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Clinical Journal of Gastroenterology

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https://www.readbyqxmd.com/read/27909975/immunoglobulin-g4-related-hepatic-inflammatory-pseudotumor-invading-the-abdominal-wall
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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/27766544/successful-treatment-of-three-patients-with-human-immunodeficiency-virus-and-hepatitis-c-virus-genotype-1b-co-infection-by-daclatasvir-plus-asunaprevir
#7
Noboru Hirashima, Hiroaki Iwase, Masaaki Shimada, Nobumitsu Ryuge, Junji Imamura, Hiroki Ikeda, Yasuhito Tanaka, Nobuyuki Matsumoto, Chiaki Okuse, Fumio Itoh, Yoshiyuki Yokomaku, Tsunamasa Watanabe
Co-infection with human immunodeficiency virus (HIV) and hepatitis C virus (HCV) often accelerates the course of HCV-associated liver disease. Daclatasvir (DCV) plus asunaprevir (ASV) have been shown to be highly effective for HCV-infected patients with genotype 1b. Three patients co-infected with HIV/HCV genotype 1b were enrolled in this study. Prior to initiation of HCV treatment, the variants associated with L31 and Y93 in the non-structural protein 5A (NS5A) region of the HCV genome were confirmed to be absent using a direct sequencing method...
October 20, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27766543/crohn-s-disease-presenting-as-a-ceco-urachal-fistula
#8
Hidenori Tsukui, Koji Koinuma, Mitsuaki Morimoto, Hisanaga Horie, Alan Kawarai Lefor, Yuka Kagaya, Haruo Takahashi, Tomonori Yano, Daisuke Matsubara, Hironori Yamamoto, Naohiro Sata
We report the case of a patient with Crohn's disease who initially presented with a ceco-urachal fistula. The patient was a 31-year-old female who underwent an appendectomy 6 years before presenting to our institution. She had a one-year history of diarrhea, and had recently developed polyuria and a sensation of residual urine. She was admitted with fever and lower abdominal pain. Endoscopy and computed tomography revealed a ceco-urachal fistula, which was consistent with Crohn's disease. An urachal resection was performed, which included partial cystectomy and ileocecal resection...
October 20, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27744539/side-by-side-placement-of-bilateral-endoscopic-metal-stents-for-the-treatment-of-postoperative-biliary-stricture
#9
Seiji Kaino, Manabu Sen-Yo, Shuhei Shinoda, Michitaka Kawano, Hirofumi Harima, Shigeyuki Suenaga, Isao Sakaida
Postoperative biliary strictures are usually complications of cholecystectomy. Endoscopic plastic stent prosthesis is generally undertaken for treating benign biliary strictures. Recently, fully covered metal stents have been shown to be effective for treating benign distal biliary strictures. We present the case of a 53-year-old woman with liver injury in which imaging studies showed a common hepatic duct stricture. Endoscopic retrograde cholangiopancreatography also confirmed the presence of a common hepatic duct stricture...
October 15, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27738909/the-prospect-of-endoscopic-submucosal-dissection-for-early-anal-canal-squamous-cell-carcinoma
#10
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...
October 13, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27730597/acute-esophageal-necrosis
#11
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...
October 11, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27699641/recent-trends-and-future-directions-for-the-medical-treatment-of-ulcerative-colitis
#12
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...
October 3, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27699640/acute-exacerbation-of-irritable-bowel-syndrome-prevented-by-prn-oral-triptan
#13
Benjamin N R Cheyette, Sarah N R Cheyette
We report a case of irritable bowel syndrome (IBS), diarrhea subtype, characterized by daily 'morning rush' and episodic acute exacerbations brought on by common IBS trigger foods including insoluble fiber, red wine and large/rich meals. The patient also had a history of migraine headaches, and a family history suggesting a common diathesis for both disorders. Given hypothesized contributions to IBS from dysregulation of the enteric serotonergic system, a trial of low-dose triptan medication was implemented in the context of the patient's known IBS triggers, with highly satisfactory results...
October 3, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27696277/anal-metastasis-from-rectal-adenocarcinoma
#14
Takeshi Nishikawa, Soichiro Ishihara, Tetsuo Ushiku, Keisuke Hata, Kazuhito Sasaki, Koji Murono, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Hiroaki Nozawa, Toshiaki Watanabe
The metastasis of rectal cancer to the anus is rare. Here, we report a case of advanced rectal cancer, which had a diffuse venous invasion with anal metastasis and multiple lymph node and liver metastases. The patient was a 72-year-old woman who complained of perianal pain and fresh blood in the stools for 6 months. She had neither history of fistula-in-ano nor anal surgery. Digital examination revealed a 2-cm tumor at the 7 o'clock position, and the barium enema and colonoscopy confirmed advanced rectal cancer...
October 1, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27696205/gastric-plexiform-schwannoma-in-association-with-neurofibromatosis-type-2
#15
Satoru Kudose, Michael Kyriakos, Michael Magdi Awad
: Plexiform schwannoma (PS) is an uncommon variant of schwannoma characterized by a multinodular (plexiform) growth pattern. It comprises up to 5 % of all schwannomas. The association between PS and neurofibromatosis type 1 or type 2 (NF1/NF2) is only rarely reported. Most cases of PS occur in the skin and subcutaneous soft tissue, with only a few reports of digestive tract involvement. We describe an 18-year-old male with NF2 who had bilateral vestibular schwannomas and multiple cutaneous PSs, and a 3-year history of abdominal pain...
September 30, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27687827/esophageal-stricture-after-endoscopic-submucosal-dissection-treated-successfully-by-temporary-stent-placement
#16
Takahisa Yamasaki, Toshihiko Tomita, Mayu Takimoto, Yoshio Ohda, Tadayuki Oshima, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
The growing use of endoscopic submucosal dissection (ESD) has enabled the highly curative treatment of early esophageal cancer. The circumferential extent of the tumor is reportedly related to the frequency of post-treatment stricture, with postoperative esophageal stricture reported to occur frequently when the post-resection mucosal defect exceeds 75 % of the esophageal luminal circumference. In some clinical cases, locally injected or orally administered steroids aimed at preventing post-treatment stricture fail to prevent re-stricture...
September 29, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27640052/retention-of-the-cellophane-wall-of-a-patency-capsule-by-intestinal-stenosis-a-report-of-three-cases
#17
Keiko Saito, Tomoo Nakagawa, Hirotaka Koseki, Takashi Taida, Takehiro Sakurai, Sayuri Yoshihama, Masaya Saito, Daisuke Maruoka, Tomoaki Matsumura, Hirotsugu Watabe, Makoto Arai, Tatsuro Katsuno, Osamu Yokosuka
Here we report three cases in which the cellophane wall of the PillCam(®) patency capsule (tag-less PC), lacking a radio frequency identification tag, was retained. Case 1 A 33-year-old man with Crohn's disease (CD) who was administered the tag-less PC, subsequently underwent resection for perforated colon. We recovered the cellophane wall that could perforate the intestine and cause peritonitis. Case 2 A 34-year-old man with a recurring intestinal obstruction of unknown cause was administered the tag-less PC test...
September 17, 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27664154/use-of-an-over-the-scope-clipping-device-for-closure-of-a-jejuno-sigmoid-fistula-a-case-report-with-long-term-follow-up
#18
Yuichi Sagara, Satoshi Shinozaki, Tomonori Yano, Hirotsugu Sakamoto, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
The over-the-scope clip (OTSC) system is a new technology that enables closure of fistulae which cannot be closed with a conventional clip. A 57-year-old woman had long-term hypoalbuminemia, edema and general malaise. Peroral double-balloon endoscopy (DBE) showed a jejuno-sigmoid fistula and blind loop syndrome of the jejunum and ileum, because ingested food bypassed the ileum through the fistula. She was advised to undergo surgical closure of the fistula, but she refused the procedure. For 7 years following DBE, repeat courses of antibiotics were required to treat bacterial overgrowth due to blind loop syndrome...
December 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27638345/pneumatosis-intestinalis-during-chemotherapy-with-nilotinib-in-a-patient-with-chronic-myeloid-leukemia-who-tested-positive-for-anti-topoisomerase-i-antibodies
#19
Akihito Fujimi, Hiroki Sakamoto, Yuji Kanisawa, Shinya Minami, Yasuhiro Nagamachi, Naofumi Yamauchi, Soushi Ibata, Junji Kato
A 55-year-old man with several comorbidities including idiopathic interstitial pneumonia under long-term corticosteroid therapy, longstanding myocardial infarction, chronic heart failure, paroxysmal atrial fibrillation, gastro-esophageal reflux disease, constipation, and history of paralytic ileus, was diagnosed with chronic myelogenous leukemia (CML) in the chronic phase. He also tested positive for anti-topoisomerase I antibodies without clinical diagnosis of any connective tissue disease, including systemic sclerosis...
December 2016: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/27624750/twelve-year-natural-history-of-a-gastric-adenocarcinoma-of-fundic-gland-type
#20
Yoshinori Sato, Takashi Fujino, Akira Kasagawa, Ryo Morita, Shun-Ichiro Ozawa, Yasumasa Matsuo, Tadateru Maehata, Hiroshi Yasuda, Masayuki Takagi, Fumio Itoh
A 77-year-old woman underwent an upper gastrointestinal (UGI) endoscopy screening examination, and a 10-mm reddish, submucosal tumor-like lesion was found on the posterior wall of the fornix. Biopsy was performed, but there was no evidence of malignancy, so annual follow-up by UGI endoscopy was decided upon. After 12 years, examination of another biopsy specimen revealed an adenocarcinoma of the fundic gland type. There had been no significant change in the size or shape of the lesion over the long follow-up period...
December 2016: Clinical Journal of Gastroenterology
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