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Clinical Journal of Gastroenterology

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https://www.readbyqxmd.com/read/28921102/pancreatic-acinar-cell-carcinoma-with-extensive-tumor-embolism-at-the-trunk-of-portal-vein-and-pancreatic-intraductal-infiltration
#1
Akihiko Kida, Koichiro Matsuda, Kai Takegoshi, Mitsuru Matsuda, Akito Sakai, Yatsugi Noda
A 59-year-old man was admitted to the hospital with acute pancreatitis. The cause was suggested to be a pancreatic tumor based on computed tomography (CT). The pancreatic tumor was 45 mm with an extensive tumor embolism at the trunk of the portal vein and intraductal infiltration of the main pancreatic duct (MPD). The pancreatic tumor was diagnosed as acinar cell carcinoma (ACC) by endoscopic ultrasound guided fine needle aspiration. Therefore, the cause of acute pancreatitis was diagnosed to be intraductal infiltration of ACC in the MPD...
September 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28913716/a-case-of-a-mucin-producing-bile-duct-tumor-diagnosed-over-the-course-of-6%C3%A2-years
#2
Sho Yamada, Yosuke Kato, Masahiro Hada, Masanori Kotake, Kaeko Oyama, Takuo Hara
We report a case of a mucin-producing intraductal papillary neoplasm of the intrahepatic bile duct (M-IPNB) diagnosed over a period of 6 years. A 64-year-old man underwent follow-up evaluations for an abdominal aortic aneurysm at our hospital. In 2009, a computed tomography (CT) scan revealed a simple hepatic cyst in segment 3 of the liver. Annual CT scans initially showed almost no change in the size or shape of the cyst. The cystic lesion, which measured 5 cm in 2014, had increased to 11 cm by 2015, and a solid component was detected within the cyst...
September 14, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28884453/gastric-cancer-associated-with-refractory-cytomegalovirus-gastritis
#3
Masayuki Ueno, Yuichi Shimodate, Shumpei Yamamoto, Hiroshi Yamamoto, Motowo Mizuno
Cytomegalovirus (CMV) sometimes causes gastritis, especially in immunocompromised patients, but whether CMV gastritis promotes the development of gastric cancer is unknown. Here, we report a case of gastric cancer that developed in the presence of CMV gastritis, which had been present for at least 4 years and was refractory to treatment. An 80-year-old woman had noted epigastric discomfort and appetite loss. Esophagogastroduodenoscopy revealed a shallow geographical ulcer extending from the upper body to the pylorus...
September 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28884440/disappearance-of-multiple-hyperechoic-liver-nodules-in-sporadic-porphyria-cutanea-tarda-after-treatment-with-ledipasvir-sofosbuvir-for-hepatitis-c
#4
Kazuhide Takata, Satoshi Shakado, Keiko Sakamoto, Hiromi Fukuda, Ryo Yamauchi, Sho Fukuda, Hideo Kunimoto, Kaoru Umeda, Takashi Tanaka, Keiji Yokoyama, Daisuke Morihara, Yasuaki Takeyama, Makoto Irie, Shotaro Sakisaka
Ultrasonography in a 60-year-old man with chronic hepatitis C (CHC) demonstrated multiple hyperechoic nodules. Radiological investigations did not reveal any signs of malignancy. However, magnetic resonance chemical shift imaging showed multiple focal fatty changes in the liver. Urinary levels of uroporphyrin and coproporphyrin were elevated, and we made a diagnosis of porphyria cutanea tarda. Direct-acting antivirals, ledipasvir/sofosbuvir, were initiated for CHC, which led to sustained viral response, resolution of the liver nodules, and normalization of urinary porphyrin...
September 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28828588/factitious-disorder-a-rare-cause-of-haematemesis
#5
Michael McFarlane, Jayne Eaden, Nicola Burch, Ben Disney
Acute upper gastrointestinal (GI) bleeding is a common condition in the UK with 50-70,000 admissions per year. In 20% of cases no cause can be found on endoscopy. Here, we present the case of a young female patient who was admitted on three occasions with large volume haematemesis and bleeding from other sites. She was extensively investigated and underwent multiple endoscopic procedures. She was eventually diagnosed with factitious disorder after concerns were raised about the inconsistent nature of her presentations...
August 21, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28815477/radiotherapy-for-mucosa-associated-lymphoid-tissue-malt-lymphoma-of-the-rectum-a-case-report
#6
Toyokazu Hayakawa, Tetsuo Nonaka, Nobutaka Mizoguchi, Yasuhito Hagiwara, Shino Shibata, Rika Sakai, Norisuke Nakayama, Tomoyuki Yokose, Yuko Nakayama
Extra-nodal mucosa-associated lymphoid tissue (MALT) lymphoma is frequently involved with the upper gastrointestinal tract, but rarely involved with the rectum. We report a case of rectal MALT lymphoma treated by radiotherapy (RT) alone. A 74-year-old woman with lower abdominal pain was diagnosed with MALT lymphoma by endoscopic mucosal resection (EMR). She was diagnosed as stage IE (Ann Arbor) MALT lymphoma by diagnostic work-up and review of EMR specimens. Definitive RT was performed with curative intent, totaling 30 Gy in 15 fractions...
August 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28815450/a-case-of-pancreatic-cancer-with-severe-vomiting-treated-by-endoscopic-ultrasound-guided-celiac-ganglia-neurolysis
#7
Asami Kawai, Masataka Kikuyama, Kohei Enokida, Shinya Kawaguchi, Naofumi Shirane, Shuzo Terada
A 50-year-old man with advanced pancreatic cancer was admitted for intractable severe vomiting 5-6 times a day, continuing over a week. He had been treated for advanced pancreatic cancer with chemotherapy for 6 months, and had undergone self-expandable metalic stent placement for obstructive jaundice due to the pancreatic cancer 4 months before admission. No abnormal findings suggesting gastrointestinal obstruction or brain metastasis were revealed on diagnostic imaging. We performed endoscopic ultrasound-guided celiac ganglia neurolysis twice by injecting ethanol into the celiac ganglion...
August 16, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28785991/successful-endoscopic-submucosal-dissection-of-colon-cancer-with-severe-fibrosis-after-tattooing
#8
Hideyuki Chiba, Jun Tachikawa, Daisuke Kurihara, Keiichi Ashikari, Akihiro Takahashi, Hiroki Kuwabara, Michiko Nakaoka, Taiki Morohashi, Toru Goto, Ken Ohata, Atsushi Nakajima
Endoscopic tattooing is often used to facilitate the identification of colorectal lesions before endoscopic treatments. However, tattooing under the lesion can result in technical difficulties because of the dark endoscopic field and submucosal fibrosis. A 65-year-old man with a non-granular-type laterally spreading tumor was referred to our hospital after tattooing with India ink for surgery. However, endoscopic submucosal dissection (ESD) was selected for the resection of this lesion because the findings of magnifying endoscopy suggested an intramucosal cancer...
August 7, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28776316/a-case-of-sigmoid-colon-adenocarcinoma-diagnosed-as-facial-cutaneous-metastasis-for-survival-after-operation-for-37%C3%A2-months
#9
Junji Ueda, Hiroshi Yoshida, Hiroshi Makino, Hiroshi Maruyama, Tadashi Yokoyama, Atsushi Hirakata, Hideyuki Takata, Natsuki Seki, Yuta Kikuchi, Eiji Uchida
Cutaneous metastasis of an internal malignancy is uncommon and is estimated to occur in 0.7-9% of patients with internal cancer including autopsy cases. We would like to report a case of long survival of sigmoid colon adenocarcinoma diagnosed as an instance of facial cutaneous metastasis. A 68-year-old male was admitted to our hospital for a tumor mass on the left side of his cheek. In his past history, acute myocardial infarction had occurred 2 years earlier. He also had chronic renal failure and chronic obstructive pulmonary disease...
August 3, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28766283/management-of-aorto-esophageal-fistula-secondary-after-thoracic-endovascular-aortic-repair-a-review-of-literature
#10
REVIEW
Kaname Uno, Tomoyuki Koike, Seiichi Takahashi, Daisuke Komazawa, Tooru Shimosegawa
Aorto-esophageal fistula (AEF) is a rare and lethal entity, and the difficulty of making diagnosis of AEF is well-known. As promising results in the short-term effectiveness of thoracic endovascular aortic repair (TEVAR) promote its usage, the occurrence of AEF after TEVAR (post-TEVAR AEF) increases as one of the major complications. Therefore, we provide a review concerning the management strategy of post-TEVAR AEF. Although its representative symptom was reported as the triad of mid-thoracic pain and sentinel hematemesis followed by massive hematemesis, the symptom-free interval between sentinel hemorrhage and massive exsanguination is unpredictable...
August 1, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28756484/distal-esophageal-spasm-with-multiple-esophageal-diverticula-successfully-treated-by-peroral-endoscopic-myotomy
#11
Koji Otani, Shinwa Tanaka, Fumiaki Kawara, Junichi Fujikawa, Akinari Sawada, Risa Uemura, Tetsuya Tanigawa, Toshio Watanabe, Takeshi Azuma, Yasuhiro Fujiwara
Distal esophageal spasm (DES) is a primary esophageal motility disorder. We encountered a rare case of DES accompanied by multiple esophageal diverticula. A 72-year-old woman complained of prolonged dysphagia and chest pain. A barium esophagogram showed multiple esophageal diverticula and significant contraction of the lower esophagus just above the cardia. Esophagogastroduodenoscopy revealed a corkscrew-like appearance, with spiral contractions and diverticula. High-resolution manometry revealed that the integrated relaxation pressure was normal; premature contractions were observed in ≥20% of the swallowing wave; the distal contractile integral was normal...
July 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28755101/a-rare-association-of-celiac-disease-and-rectal-neuroendocrine-tumor
#12
Deniz Çetin, Özgür Tanrıverdi, Havva Solak Özşeker, Burak Özşeker
Celiac disease (CD) is a chronic immune-mediated enteropathy which is triggered by dietary gluten in genetically predisposed individuals. Increased risk of all gastrointestinal cancers was found during the first year after diagnosis of CD. Gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are a heterogeneous tumor group originating from the diffuse neuroendocrine system. Today, the incidences of both GEP-NETs and CD have increased due to the increased availability of diagnostic tools and awareness. Association of GEP-NETs with CD is rarely seen...
July 28, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28744763/a-case-of-colonic-stenosis-caused-by-cold-snare-polypectomy-for-the-removal-of-a-colonic-polyp
#13
Naotaka Ogasawara, Masaaki Takayama, Satoshi Ono, Shunsuke Katoh, Hirohiko Komai, Yasutaka Hijikata, Masahide Ebi, Yasushi Funaki, Makoto Sasaki, Kunio Kasugai
A 78-year-old woman with hypertension had a positive fecal immunochemical test and underwent colonoscopy, which revealed a 4 mm sessile polyp (Paris type; 0-Is) in the transverse colon. Based on low magnification colonoscopy with narrow band imaging, the polyp was Type 2 according to the NBI International Colorectal Endoscopic classification, diagnosed as an adenoma, and then resected via cold snare polypectomy (CSP). Five days after CSP, she complained of right-sided abdominal pain. Abdominal CT showed focal wall thickening of the transverse colon and focal infiltration of tissues surrounding the transverse colon...
July 25, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28730320/esophageal-bezoar-due-to-karaya-gum-granules-used-as-a-laxative
#14
Sern Wei Yeoh
Esophageal obstruction from soluble fiber laxatives, such as karaya gum, has been rarely reported in the literature. However, as such preparations are widely commercially available, it is important for gastroenterologists to be aware of their potential to form a bezoar in the esophagus due to swelling on contact with liquid. This report highlights such a case and discusses its challenging management.
July 20, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28721541/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
#15
REVIEW
Rajesh Panwar, Preet Mohinder Singh
Metallic stents are being increasingly used for endoscopic drainage of peripancreatic fluid collections (PFCs) but their superiority over plastic stents has not been proven. We carried out a meta-analysis to consolidate the results from available studies and to suggest evidence-based recommendations. Studies that compared plastic and metallic stents for endoscopic drainage of PFCs and published before October 2016 were searched. Comparisons were performed for clinical success, adverse events, salvage interventions, mortality, technical success and recurrence...
July 18, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28676994/cimetidine-lactulose-therapy-ameliorates-erythropoietic-protoporphyria-related-liver-injury
#16
Naoyuki Fujimori, Michiharu Komatsu, Naoki Tanaka, Mai Iwaya, Hajime Nakano, Ayumi Sugiura, Tomoo Yamazaki, Soichiro Shibata, Yugo Iwaya, Takashi Muraki, Yuki Ichikawa, Takefumi Kimura, Satoru Joshita, Takeji Umemura, Akihiro Matsumoto, Eiji Tanaka
A 21-year-old Japanese man was admitted to our hospital because of severe abdominal pain and jaundice. He had been suffering from abdominal pain attacks and liver dysfunction since 18 years of age. Liver histology showed amorphous brown deposits in the sinusoidal space and significant periportal fibrosis without apparent hepatitis. Increased protoporphyrin in serum and feces and ferrochelatase gene mutation confirmed the final diagnosis of erythropoietic protoporphyria (EPP). Since ursodeoxycholic acid (UDCA) intake and glucose infusion are insufficient to ameliorate jaundice and abdominal attacks, cimetidine and lactulose were added in order to suppress hepatic delta-aminolevulinic acid synthase and limit re-absorption of protoporphyrin, respectively...
July 4, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28664383/the-slow-progressive-nature-of-duodenal-neuroendocrine-tumor-a-case-report-of-long-term-observation-over-14%C3%A2-years
#17
Kiichi Takahashi, Waku Hatta, Tomoyuki Koike, Takeshi Kanno, Nobuyuki Ara, Kiyotaka Asanuma, Naoki Asano, Akira Imatani, Fumiyoshi Fujishima, Hironobu Sasano, Tooru Shimosegawa
The number of duodenal neuroendocrine tumors has recently increased, but their natural history has not been well characterized. Here we report the case of a 59-year-old female undergoing complete resection by endoscopic mucosal resection after monitoring endoscopic morphologic changes and the size increment of a duodenal neuroendocrine tumor over the longest follow-up duration. An elevated lesion was initially detected on the duodenal bulb. Endoscopic biopsy from this lesion was performed three times during the follow-up, but all of the specimens simply demonstrated the presence of gastric metaplasia...
June 29, 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28695451/the-endoscopic-findings-of-the-upper-gastrointestinal-tract-in-patients-with-crohn-s-disease
#18
REVIEW
Yoshiki Nomura, Kentaro Moriichi, Mikihiro Fujiya, Toshikatsu Okumura
Crohn's disease (CD) is a type of chronic inflammatory bowel disease (IBD) associated with ulceration, and the main foci of the inflammation in CD patients are typically the terminal ileum and colon. However, in the upper gastrointestinal tract (GIT), including the esophagus, stomach and duodenum, inflammatory lesions are also detected as well, with a relatively high frequency (30-75%). Recent advances in imaging modalities, including endoscopy, have aided in the diagnosis of CD. Various lesions, including aphtha, erosion, ulcers, bamboo-joint-like appearance and notch-like appearance, are detected in the upper GI of CD patients...
August 2017: Clinical Journal of Gastroenterology
https://www.readbyqxmd.com/read/28664384/a-case-of-protein-losing-enteropathy-caused-by-sclerosing-mesenteritis-diagnosed-with-capsule-endoscopy-and-double-balloon-endoscopy
#19
Yasushi Saito, Katsushi Hiramatsu, Takuto Nosaka, Yoshihiko Ozaki, Kazuto Takahashi, Tatsushi Naito, Kazuya Ofuji, Hidetaka Matsuda, Masahiro Ohtani, Tomoyuki Nemoto, Yoshiaki Imamura, Yasunari Nakamoto
A 75-year-old man presented with abdominal distension, hypoproteinemia, ascites and a 35-mm mass in the small bowel mesentery. Laparotomy was performed, and he was diagnosed with sclerosing mesenteritis. His clinical condition improved, with computed tomography (CT) showing tumor shrinkage and decreasing ascites after administration of prednisolone; however, on drug withdrawal, abdominal fullness recurred and CT revealed an enlarging tumor and increasing ascites. Capsule endoscopy (CE) and double-balloon enteroscopy (DBE) were performed to further investigate hypoalbuminemia, which revealed white villi, white nodules, white debris, and mucosal edema in the jejunum...
August 2017: Clinical Journal of Gastroenterology
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
#20
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...
August 2017: Clinical Journal of Gastroenterology
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