The rendezvous technique involving insertion of a guidewire in a percutaneous transhepatic gallbladder drainage tube for biliary access in a case of difficult biliary cannulation / Journal of Rural Medicine

<p>Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic method and treatment approach for biliary diseases. However, biliary cannulation can be difficult in some cases. We performed ERCP in a 97-year-old woman with abdominal pain resulting from acute cholangitis caused by choledocholithiasis and observed difficult biliary cannulation. Eventually, the patient was successfully treated with the rendezvous technique. We could not cannulate the biliary duct during ERCP twice. Therefore, we placed a percutaneous transhepatic gallbladder drainage (PTGBD) tube without intrahepatic dilation. The rendezvous technique was performed using the PTGBD tube. The patient did not experience pancreatitis or perforation.</p>

Asymptomatic anisakiasis of the colon incidentally diagnosed and treatedduring colonoscopy by retroflexion in the ascending colon / Journal of Rural Medicine

<p>A 74-year-old man with diabetes underwent colonoscopy as routine screening for coloncancer. An <i>Anisakis</i> larva was found incidentally during colonoscopy usingthe retroflexion technique in the ascending colon, and was removed using a forceps.Asymptomatic colonic anisakiasis is very rare, and few reports have described diagnosisand treatment of anisakiasis during colonoscopy by the retroflexion technique in theascending colon. We have reported this rare case along with a literature review.</p>

Collagenous Colitis Associated with Lansoprazole (Report on Three Cases) / 日本農村医学会雑誌

Collagenous colitis (CC) has been looked upon as a rare disease in the past years. However, as we have acquired more knowledge about this disease, the cases diagnosed as CC are on the rise. Many case reports on Lansoprazole (LPZ) are available in our country, and our hospital has had three cases in the last year. Here, we present a typical example. Case 1: An 84-year-old woman who had been taking LPZ visited our outpatient clinic, complaining of chronic watery diarrhea for three months. Colonoscopy produced no abnormal findings other than a tiny capillary vascular growth in the descending colon. However, the histopathological findings secured from the entire colonic region revealed a thickened subepithelial collagen band. She was therefore diagnosed as suffering from CC. With the administration of LPZ suspended, her diarrhea improved in two weeks. The other two cases also underwent colonoscopy to check their chronic diarrhea. Their symptoms improved in a few weeks with the intake of LPZ suspended. In the differential diagnosis of chronic diarrhea, therefore, we believe it important to take possible CC into account, review the detailed history of medicine, and perform colonoscopy and mucosal biopsy.