polypeptide (PP)-positive cells. The PP-rich area that encircled the duodenum was fused with the PP-poor area in the head of the pancreas...
March 31, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28364315/mucosal-healing-of-crohn-s-disease-in-a-patient-with-concurrent-systemic-lupus-erythematosus-using-infliximab
#2
Yuka Kagaya, Hirotsugu Sakamoto, Tomonori Yano, Keijiro Sunada, Alan Kawarai Lefor, Toshiro Niki, Hironori Yamamoto
We describe a patient with Crohn's disease (CD) concurrent with systemic lupus erythematosus (SLE). Continuous prednisolone and cyclosporine treatment resulted in no recurrent symptoms. However, diarrhea, vomiting, and fever occurred for approximately 3 months. A colonoscopy was then performed, which showed a discontinuous cobblestone appearance and longitudinal ulcers extending from the sigmoid colon to the descending colon and distal ileum. A biopsy revealed a noncaseating granulomatous lesion in the colonic mucosa...
March 31, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28364314/endoscopic-tissue-shielding-for-esophageal-perforation-caused-by-endoscopic-resection
#3
Ryo Takahashi, Toshiyuki Yoshio, Yusuke Horiuchi, Masami Omae, Akiyoshi Ishiyama, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida, Junko Fujisaki
In Japan, endoscopic resection (ER), including endoscopic mucosal resection and endoscopic submucosal dissection, is widely performed for superficial esophageal neoplasms and accepted as a minimally invasive treatment. Perforation is a major complication of ER, with an incidence rate of 1-5%. While conservative treatment has become a more common choice, surgical treatment of perforations is sometimes required, especially for large perforations. Of 1408 cases of esophageal ER that have been performed, 17 cases of perforation occurred at the Cancer Institute Hospital between 2005 and 2016...
March 31, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28353200/asymptomatic-acute-hepatitis-e-in-a-female-patient-with-ulcerative-colitis
#4
Kazuyuki Suzuki, Ichiro Kumagai, Yuichi Yoshida, Akio Miyasaka, Yasuhiro Takikawa, Ryoichi Kamiya, Kouryo Kondo, Akinobu Kato, Toshimi Chiba, Hiroaki Okamoto
We present a 60-year-old female patient with asymptomatic acute hepatitis E that was fortuitously detected during the course of ulcerative colitis (UC). She was admitted to hospital on October 30, 2015. Endoscopy and histological examination of the colon showed typical findings of UC. All parameters of liver function tests were normal on this date. Combination therapy with oral prednisolone and mesalazine was started and intravenous administration of infliximab once every 8 weeks was added later. Her symptoms gradually improved after these treatments, and she was discharged on February 7, 2016...
March 28, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28324273/acute-pancreatitis-caused-by-mycoplasma-pneumoniae-an-unusual-etiology
#5
Teresa Valdés Lacasa, María Alejandra Duarte Borges, Alicia García Marín, Covadonga Gómez Cuervo
It is well known that the most important etiologies of acute pancreatitis are gallstones and alcohol consumption. Once these causes have been ruled out, especially in young adults, it is important to consider less frequent etiologic factors such as drugs, trauma, malformations, autoimmunity or systemic diseases. Other rare and less well studied causes of this pathology are infections, among which Mycoplasma pneumoniae has been reported to cause acute pancreatitis as an unusual extrapulmonary manifestation. Here, we report the case of a 21-year-old patient who had acute idiopathic pancreatitis associated with an upper respiratory tract infection...
March 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28324272/lusutrombopag-increases-hematocytes-in-a-compensated-liver-cirrhosis-patient
#6
Akira Sakamaki, Takayuki Watanabe, Satoshi Abe, Kenya Kamimura, Atsunori Tsuchiya, Masaaki Takamura, Hirokazu Kawai, Satoshi Yamagiwa, Shuji Terai
A 56-year-old Japanese man with liver cirrhosis (LC) due to hepatitis C virus was admitted to our hospital for radiofrequency ablation of residual tumor following lusutrombopag administration. Laboratory tests revealed thrombocytopenia and leukopenia. The patient's LC was managed, and he was classified as Child-Pugh A. After admission, lusutrombopag was administered for 7 days. The platelet count increased to over 50,000/mm(3) after 7-14 days and returned to previous levels 50 days after administration. Leukocyte and erythrocyte counts also increased in response to the treatment and stayed elevated for over 120 days...
March 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28321821/duodenal-diverticulitis-accompanied-by-abscess-formation-treated-successfully-using-an-endoscopic-nasobiliary-drainage-catheter-a-case-report
#7
Yasushi Tamura, Masato Hayakawa, Masato Isogawa, Tadayuki Togashi, Masato Igarashi, Sumio Takahashi, Yutaka Aoyagi
Diverticulitis and diverticular abscesses are rare and potentially serious complications of duodenal diverticulum. These conditions often lead to perforation of the diverticulum, necessitating surgical treatment. There have been few reported cases of duodenal diverticulitis with or without perforation treated by endoscopic drainage. Here, we present a case of duodenal diverticulitis accompanied by abscess formation that was treated successfully with an endoscopic nasobiliary drainage catheter. We suggest this treatment could be an acceptable option for selected patients with a localized abscess that is resistant to conservative treatment...
March 20, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28315155/synchronous-triple-primary-cancers-of-the-pharynx-and-esophagus
#8
Seita Kataoka, Masami Omae, Yusuke Horiuchi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Yorimasa Yamamoto, Tomohiro Tsuchida, Junko Fujisaki, Kazuhiko Yamada, Masahiro Igarashi
A 72-year-old male with nausea and heartburn was found to have early pharyngeal squamous cell carcinoma, superficial and advanced esophageal squamous cell carcinoma and early esophageal adenocarcinoma by esophagogastroduodenoscopy. Computerized tomography demonstrated left cardiac lymph node swellings. We prioritized the treatment for esophageal squamous cell carcinoma, as this was the most advanced cancer among the triple primaries. The patient underwent neoadjuvant chemotherapy for esophageal squamous cell carcinoma followed by esophagectomy...
March 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28303455/duodenal-cancer-in-a-young-patient-with-peuts-jeghers-syndrome-harboring-an-entire-deletion-of-the-stk11-gene
#9
Satoshi Teramae, Koichi Okamoto, Kumiko Tanaka, Reika Matsumoto, Shinji Kitamura, Tetsuo Kimura, Masahiro Sogabe, Hiroshi Miyamoto, Naoki Muguruma, Yoshimi Bando, Mitsuo Shimada, Tetsuji Takayama
A 21-year-old woman with Peuts-Jeghers syndrome (PJS) was referred to our hospital for gastrointestinal surveillance. She had been diagnosed as having PJS from a young age based on her family history and the presence of mucocutaneous pigmentation on her lips and oral mucosa. Her mother and brother had PJS harboring an entire deletion of the STK11 gene. She had tetralogy of Fallot, atrial tachycardia, sick sinus syndrome, and mental retardation in her past history. Esophagogastroduodenoscopy identified a protruded lesion with a depressed area that occupied the lumen half-circumferentially in the duodenal second portion and also showed a 10-mm protruded lesion on the anterior wall of the lower gastric body...
March 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28290069/significance-of-genetic-polymorphisms-in-patients-with-nonalcoholic-fatty-liver-disease
#10
REVIEW
Hisamitsu Miyaaki, Kazuhiko Nakao
Because of recent advances in genetic research such as genome-wide association studies, the underlying genetic mechanisms of nonalcoholic fatty liver disease (NAFLD) pathophysiology have been elucidated. Here, we present a review of the current literature on the impact of genetic polymorphisms in patients with NAFLD. These genetic polymorphisms, which regulate lipid metabolism, glucose metabolism, and the renin-angiotensin system, are involved in NAFLD onset, steatosis, inflammation, fibrosis, and hepatocellular carcinoma (HCC)...
March 13, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28271435/adalimumab-therapy-in-a-patient-with-crohn-s-disease-with-a-giant-pelvic-paraganglioma-after-chemotherapy
#11
Tsutomu Mizoshita, Masashi Ando, Hiroyuki Sagawa, Yoshinori Mori, Takahito Katano, Keiji Ozeki, Satoshi Tanida, Yasuyuki Okamoto, Takaya Shimura, Eiji Kubota, Hiromi Kataoka, Takeshi Kamiya, Takashi Joh
A 23-year-old man was diagnosed with a giant pelvic paraganglioma in September 2013, and a 6-month chemotherapy course was performed. The chemotherapy resulted in stable disease of the tumor for about 1 year. However, in April 2015, the patient complained of fever and diarrhea of more than ten times a day. Endoscopy showed serpiginous (snake-like) ulcers in the cecum, ascending, descending, and sigmoid colons, with granulomas without caseation histologically. The patient was diagnosed with the active stage of Crohn's disease (CD) in June 2015...
March 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28265895/clinical-peritonitis-from-allergy-to-silicone-ventriculoperitoneal-shunt
#12
Michael Kurin, Kenneth Lee, Paul Gardner, Merritt Fajt, Chandraprakash Umapathy, Kenneth Fasanella
Silicones are inorganic compounds that have been used for the purpose of shunting ventricular fluid since the mid-20th century [1]. Complications of ventriculoperitoneal shunts have rarely been attributed to silicone allergy, with only a handful of cases reported in literature. The classic presentation of allergy to silicone ventriculoperitoneal shunt, i.e., abdominal pain with recurrent skin breakdown along the shunt tract, is nonspecific and difficult to distinguish clinically from other causes of shunt-related symptoms...
March 6, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28265894/endoscopic-ultrasonography-features-of-gastric-mucosal-cobblestone-like-changes-from-a-proton-pump-inhibitor
#13
Shuichi Miyamoto, Takahiko Kudo, Mototsugu Kato, Kana Matsuda, Satoshi Abiko, Momoko Tsuda, Takeshi Mizushima, Keiko Yamamoto, Shoko Ono, Yuichi Shimizu, Naoya Sakamoto
A 68-year-old man with no symptoms presented to Hokkaido University Hospital for esophagogastroduodenoscopy screening. He had a history of Helicobacter pylori eradication. Initial esophagogastroduodenoscopy showed no gastric cobblestone-like mucosa or gastric cracked mucosa. After 1 year, he received esomeprazole (20 mg) once daily for heartburn at another hospital. Esophagogastroduodenoscopy was performed after 2 years of esomeprazole administration. Endoscopic findings showed that after H. pylori eradication, according to the Kyoto classification, gastric cobblestone-like mucosa presented in the gastric body area...
March 6, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28258561/a-resected-case-of-two-branch-duct-type-intraductal-papillary-mucinous-neoplasms-showing-different-clinical-courses-after-a-two-year-follow-up
#14
Hideki Shibata, Nobuyuki Ohike, Tomoko Norose, Tomohide Isobe, Reika Suzuki, Hideyuki Imai, Akira Shiokawa, Masafumi Takimoto, Akihiro Tabuchi, Yuichi Takano, Eiichi Yamamura, Masatsugu Nagahama, Nobuyuki Takeyama, Kazuaki Yokomizo, Hiroki Mizukami, Jun-Ichi Tanaka, Takeshi Aoki, Masahiko Murakami
The patient was a 60-year-old man without any particular complaints, but he underwent abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) due to a fatty liver, which revealed two similar cystic lesions regarded as branch duct-type intraductal papillary mucinous neoplasm (BD-IPMN) in the pancreatic body [BD-IPMN (b), 16 mm in size] and tail [BD-IPMN (t), 13 mm in size] without a "high-risk stigmata" or "worrisome features". He subsequently received follow-up by MRCP every 6 months...
March 3, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28258560/new-subtype-of-gastric-adenocarcinoma-mixed-fundic-and-pyloric-mucosa-type-adenocarcinoma
#15
Takashi Kanesaka, Noriya Uedo, Kenshi Yao, Hiroshi Tanabe, Yasushi Yamasaki, Yoji Takeuchi, Akinori Iwashita, Yasuhiko Tomita
A 73-year-old woman underwent upper endoscopic screening that revealed a 30-mm superficial elevated lesion in the anterior wall of the upper gastric body. The lesion had a whitish color and coarse granular surface in conventional white light endoscopy. Magnifying narrow-band imaging indicated irregular microvascular and microsurface patterns within a demarcation line. The microvessels had a distorted polygonal shape within the area surrounded by the marginal crypt epithelium. The patient underwent endoscopic resection...
March 3, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28247277/diagnosis-and-treatment-of-eosinophilic-esophagitis-in-clinical-practice
#16
REVIEW
Yasuhiko Abe, Yu Sasaki, Makoto Yagi, Takao Yaoita, Shoichi Nishise, Yoshiyuki Ueno
Eosinophilic esophagitis (EoE) is a chronic and abnormal Th2 type immunological response characterized by intense eosinophilic inflammation localized within the esophagus. This leads to esophageal dysfunction and remodeling accompanied by subepithelial fibrosis. Recently, EoE has been recognized as one of the major causes of dysphagia or food impaction in adults. The prevalence of EoE has been increasing over the past several decades, particularly in Western countries. EoE should be differentiated from secondary esophageal eosinophilia (EE) in gastroesophageal reflux disease (GERD) and eosinophilic gastroenteritis, involving the entire gastrointestinal tract...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28236277/dual-drainage-using-a-percutaneous-pancreatic-duct-technique-contributed-to-resolution-of-severe-acute-pancreatitis
#17
Tatsunori Satoh, Masataka Kikuyama, Yoshihiro Yokoi, Shinya Kawaguchi
A 66-year-old man was admitted for severe acute alcoholic pancreatitis with infected pancreatic necrosis (IPN). Abdominal computed tomography revealed an inflamed pancreatic head, a dilated main pancreatic duct (MPD), and a large cavity with heterogeneous fluid containing gas adjacent to the pancreatic head, and extending to the pelvis. The cavity was drained percutaneously near the pancreatic head on admission; another tube was inserted into the pelvic cavity on hospital day 3. The drained fluid contained pus with high amylase concentration...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28229343/a-case-of-pancreaticobiliary-maljunction-with-a-connecting-duct-without-a-long-common-channel
#18
Masataka Kikuyama, Terumi Kamisawa, Sawako Kuruma, Kazuro Chiba, Satomi Koizumi, Taku Tabata, Goro Honda
Pancreaticobiliary maljunction (PBM) is a congenital malformation in which the pancreatic and bile ducts join anatomically outside the duodenal wall, usually forming an abnormally long common channel. In PBM, since the long common channel defeats the effect of the sphincter of Oddi, pancreatobiliary reflux frequently occurs, resulting in high rates of biliary tract cancers. We present the case of a 68-year-old female with advanced gallbladder cancer concomitant with bile duct cancer associated with PBM without biliary dilatation that had an extremely rare configuration showing a connecting duct without a long common channel...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28224470/three-patients-treated-with-sofosbuvir-plus-ledipasvir-for-recurrent-hepatitis-c-after-liver-transplantation
#19
Tomokazu Kawaoka, Michio Imamura, Kei Morio, Yuki Nakamura, Masataka Tsuge, Clair Nelson Hayes, Yoshiiku Kawakami, Hiroshi Aikata, Hidenori Ochi, Kouhei Ishiyama, Hideki Ohdan, Kazuaki Chayama
We previously reported results of interferon (IFN)-free daclatasvir and asunaprevir for the treatment of recurrent hepatitis C virus (HCV) genotype 1 infection after liver transplantation (LT). Here we report three patients who achieved viral response with no effect on the blood concentrations of immunosuppressive agents following sofosbuvir plus ledipasvir treatment. The first patient was a 68-year-old female with HCV-related liver cirrhosis who failed to respond to pegylated-IFN and ribavirin (PEG-IFN/RBV) after living donor LT...
April 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28213744/intraductal-papillary-neoplasm-originating-from-an-anomalous-bile-duct
#20
Harufumi Maki, Taku Aoki, Takeaki Ishizawa, Mariko Tanaka, Takashi Sakatani, Yoshifumi Beck, Kiyoshi Hasegawa, Yoshihiro Sakamoto, Norihiro Kokudo
An 82-year-old woman who had been suffering from repeated obstructive jaundice for 7 years was referred to our hospital. Although endoscopic aspiration of the mucin in the common bile duct had been temporally effective, origin of the mucin production had not been detectable. The patient thus had been forced to be on long-term follow-up without curative resection. Endoscopic retrograde cholangioscopy on admission revealed massive mucin in the common bile duct. In addition, an anomalous bile duct located proximal to the gallbladder was identified...
April 2017: Clinical Journal of Gastroenterology
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