Clinical Journal of Gastroenterology最新文献_第2页

A case of gastric/duodenal diffuse large B cell lymphoma observed during the administration of tacrolimus/azathioprine for dermatomyositis.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-05 DOI: 10.1007/s12328-024-02077-9

Ayako Yamamoto, Ayumi Ito, Shinichi Nakamura, Tomoaki Higuchi, Masayoshi Harigai, Akihito Shinohara, Tomoko Yamamoto, Yoji Nagashima, Katsutoshi Tokushige

{"title":"A case of gastric/duodenal diffuse large B cell lymphoma observed during the administration of tacrolimus/azathioprine for dermatomyositis.","authors":"Ayako Yamamoto, Ayumi Ito, Shinichi Nakamura, Tomoaki Higuchi, Masayoshi Harigai, Akihito Shinohara, Tomoko Yamamoto, Yoji Nagashima, Katsutoshi Tokushige","doi":"10.1007/s12328-024-02077-9","DOIUrl":"https://doi.org/10.1007/s12328-024-02077-9","url":null,"abstract":"The patient was diagnosed with amyopathic dermatomyositis complicated with interstitial pneumonia (IP) at age 35. She had been treated with prednisolone and maintained on tacrolimus (TAC) + azathioprine (AZA). Eight years later, she experienced epigastric pain, and esophagogastroduodenoscopy (EGD) led to a diagnosis of duodenal ulcer. The pain did not improve, so she visited our hospital, where she presented with malaise, anemia, and weight loss. An EGD revealed submucosal tumor-like protrusions in the anterior and posterior walls of the gastric antrum and punched-out ulcers with auricle-like marginal swelling on the inside of the protrusions. Irregular-shaped punched-out ulcers were also observed in the duodenal bulb. Lymphoma was suspected, and biopsy was performed. Histopathology showed diffuse large, atypical lymphocytes with enlarged nuclei, and immunohistochemical staining revealed CD20-positive cells. Diffuse large B cell lymphoma (DLBCL) was diagnosed, which was considered as lymphomas arising in immune deficiency/dysregulation. After discontinuing TAC + AZA for three months, the gastrointestinal symptoms improved, and on EGD, the duodenal lesions had disappeared, with only a shallow depression covered with regenerated epithelium remaining in the posterior wall of the gastric antrum. Seven months later, the patient underwent follow-up EGD, and the disappearance of lymphoma cells was confirmed histopathologically by biopsy. Repeated and detailed endoscopic examination should be considered in an immunosuppressed patient with treatment-resistant gastric or duodenal ulcers.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comprehensive genome analysis of hepatitis B virus using nanopore sequencing technology in patients with previously resolved infection and spontaneous reactivation without drug exposure.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-03 DOI: 10.1007/s12328-024-02078-8

Shunsuke Yamada, Yoshihito Uchida, Jun-Ichi Kouyama, Kayoko Naiki, Hiroshi Yamaguchi, Nobuaki Nakayama, Yukinori Imai, Suguru Mizuno, Taketo Yamada, Satoshi Mochida

{"title":"Comprehensive genome analysis of hepatitis B virus using nanopore sequencing technology in patients with previously resolved infection and spontaneous reactivation without drug exposure.","authors":"Shunsuke Yamada, Yoshihito Uchida, Jun-Ichi Kouyama, Kayoko Naiki, Hiroshi Yamaguchi, Nobuaki Nakayama, Yukinori Imai, Suguru Mizuno, Taketo Yamada, Satoshi Mochida","doi":"10.1007/s12328-024-02078-8","DOIUrl":"https://doi.org/10.1007/s12328-024-02078-8","url":null,"abstract":"A 75-year-old Japanese woman experienced persistent fatigue and progressive jaundice for 6 weeks, and was subsequently diagnosed with acute liver failure. She had not received any immunosuppressive therapies and/or antineoplastic chemotherapy. Blood tests revealed elevated levels of HBsAg, HBV-DNA, and anti-HBc IgG, while anti-HBc IgM was negative. She had undergone hepatitis virus testing 48 weeks earlier, during which HBsAg was negative, indicating that HBV reactivation occurred in a patient with a previously resolved infection, without any drug therapies as triggers, ultimately leading to acute liver failure. Despite receiving multidisciplinary intensive treatment, her condition worsened, resulting in death. Full-length genomic analysis of the HBV strain, performed using nanopore sequencing technology, identified an I126S substitution in HBsAg, known as a vaccine escape mutation, along with a quasispecies consisting primarily of two HBV clone variants: one full-length and the other with a deletion in the nt2,448-nt488 region (sp1 spliced variant). These genetic factors may have contributed to the spontaneous HBV reactivation.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic ultrasound navigated application of botulinum toxin in severe esophageal motility disorder.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-03 DOI: 10.1007/s12328-024-02066-y

Diana Vážanová, Martin Ďuriček, Peter Uhrík, Peter Bánovčin

{"title":"Endoscopic ultrasound navigated application of botulinum toxin in severe esophageal motility disorder.","authors":"Diana Vážanová, Martin Ďuriček, Peter Uhrík, Peter Bánovčin","doi":"10.1007/s12328-024-02066-y","DOIUrl":"https://doi.org/10.1007/s12328-024-02066-y","url":null,"abstract":"The use of botulinum toxin in the therapy of esophageal motility disorders is reserved for elderly and comorbid patients considered risky for endoscopic or surgical treatment. However, there is a lack of data on the treatment of motility disorders outside the Chicago classification.We present the case of a 56-year-old patient with dysphagia and non-cardial chest pain (Eckardt 8). High resolution manometry ruled out achalasia or other motility disorder, but confirmed a localized 7-cm-long spastic segment in the upper to middle third of esophagus. We considered endoscopic or surgical therapy in this location too risky, therefore we decided to apply botulinum toxin into this segment. The spasm on high resolution manometry correlated with the thickened muscularis propria layer according to the endoscopic ultrasound. We used endoscopic ultrasound for the navigation of botulinum toxin application into the muscularis propria layer. We applied 100 IU of botulinum toxin into four quadrants, 20 and 24 cm from front teeth (12.5 IU for 1 application).The therapy led to improvement of symptoms (Eckardt 3) and to restitution of propulsive peristalsis with complete elimination of spastic segment. The worsening of symptoms appeared after 2 years, with subsequent recurrence of motility disorder fulfilling criteria of type II achalasia.Presenting this case, we wanted to point at the unique use of botulinum toxin as useful treatment in selected cases of unclassified esophageal motility disorder as a bridge therapy. Moreover, endoscopic ultrasound could be used to guide precise application of botulinum toxin.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of colon cancer implanted on endoscopic resection ulcer certified by cancer genomic testing. 一例经癌症基因组检测证实的内镜切除溃疡上的植入性结肠癌。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-09-26 DOI: 10.1007/s12328-024-02037-3

Yuji Urabe, Hidenori Tanaka, Hikaru Nakahara, Fumiaki Tanino, Ken Yamashita, Shintaro Akabane, Akira Ishikawa, Manabu Shimomura, Hideki Ohdan, Shiro Oka

{"title":"A case of colon cancer implanted on endoscopic resection ulcer certified by cancer genomic testing.","authors":"Yuji Urabe, Hidenori Tanaka, Hikaru Nakahara, Fumiaki Tanino, Ken Yamashita, Shintaro Akabane, Akira Ishikawa, Manabu Shimomura, Hideki Ohdan, Shiro Oka","doi":"10.1007/s12328-024-02037-3","DOIUrl":"10.1007/s12328-024-02037-3","url":null,"abstract":"A 90 year-old man underwent endoscopic mucosal resection for lesions in the descending and sigmoid colons as well as endoscopic submucosal dissection (ESD) for a lesion in the rectal peritoneal reflection (Ra) 1 month before undergoing laparoscopic resection and D3 dissection for advanced cancer in the descending colon. One year later, he underwent a surveillance colonoscopy, and advanced colorectal cancer was detected on the ESD scar. The history suggested that this newly detected recurrent colorectal neoplasm on the ESD scar may have originated from cancer cells derived from the descending colon cancer that were implanted in the ESD ulcer, thereby initiating a new colorectal neoplasm. Cancer genomic testing further indicated that three of the four pathogenic variants detected in the recurrent colorectal neoplasm were consistent with pathogenic variants of descending colon cancer. This finding strongly supports our contention that cancer cells derived from the descending colon cancer were implanted in the post-ESD ulcer of the rectal Ra and proliferated, forming the recurrent colorectal neoplasm. This case report highlights the potential for tumor cell implantation on endoscopic resection ulcers and the utility of cancer genomic testing in validating this phenomenon.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1047-1052"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549191/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tubular adenoma at the hepatico-jejunal anastomosis in familial adenomatous polyposis (FAP) following pancreaticoduodenectomy: challenges in adenoma surveillance and management. 胰十二指肠切除术后家族性腺瘤性息肉病（FAP）肝空肠吻合处的管状腺瘤：腺瘤监测和管理的挑战。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-10-05 DOI: 10.1007/s12328-024-02048-0

Muhammad Ali Butt, Lyubov Tiegs, Rahul Karna, Justin Peltola, Mohammad Bilal

引用次数: 0

Variceal bleeding following treatment with atezolizumab plus bevacizumab in two patients with unresectable hepatocellular carcinoma. 两名无法切除的肝细胞癌患者在接受阿特珠单抗加贝伐单抗治疗后出现静脉曲张出血。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-08-16 DOI: 10.1007/s12328-024-02031-9

Teppei Matsui, Hidenari Nagai, Takanori Mukozu, Noritaka Wakui, Takahisa Matsuda, Yoshinori Igarashi

{"title":"Variceal bleeding following treatment with atezolizumab plus bevacizumab in two patients with unresectable hepatocellular carcinoma.","authors":"Teppei Matsui, Hidenari Nagai, Takanori Mukozu, Noritaka Wakui, Takahisa Matsuda, Yoshinori Igarashi","doi":"10.1007/s12328-024-02031-9","DOIUrl":"10.1007/s12328-024-02031-9","url":null,"abstract":"Bleeding-related adverse events may occur due to anti-vascular endothelial growth factors. Here, we report two cases of variceal rupture during atezolizumab plus bevacizumab (ATZ/BV) treatment for unresectable hepatocellular carcinoma (u-HCC).Case 1 involved a man in his 60 s with alcoholic liver cirrhosis (LC) and u-HCC. Seventy-four days after ATZ/BV administration, the patient was admitted for hematemesis. Upper esophagogastroduodenoscopy (EGD) revealed worsening of the esophageal varices (EVs) to F2 grade with active bleeding. Endoscopic variceal ligation successfully achieved hemostasis.Case 2 involved a man in his 70 s with alcoholic LC and u-HCC. The patient was admitted with hematemesis 114 days after ATZ/BV administration. During EGD, the EVs deteriorated to F3 grade, although hemostasis had already been achieved. The evaluation was discontinued during the observation stage because of the worsening hepatic reserve.Neither patient had EVs warranting prophylactic treatment before ATZ/BV administration, showed a partial tumor response, or had portal vein tumor thrombus. Both patients demonstrated increased total diameters of the collateral veins and splenic volume compared to those before treatment. These findings suggest that ATZ/BV treatment may increase portal pressure. In conclusion, the administration of ATZ/BV to patients with LC and u-HCC necessitates careful management of EVs aggravation and rupture.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1058-1066"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Metastatic melanoma: an unexpected cause of acute liver failure. 转移性黑色素瘤：急性肝功能衰竭的意外病因。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-09-17 DOI: 10.1007/s12328-024-02039-1

Robert S O'Neill, Phillip Leaver, Connor Ryan, Sharron Liang, Santosh Sanagapalli, Rasha Cosman

{"title":"Metastatic melanoma: an unexpected cause of acute liver failure.","authors":"Robert S O'Neill, Phillip Leaver, Connor Ryan, Sharron Liang, Santosh Sanagapalli, Rasha Cosman","doi":"10.1007/s12328-024-02039-1","DOIUrl":"10.1007/s12328-024-02039-1","url":null,"abstract":"Acute liver failure secondary to metastatic melanoma is exceedingly rare with the literature limited to case reports. The disease itself presents with vague symptoms making diagnosis difficult without a high clinical suspicion. Further to this, the prognosis of acute liver failure secondary to metastatic melanoma is dismal. We present the case of a 59-year-old male with a distant history of previously excised cutaneous melanoma who presented to our institution with abdominal pain and liver enzyme derangement suggestive of acute hepatitis. Due to progressive derangement in liver function and cross-sectional imaging suggestive of an infiltrative cause, a left axillary lymph node was biopsied which demonstrated metastatic melanoma. The patient subsequently deteriorated into acute liver failure and despite acute treatment of his underlying metastatic melanoma died 17 days post initial presentation. This case highlights an uncommon cause of acute liver failure as well as the poor prognosis associated with acute liver failure secondary to metastatic melanoma.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1125-1129"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of complete remission by cabozantinib as an end-line treatment for advanced hepatocellular carcinoma.

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 DOI: 10.1007/s12328-024-02062-2

Shuhei Nagashima, Satoshi Kobayashi, Shotaro Tsunoda, Yui Yamachika, Yuichiro Tozuka, Taito Fukushima, Manabu Morimoto, Makoto Ueno, Junji Furuse, Shin Maeda

{"title":"A case of complete remission by cabozantinib as an end-line treatment for advanced hepatocellular carcinoma.","authors":"Shuhei Nagashima, Satoshi Kobayashi, Shotaro Tsunoda, Yui Yamachika, Yuichiro Tozuka, Taito Fukushima, Manabu Morimoto, Makoto Ueno, Junji Furuse, Shin Maeda","doi":"10.1007/s12328-024-02062-2","DOIUrl":"https://doi.org/10.1007/s12328-024-02062-2","url":null,"abstract":"Cabozantinib is a multi-kinase inhibitor targeting multiple tyrosine kinases. It improves overall survival and progression-free survival in patients previously treated with sorafenib for advanced hepatocellular carcinoma (HCC) compared to the placebo in the phase 3 CELESTIAL trial. A 71-year-old man presented to our hospital for treatment of HCC with chronic hepatitis C. He was refractory to sorafenib, lenvatinib, regorafenib, and ramucirumab and started atezolizumab and bevacizumab therapy in November 2020. After administering the second cycle on December 10, 2020, the patient was diagnosed with progressive disease in January 2021. Therefore, cabozantinib (60 mg/day) was initiated on January 14, 2021. As the grade 3 aspartate aminotransferase and alanine aminotransferase levels increased, grade 3 anorexia and a decline in performance status were observed in the first week, and cabozantinib was terminated. His performance status and anorexia gradually improved, and contrast-enhanced computed tomography (CT) in June 2021 showed complete remission (CR) according to the modified Response Evaluation Criteria in Solid Tumors. The patient did not show disease progression for 11 months without receiving any treatment for HCC. To the best of our knowledge, this is the first report of CR with cabozantinib in advanced HCC.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142766640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diffuse large B-cell lymphoma of the gallbladder with hepatoduodenal invasion exhibiting a necrotic tendency. 胆囊弥漫大 B 细胞淋巴瘤，伴有肝十二指肠侵犯，呈坏死倾向。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-09-10 DOI: 10.1007/s12328-024-02034-6

Hironao Matsumoto, Shunsuke Horitani, Yutaro Tokutomi, Masataka Kano, Masahiro Orino, Kanehiko Suwa, Masahiro Takeo, Toshiyuki Mitsuyama, Takeshi Yamashina, Masaaki Shimatani

{"title":"Diffuse large B-cell lymphoma of the gallbladder with hepatoduodenal invasion exhibiting a necrotic tendency.","authors":"Hironao Matsumoto, Shunsuke Horitani, Yutaro Tokutomi, Masataka Kano, Masahiro Orino, Kanehiko Suwa, Masahiro Takeo, Toshiyuki Mitsuyama, Takeshi Yamashina, Masaaki Shimatani","doi":"10.1007/s12328-024-02034-6","DOIUrl":"10.1007/s12328-024-02034-6","url":null,"abstract":"We report a case of diffuse large B-cell lymphoma (DLBCL) of the gallbladder with extensive hepatoduodenal invasion, which was challenging to diagnose histologically due to a strong tendency to be necrotic. An 71 year-old man presented with upper abdominal pain and was referred to our hospital. Computed tomography revealed a distended gallbladder with air within the irregular gallbladder wall and an indistinct border with the hepatoduodenum, suggesting invasion. Esophagogastroduodenoscopy detected an ulceration in the duodenal bulb. However, histologic analysis failed to provide a definitive diagnosis due to the presence of necrotic tissue. Furthermore, direct biopsy from the gallbladder mucosa by endoscopic retrograde cholangiography revealed only necrotic tissue and no diagnosis. Contrast ultrasonography for the hepatic invasion revealed enhancement with blood flow, suggesting non-necrotic tissue. Subsequently, an ultrasound-guided core-needle biopsy was conducted to obtain tissue samples from the described lesion. The pathology showed atypical lymphocytes with irregular nuclei. Immunostaining indicated positive expression of CD10, CD20, Bcl-6, and C-Myc, consistent with a diagnosis of DLBCL. In our case, the lymphoma exhibited a strong tendency to be necrotic, making histologic diagnosis difficult. However, selective biopsy from the site of blood flow made the diagnosis possible and proved to be useful.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1087-1092"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142281359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic ultrasound-guided drainage for mediastinal abscess: first report of bridge to surgery for esophageal cancer. 内窥镜超声引导下纵隔脓肿引流术：首次报告食管癌手术的桥梁。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-12-01 Epub Date: 2024-10-17 DOI: 10.1007/s12328-024-02049-z

Yoshitaro Yamamoto, Kazuo Hara, Nozomi Okuno, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Takashi Kondo, Minako Urata

{"title":"Endoscopic ultrasound-guided drainage for mediastinal abscess: first report of bridge to surgery for esophageal cancer.","authors":"Yoshitaro Yamamoto, Kazuo Hara, Nozomi Okuno, Nobumasa Mizuno, Shin Haba, Takamichi Kuwahara, Toshitaka Fukui, Takashi Kondo, Minako Urata","doi":"10.1007/s12328-024-02049-z","DOIUrl":"10.1007/s12328-024-02049-z","url":null,"abstract":"Perforated esophageal cancer rarely results in the formation of mediastinal abscess. Endoscopic ultrasound (EUS)-guided abscess drainage (AD) has increasingly been used in the management of abscesses in locations that are difficult to treat percutaneously. We describe a case of EUS-AD for mediastinal abscess due to perforating esophageal cancer and successful bridge to surgery. A 71-year-old man with suspected esophageal issues was referred to our hospital. Computed tomography showed an esophageal cancer perforating the mediastinum, forming a mediastinal abscess. EUS-AD was planned before curative resection, because there was little improvement in inflammatory response with antimicrobial therapy. The mediastinal abscess cavity was confirmed on EUS and punctured using a 19-G needle, and then, a 0.025-inch guidewire was placed in the abscess cavity. The fistula was dilated with a 7-Fr dilator and a 6-Fr, single-pigtail nasobiliary tube was placed in the abscess cavity. One month later, clinical signs had improved and curative surgery was performed. Postoperative adjuvant therapy was administered using fluorouracil/cisplatin therapy. As of 2 years postoperatively, the patient remains free of recurrence.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":"1009-1014"},"PeriodicalIF":0.8,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0