Clinical Journal of Gastroenterology最新文献_第6页

Laparoscopic transhiatal surgery based on high-resolution manometric evaluation of epiphrenic esophageal diverticulum. 基于高分辨率测压法评估虹膜上食管憩室的腹腔镜经食管手术。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-30 DOI: 10.1007/s12328-024-02056-0

Ryoma Taketo, Katsuhiro Ogawa, Tomotaka Shibata, Atsuro Fujinaga, Tomonori Akagi, Shigeo Ninomiya, Yoshitake Ueda, Hidefumi Shiroshita, Tsuyoshi Etoh, Masafumi Inomata

{"title":"Laparoscopic transhiatal surgery based on high-resolution manometric evaluation of epiphrenic esophageal diverticulum.","authors":"Ryoma Taketo, Katsuhiro Ogawa, Tomotaka Shibata, Atsuro Fujinaga, Tomonori Akagi, Shigeo Ninomiya, Yoshitake Ueda, Hidefumi Shiroshita, Tsuyoshi Etoh, Masafumi Inomata","doi":"10.1007/s12328-024-02056-0","DOIUrl":"https://doi.org/10.1007/s12328-024-02056-0","url":null,"abstract":"Epiphrenic esophageal diverticulum is rare and often associated with abnormalities of esophageal motility. Here, we report a case of a patient diagnosed with high-resolution manometry as having epiphrenic esophageal diverticulum with esophagogastric junction outflow obstruction, which were successfully treated with laparoscopic transhiatal surgery. A 59-year-old woman presented to our hospital for treatment of a symptomatic epiphrenic esophageal diverticulum. An esophagogram revealed a left epiphrenic diverticulum measuring 50 mm. High-resolution manometry showed a high integrated relaxation pressure of 35.6 mmHg (> 26 mmHg) and preserved esophageal peristalsis. A chest computed tomography scan showed no external compression of the distal esophagus. Therefore, we diagnosed an epiphrenic esophageal diverticulum with esophagogastric junction outflow obstruction according to the Chicago Classification v3.0. Laparoscopic transhiatal diverticulectomy, planned and selective myotomy, and Dor fundoplication were performed. We performed myotomy just on the esophageal side and did not perform gastric myotomy. The postoperative course was uneventful, and the postoperative esophagogram showed smooth passage of contrast without leakage or stenosis. High-resolution manometry showed a normal integrated relaxation pressure (11.6 mmHg) at three months after surgery. Because an epiphrenic esophageal diverticulum is frequently associated with esophageal motility disorder, not only morphologic but also functional and appropriate treatment must be considered.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544116","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 complete response to radiotherapy combined with durvalumab and tremelimumab in a patient with unknown primary hepatocellular carcinoma arising in the lumbar spine. 一例腰椎部位不明原发性肝细胞癌患者对放疗联合杜瓦单抗和曲妥木单抗治疗的完全反应。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-24 DOI: 10.1007/s12328-024-02044-4

Aiko Tanaka, Tomokazu Kawaoka, Shinsuke Uchikawa, Hatsue Fujino, Atsushi Ono, Eisuke Murakami, Clair Nelson Hayes, Daiki Miki, Masataka Tsuge, Shiro Oka

{"title":"A case of complete response to radiotherapy combined with durvalumab and tremelimumab in a patient with unknown primary hepatocellular carcinoma arising in the lumbar spine.","authors":"Aiko Tanaka, Tomokazu Kawaoka, Shinsuke Uchikawa, Hatsue Fujino, Atsushi Ono, Eisuke Murakami, Clair Nelson Hayes, Daiki Miki, Masataka Tsuge, Shiro Oka","doi":"10.1007/s12328-024-02044-4","DOIUrl":"https://doi.org/10.1007/s12328-024-02044-4","url":null,"abstract":"A 58-year-old man visited an orthopedic clinic complaining of pain in his right lower back and numbness in his lower limbs for one month. Imaging tests revealed a tumorous lesion from the left side of the second lumbar vertebra to the paraspinal muscles. CT-guided biopsy of the tumor was performed, and immunostaining results diagnosed hepatocellular carcinoma (HCC). Although the liver showed signs of chronic liver damage, no primary tumor was found within the liver or in other organs. Blood tests showed negative hepatitis virus markers for both HBV and HCV. The tumor markers AFP, AFP-L3, and DCP were high. Because he developed spinal cord compression syndrome due to a lumbar tumor, radiation therapy and denosumab administration were performed. Subsequently, systemic therapy with durvalumab plus tremelimumab was started. In the year following the start of treatment, the tumor has shrunk, and no new lesions have been observed. Tumor markers have also decreased. We have experienced a case of HCC in the lumbar spine without a primary tumor in the liver. This is a very rare case, and the combination therapy with durvalumab and tremelimumab resulted in a complete response, which we consider to be a valuable case.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142496298","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 successful conversion surgery for unresectable gallbladder cancer treated with durvalumab in combination with gemcitabine plus cisplatin. 一例使用杜伐单抗联合吉西他滨加顺铂治疗无法切除的胆囊癌的成功转化手术病例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-22 DOI: 10.1007/s12328-024-02053-3

Tatsuhiro Araki, Ryo Muranushi, Kohji Takagi, Haruyoshi Tanaka, Kazuto Shibuya, Takayuki Ando, Isaku Yoshioka, Kenichi Hirabayashi, Ichiro Yasuda, Tsutomu Fujii

{"title":"A case of successful conversion surgery for unresectable gallbladder cancer treated with durvalumab in combination with gemcitabine plus cisplatin.","authors":"Tatsuhiro Araki, Ryo Muranushi, Kohji Takagi, Haruyoshi Tanaka, Kazuto Shibuya, Takayuki Ando, Isaku Yoshioka, Kenichi Hirabayashi, Ichiro Yasuda, Tsutomu Fujii","doi":"10.1007/s12328-024-02053-3","DOIUrl":"https://doi.org/10.1007/s12328-024-02053-3","url":null,"abstract":"We report a rare case of a patient with initially unresectable gallbladder cancer who underwent conversion surgery with durvalumab in combination with gemcitabine plus cisplatin and achieved an R0 resection. A 68 year-old woman was found to have gallbladder cancer and multiple enlarged lymph nodes around the suprapancreatic rim and hepatic hilum invading the proper hepatic artery on computed tomography. The diagnosis was cT3cN2cM0, cStage IVB. After eight cycles of durvalumab in combination with gemcitabine plus cisplatin, all tumor markers became negative, and lymph node invasion of the hepatic artery disappeared. The patient underwent conversion surgery with gallbladder bed resection and regional lymph node dissection. There was no need for hepatic artery reconstruction. Pathology revealed ypT2aypN0ycM0, ypStage IIA, and radical resection was considered. Immunostaining of tissue collected at the time of endoscopic ultrasound-guided tissue acquisition revealed less than 1% programmed death ligand-1 expression. The patient continued adjuvant chemotherapy with single-agent durvalumab every 4 weeks and maintained a relapse-free survival of 8 months postoperatively. The utility of durvalumab in combination with gemcitabine plus cisplatin in unresectable gallbladder cancer independent of programmed death ligand-1 expression has been confirmed and may be an important option in future multimodal treatment, including conversion surgery.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459616","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 hepatocellular carcinoma arising from the intraductal hepatic bile duct without parenchymal lesion. 一例由肝导管内胆管引发的肝细胞癌，无实质病变。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-22 DOI: 10.1007/s12328-024-02054-2

Yu Nakashima, Kazuhiro Hiramatsu, Masahide Fukaya, Taro Aoba, Atsuki Arimoto, Hiromasa Yamashita, Yoshifumi Arai, Takehito Kato

{"title":"A case of hepatocellular carcinoma arising from the intraductal hepatic bile duct without parenchymal lesion.","authors":"Yu Nakashima, Kazuhiro Hiramatsu, Masahide Fukaya, Taro Aoba, Atsuki Arimoto, Hiromasa Yamashita, Yoshifumi Arai, Takehito Kato","doi":"10.1007/s12328-024-02054-2","DOIUrl":"https://doi.org/10.1007/s12328-024-02054-2","url":null,"abstract":"Hepatocellular carcinoma (HCC) rarely presents as an intraductal tumor with no parenchymal lesions. Here, we present a case of HCC arising from an intrahepatic bile duct. A 74-year-old man who had been treated with direct-acting antiviral therapy for hepatitis C virus infection was referred to our hospital because of elevated serum prothrombin levels induced by vitamin K absence II (PIVKA-II). Initial imaging revealed no findings suspicious of HCC; however, repeat CT six months later revealed dilation of the intrahepatic bile ducts in the lateral segment of the liver. Cholangiography revealed a significant stricture of B3, and biopsy suggested adenocarcinoma. A left hepatectomy was performed with a preoperative diagnosis of intrahepatic cholangiocarcinoma. Although a surface nodule on the lateral segment of the liver, suspicious for intrahepatic metastasis, was found intraoperatively, radical resection was performed. Histopathological examination revealed a tumor filling the intrahepatic bile duct from the stump to the peripheral bile duct, with no infiltration into the liver parenchyma. The surface nodule is a dilated peripheral bile duct filled with a tumor with no extrabiliary invasion. Immunohistochemistry suggested HCC. No tumor lesions were observed in the hepatic parenchyma, and the tumor was finally diagnosed as HCC stemming from the biliary epithelium.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459613","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

Autopsy diagnosis of diffuse intrahepatic cholangiocarcinoma. 尸检诊断为弥漫性肝内胆管癌。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-21 DOI: 10.1007/s12328-024-02052-4

Akihiro Maruyama, Takahiro Nishikawa, Asuka Nagura, Takuya Kurobe, Jun Yashika, Yuho Nimura, Leiwing Hu, Tomohiro Yamaguchi, Iori Kojima, Koji Nonogaki

{"title":"Autopsy diagnosis of diffuse intrahepatic cholangiocarcinoma.","authors":"Akihiro Maruyama, Takahiro Nishikawa, Asuka Nagura, Takuya Kurobe, Jun Yashika, Yuho Nimura, Leiwing Hu, Tomohiro Yamaguchi, Iori Kojima, Koji Nonogaki","doi":"10.1007/s12328-024-02052-4","DOIUrl":"https://doi.org/10.1007/s12328-024-02052-4","url":null,"abstract":"Intrahepatic cholangiocarcinoma (ICC), a severe liver cancer, makes up to 20% of all hepatic malignancies and is difficult to diagnose early due to its often asymptomatic nature. This case report documents a rare presentation of ICC with multiple diffuse nodules not previously recorded in medical literature. A 65-year-old man with no significant medical history presented with back pain, anorexia, and significant weight loss. Elevated tumor markers and enlarged lymph nodes were observed, though imaging did not reveal a primary liver mass. Diagnostic efforts, including computed tomography and positron emission tomography scans and biopsies of lymph nodes and bone marrow, suggested adenocarcinoma of unknown primary origin. A definitive diagnosis was only made post-mortem, revealing multiple diffuse nodules in the liver identified as ICC, marking a rare presentation without a primary mass. This case highlights the diagnostic challenges posed by atypical ICC manifestations, where typical imaging does not indicate a primary mass, delaying diagnosis and treatment. The findings emphasize the importance of considering ICC in differential diagnoses in cases of unknown primary adenocarcinoma with liver involvement. The discovery of ICC with diffusely infiltrative nodules underscores the necessity for comprehensive diagnostic evaluations in patients presenting with nonspecific systemic symptoms and abnormal liver findings.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459617","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 esophageal squamous cell carcinoma with epidermization showing a unique morphology. 一例形态独特的表皮化食管鳞状细胞癌。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-18 DOI: 10.1007/s12328-024-02042-6

Jyunichi Mizuno, Yuji Urabe, Hikaru Nakahara, Ken Yamashita, Yuichi Hiyama, Hidehiko Takigawa, Akira Ishikawa, Toshio Kuwai, Takao Hinoi, Shiro Oka

{"title":"A case of esophageal squamous cell carcinoma with epidermization showing a unique morphology.","authors":"Jyunichi Mizuno, Yuji Urabe, Hikaru Nakahara, Ken Yamashita, Yuichi Hiyama, Hidehiko Takigawa, Akira Ishikawa, Toshio Kuwai, Takao Hinoi, Shiro Oka","doi":"10.1007/s12328-024-02042-6","DOIUrl":"https://doi.org/10.1007/s12328-024-02042-6","url":null,"abstract":"An 80-year-old woman with a history of endoscopic balloon dilation for esophageal stricture caused by accidental ingestion of caustic soda during infancy presented with dysphagia. Upper gastrointestinal endoscopy revealed a 10-cm-long, highly white, elevated lesion with a feathered appearance. This lesion was determined to be the cause of dysphagia and was completely resected via endoscopic submucosal dissection. Histopathological examination revealed a thick keratin layer on the surface of the stratified squamous epithelium, with a prominent granular layer underneath and some areas showing nuclear atypia. The lesion was diagnosed as a well-differentiated squamous cell carcinoma, pT1a-LPM, derived from epidermoid metaplasia. Cancer genome analysis revealed mutations in TP53 as well as amplification of MYC, FGFR1, chromosome 7, and chromosome 20q. This case suggests that epidermoid metaplasia caused by chronic irritation from an esophageal stricture may have been exacerbated by the dilation procedure.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459612","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 non-occlusive mesenteric ischemia following hepatocellular carcinoma rupture. 一例肝癌破裂后非闭塞性肠系膜缺血病例。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-18 DOI: 10.1007/s12328-024-02051-5

Ivana Radosavaljevic, Takao Miwa, Masafumi Kawade, Shinji Unome, Kenji Imai, Koji Takai, Fuminori Yamaji, Tetsuya Fukuta, Shusuke Nomura, Masahito Shimizu

{"title":"A case of non-occlusive mesenteric ischemia following hepatocellular carcinoma rupture.","authors":"Ivana Radosavaljevic, Takao Miwa, Masafumi Kawade, Shinji Unome, Kenji Imai, Koji Takai, Fuminori Yamaji, Tetsuya Fukuta, Shusuke Nomura, Masahito Shimizu","doi":"10.1007/s12328-024-02051-5","DOIUrl":"https://doi.org/10.1007/s12328-024-02051-5","url":null,"abstract":"Hepatocellular carcinoma (HCC) rupture is a severe complication, yet there is limited literature on cases complicated by subsequent non-occlusive mesenteric ischemia (NOMI). A 77-year-old man presented to our hospital with abdominal pain and shock. Arterial phase computed tomography (CT) hepatic arteriography revealed a 77-mm HCC in the left lobe with active extravasation, and the feeding artery was embolized. Although the abdominal pain initially subsided after the procedure, it recurred the next day. A contrast-enhanced CT scan revealed pneumatosis intestinalis and decreased enhancement of the small intestinal wall. The patient underwent resection of the affected segment of the small intestine and was ultimately diagnosed with NOMI based on pathological findings. This is the first reported case of NOMI following HCC rupture. Given the high mortality associated with these conditions, clinicians should be aware of this rare complication and ensure comprehensive evaluation and timely intervention to improve patient outcomes.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459615","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 MSI-high pancreatic body-tail cancer successfully treated with radical resection after pembrolizumab. 一例 MSI 高的胰腺体尾癌患者在使用 Pembrolizumab 后成功接受了根治性切除术。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-14 DOI: 10.1007/s12328-024-02043-5

Miki Ito, Toru Watanabe, Yoko Oga, Shigeki Matsumoto, Nana Kimura, Masakazu Nagamori, Haruyoshi Tanaka, Kazuto Shibuya, Isaku Yoshioka, Tsutomu Fujii

{"title":"A case of MSI-high pancreatic body-tail cancer successfully treated with radical resection after pembrolizumab.","authors":"Miki Ito, Toru Watanabe, Yoko Oga, Shigeki Matsumoto, Nana Kimura, Masakazu Nagamori, Haruyoshi Tanaka, Kazuto Shibuya, Isaku Yoshioka, Tsutomu Fujii","doi":"10.1007/s12328-024-02043-5","DOIUrl":"https://doi.org/10.1007/s12328-024-02043-5","url":null,"abstract":"A 72-year-old woman was diagnosed with unresectable pancreatic body-tail cancer (cT4N1M1, cStage IV) with para-aortic lymph node metastasis. She underwent six courses of gemcitabine + nab-paclitaxel as first-line chemotherapy, 12 courses of oxaliplatin + irinotecan + levofolinate + fluorouracil as second-line chemotherapy, and five courses of albumin-suspended irinotecan + levofolinate + fluorouracil as third-line chemotherapy. After each chemotherapy regimen, the disease was determined to be progressive. Analyses of endoscopic ultrasound-fine needle aspiration specimens and peripheral blood samples revealed microsatellite-instability (MSI)-high pancreatic cancer. The patient underwent 19 courses of pembrolizumab and achieved a partial response. She then underwent conversion surgery, including distal pancreatectomy, lymph node dissection, local gastrectomy and partial mesenteric resection of transverse colon. She is currently alive without recurrence at 18 months postoperatively. It is extremely rare for patients with unresectable and MSI-high pancreatic cancer to successfully undergo conversion surgery after pembrolizumab treatment.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459614","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

Arsenic and young liver: a case report of hepatic steatosis due to arsenic toxicity. 砷与年轻的肝脏：砷中毒导致肝脂肪变性的病例报告。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-08 DOI: 10.1007/s12328-024-02045-3

Cindy Khanh Nguyen, Meagan Alvarado, Won Jae Huh, Jennifer Batisti

引用次数: 0

A case of situs inversus totalis with hemosuccus pancreaticus due to intrapancreatic pseudocyst perforation of the common hepatic artery treated with a vascular stent graft. 一例因胰腺内假性囊肿导致肝总动脉穿孔而引起的全瘫伴胰腺血肿，采用血管支架移植治疗。

IF 0.8

Clinical Journal of Gastroenterology Pub Date : 2024-10-08 DOI: 10.1007/s12328-024-02046-2

Ko Tomishima, Hironao Okubo, Daiki Abe, Shunsuke Nakamura, Takumi Okuaki, Tomonori Yamauchi, Koichi Ito, Yuka Fukuo, Takahiro Yamamoto, Hiroyuki Isayama

{"title":"A case of situs inversus totalis with hemosuccus pancreaticus due to intrapancreatic pseudocyst perforation of the common hepatic artery treated with a vascular stent graft.","authors":"Ko Tomishima, Hironao Okubo, Daiki Abe, Shunsuke Nakamura, Takumi Okuaki, Tomonori Yamauchi, Koichi Ito, Yuka Fukuo, Takahiro Yamamoto, Hiroyuki Isayama","doi":"10.1007/s12328-024-02046-2","DOIUrl":"https://doi.org/10.1007/s12328-024-02046-2","url":null,"abstract":"Hemosuccus pancreaticus (HP) is characterized by gastrointestinal bleeding from the papilla of Vater via the pancreatic duct. In this report, we describe a case of HP due to arterial perforation in a pancreatic pseudocyst and discuss the computed tomography (CT) findings and efficacy of stent graft placement. A 64-year-old man with a history of heavy alcohol use, situs inversus totalis, and total gastrectomy was hospitalized with hematochezia. Enhanced CT revealed a pseudoaneurysm in the common hepatic artery (CHA) with mildly high density in the main pancreatic duct. Subsequent CT revealed an enlarged cystic lesion with inflow of contrast medium. Angiography confirmed blood flow from the CHA into the pancreatic pseudocyst, and the patient was diagnosed with HP due to intrapancreatic pseudocyst perforation of the CHA pseudoaneurysm. Coil packing into the pseudocyst failed to block the blood flow, and a covered stent graft was placed into the CHA. The patient had an uneventful clinical course. The identification of a pseudoaneurysm and a high-density area in the main pancreatic duct on enhanced CT and changes in the pancreatic cyst diameter may indicate the acute phase of HP, and stent grafting is an effective treatment for intracystic arterial perforation.","PeriodicalId":10364,"journal":{"name":"Clinical Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388542","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