Clinical Journal of Gastroenterology最新文献_第3页

A case of impaired consciousness due to water intoxication during underwater endoscopic submucosal dissection for colorectal cancer. 结直肠癌水下内镜粘膜下解剖术中水中毒致意识障碍1例。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-19 DOI: 10.1007/s12328-026-02338-9

Mizuho Fujisawa, Tomoki Horikawa, Takayuki Kitano, Takumi Takauchi, Shinichiro Shinzaki

{"title":"A case of impaired consciousness due to water intoxication during underwater endoscopic submucosal dissection for colorectal cancer.","authors":"Mizuho Fujisawa, Tomoki Horikawa, Takayuki Kitano, Takumi Takauchi, Shinichiro Shinzaki","doi":"10.1007/s12328-026-02338-9","DOIUrl":"https://doi.org/10.1007/s12328-026-02338-9","url":null,"abstract":"An 85-year-old woman complained of a large amount of sudden bloody stool. A blood test revealed anemia, and colonoscopy showed an elevated tumor (> 50 mm in size) in the ascending colon, with biopsy findings suggested the likelihood of adenocarcinoma. Based on these observations, bleeding from the tumor was determined to be the cause of anemia. As she declined surgery, underwater endoscopic submucosal dissection (ESD) was performed, during which saline solution was supplied from the tip of the knife and electrolyte-free water was supplied from the endoscopic sub-fed port. After treatment initiation, her level of consciousness gradually declined, and convulsive seizures appeared. A blood test revealed marked hyponatremia, with a serum sodium level of 109 mEq/L. Ultimately, it was determined that the patient developed water intoxication with underwater ESD, due to the absorption of electrolyte-free water into the bloodstream. ESD was promptly terminated, serum sodium compensation by intravenous infusion was started, and the patient's impaired consciousness improved. This case suggests that water intoxication during underwater ESD represents a potentially life-threatening complication, particularly for large tumors during prolonged procedures in elderly patients.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721675","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 diagnostic dilemma: abdominal tuberculosis mimicking suspected Crohn's disease or latent tuberculosis activated by biologic therapy. 诊断困境：腹部结核模拟疑似克罗恩病或潜伏结核激活的生物治疗。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-19 DOI: 10.1007/s12328-026-02337-w

Anthony Papale, Robert Flattau, Michael Delicce, Fernanda Mitchell, Ronald Greenberg, Keith Sultan

引用次数: 0

Application of preoperative recombinant thrombomodulin in emergency laparoscopic cholecystectomy for acute cholecystitis with DIC. 术前重组血栓调节蛋白在急性胆囊炎合并DIC急诊腹腔镜胆囊切除术中的应用。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-18 DOI: 10.1007/s12328-026-02335-y

Mitsunobu Arizono, Kenei Furukawa, Koichiro Haruki, Tomohiko Taniai, Mitsuru Yanagaki, Masashi Tsunematsu, Yoshihiro Shirai, Shinji Onda, Michinori Matsumoto, Toru Ikegami

引用次数: 0

Fulminant disseminated carcinomatosis of the bone marrow from pancreatic mucinous carcinoma with predominant signet ring cell morphology. 胰腺黏液癌引起的骨髓暴发性弥散性癌，以印戒细胞形态为主。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-17 DOI: 10.1007/s12328-026-02332-1

Katsuya Ami, Keiko Kamei, Masaya Nakano, Chihoko Nobori, Yuta Yoshida, Kentaro Tai, Takaaki Murase, Atsushi Takebe, Takaaki Chikugo, Ippei Matsumoto

{"title":"Fulminant disseminated carcinomatosis of the bone marrow from pancreatic mucinous carcinoma with predominant signet ring cell morphology.","authors":"Katsuya Ami, Keiko Kamei, Masaya Nakano, Chihoko Nobori, Yuta Yoshida, Kentaro Tai, Takaaki Murase, Atsushi Takebe, Takaaki Chikugo, Ippei Matsumoto","doi":"10.1007/s12328-026-02332-1","DOIUrl":"https://doi.org/10.1007/s12328-026-02332-1","url":null,"abstract":"Disseminated carcinomatosis of the bone marrow (DCBM) is a rare and highly aggressive form of bone metastasis arising from solid tumors, most commonly gastric cancers. DCBM originating from pancreatic cancer is exceedingly rare, with only a few cases reported in the literature. A 62-year-old man presented with back pain, loss of appetite, and weight loss. Laboratory tests revealed anemia and thrombocytopenia. Contrast-enhanced computed tomography revealed a hypovascular mass measuring approximately 10 mm in size in the pancreatic tail. Endoscopic ultrasound-guided fine-needle aspiration confirmed the diagnosis of pancreatic mucinous carcinoma. Laboratory evaluation suggested disseminated intravascular coagulation (DIC). Although no nodular bone metastases were detected on imaging studies, bone marrow biopsy revealed diffuse infiltration by adenocarcinoma predominantly composed of tumor cells with signet ring cell carcinoma morphology, leading to a diagnosis of DCBM from pancreatic mucinous carcinoma. The patient developed a subarachnoid hemorrhage due to severe bleeding tendency, and chemotherapy could not be initiated. The patient died on hospital day 11. To our knowledge, this is the first reported case of DCBM arising from pancreatic mucinous carcinoma with bone marrow metastasis predominantly composed of signet ring cell carcinoma morphology. In patients with pancreatic cancer who present with DIC, particularly mucin-producing tumors such as mucinous carcinoma, the possibility of DCBM should be actively suspected, and early bone marrow aspiration and biopsy should be considered.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716198","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

Successful retreatment with glecaprevir/pibrentasvir after sofosbuvir/velpatasvir failure in a patient with hepatitis C-related decompensated cirrhosis complicated by hepatocellular carcinoma. sofosbuvir/velpatasvir治疗失败后，丙型肝炎相关失代偿性肝硬化合并肝细胞癌患者再用glecaprevir/pibrentasvir治疗成功。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-16 DOI: 10.1007/s12328-026-02330-3

Minami Ogura, Atsushi Naganuma, Shohei Kodama, Keiji Nakajo, Otone Kasai, Yuhei Suzuki, Sanae Uehara, Takeshi Hatanaka, Takashi Hoshino, Satoru Kakizaki

{"title":"Successful retreatment with glecaprevir/pibrentasvir after sofosbuvir/velpatasvir failure in a patient with hepatitis C-related decompensated cirrhosis complicated by hepatocellular carcinoma.","authors":"Minami Ogura, Atsushi Naganuma, Shohei Kodama, Keiji Nakajo, Otone Kasai, Yuhei Suzuki, Sanae Uehara, Takeshi Hatanaka, Takashi Hoshino, Satoru Kakizaki","doi":"10.1007/s12328-026-02330-3","DOIUrl":"https://doi.org/10.1007/s12328-026-02330-3","url":null,"abstract":"Direct-acting antivirals (DAAs) markedly improve sustained virologic response (SVR) rates in chronic hepatitis C virus (HCV) infection, including decompensated cirrhosis. However, retreatment options remain limited in patients with decompensated cirrhosis after DAA failure. We experienced a case of decompensated cirrhosis that was successfully retreated with glecaprevir/pibrentasvir (GLE/PIB) after sofosbuvir/velpatasvir (SOF/VEL) failure. The patient was a woman in her 70 s with HCV genotype 1b and an HCV RNA level of 7.1 log IU/mL. The Child-Pugh classification was class B, with a score of 7. The albumin-bilirubin (ALBI) score was - 1.99, with a modified ALBI grade of 2b. Screening prior to antiviral therapy detected multifocal hepatocellular carcinoma (HCC). She initially underwent treatment for HCC and esophageal varices, achieving a cancer-free status. SOF/VEL was subsequently initiated, but virologic relapse occurred. Resistance testing detected NS5A substitutions (L31I/M and Y93H) without P32 deletion. Seven months after completing SOF/VEL, the patient's Child-Pugh score had improved to 6, although she was still receiving oral branched-chain amino acids. Because established retreatment options for decompensated cirrhosis after SOF/VEL failure are scarce, she underwent GLE/PIB therapy after institutional ethics approval and achieved SVR. This case highlights the practical challenges of managing DAA failure in patients with decompensated cirrhosis and suggests that carefully selected retreatment may be feasible after stabilization of hepatic decompensation, although safety considerations remain paramount.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147688397","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

Recto-anal high-grade squamous intraepithelial lesion with 5-year stability: curative endoscopic submucosal dissection. 直肠至肛门高级别鳞状上皮内病变伴5年稳定性：内镜下粘膜下夹层可治愈。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-16 DOI: 10.1007/s12328-026-02319-y

Xiaona Shao, Naoya Toyoshima, Uozumi Takeshi, Yuichiro Hirai, Masau Sekiguchi, Hiroyuki Takamaru, Masayoshi Yamada, Toshihiro Haga, Jianwei Shen, Yutaka Saito

{"title":"Recto-anal high-grade squamous intraepithelial lesion with 5-year stability: curative endoscopic submucosal dissection.","authors":"Xiaona Shao, Naoya Toyoshima, Uozumi Takeshi, Yuichiro Hirai, Masau Sekiguchi, Hiroyuki Takamaru, Masayoshi Yamada, Toshihiro Haga, Jianwei Shen, Yutaka Saito","doi":"10.1007/s12328-026-02319-y","DOIUrl":"https://doi.org/10.1007/s12328-026-02319-y","url":null,"abstract":"High-grade squamous intraepithelial lesion (HSIL) is a recognized precursor of anal squamous cell carcinoma (SCC). Randomized controlled trials in human immunodeficiency virus (HIV)-positive individuals have shown that local treatment of HSIL reduces the risk of progression to SCC, but the natural history of HSIL in HIV-negative patients is not well defined. We describe a rare case of recto-anal HSIL in an HIV-negative patient that remained morphologically stable for 5 years. Endoscopically, the lesion measured 33 × 25 mm and extended from the lower rectum (Rb) to the anal canal. The lesion was removed en bloc by endoscopic submucosal dissection (ESD), achieving R0 resection. The pinned en bloc specimen measured 55 × 33 mm, and on histology the lesion measured 44 × 15 mm. Histopathology confirmed HSIL (squamous cell carcinoma in situ) with diffuse p16 positivity, consistent with human papillomavirus infection. Published HIV-negative case-level reports that explicitly document long-term stability without intervention are scarce; this case adds to that under-reported subgroup and supports ESD as a curative, organ-preserving option in selected early-stage cases when en bloc EMR is unlikely.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698035","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

Extensive high-grade PanIN of the main pancreatic duct requiring total pancreatectomy diagnosed after long-term surveillance. 主胰管广泛的高级别PanIN需要在长期监测后诊断为全胰切除术。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-16 DOI: 10.1007/s12328-026-02326-z

Ryo Yaguchi, Ryoga Hamura, Nanako Kodaira, Masashi Tsunematsu, Yoshihiro Shirai, Akiharu Kudo, Shigeru Nishiyama, Shogo Sakata, Takeshi Hisa, Kyohei Abe

{"title":"Extensive high-grade PanIN of the main pancreatic duct requiring total pancreatectomy diagnosed after long-term surveillance.","authors":"Ryo Yaguchi, Ryoga Hamura, Nanako Kodaira, Masashi Tsunematsu, Yoshihiro Shirai, Akiharu Kudo, Shigeru Nishiyama, Shogo Sakata, Takeshi Hisa, Kyohei Abe","doi":"10.1007/s12328-026-02326-z","DOIUrl":"https://doi.org/10.1007/s12328-026-02326-z","url":null,"abstract":"Background: High-grade pancreatic intraepithelial neoplasia (PanIN) is a non-invasive precursor of invasive pancreatic ductal adenocarcinoma. Owing to the absence of mass formation and the limited sensitivity of cytology, the diagnosis and determination of surgical margins remain difficult.Case presentation: A 64-year-old woman was referred for the evaluation of progressive pancreatic ductal dilation without an obvious mass lesion. Magnetic resonance cholangiopancreatography revealed main pancreatic duct (MPD) irregularities and partial pancreatic parenchymal atrophy. Long-term surveillance revealed progressive pancreatic atrophy, with substantial dilation of the MPD in the tail of the pancreas. Although the cytological examination was inconclusive, the imaging findings raised the suspicion of high-grade pancreatic intraepithelial neoplasia (HG PanIN). The patient underwent distal pancreatectomy; however, the resection margin was positive for HG PanIN. Total pancreatectomy was subsequently performed. The final histopathological examination revealed high-grade PanIN extending 45 mm (body) and 55 mm (head) along the MPD. The patient's recovery was uneventful and she remained disease-free 5 years post-surgery.Conclusion: We report the importance of recognizing subtle imaging features suggestive of high-grade PanIN and the need for comprehensive surgical planning to ensure curative resection.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698041","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 methotrexate-associated primary splenic lymphoma diagnosed by endoscopic biopsy of a small gastric lesion. 甲氨蝶呤相关的原发性脾淋巴瘤的病例诊断内镜活检的一个小的胃病变。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-16 DOI: 10.1007/s12328-026-02327-y

Keiichiro Nagaya, Akio Tamura, Yu Okita, Masamichi Okamura, Yoshitaka Kitayama, Hiroshi Kashida, Takashi Itoh, Shinichiro Shinzaki, Hiroto Miwa, Akira Andoh

引用次数: 0

Acinar cystic transformation of pancreas as a rare cause of acute pancreatitis and a diagnostic challenge in a young male. 胰腺腺泡囊性转化是一种罕见的急性胰腺炎的原因和诊断挑战在一个年轻的男性。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-13 DOI: 10.1007/s12328-026-02318-z

Christos Longros, Dietrich Alexander Ruess

引用次数: 0

Urinary bladder invasion secondary to dissemination of gallbladder cancer: an unusual presentation. 胆囊癌播散后膀胱浸润：一种不寻常的表现。

IF 0.9

Clinical Journal of Gastroenterology Pub Date : 2026-04-13 DOI: 10.1007/s12328-026-02324-1

Ryotaro Watanabe, Tatsuya Koshitani, Shinsuke Hashidume, Keiu Kasho, Akitaka Yokomura, Hiroshi Takihara, Takahiro Takemoto, Masaaki Itoh, Naoki Nakajima

引用次数: 0