Japanese Journal of Gastroenterology最新文献

{"title":"[Retroperitoneal emphysema, mediastinal emphysema, and cervical subcutaneous emphysema associated with perforation of a sigmoid colon diverticulum diagnosed due to intestinal obstruction caused by barium during a gastric cancer screening: a case report].","authors":"Shintaro Iwanaga, Kenichi Sawa, Shogo Yamamoto, Kazuaki Tajima, Fuminao Takeshima, Kotaro Hayashida, Masachika Kitajima, Keiji Inoue, Yuji Ito","doi":"10.11405/nisshoshi.122.434","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.434","url":null,"abstract":"<p><p>A 66-year-old man was admitted to the hospital and diagnosed with mediastinal emphysema after an abnormal chest X-ray during physical examination. During hospitalization, an intestinal obstruction was observed to be caused by barium used during gastric cancer screening. Colonoscopy demonstrated stenosis and perforation due to sigmoid colon diverticulitis. Hartmann surgery was performed, and the patient was discharged on the 58th day. Therefore, colon perforation should be considered as a cause of mediastinal emphysema, and organic stenosis may occur with intestinal obstruction caused by barium.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 6","pages":"434-440"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276184","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}

{"title":"[Surveillance of non-resected intraductal papillary mucinous neoplasms].","authors":"Yousuke Nakai, Tsuyoshi Hamada, Hiroki Oyama","doi":"10.11405/nisshoshi.122.17","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.17","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 1","pages":"17-22"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980229","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}

{"title":"[Short bowel syndrome in adults].","authors":"Kazuhiro Watanabe, Shinobu Ohnuma, Michiaki Unno","doi":"10.11405/nisshoshi.122.169","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.169","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 3","pages":"169-177"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587554","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}

{"title":"[Difficulty factors related to self-expandable metallic stent placement for malignant colonic obstruction].","authors":"Kazuki Boda, Hideharu Okanobu, Tomohiko Kohno, Toshitsune Ikeda, Takuya Okamoto, Kaho Fukuda, Eisuke Miyaki, Ryo Yuge, Tomoyuki Minami, Yoshinari Furukawa","doi":"10.11405/nisshoshi.122.278","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.278","url":null,"abstract":"<p><p>Recently, the endoscopic placement of self-expandable metallic stents (SEMS) for malignant colorectal obstruction has been increasing, but the longer procedure time may cause serious complications. This study aimed to confirm the efficacy and factors that prolong the procedure time for SEMS placement. This study enrolled 92 patients who required SEMS placement for malignant colonic obstruction at the Hiroshima Red Cross Hospital and Atomic-bomb Survivors Hospital from June 2015 to July 2024. The technical success rate was 95.7% and the clinical success rate was 92.4%. The total median procedure time was 37 min and the median procedure time for SEMS placement was 23 min. The major adverse events included perforation (3.3%), stent migration (4.3%), and stent occlusion (4.3%). Deaths related to SEMS placement were not reported. Multivariate analyses revealed significant associations between technically difficult placement and stricture length of ≥5cm (odds ratio [OR]:6.34;p=0.022) as well as lesions invisible from the front (OR:34.30;p<0.001). Endoscopic placement of SEMS for malignant colorectal obstruction is an effective treatment with a high success rate but requires careful attention for lesions that are invisible from the front.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 4","pages":"278-287"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001354","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}

{"title":"[Evidence based medical care of MASLD/MASH -Future perspective of Japanese guideline].","authors":"Norio Akuta","doi":"10.11405/nisshoshi.122.319","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.319","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 5","pages":"319-322"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062716","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}

{"title":"","authors":"","doi":"10.11405/nisshoshi.122.39","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.39","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 1","pages":"39-50"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980223","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}

{"title":"[Spontaneous reactivation of hepatitis B virus in an elderly patient: a case report and review of the literature].","authors":"Haruo Nakayama, Satoshi Takai, Masanori Tosa, Toshiyuki Ikeda, Seiichi Takahashi, Shinichi Ikeya","doi":"10.11405/nisshoshi.122.121","DOIUrl":"10.11405/nisshoshi.122.121","url":null,"abstract":"<p><p>Reactivation of resolved hepatitis B virus (HBV) infection without any immunosuppressants has rarely been reported. Here, we describe the spontaneous HBV reactivation in a 78-year-old male patient with resolved HBV infection. Twenty-five years ago, he received interferon treatment for chronic hepatitis C. Concurrently, he was negative for HBsAg and positive for anti-HBcAb, and he achieved a sustained virological response (SVR). He developed hepatitis B infection without any cause at the age of 78 years. His serum was positive for HBsAg, HBeAg, and HBV DNA (4.9logIU/ml;genotype B), but negative for anti-HBc IgM and HCV RNA. A liver biopsy revealed A2F1. His serum HBsAg and HBV DNA levels became negative 2 months and 6 months after entecavir treatment, respectively. HBcrAg, the last remaining HBV marker, became negative after 2 years, and ETV treatment was completed after 27 months. No HBV reactivation was observed 4 years after the end of treatment. Full-genome HBV sequence analysis indicated that the patient was infected with HBV of subgenotype B1 and had no mutations in the S, the core promoter, and pre-core regions. This case developed de novo hepatitis B without any immunosuppressants, indicating that aging may have been responsible for the spontaneous HBV reactivation. Additionally, in this report, we summarized the reported cases of reactivation of resolved hepatitis B in elderly patients with no previous triggers.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 2","pages":"121-129"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383504","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}

{"title":"[Neuroendocrine carcinoma of the extrahepatic bile duct:a case report].","authors":"Shohei Hirano, Koji Kubota, Akira Shimizu, Tsuyoshi Notake, Tomohiko Ikehara, Yudai Kuroiwa, Kenya Nakamura, Yuji Soejima","doi":"10.11405/nisshoshi.122.59","DOIUrl":"10.11405/nisshoshi.122.59","url":null,"abstract":"<p><p>A 78-year-old male patient came to our hospital with a chief complaint of fever. Computed tomography revealed an indistinct tumor in the pancreatic head, along with dilatation of the bile duct and main pancreatic duct. An endoscopic transpapillary biopsy demonstrated adenocarcinoma in the glandular epithelium and a dense formation of quasi-round cells. Pathology results indicated positive CK AE1/AE3 and INSM-1, negative CD45, and a Ki67 index of about 80%, leading to a diagnosis of neuroendocrine carcinoma (NEC) Grade 3 of the pancreatic head. Consequently, a pancreatoduodenectomy was performed. Postoperative pathology revealed small cell NEC (SCNEC) at the pancreatic head, with infiltrative growth of atypical gland ducts around the bile ducts, indicating the presence of a well-differentiated adenocarcinoma. The adenocarcinoma contained in situ lesions and biliary intraepithelial neoplasia (BilIN), with SCNEC being contiguous. Therefore, the diagnosis was NEC originating from the extrahepatic bile duct, which invaded the pancreatic head. NEC of the extrahepatic bile duct is rare, accounting for approximately 0.2-2% of gastrointestinal neuroendocrine tumors, and it has a poor prognosis, similar to other gastrointestinal NECs, even when surgical treatment is performed. The patient remained an outpatient without recurrence 17 months postoperatively.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 1","pages":"59-67"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142980227","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}

{"title":"[Methotrexate-related lymphoproliferative disease of the ileum with fistular formation between the small bowel and rectum:a case report].","authors":"Shuya Shigenobu, Akiyoshi Tsuboi, Yuka Matsubara, Issei Hirata, Ken Yamashita, Yuji Urabe, Toshio Kuwai, Hideki Ohdan, Koji Arihiro, Shiro Oka","doi":"10.11405/nisshoshi.122.425","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.425","url":null,"abstract":"<p><p>Methotrexate (MTX), the first-line drug for rheumatoid arthritis, rarely causes malignant lymphomas, which have been reported as MTX-associated lymphoproliferative disorders (MTX-LPD). Herein, report a case of MTX-LPD in the ileum with fistula formation in the small bowel and rectum. At the end of January 2023, an 81-year-old man who had been taking MTX for rheumatoid arthritis since the age of 73 years complained of abdominal pain and was diagnosed with intestinal obstruction at a previous hospital. In the early February 2023, the patient was referred to our hospital for further examination and treatment. A computed tomography scan revealed a thickened terminal ileum wall and enlarged mesenteric lymph nodes. A retrograde double-balloon endoscopy (DBE) detected circumferential ulcerative lesions at the terminal ileum with deep depressions in parts of the ulcer base. In addition, submucosal tumor-like lesions with central depressions were observed in the rectum. Retrograde contrast imaging under DBE confirmed the presence of fistulae between the ileum and rectum. A biopsy of the ulcerative lesion revealed hyperplasia of germinal center cell-like cells, and immunohistochemistry demonstrated CD20 and CD79a positivity, but CD5, CD10, and cyclin D1 negativity. Ki-67 positivity was 90%, indicating B-cell lymphoma. Based on histopathological findings and patient's history, the patient was suspected to have MTX-LPD, resulting in ileal and high anterior rectal resection. Histopathological examination of the resected specimen revealed large atypical lymphocyte proliferation. Immunohistochemistry confirmed CD20 and CD79a positivity;CD5, CD10, and cyclin D1 negativity;a Ki-67 positivity rate of 70%;and Epstein-Barr virus-encoded small RNA in situ hybridization negativity, confirmming the MTX-LPD diagnosis, presenting as diffuse large B-cell lymphoma. Postoperatively, the patient was monitored with MTX discontinuation, and no recurrence occurred. The clinical course remained consistent with MTX-LPD.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 6","pages":"425-433"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276181","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}

{"title":"[Current status and prospects of image enhanced endoscopy in the upper gastrointestinal tract].","authors":"Mitsuru Kaise, Katsuhiko Iwakiri","doi":"10.11405/nisshoshi.122.78","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.78","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 2","pages":"78-86"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383497","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}