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Clinical Journal of Gastroenterology

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https://www.readbyqxmd.com/read/28646342/a-case-of-malignant-peritoneal-mesothelioma-suggesting-the-utility-of-combining-double-contrast-radiography-and-endoscopy-with-computed-tomography-for-diagnosis
#1
Hirokazu Saito, Shota Hasuda, Jiro Nasu, Mitsuhiko Kitaoka, Ikuo Matsushita
A 68-year-old woman presented with abdominal pain, weight loss, and vomiting. Enhanced computed tomography (CT) showed slightly increased density in the mesentery and edema of the third portion of the duodenum and proximal jejunum. Little ascites, but no primary lesion, lymph node metastases, or distant metastases, were observed. Endoscopic findings included erythema and edema in the distal duodenum and proximal jejunum without epithelial lesions. Double-contrast radiography revealed transverse ridging with convergence, suggesting a serosal lesion...
June 23, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28600688/endoscopic-management-of-biliary-strictures-after-living-donor-liver-transplantation
#2
REVIEW
Takeshi Tsujino, Hiroyuki Isayama, Hirofumi Kogure, Tatsuya Sato, Yousuke Nakai, Kazuhiko Koike
Living donor liver transplantation (LDLT) is an effective alternative to deceased liver transplantation (DDLT) for end-stage liver disease. Although advances in surgical techniques, immunosuppressive management, and post-transplant care have improved the overall outcomes of LDLT, biliary strictures remain the major unsolved problem. Endoscopic retrograde cholangiopancreatography (ERCP) is currently considered the first-line therapy for biliary strictures following LDLT with duct-to-duct reconstruction, with percutaneous and surgical interventions reserved for patients with unsuccessful management via ERCP...
June 9, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28597413/late-onset-ornithine-transcarbamylase-deficiency-associated-with-hyperammonemia
#3
Kana Daijo, Tomokazu Kawaoka, Takashi Nakahara, Yuko Nagaoki, Masataka Tsuge, Akira Hiramatsu, Michio Imamura, Yoshiiku Kawakami, Hiroshi Aikata, Keiichi Hara, Go Tajima, Masao Kobayashi, Kazuaki Chayama
The urea cycle converts ammonia and produces urea. One form of urea cycle abnormality is ornithine transcarbamylase (OTC) deficiency. This hereditary disorder is associated with hyperammonemia. OTC deficiency commonly appears during neonatal and early childhood life and is rare in adults. We report a 69-year-old man who presented at the local hospital with 3-day loss of appetite, early morning vomiting, and state of confusion. Blood ammonia was 293 μg/dl. At 2-3 h after admission, the patient went into a deep coma...
June 9, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28589502/endoscopic-removal-of-an-impacted-barolith-at-the-sigmoid-colon-a-rare-case-report
#4
Tomoya Iida, Takehiro Hirano, Kei Onodera, Toshiyuki Kubo, Kentaro Yamashita, Hiroo Yamano, Hiroshi Nakase
A 45-year-old woman visited our hospital complaining of abdominal pain 1 week after undergoing an annual medical checkup. Her vital signs and blood test results were normal, but tenderness was found in the lower abdomen. A high-density round structure found at the midline of the lower abdomen on an abdominal radiograph was thought to be an accumulation of barium (a barolith) from upper gastrointestinal barium radiography. Two liters of an oral gastrointestinal cleaning agent was administered, but defecation did not occur...
June 6, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28555355/laparoscopic-cholecystectomy-for-cholelithiasis-in-children-with-sickle-cell-disease
#5
REVIEW
Yousef Al Talhi, Bader Hamza Shirah, Muteb Altowairqi, Yasmin Yousef
Patients with sickle cell disease (SCD) suffer from an increased incidence of gallstone formation due to hemolysis of sickled red blood cells; this leads to an increased level of bilirubin in secreted bile that becomes a nidus for pigment stone formation. Laparoscopic cholecystectomy (LC) is considered a standard operative procedure for gallstone disease mainly due to lower postoperative wound complaints, faster recovery, better postoperative cosmetic results, shorter hospital stay, and earlier return to work...
May 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28550655/primary-malignant-melanoma-of-esophagus-following-chemoradiotherapy-for-esophageal-squamous-cell-carcinoma-report-of-a-case
#6
Shinichiro Imai, Akira Suzuki, Yuta Yamamoto, Makoto Koyama, Satoshi Sugiyama, Masato Kitazawa, Yusuke Miyagawa, Shinichi Miyagawa
Primary malignant melanoma of the esophagus (PMME) is a rare neoplasm. We observed a case of PMME that had occurred at an irradiated site in the thoracic esophagus. The patient was a 74-year-old man who had received definitive chemoradiotherapy for esophageal squamous cell carcinoma at the age of 68, and had completely recovered. Six years later, via periodic upper gastrointestinal endoscopy, he had been diagnosed with esophageal tumors. After the patient underwent esophagectomy, the removed esophageal tumors were immunohistologically diagnosed as PMME, and most of the tumor was observed to be located within the irradiated area corresponding to the previous radiotherapy...
May 26, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28540696/negative-conversion-of-high-serum-p53-antibody-titers-in-a-patient-with-gastric-cancer-at-31%C3%A2-months-after-surgery
#7
Kenji Murayama, Tatsuki Nanami, Takashi Suzuki, Yoko Oshima, Satoshi Yajima, Tetsuo Nemoto, Hideaki Shimada
We performed distal gastrectomy with D2 lymph node dissection, pathological stage was Stage IB (T2N0M0), in a 68-year-old male with gastric adenocarcinoma. We then monitored serum p53 antibody titers for 5 years and found it consistently decreased, without disease recurrence. Although the s-p53-Ab titer remained positive even after 2 years, it decreased to 16.5, 4.45, 2.66, 1.55, and 1.18 U/ml at 3 months, 7 months, 1 year, 2 years and 3 years after surgery, respectively. The s-p53-Ab titer finally converted from positive to negative at 31 months postoperatively without any sign of recurrence by computed tomography examination at 5 years after surgery...
May 24, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28523629/a-case-of-diminished-pericardial-effusion-after-treatment-of-a-giant-hepatic-cyst
#8
Hiroshi Okano, Tomomasa Tochio, Hiroaki Kumazawa, Yoshiaki Isono, Hiroki Tanaka, Shimpei Matsusaki, Tomohiro Sase, Tomonori Saito, Katsumi Mukai, Akira Nishimura, Tetsuya Kitamura, Takuya Mori
A 75-year-old woman was discovered to have a pericardial effusion when she was admitted to our hospital because of a giant hepatic cyst. We could not detect the cause of the effusion and diagnosed idiopathic pericardial effusion. The patient underwent transcutaneous drainage of the hepatic cyst and an injection of antibiotics. There was no communication between the pericardial effusion and the hepatic cyst. Although the hepatic cyst was reduced in size, the pericardial effusion showed no remarkable change immediately after treatment; however, 5 months later, the pericardial effusion was found to be diminished...
May 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28523628/burkitt-lymphoma-as-a-lead-point-for-jejunojejunal-intussusception-in-a-human-immunodeficiency-virus-patient
#9
Prabin Sharma, Shivashanker Balasingham, Kristin Stawiarski, Mahboubeh Rahmani, Antonio Costantino, Pranav Sharma, Mina Xu, Amir Masoud
Intussusception is commonly seen in children but is rare in adults and represents only 5% of all intussusceptions causing 1% of intestinal obstructions. More than 50% of these intussusceptions in adults are due to intestinal neoplasms, including malignant lymphoma, e.g., Burkitt lymphoma. These lymphomas are more common in human immunodeficiency virus (HIV)-positive patients than in the general population. We present a case of a young male who was diagnosed with HIV when he developed intestinal obstruction and intussusception secondary to Burkitt lymphoma...
May 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28516371/perforated-emphysematous-cholecystitis-managed-by-endoscopic-transpapillary-gallbladder-drainage
#10
Chikara Iino, Tadashi Shimoyama, Takasato Igarashi, Tomoyuki Aihara, Kentaro Ishii, Juichi Sakamoto, Hiroshi Tono, Shinsaku Fukuda
An 88-year-old woman with dementia was diagnosed as having perforated emphysematous cholecystitis with localized peritonitis. Because she was at high risk for surgery, gallbladder drainage was required before surgery. Endoscopic transpapillary gallbladder drainage instead of percutaneous transhepatic biliary drainage was performed because bile could leak from the puncture site to free space around the perforated gallbladder. After the insertion of a nasobiliary drainage tube, the gallbladder was drained and cleaned with saline solution...
May 17, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28500570/narrow-band-imaging-can-increase-the-visibility-of-fibrin-caps-after-bleeding-of-esophageal-varices-a-case-with-extensive-esophageal-candidiasis
#11
Yoshihiro Furuichi, Yoshitaka Kasai, Hirohito Takeuchi, Yuu Yoshimasu, Takashi Kawai, Katsutoshi Sugimoto, Yoshiyuki Kobayashi, Ikuo Nakamura, Takao Itoi
A 58-year-old man with hepatitis B cirrhosis noticed black stools and underwent an endoscopy at a community hospital. The presence of esophageal varices (EVs) was confirmed, but the bleeding point was not found. He was referred to our institution and underwent a second endoscopy. Extensive white patches of esophageal candidiasis were visible on endoscopy by white-light imaging (WLI), but it was difficult to find the fibrin cap of the EVs. This was easier under narrow-band imaging (NBI), however, as the color turned red from absorption by hemoglobin adhered to it...
May 12, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28451951/gastrointestinal-mantle-cell-lymphoma-with-isolated-mass-and-multiple-lymphomatous-polyposis-report-of-two-cases
#12
Shunichi Yanai, Shotaro Nakamura, Satoko Yamaguchi, Keisuke Kawasaki, Kazuyuki Ishida, Tamotsu Sugai, Junji Umeno, Motohiro Esaki, Takayuki Matsumoto
We herein report two patients with mantle cell lymphoma (MCL), who had isolated mass and multiple lymphomatous polyposis (MLP) in the gastrointestinal tract. In case 1, esophagogastroduodenoscopy revealed a protruding mass in the duodenum and double-balloon endoscopy disclosed numerous polypoid lesions in the ileum. Case 2 had polyposis in the duodenum and a large mass-forming lesion in the ascending colon. Based on the histologic and immunohistochemical findings of the biopsy specimens, the diagnosis of MCL was made in both patients...
April 27, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28447327/uptake-of-123-i-metaiodobenzylguanidine-by-gastrointestinal-stromal-tumor
#13
Patommatat Bhanthumkomol, Susumu Hijioka, Nobumasa Mizuno, Takamichi Kuwahara, Nozomi Okuno, Ayako Ito, Tsutomu Tanaka, Makoto Ishihara, Yutaka Hirayama, Sachiyo Onishi, Yasumasa Niwa, Masahiro Tajika, Yuichi Ito, Eiichi Sasaki, Yoshitaka Inaba, Yasuhiro Shimizu, Yasushi Yatabe, Kazuo Hara
A 52-year-old woman was admitted with a large intraabdominal mass. (123)I- metaiodobenzylguanidine ((123)I-MIBG) scintigraphy revealed considerable (123)I-MIBG accumulation by the mass that was compatible with a diagnosis of paraganglioma. However, a spindle cell tumor that was identified using endoscopic ultrasound-guided fine needle aspiration before surgery was positive for CD117. The surgically resected mass was confirmed as a gastrointestinal stromal tumor (GIST). Although the mechanism of (123)I-MIBG uptake by GIST has not been elucidated, GIST should be included in the differential diagnosis of intra-abdominal tumor with (123)I-MIBG uptake...
April 26, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28447326/ct-colonography-role-in-fobt-based-screening-programs-for-colorectal-cancer
#14
REVIEW
Lapo Sali, Grazia Grazzini, Mario Mascalchi
Computed tomographic colonography (CTC) is a minimally invasive imaging examination for the colon, and is safe, well tolerated and accurate for the detection of colorectal cancer (CRC) and advanced adenoma. While the role of CTC as a primary test for population screening of CRC is under investigation, the fecal occult blood test (FOBT) has been recommended for population screening of CRC in Europe. Subjects with positive FOBT are invited to undergo total colonoscopy, which has some critical issues, such as suboptimal compliance, contraindications and the possibility of an incomplete exploration of the colon...
April 26, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28447328/utility-of-doppler-ultrasonography-for-diagnosing-and-assessing-treatment-effects-in-liver-compartment-syndrome
#15
Yusuke Ando, Masatoshi Ishigami, Yoji Ishizu, Teiji Kuzuya, Takashi Honda, Kazuhiko Hayashi, Tetsuya Ishikawa, Hidemi Goto, Yoshiki Hirooka
Liver compartment syndrome is a life-threatening complication of hepatic subcapsular hematoma; diagnosis and assessment of treatment effects are therefore important. We report a rare case of liver compartment syndrome due to spontaneous hepatic subcapsular hematoma without any underlying conditions, in which Doppler ultrasonography (US) proved useful in both diagnosis and assessment of treatment effects. A 32-year-old woman experienced sudden epigastralgia and was diagnosed with hepatic subcapsular hematoma in the right lobe, based on contrast-enhanced computed tomography...
June 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28447325/interferon-free-therapy-with-sofosbuvir-plus-ribavirin-for-successful-treatment-of-genotype-2-hepatitis-c-virus-with-lichen-planus-a-case-report
#16
Ayumu Yoshikawa, Katsumi Terashita, Kenichi Morikawa, Soichiro Matsuda, Takahiro Yamamura, Koichiro Sarashina, Shintaro Nakano, Yoshimitsu Kobayashi, Susumu Sogabe, Kazuhiro Takahashi, Shin Haba, Hisashi Oda, Tatsuro Takahashi, Takuto Miyagishima, Naoya Sakamoto
Hepatitis C virus (HCV) infection remains the main cause of liver disease and can lead to chronic hepatitis, cirrhosis, and hepatocellular carcinoma. HCV may also develop extrahepatic manifestations in the skin, eyes, joints, kidneys, nervous system, and immune system. In fact, several studies reported that up to 70% of HCV patients experienced extrahepatic manifestations. Lichen planus (LP), which is an immune system disorder that is triggered by viral infections, allergens, and stress, can affect the skin, mouth, nails, and scalp...
June 2017: Clinical Journal of Gastroenterology
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
#17
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...
June 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
#18
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...
June 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28364314/endoscopic-tissue-shielding-for-esophageal-perforation-caused-by-endoscopic-resection
#19
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...
June 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28353200/asymptomatic-acute-hepatitis-e-in-a-female-patient-with-ulcerative-colitis
#20
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...
June 2017: Clinical Journal of Gastroenterology
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