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1.
Intern Med ; 63(4): 487-491, 2024 Feb 15.
Article in English | MEDLINE | ID: mdl-37407450

ABSTRACT

A 76-year-old man experienced abdominal pain 43 days after gastric cancer resection. Computed tomography revealed a gastric wall defect extending to the pancreas, and endoscopic retrograde pancreatography revealed a gastropancreatic fistula. Afterward, a nasopancreatic duct drainage tube was inserted. Seven days later, no leakage of the contrast medium from the duct was observed, and the patient was discharged 22 days after endoscopic nasopancreatic duct drainage. Endoscopic nasopancreatic duct drainage prevents pancreatic juice leakage and promotes gastric ulcer healing.


Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Fistula , Male , Humans , Aged , Cholangiopancreatography, Endoscopic Retrograde/methods , Pancreas/diagnostic imaging , Pancreas/surgery , Pancreatic Juice , Drainage/methods , Pancreatic Ducts , Pancreatic Fistula/diagnostic imaging , Pancreatic Fistula/etiology , Pancreatic Fistula/surgery
3.
Clin J Gastroenterol ; 16(4): 550-553, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37055609

ABSTRACT

A male patient in his 70s who had undergone a regular upper gastrointestinal endoscopy noted a flat, erythematous area on the right soft palate of the oropharynx 9 months after his treatment of oropharyngeal cancer. Six months after noticing the lesion, endoscopy revealed that the lesion had rapidly developed into a thick, erythematous, bump. Endoscopic submucosal dissection was performed. Pathological analysis of the resected tissue found a squamous cell carcinoma with a thickness of 1400 µm invading the subepithelial layer. There are few reports on the growth speed of pharyngeal cancer and it remains unclear. In some cases, the growth of the pharyngeal cancer may be rapid, and it is important to follow up the patient in a short period of time.


Subject(s)
Endoscopic Mucosal Resection , Oropharyngeal Neoplasms , Pharyngeal Neoplasms , Humans , Male , Treatment Outcome , Endoscopy, Gastrointestinal , Pharyngeal Neoplasms/pathology , Oropharyngeal Neoplasms/surgery
4.
Intern Med ; 62(22): 3327-3331, 2023 Nov 15.
Article in English | MEDLINE | ID: mdl-36948615

ABSTRACT

A 59-year-old woman presented with a chief complaint of melena. She had no abdominal findings, such as tenderness or tapping pain. Laboratory tests revealed a white blood cell count of 5,300 cells/µL and C-reactive protein level of 0.07 mg/dL. Inflammation and anemia (hemoglobin 12.4 g/dL) were denied. Contrast-enhanced computed tomography (CT) revealed multiple duodenal diverticula and air surrounding a descending duodenal diverticulum. Based on these findings, duodenal diverticular perforation (DDP) was suspected. Oral food intake was stopped, and nasogastric tube feeding and conservative treatment with cefmetazole, lansoprazole, and ulinastatin were begun. On day 8 of hospitalization, follow-up CT revealed the disappearance of the air surrounding the duodenum, and the patient was discharged on day 19 after the resumption of oral feeding.


Subject(s)
Diverticulum , Duodenal Diseases , Intestinal Perforation , Female , Humans , Middle Aged , Duodenal Diseases/diagnostic imaging , Duodenal Diseases/therapy , Intestinal Perforation/diagnostic imaging , Intestinal Perforation/etiology , Intestinal Perforation/therapy , Duodenum , Diverticulum/diagnostic imaging , Diverticulum/therapy , Conservative Treatment
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