{"title":"[Obstructive colitis induced by laxatives during colonoscopy preparation after ischemic enteritis and improved by endoscopic fecal removal: a case report].","authors":"Hidekazu Horiuchi, Yamato Nagata, Shotaro Akiba, Kazuo Okumoto, Shigemi Hachinohe","doi":"10.11405/nisshoshi.121.904","DOIUrl":"10.11405/nisshoshi.121.904","url":null,"abstract":"<p><p>An 84-year-old male patient who was diagnosed with melena was admitted to the hospital with ischemic colitis. During the preparatory procedure for colonoscopy, he reported severe abdominal pain and exhibited decreased blood pressure. Obstructive colitis was suspected, and a colonoscopy was performed. A large amount of hard stool was found in the sigmoid colon, with ulcers and erosions exposing the submucosal layer observed on the proximal side. The endoscope was able to pass through the ileocecal region, and the patient's symptoms subsequently improved. The decline in intestinal function following ischemic enteritis may have contributed to the passage obstruction. Although fecal obstructive enterocolitis is extremely rare, caution is warranted during colonoscopy preparation.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"121 11","pages":"904-909"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629614","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":"[Small intestinal perforation manifesting as post-transplant lymphoproliferative disorder occurring 23 years after living lung transplantation: a case report].","authors":"Daisuke Kametaka, Masaya Iwamuro, Shoko Inoo, Seiji Kawano, Takehiro Tanaka, Yoshiro Kawahara, Motoyuki Otsuka","doi":"10.11405/nisshoshi.121.896","DOIUrl":"10.11405/nisshoshi.121.896","url":null,"abstract":"<p><p>A Japanese female patient underwent a living lung transplant at age 29 and has been on immunomodulatory drug therapy since then. At age 52, she presented with sudden hematochezia. Despite abdominal computed tomography scan, esophagogastroduodenoscopy, and colonoscopy, no definitive source of bleeding was identified. Considering the possibility of small bowel bleeding, video capsule endoscopy was performed, which revealed a suspected ulcerative lesion in the jejunum. Subsequent per-oral double-balloon endoscopy confirmed the presence of an ulcerative lesion in the jejunum. A potential pathological diagnosis of post-transplant lymphoproliferative disorder (PTLD) was considered based on endoscopic biopsy specimens from the jejunal lesion. However, before the pathologic biopsy results were available, the patient experienced small intestinal perforation, necessitating emergency partial resection. Pathologic examination revealed a dense proliferation of medium-to-large atypical lymphocytes with neutrophilic infiltration in the perforated area of the small intestinal wall. Immunostaining showed lymphoid cells positive for CD20 but negative for CD3. Epstein-Barr virus (EBV) -encoded RNA was detected by in situ hybridization, and Ki-67 staining demonstrated a higher percentage of positive cells. Consequently, an EBV-positive diffuse large B-cell lymphoma, developed as PTLD, was diagnosed. Complete remission was achieved with a reduced immunomodulatory drug dosage and rituximab therapy. She has been alive for 8 months postoperatively without recurrence. This case suggests that PTLD should be considered in assessing patients presenting with abdominal symptoms following organ transplantation.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"121 11","pages":"896-903"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142629632","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":"[Diagnostic yield and utility of boring biopsy for subepithelial lesions of the stomach and esophagus].","authors":"Shoma Mizuno, Keiko Fukuoka, Takahiro Ikemura, Kaede Kurokawa, Ikumi Saito, Kei Akaji, Mai Takeda, Yoshitaka Hayashi, Fumihiro Uwamori, Soichiro Umemura, Shintaro Hino, Shintaro Murakami, Ryoko Yasumatsu, Toshinobu Izumi","doi":"10.11405/nisshoshi.121.667","DOIUrl":"https://doi.org/10.11405/nisshoshi.121.667","url":null,"abstract":"<p><p>Herein, we aimed to examine the diagnostic yield and utility of boring biopsy for subepithelial lesions (SEL) of the stomach and esophagus. A total of 52 patients with SELs of the stomach or esophagus underwent boring biopsy. The diagnostic yield of boring biopsy for gastric and esophageal SELs was 50% (21/42) and 80% (8/10), and for SELs with a diameter of less than 10mm, the diagnostic yield was 67% (6/9) and 83% (5/6), respectively. Forty-three percent (9/21) of the gastric SELs were diagnosed with gastrointestinal stromal tumor (GIST), while all esophageal SELs (8/8) were leiomyomas. Ten percent (4/42) of boring biopsies for the stomach were accompanied by complications:two cases of perforation and two of bleeding.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"121 8","pages":"667-674"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141972008","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":"[Diagnostic imaging for benign and malignant biliary strictures].","authors":"Kojiro Suzuki","doi":"10.11405/nisshoshi.121.258","DOIUrl":"https://doi.org/10.11405/nisshoshi.121.258","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"121 4","pages":"258-265"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867622","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":"[Ascending colon cancer with submucosal tumor-like morphology arising near ileal valve lipohyperplasia:a case report].","authors":"Shunsuke Furukawa, Masatsugu Hiraki, Michiaki Akashi, Koichi Miyahara, Ryuichiro Samejima","doi":"10.11405/nisshoshi.121.315","DOIUrl":"https://doi.org/10.11405/nisshoshi.121.315","url":null,"abstract":"<p><p>An 89-year-old man was diagnosed with a submucosal tumor suspected to be a lipoma and was followed up for 6 years. The patient was admitted to the hospital because of increased tumor size and morphological changes despite negative bioptic findings. The lesion was diagnosed as an advanced adenocarcinoma of the ascending colon (cT3N0M0, cStage IIa). Laparoscopic-assisted right hemicolectomy with D3 lymph node dissection was performed. Pathological diagnosis of a surgically resected specimen revealed adenocarcinoma with lipohyperplasia (pT3N2aM0, pStage IIIb). Reports of colon cancer accompanied by colonic lipomas or lipohyperplasia are limited. This case showed an interesting submucosal tumor-like morphology because the cancer developed at the base of the lipohyperplasia and grew and spread below it.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"121 4","pages":"315-320"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858254","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":"[Frontiers and challenges in diagnosis and treatment for Crohn's disease -from epidemiology to treatment].","authors":"Fumihito Hirai, Shinya Ashizuka, Nobuaki Kuno","doi":"10.11405/nisshoshi.121.523","DOIUrl":"10.11405/nisshoshi.121.523","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"121 7","pages":"523-534"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581040","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}