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Clinical Journal of Gastroenterology

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https://www.readbyqxmd.com/read/28084581/colon-capsule-endoscopy-toward-the-future
#1
REVIEW
Naoki Muguruma, Kumiko Tanaka, Satoshi Teramae, Tetsuji Takayama
Colon capsule endoscopy is a wireless and minimally invasive technique for visualization of the whole colon. With recent improvements of technical features in second-generation systems, a more important role for colon capsule endoscopy is rapidly emerging. Although several limitations and drawbacks are yet to be resolved, its usefulness as a tool for colorectal cancer screening and monitoring disease activity in inflammatory bowel diseases has become more apparent with increased use. Further investigations, including multicenter trials, are required to evaluate the substantial role of the colon capsule in managing colorectal diseases...
January 13, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28054178/hemosuccus-pancreaticus-caused-by-a-mucinous-cystic-neoplasm-of-the-pancreas
#2
Yuri Matsumoto, Hiroshi Miyamoto, Akira Fukuya, Fumika Nakamura, Takahiro Goji, Shinji Kitamura, Tetsuo Kimura, Koichi Okamoto, Masahiro Sogabe, Naoki Muguruma, Mitsuo Shimada, Yoshimi Bando, Tetsuji Takayama
Hemosuccus pancreaticus is a gastrointestinal hemorrhage through the main pancreatic duct. Here, we report a rare case of hemosuccus pancreaticus due to a mucinous cystic neoplasm of the pancreas. A 62-year-old woman who had been followed for a branch duct intraductal papillary mucinous neoplasm visited our emergency room due to severe abdominal pain and bloody discharge. Computed tomography revealed that the pancreatic cyst increased the tension of the wall and a high-density area indicative of bleeding into the cyst was observed...
January 4, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28028783/primary-mesenteric-neuroendocrine-tumor-that-changed-its-internal-composition-from-cystic-to-solid-a-case-report
#3
Akira Yasuda, Hidehiko Kitagami, Yasuhiro Kondo, Keisuke Nonoyama, Kaori Watanabe, Shiro Fujihata, Hirotaka Miyai, Minoru Yamamoto, Yasunobu Shimizu, Moritsugu Tanaka
Mesenteric neuroendocrine tumors are usually metastases originating from the small intestine; however, primary mesenteric cases are rare. We present an interesting case of a mesenteric neuroendocrine tumor that changed its internal composition from cystic to solid. A 72-year-old male visited our hospital because of epigastralgia 4 years earlier. A 25-mm tumor was recognized around the terminal duodenum on computed tomography and magnetic resonance imaging, and was diagnosed as a cystic lesion. Over the following 2 years, the tumor grew to 40 mm and its internal composition changed from cystic to solid...
December 27, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28025783/idelalisib-induced-colitis-and-skin-eruption-mimicking-graft-versus-host-disease
#4
Muhammad Bader Hammami, Ahmad Al-Taee, Marshall Meeks, Mark Fesler, M Yadira Hurley, Dengfeng Cao, Jin-Ping Lai
INTRODUCTION: Idelalisib is a selective inhibitor of the delta isoform of phosphatidylinositol 3-kinase which was approved by the United States Federal Drug Administration in 2014 for the treatment of relapsed chronic lymphocytic leukemia and indolent non-Hodgkin lymphoma. Drug-induced injury of the gastrointestinal tract is a relatively frequent but usually under-recognized disease entity. CASE PRESENTATION: We report the case of a 56-year-old male with a history of relapsed follicular lymphoma status post allogenic bone marrow transplant who developed severe diarrhea with a skin eruption mimicking graft-versus-host disease (GVHD) 6 months after starting idelalisib...
December 26, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28013449/follicular-lymphoma-related-colitis-resembling-ulcerative-colitis
#5
Takahiro Zenda, Noriharu Nakagawa, Hiroyuki Maruyama, Tamao Endo, Kotaro Higashi, Junpei Yamamoto, Keigo Komai, Kishichiro Watanabe, Ichiro Araki
Among the various manifestations of colonic involvement in malignant lymphomas, an ulcerative colitis-like appearance is rare. Herein, we describe a case in which extranodal colonic involvement resembled ulcerative colitis in a patient with advanced follicular lymphoma. A 59-year-old Japanese man with diarrhea and body weight loss was referred to our hospital. Computed tomography (CT) revealed systemic lymphadenopathy, splenomegaly, and thickening of the sigmoid colon and rectum walls. (18)F-fluorodeoxy-glucose positron emission tomography ((18)F-FDG-PET/CT) revealed intense tubular (18)F-FDG accumulation extending from the rectum to the colon at the hepatic flexure and much weaker accumulation in the systemic lymph nodes, bone marrow, and spleen...
December 24, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28004249/delayed-perforation-occurring-on-the-24th-day-after-endoscopic-submucosal-dissection-for-early-gastric-cancer
#6
Satoru Homma, Kazuaki Tokodai, Minami Watanabe, Kai Takaya, Eiji Hashizume
Delayed perforation occurs after 0.5% of endoscopic submucosal dissection (ESD) procedures for early gastric cancer (EGC). This complication can occur within a few hours or days after ESD. There are few reports in the English literature concerning patients who developed delayed perforation after ESD for EGC. An 81-year-old woman was referred to the emergency department of our hospital on the 24th day after ESD because of abdominal pain. We diagnosed her with delayed perforation with peritonitis after ESD for EGC using computed tomography (CT) and esophagogastroduodenoscopy (EGD)...
December 21, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28004248/message-from-the-editor-in-chief-regarding-ethical-violations
#7
(no author information available yet)
No abstract text is available yet for this article.
December 21, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27995469/a-case-of-liver-hemangioma-with-markedly-reduced-tumor-size-after-metformin-treatment-a-case-report
#8
Minoru Ono, Koji Sawada, Toshikatsu Okumura
A 52-year-old man with a 9-year history of hepatic hemangioma was treated with the anti-diabetic drug metformin, resulting in complete remission of the tumor. In 2006, a hemangioma with diameter of 20 × 25 mm was detected incidentally in the liver. The results of imaging studies including ultrasound (US), computed tomography (CT) and magnetic resonance imaging (MRI) were all compatible with that of hepatic hemangioma. The patient consequently underwent imaging annually from 2006 to 2015. The tumor size increased slightly, to 30 × 35 mm in 2012; however, the general tumor characteristics in imaging were not changed...
December 19, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27995468/alpha-fetoprotein-producing-esophageal-adenocarcinoma-a-mimicker-of-hepatocellular-carcinoma
#9
Jeremy Wang, Wendy Liu, Keyur Parikh, Anthony Benjamin Post
Alpha-fetoprotein (AFP)-producing esophageal adenocarcinoma (EAC) is a rare occurrence. Elevation of serum AFP is commonly associated with hepatocellular carcinoma and yolk sac tumors, but rarely with esophageal carcinoma. Here, we report a rare case of AFP-producing EAC. A 51-year-old man presented with two weeks of acid reflux and a 35-lb weight loss. Laboratory data were notable for transaminitis and AFP was 2524 ng/mL. Computed tomography of the abdomen revealed abnormal thickening of the esophagus and multiple metastatic masses throughout the liver...
December 19, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27995467/a-case-of-gastrojejunocolic-fistula-with-steatohepatitis
#10
Teppei Omori, Katsutoshi Tokushige, Fukiko Kinoshita, Ayumi Ito, Makiko Taniai, Mikiko Taneichi, Bunei Iizuka, Michio Itabashi, Yoji Nagashima, Masakazu Yamamoto, Shinichi Nakamura, Etsuko Hashimoto
A man in his 30s, who had undergone retrocolic Billroth II reconstruction for perforated duodenal ulcer, presented with watery diarrhea for 2 years and suspected fatty liver. He was referred to our hospital for management of chronic diarrhea, weight loss, hepatopathy and hypoalbuminemia. Initial upper and lower gastrointestinal endoscopies were negative. Since a small bowel lesion was suspected, peroral single-balloon enteroscopy was performed, which identified feces-like residue near the Billroth II anastomotic site and a connection to the colon separate from the afferent and efferent loops...
December 19, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27943060/massive-ascites-caused-by-intra-pancreatic-arterioportal-fistula-a-rare-complication-of-chronic-pancreatitis
#11
Tomoo Yamazaki, Yasuhide Ochi, Naoki Tanaka, Takayuki Watanabe, Yugo Iwaya, Ayako Seki, Etsuo Hara, Eiji Tanaka, Tomoharu Watanabe, Shun Imai, Osamu Hasebe
An 86-year-old man with a long-term habit of ethanol consumption was admitted due to massive transudate ascites and leg edema. Abdominal computed tomography revealed a dilated main pancreatic duct and atrophied pancreatic parenchyma, leading to the diagnosis of chronic pancreatitis. Moreover, the portal vein was enhanced in the early arterial phase, which indicated the presence of an arterioportal fistula. The fistula was located between the posterior superior pancreaticoduodenal artery and the portal vein near a pancreatic retention cyst...
December 10, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27909975/immunoglobulin-g4-related-hepatic-inflammatory-pseudotumor-invading-the-abdominal-wall
#12
Shinji Miyajima, Akihiro Okano, Masaya Ohana
A 50-year-old woman presented with epigastralgia. Computed tomography (CT) of the abdomen revealed a 6-cm well-enhanced mass extending from the left lobe of the liver to the abdominal wall, suggestive of cholangiocarcinoma. Liver and skin mass biopsies did not provide evidence of hepatic malignancy but were rich in plasma cells and sclerotic lesions. Subsequent detection of elevated serum immunoglobulin G4 (IgG4) led to a diagnosis IgG4-related inflammatory pseudotumor (IPT) of the liver. Treatment with systemic corticosteroids resulted in rapid clinical improvement...
December 1, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27873064/development-of-diffuse-large-b-cell-lymphoma-from-follicular-lymphoma-of-the-duodenum-changes-in-endoscopic-findings-during-a-6-year-follow-up
#13
Hiroyuki Kitabatake, Tadanobu Nagaya, Naoki Tanaka, Hiroyoshi Ota, Kenji Sano, Naoko Asano, Tomoaki Suga, Yoshiyuki Nakamura, Taiji Akamatsu, Eiji Tanaka
A 71-year-old Japanese man was diagnosed as having stage I primary follicular lymphoma (FL) of the duodenum according to Lugano International Conference Classification and began receiving annual checkups. Endoscopic examination disclosed white villi swelling with depressed red mucosal lesions. Biopsy specimens from the area of white villi exhibited histopathological features that met the diagnostic criteria for low-grade FL. The depressed red lesions gradually enlarged over six years of follow-up. A biopsy of the white villi swelling revealed distinct well-circumscribed follicles with attenuated mantles in the lamina propria that were positive for CD20, bcl-2, and CD10...
November 21, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27848147/hepatitis-a-virus-genotype-ia-infected-patient-with-marked-elevation-of-aspartate-aminotransferase-levels
#14
Yoshifumi Miura, Tatsuo Kanda, Shin Yasui, Koji Takahashi, Yuki Haga, Reina Sasaki, Masato Nakamura, Shuang Wu, Shingo Nakamoto, Makoto Arai, Tsutomu Nishizawa, Hiroaki Okamoto, Osamu Yokosuka
We describe a case of acute liver failure (ALF) without hepatic encephalopathy with marked elevation of aminotransferase due to hepatitis A, according to the revised Japanese criteria of ALF. This liver biopsy of the patient showed compatible to acute viral hepatitis and she immediately recovered without intensive care. She had no comorbid disorders. Of interest, phylogenetic tree analysis using almost complete genomes of hepatitis A virus (HAV) demonstrated that the HAV isolate from her belonged to the HAV subgenotype IA strain and was similar to the HAJFF-Kan12 strain (99% nucleotide identity) or FH1 strain (98% nucleotide identity), which is associated with severe or fulminant hepatitis A...
November 15, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27815815/gossypiboma-with-bleeding-from-fistula-to-the-colon-observed-by-colonoscopy
#15
Naoyuki Nishimura, Motowo Mizuno, Yuichi Shimodate, Akira Doi, Hirokazu Mouri, Kazuhiro Matsueda, Hiroshi Yamamoto
A gossypiboma is a mass of cotton sponge left in the body postoperatively. Here, we report a case of gossypiboma with bleeding through a fistula to the colon, which became clinically evident 24 years after gynecological surgery, and resembled a bleeding diverticulum at colonoscopy. A 67-year-old woman presented with anemia and hematochezia. She had undergone a hysterectomy for myoma uteri 24 years earlier. Colonoscopy showed a deep depressed lesion mimicking a diverticulum with bleeding in the transverse colon...
November 4, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27796825/complete-response-to-post-transplant-lymphoproliferative-disorder-by-surgical-resection-and-rituximab-after-living-donor-liver-re-transplantation-for-recurrent-primary-sclerosing-cholangitis
#16
Koichiro Haruki, Hiroaki Shiba, Junichi Shimada, Norimitsu Okui, Tomonori Iida, Katsuhiko Yanaga
Post-transplant lymphoproliferative disorder (PTLD) is a life-threatening complication of solid organ transplantation. We herein report a case of PTLD after living-donor liver re-transplantation (reLDLT) for recurrent primary sclerosing cholangitis (PSC), for which complete response was achieved by surgical resection and rituximab. A 47-year-old man, who had undergone living-donor liver transplantation (LDLT) twice at age of 43 and 45 years for end-stage liver disease firstly for PSC and secondary for recurrent PSC, suffered liver dysfunction due to an acute cellular rejection (ACR) 17 months after reLDLT...
October 31, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27783218/helicobacter-pylori-negative-gastric-cancer-advanced-stage-undifferentiated-adenocarcinoma-located-in-the-pyloric-gland-area
#17
Akihiro Okano, Shigeru Kato, Masaya Ohana
The incidence of Helicobacter pylori-negative gastric cancer (HpNGC) is extremely low. A 78-year old female without H. pylori infection was diagnosed with type 4 advanced-stage gastric prepylorus cancer. Distal gastrectomy was performed as for HpNGC (cT3N0M0). Histological findings of the resected specimen showed poorly differentiated adenocarcinoma and signet ring cell carcinoma, which were located in the pyloric gland area, diffusely invaded beyond the serosa without lymph node metastasis (pT4aN0M0). Most cases of undifferentiated-type HpNGC are diagnosed in the early stage and are located in the fundic gland area...
October 25, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27738909/the-prospect-of-endoscopic-submucosal-dissection-for-early-anal-canal-squamous-cell-carcinoma
#18
Takahiko Ito, Shuko Morita, Naoto Shimeno, Keiichiro Uehara, Yukihiro Imai, Tetsuro Inokuma
Squamous cell carcinoma (SCC) of the anal canal is seldom diagnosed at an early stage. Chemoradiation therapy is a standard in Europe and the United States, though in squamous cell carcinoma there is no evidence-based therapy. In Japan, endoscopic submucosal dissection (ESD) is the standard minimally invasive treatment for early stage cancer of the digestive tract, including the colorectum. Therefore, if the lesion is diagnosed at an early stage, ESD may be selected for anal canal lesions. We experienced two cases of early stage anal canal cancer in which the diagnosis and the extent of the lesions were confirmed using magnifying endoscopy with narrow-band imaging (NBI), as well as performing ESD...
December 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27730597/acute-esophageal-necrosis
#19
Beatriz Deoti E Silva Rodrigues, Raniere Dos Santos, Magda Maria Profeta da Luz, Flávia Chaves E Silva, Igor Guedes Nogueira Reis
Acute esophageal necrosis (AEN) or "black esophagus" is a rare condition presented by patients with critical state of health and characterized by a darkened esophagus, usually the distal third, in upper digestive endoscopy. The main clinical manifestation is upper gastrointestinal bleeding and there may be abdominal pain, dysphagia, nausea, vomiting, fever and syncope associated. The diagnosis depends on clinical suspicion and performing endoscopy, the biopsy not being required. In this article we present a case of a patient who had lots of comorbidities and developed AEN during a post-operative period, and discuss the importance of AEN in an increasingly ageing population...
December 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27699641/recent-trends-and-future-directions-for-the-medical-treatment-of-ulcerative-colitis
#20
REVIEW
Makoto Naganuma, Shinta Mizuno, Kosaku Nanki, Shinya Sugimoto, Takanori Kanai
Recently, several medical treatments for ulcerative colitis (UC) have been developed, including 5-aminosalicylic acids (5-ASAs), corticosteroids, thiopurine, calcineurin inhibitors, and anti-tumor necrosis factor (TNF) α treatments. Treatment options including calcineurin inhibitors and anti-TNF treatment for refractory UC are discussed in this article. Furthermore, upcoming treatments are introduced, such as golimumab, vedolizumab, AJM300, tofacitinib. Budesonide foamwill be used as one treatment option in patients with distal colitis...
December 2016: Clinical Journal of Gastroenterology
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