Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 10 de 10
Filter
Add more filters










Publication year range
1.
Nihon Shokakibyo Gakkai Zasshi ; 120(8): 689-694, 2023.
Article in Japanese | MEDLINE | ID: mdl-37558416

ABSTRACT

A woman in her 80s underwent computed tomography that revealed a 22-mm-sized unilocular mass in segment 4 of her liver. The mass grew to 26mm at the 4-year follow-up and to 36mm at the 11-year follow-up, becoming a multilocular mass that invaded the bile duct. At this point, the patient was diagnosed with hepatic echinococcosis based on a serological examination and oral albendazole treatment was initiated. The patient developed cholangitis and underwent endoscopic biliary stenting 12 years after her initial diagnosis. We consider this case valuable as it allowed us to follow the natural course of hepatic echinococcosis.


Subject(s)
Cholangitis , Echinococcosis, Hepatic , Humans , Female , Echinococcosis, Hepatic/diagnostic imaging , Echinococcosis, Hepatic/therapy , Bile Ducts , Cholangitis/etiology , Albendazole/therapeutic use
2.
Nihon Shokakibyo Gakkai Zasshi ; 120(3): 250-255, 2023.
Article in Japanese | MEDLINE | ID: mdl-36908143

ABSTRACT

The patient was an elderly woman in her 80s. Upper and lower gastrointestinal endoscopies were conducted as a thorough analysis for cardiac amyloidosis, revealing no abnormal findings. A mucosal biopsy, however, resulted in an amyloid AA-type amyloidosis diagnosis. About 2 months later, she visited our department with sudden vomiting and epigastric pain onset. Plain abdominal radiography and computed tomography demonstrated gastric emphysema, and thus, she was admitted to our department. The gastric emphysema was alleviated with conservative treatment. Herein, we report a valuable case in which gastric emphysema manifested as a gastrointestinal tract lesion of amyloidosis.


Subject(s)
Amyloidosis , Emphysema , Gastritis , Immunoglobulin Light-chain Amyloidosis , Humans , Female , Aged , Amyloidosis/diagnosis
3.
Endoscopy ; 55(3): 207-216, 2023 03.
Article in English | MEDLINE | ID: mdl-35835446

ABSTRACT

BACKGROUND : Transnasal endoscopy presents a technical difficulty when inserting the flexible endoscope. It is unclear whether a particular breathing method is useful for transnasal endoscopy. Therefore, we conducted a prospective randomized controlled trial to compare endoscopic operability and patient tolerance between patients assigned to nasal breathing or oral breathing groups. METHODS : 198 eligible patients were randomly assigned to undergo transnasal endoscopy with nasal breathing or with oral breathing. Endoscopists and patients answered questionnaires on the endoscopic operability and patient tolerance using a 100-mm visual analog scale ranging from 0 (non-existent) to 100 (most difficult/unbearable). The visibility of the upper-middle pharynx was recorded. RESULTS : Patient characteristics did not differ significantly between the groups. Nasal breathing showed a higher rate of good visibility of the upper-middle pharynx than oral breathing (91.9 % vs. 27.6 %; P < 0.001). Nasal breathing showed lower mean [SD] scores than oral breathing in terms of overall technical difficulty (21.0 [11.4] vs. 35.4 [15.0]; P < 0.001). Regarding patient tolerance, nasal breathing showed lower scores than oral breathing for overall discomfort (22.1 [18.8] vs. 30.5 [20.9]; P = 0.004) and other symptoms, including nasal and throat pain, choking, suffocating, gagging, belching, and bloating (all P < 0.05). The pharyngeal bleeding rate was lower in the nasal breathing group than in the oral breathing group (0 % vs. 9.2 %; P = 0.002). CONCLUSIONS : Nasal breathing is superior to oral breathing for those performing and undergoing transnasal endoscopy. Nasal breathing led to good visibility of the upper-middle pharynx, improved endoscopic operability, and better patient tolerance, and was safer owing to decreased pharyngeal bleeding.


Subject(s)
Endoscopy, Gastrointestinal , Endoscopy , Humans , Prospective Studies , Endoscopy, Gastrointestinal/methods , Nose , Endoscopes , Pain
4.
J Gastric Cancer ; 21(3): 319-324, 2021 Sep.
Article in English | MEDLINE | ID: mdl-34691815

ABSTRACT

The abscopal effect refers to the phenomenon in which local radiotherapy is associated with the regression of metastatic cancer that is distantly located from the irradiated site. Here, we present a case of a patient with advanced gastric cancer and brain metastases who was successfully treated with brain radiotherapy and anti-programmed death-1 (PD-1) therapy-induced abscopal effect. Although anti-PD-1 therapy alone could not prevent disease progression, the metastatic lesions in the brain and also in the abdominal lymph node showed a drastic response after brain radiotherapy and anti-PD-1 therapy. To our knowledge, this is the first reported case of successful treatment of advanced gastric cancer with multiple brain and abdominal lymph node metastases, possibly through anti-PD-1 therapy combined with brain radiotherapy-induced abscopal effect. We suggest that the combination of brain radiotherapy and anti-PD-1 therapy may be considered as a therapeutic option for advanced gastric cancer, especially when there is brain metastasis.

5.
Nihon Shokakibyo Gakkai Zasshi ; 116(6): 506-514, 2019.
Article in Japanese | MEDLINE | ID: mdl-31178580

ABSTRACT

In the assessment of invasion depth of early gastric cancer (EGC), the effect of adding X-ray examination to endoscopy was retrospectively investigated in 84 EGC lesions diagnosed at our hospital, including 62 differentiated and 22 undifferentiated lesions. Overall diagnostic accuracy was 75% with endoscopy and 82.1% when X-ray examination was performed in addition to endoscopy. This demonstrated an increase in the accuracy of 7.1% by adding X-ray examination. In terms of presence of ulceration, the additional effect of X-ray examination was higher for lesions without ulceration for both differentiated and undifferentiated lesions. In terms of tumor diameter, the additional effect of X-ray examination was higher for differentiated lesions of ≤30mm and for undifferentiated lesions of ≥21mm. In terms of tumor location, the additional effect of X-ray examination was higher for lesions located in the upper gastric corpus. Depending on the lesion, the addition of X-ray examination to endoscopy contributed to an increase in the accuracy of the assessment of the invasion depth of EGC.


Subject(s)
Endoscopy , Stomach Neoplasms/diagnostic imaging , Gastric Mucosa , Gastroscopy , Humans , Lymphatic Metastasis , Retrospective Studies , X-Rays
6.
Nihon Shokakibyo Gakkai Zasshi ; 115(1): 79-86, 2018.
Article in Japanese | MEDLINE | ID: mdl-29353854

ABSTRACT

A 78-year-old man underwent a detailed examination by upper gastrointestinal endoscopy for the complaint of epigastric pain. The examination revealed a hemicircumferential type 2 tumor in the descending duodenum. A subsequent biopsy led to a diagnosis of neuroendocrine carcinoma. Subtotal stomach-preserving pancreaticoduodenectomy was performed. The lesion was composed of small- and large-cell neuroendocrine carcinomas. The large-cell type component was positive for both caudal homeobox protein 2 and the cluster of differentiation 138, whereas the small-cell type component was negative for both. Our report may provide valuable information regarding the pathogenesis of neuroendocrine carcinoma.


Subject(s)
Carcinoma, Neuroendocrine/diagnosis , Duodenal Neoplasms/diagnosis , Aged , Carcinoma, Neuroendocrine/therapy , Duodenal Neoplasms/therapy , Humans , Male
7.
Nihon Shokakibyo Gakkai Zasshi ; 114(10): 1845-1852, 2017.
Article in Japanese | MEDLINE | ID: mdl-28978884

ABSTRACT

The patient was a 73-year-old man who visited our department with black stools as the chief complaint. Upper digestive tract endoscopy revealed three type 2 lesions in the lesser curvature of the gastric antrum and the gastric angle and the posterior wall of the upper gastric body, which were diagnosed by biopsy as tub2, por, and sig, respectively. Total gastrectomy was performed. The final pathological diagnosis was quintuple gastric cancer with a main lesion of large-cell endocrine carcinoma and four adenocarcinoma sublesions. We report this extremely rare case of gastric endocrine cell carcinoma complicated by adenocarcinoma.


Subject(s)
Adenocarcinoma , Endocrine Gland Neoplasms , Neoplasms, Multiple Primary/pathology , Stomach Neoplasms/pathology , Adenocarcinoma/surgery , Aged , Biopsy , Endocrine Gland Neoplasms/surgery , Gastrectomy , Gastroscopy , Humans , Male , Neoplasms, Multiple Primary/surgery , Stomach Neoplasms/surgery
8.
Nihon Shokakibyo Gakkai Zasshi ; 113(10): 1769-1776, 2016.
Article in Japanese | MEDLINE | ID: mdl-27725466

ABSTRACT

A 71-year-old man who tested positive in a pepsinogen test also underwent upper gastrointestinal endoscopy. A 0-IIc lesion was identified at the posterior wall of the antrum. Biopsy findings indicated endocrine cell carcinoma. The patient underwent distal gastrectomy, and subsequent histopathological examination of the resected specimens showed a moderately differentiated adenocarcinoma (tub2) in the mucosa with transformation to small cell carcinoma in the submucosal and muscle layers. The final diagnosis was of a mixed adenoneuroendocrine carcinoma. We herein describe a case report of this patient with this rare form of gastric carcinoma.


Subject(s)
Adenocarcinoma/diagnostic imaging , Carcinoma, Neuroendocrine/diagnostic imaging , Stomach Neoplasms/diagnostic imaging , Adenocarcinoma/drug therapy , Adenocarcinoma/surgery , Aged , Carcinoma, Neuroendocrine/drug therapy , Carcinoma, Neuroendocrine/surgery , Chemotherapy, Adjuvant , Gastrectomy , Gastroscopy , Humans , Male , Stomach Neoplasms/drug therapy , Stomach Neoplasms/pathology , Stomach Neoplasms/surgery
9.
Intern Med ; 55(2): 141-6, 2016.
Article in English | MEDLINE | ID: mdl-26781013

ABSTRACT

We herein report the rare case of a 76-year-old woman who underwent cholecystectomy with bile duct resection for advanced gallbladder cancer associated with pancreaticobiliary maljunction (PBM) and subsequently developed multiple cancers of the pancreaticobiliary system (the distal bile duct, intrahepatic duct and pancreatic duct) after the operation. We performed conventional endoscopic retrograde cholangiopancreatography (ERCP) using a side-viewing scope to evaluate the masses in the distal bile duct and the pancreatic duct. We also performed ERCP using double-balloon enteroscopy (DBE) to observe the mass in the intrahepatic duct. It was possible to directly observe the lesion using DBE and to perform a biopsy under visual control. All lesions were correctly diagnosed by the combination of ERCP using different endoscopes. The present case suggests that it is necessary to pay close attention (with regard to carcinogenesis) to the whole pancreaticobiliary system in patients with PBM. In addition, the combination of ERCP using DBE and a side-viewing scope may be useful for making a precise diagnosis in patients with altered biliary anatomy who have multiple cancers of the pancreaticobiliary system.


Subject(s)
Bile Ducts/pathology , Biliary Tract/pathology , Gallbladder Neoplasms/pathology , Gallbladder Neoplasms/surgery , Pancreatic Ducts/pathology , Aged , Biliary Tract/diagnostic imaging , Cholangiopancreatography, Endoscopic Retrograde , Cholecystectomy , Double-Balloon Enteroscopy , Female , Humans
10.
Nihon Shokakibyo Gakkai Zasshi ; 112(4): 683-9, 2015 Apr.
Article in Japanese | MEDLINE | ID: mdl-25843456

ABSTRACT

A 77-year-old woman was referred to our hospital because of blood in feces and anal pain. Colonoscopy revealed a villous semicircular tumor in the rectum. A biopsy showed well-differentiated adenocarcinoma. Miles' operation was performed because of the persistence of anal pain and blood in feces. Histological and immunohistochemical analysis showed coexistent tubulovillous adenoma, tubulovillous adenocarcinoma, and large cell neuroendocrine carcinoma (LCNEC), which was positive for CD56, chromogranin A, and synaptophysin. Pathological examination revealed that most of the lesion was occupied by the LCNEC. The tumor was therefore diagnosed as LCNEC of the rectum. The patient underwent adjuvant chemotherapy with cisplatin (CDDP), irinotecan (CPT-11), and mFOLFOX6, but died because of LCNEC progression 10 months after the operation. LCNEC rarely occurs in the gastrointestinal tract; here we report a case of rectal LCNEC.


Subject(s)
Carcinoma, Neuroendocrine/pathology , Rectal Neoplasms/pathology , Aged , Carcinoma, Neuroendocrine/surgery , Female , Humans , Rectal Neoplasms/surgery
SELECTION OF CITATIONS
SEARCH DETAIL
...