DEN open最新文献

{"title":"Successful perforation management during esophageal endoscopic submucosal dissection using the stent-anchoring method: A case report","authors":"Mai Utsumi,&nbsp;Taro Iwatsubo,&nbsp;Kazuki Takayama,&nbsp;Shun Sasaki,&nbsp;Hironori Tanaka,&nbsp;Akitoshi Hakoda,&nbsp;Noriaki Sugawara,&nbsp;Kazuhiro Ota,&nbsp;Hiroki Nishikawa","doi":"10.1002/deo2.70114","DOIUrl":"https://doi.org/10.1002/deo2.70114","url":null,"abstract":"<p>Patients with esophageal endoscopic submucosal dissection-associated adverse events can have a severe clinical course. In this report, we describe the case of a 67-year-old male with a history of endoscopic submucosal dissection who had metachronous superficial esophageal cancer. Although endoscopic submucosal dissection was attempted for challenging lesions adjacent to the scar, perforations occurred during the procedure. We placed an esophageal fully covered self-expandable metallic stent at the perforation site to avoid emergency surgery after lesion removal. However, stent migration and displacement concerns remained, as no stenosis was observed in the esophagus. Therefore, a clip with a thread on the upper edge of the stent was placed, and this anchoring clip was useful in preventing stent migration and closing the perforation. The patient improved with conservative treatment. In conclusion, the stent placement and anchoring method with clip and thread could be a treatment option in such cases.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852785","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}

{"title":"Analysis of the treatment outcome of duodenal varices: A retrospective case series of 15 patients from a single institution","authors":"Yuri Mitamura,&nbsp;Eisuke Murakami,&nbsp;Ko Hashimoto,&nbsp;Tomoaki Emori,&nbsp;Aiko Tanaka,&nbsp;Yusuke Tanaka,&nbsp;Keiichi Hiraoka,&nbsp;Yuki Shirane,&nbsp;Masanari Kosaka,&nbsp;Yusuke Johira,&nbsp;Ryoichi Miura,&nbsp;Serami Murakami,&nbsp;Kenji Yamaoka,&nbsp;Yasutoshi Fujii,&nbsp;Shinsuke Uchikawa,&nbsp;Hatsue Fujino,&nbsp;Atsushi Ono,&nbsp;Tomokazu Kawaoka,&nbsp;Daiki Miki,&nbsp;Clair Nelson Hayes,&nbsp;Masataka Tsuge,&nbsp;Keigo Chosa,&nbsp;Kazuo Awai,&nbsp;Shiro Oka","doi":"10.1002/deo2.70119","DOIUrl":"https://doi.org/10.1002/deo2.70119","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; aims</h3>\u0000 \u0000 <p>Duodenal varices (DVs) are a rare type of ectopic varices occurring in portal hypertension, for which no standardized treatment strategy has been established. This retrospective study analyzed the outcomes of DV treatments in 15 patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Material and methods</h3>\u0000 \u0000 <p>All enrolled patients with DVs were treated at a single institution Hospital between 2011 and 2022. The treatment procedure and outcome were analyzed retrospectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six patients presented with hemorrhagic DVs. Endoscopic variceal ligation was used for initial hemostasis in five bleeding cases. Balloon-occluded retrograde transvenous obliteration was the initial treatment in nine cases, achieving curative obliteration in eight cases. Percutaneous transhepatic variceal obliteration was performed as the initial treatment in three cases for which balloon-occluded retrograde transvenous obliteration was difficult to perform for anatomical reasons, and all cases achieved curative obliterations. Splenectomy was performed as the initial treatment in three patients due to complicating gastroesophageal varices. DVs recurred in two cases with splenectomy after approximately 1 year, but balloon-occluded retrograde transvenous obliteration and percutaneous transhepatic variceal obliteration were curatively applied in each case, and no recurrence has been observed since then. Gastroesophageal varices aggravated after the initial DV treatment in eight of the 15 cases during the observation period, and the cumulative aggravating rate was 58.1% at 4 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>All 15 cases with DVs were preferably controlled by selecting appropriate treatment based on individual hemodynamics of varices. Because of the relatively high rate of aggravation of gastroesophageal varices, careful long-term follow-up may be important for the treatment of DVs.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70119","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840852","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}

{"title":"Primary aorto-enteric fistula diagnosed by double-balloon endoscopy","authors":"Momoko Yamamoto,&nbsp;Kei Nomura,&nbsp;Tomoyoshi Shibuya,&nbsp;Masashi Omori,&nbsp;Rina Odakura,&nbsp;Kentaro Ito,&nbsp;Hirofumi Fukushima,&nbsp;Osamu Nomura,&nbsp;Dai Ishikawa,&nbsp;Akihito Nagahara","doi":"10.1002/deo2.70118","DOIUrl":"https://doi.org/10.1002/deo2.70118","url":null,"abstract":"<p>A primary aorto-enteric fistula (PAEF), rarer than a secondary aorto-enteric fistula, is a direct rupture of the bowel by an abdominal aortic aneurysm (AAA). More than 54% of cases were in the duodenum, while jejunum and ileum were affected in only 15% of cases.</p><p>An 82-year-old woman with hematemesis and hematochezia was admitted to our hospital emergently. Upper and lower endoscopies did not reveal the source of bleeding. We performed an urgent antegrade double-balloon endoscopy, revealing a submucosal tumor-like protuberance with an ulcer in the jejunum. These findings raised suspicion by PAEF. Subsequent computed tomography showed free air near the AAA, confirming PAEF as the hemorrhage source. An abdominal aortic stent graft was implanted, followed by laparotomy. An adhesion between the AAA and small intestinal wall was found. Postoperative recovery was uneventful, with no recurrence observed. This case underscores the importance of considering PAEF as a potential diagnosis in patients with gastrointestinal bleeding and a history of AAA. Endoscopists should be aware of submucosal tumor such as in this case to avoid misdiagnosing PAEF, as diagnosis and intervention are crucial for favorable outcomes.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840849","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}

{"title":"Small bowel metastasis from endometrial cancer presenting as a bowel obstruction: A case report with literature review","authors":"Yasuhiko Hamada,&nbsp;Hiroki Yukimoto,&nbsp;Yohei Ikenoyama,&nbsp;Yuhei Umeda,&nbsp;Yasuko Fujiwara,&nbsp;Akina Shigefuku,&nbsp;Hiroto Suzuki,&nbsp;Misaki Nakamura,&nbsp;Noriyuki Horiki,&nbsp;Hayato Nakagawa","doi":"10.1002/deo2.70117","DOIUrl":"https://doi.org/10.1002/deo2.70117","url":null,"abstract":"<p>This report describes a rare case of small bowel metastasis from endometrial cancer, diagnosed six years after initial treatment. A 62-year-old woman with a history of grade 2 stage IA endometrial cancer, previously treated with hysterectomy and bilateral salpingo-oophorectomy, presented with intermittent abdominal pain and nausea. Imaging studies revealed small bowel obstruction and balloon-assisted enteroscopy identified an annular ulcer with luminal narrowing in the jejunum. Histopathological examination of the biopsy specimen suggested carcinoma; however, its primary origin remained unclear. Subsequent surgical resection confirmed metastatic endometrial adenocarcinoma based on immunohistochemical analysis, which demonstrated positivity for estrogen receptor and paired box gene 8, while CK7, CK20, and CDX2 were negative. Following surgery, the patient experienced symptomatic relief, and no additional metastatic lesions were detected, leading to a conservative follow-up strategy. This case highlights the diagnostic utility of balloon-assisted enteroscopy in detecting rare small bowel metastases. Given that such metastases often remain asymptomatic until reaching an advanced stage, early identification is critical. Furthermore, immunohistochemical profiling plays a crucial role in distinguishing metastatic endometrial cancer from other primary small bowel malignancies. Endoscopists should maintain a high index of suspicion for metastatic involvement in patients with a history of endometrial cancer who present with unexplained gastrointestinal symptoms.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840631","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}

{"title":"Efficacy and safety of oral sulfate solution versus polyethylene glycol for colonoscopy: A systematic review and meta-analysis of randomized controlled trials","authors":"Umar Akram,&nbsp;Shahzaib Ahmed,&nbsp;Eeshal Fatima,&nbsp;Eeman Ahmad,&nbsp;Hamza Ashraf,&nbsp;Syed Adeel Hassan,&nbsp;Zaheer Qureshi,&nbsp;Faryal Altaf,&nbsp;Daniel Buckles,&nbsp;Javed Iqbal,&nbsp;Khabab Abbasher Hussien Mohamed Ahmed","doi":"10.1002/deo2.70113","DOIUrl":"https://doi.org/10.1002/deo2.70113","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colonoscopy is the gold standard for early detection and monitoring of colorectal cancer. Procedural effectiveness is dependent on optimal bowel preparation. Traditional polyethylene glycol (PEG) solutions are difficult to tolerate, whereas newer low-volume alternatives, including PEG with ascorbic acid and oral sulfate solutions (OSS), offer improved efficacy and tolerability. The meta-analysis was performed to evaluate the efficacy and safety of OSS compared to PEG for bowel preparation in colonoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies were identified by searching PubMed, Embase, Cochrane CENTRAL, and clinicaltrials.gov from inception until June 2024. Only randomized controlled trials comparing OSS with PEG were included. Data was analyzed using R version 4.4.0 using a random effects model to calculate risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-one studies with 6346 participants met the inclusion criteria. OSS significantly improved adenoma detection (RR, 1.13; 95% CI, 1.04–1.22; <i>p</i>-value &lt;0.01; I² = 0%) and polyp detection rates (RR, 1.16; 95% CI, 1.06–1.26; <i>p</i>-value &lt;0.01; I² = 0%), and had a higher Boston Bowel Preparation Scale (BBPS) score (MD, 0.31; 95% CI, 0.13–0.50; <i>p</i>-value &lt;0.01; I² = 81%). PEG was associated with more sleep disturbances (RR, 0.45; 95% CI, 0.25–0.82; <i>p</i>-value = 0.03; I² = 0%). However, other adverse effects were similar between both solutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>OSS demonstrated superior adenoma and polyp detection rates. When compared to PEG, patients utilizing OSS achieved higher BBPS scores. Data gleaned support enhanced cleansing efficacy and safety of OSS as a bowel preparation regimen.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70113","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143840565","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}

{"title":"Guidewire-assisted successful closure of mis-punctured transverse colon during endoscopic ultrasound-guided cyst drainage","authors":"Naoki Fujita,&nbsp;Hideki Kamada,&nbsp;Ryota Nakabayashi,&nbsp;Takuma Yamashita,&nbsp;Shima Mimura,&nbsp;Hiroki Yamana,&nbsp;Kiyoyuki Kobayashi,&nbsp;Minoru Oshima,&nbsp;Keiichi Okano,&nbsp;Hideki Kobara","doi":"10.1002/deo2.70112","DOIUrl":"https://doi.org/10.1002/deo2.70112","url":null,"abstract":"<p>Endoscopic ultrasound-guided cyst drainage (EUS-CD) was performed for walled-off pancreatic necrosis. Computed tomography performed the next day showed that the tip of the external drainage tube was located in the transverse colon, confirming an accidental EUS-CD-associated complication of mis-puncture. A colonoscopy was performed to confirm the puncture site, which was identified as a defect measuring 2 mm in diameter. The external drainage tube was removed immediately via a guidewire. We intentionally retained the guidewire as a landmark for the puncture site in the colon. The defect was approximated using an endoclip under full vision, with the guidewire covered with surrounding mucosa. After removing the guidewire smoothly, complete closure was achieved with additional endoclips. Four days later, EUS-CD was successfully repeated, resulting in the resolution of the walled-off pancreatic necrosis. This is the first known case in which an accidental puncture of the transverse colon occurred during EUS-CD for walled-off pancreatic necrosis, and guidewire-guided clip closure of the colon contributed to troubleshooting.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70112","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143818676","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}

{"title":"Successful conservative management of delayed perforation following endoscopic submucosal dissection of the esophagus: A case report","authors":"Sachiyo Onishi,&nbsp;Jun Takada,&nbsp;Kiichi Otani,&nbsp;Naoya Masuda,&nbsp;Hiroki Taniguchi,&nbsp;Kentaro Kojima,&nbsp;Masaya Kubota,&nbsp;Takashi Ibuka,&nbsp;Takuji Iwashita,&nbsp;Masahito Shimizu","doi":"10.1002/deo2.70115","DOIUrl":"https://doi.org/10.1002/deo2.70115","url":null,"abstract":"<p>Delayed perforation after esophageal endoscopic submucosal dissection is a rare complication that may result in severe outcomes. Here, we report a case of delayed perforation that was successfully managed with conservative treatment. A 72-year-old male with hypertensive renal failure and on maintenance hemodialysis underwent endoscopic submucosal dissection for a 2/3 circumferential superficial esophageal cancer in the middle thoracic esophagus, involving resection of 4/5 of the esophageal circumference. Locoregional steroid injections were administered after resection to prevent stenosis. No perforation occurred during the procedure; however, delayed perforation was identified on postoperative day 3. Endoscopy revealed necrosis and brittleness in a large area of the post-endoscopic submucosal dissection ulcer. The patient developed fever and mediastinal emphysema, and endoscopic attempts to close the perforation were unsuccessful. Conservative management—including fasting, antibiotics, and subsequent drainage—was initiated. The patient's condition improved with drainage tube placement, enteral nutrition, and antibiotic administration. A follow-up computed tomography scan on postoperative day 56 confirmed the resolution of mediastinal emphysema, and endoscopy revealed that the perforation healed with scarring. This case highlights that surgery may be avoided if appropriate treatment is initiated as early as possible, including drainage to prevent exposure to gastric and intestinal fluids, early initiation of enteral nutrition, rehabilitation to maintain strength, and blood transfusions as supportive care.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70115","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801391","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}

{"title":"Visibility evaluation of gastric epithelial neoplasm of fundic gland mucosa lineage using texture and color enhancement imaging","authors":"Hisanori Utsunomiya,&nbsp;Hiroya Ueyama,&nbsp;Tsutomu Takeda,&nbsp;Shunsuke Nakamura,&nbsp;Yasuko Uemura,&nbsp;Tomoyo Iwano,&nbsp;Momoko Yamamoto,&nbsp;Ryota Uchida,&nbsp;Daiki Abe,&nbsp;Shotaro Oki,&nbsp;Nobuyuki Suzuki,&nbsp;Atsushi Ikeda,&nbsp;Yoichi Akazawa,&nbsp;Kumiko Ueda,&nbsp;Mariko Hojo,&nbsp;Shuko Nojiri,&nbsp;Takashi Yao,&nbsp;Akihito Nagahara","doi":"10.1002/deo2.70110","DOIUrl":"https://doi.org/10.1002/deo2.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Recently, the incidence of Helicobacter pylori-uninfected gastric cancers, such as gastric epithelial neoplasm of fundic-gland mucosa lineage (GEN-FGML), has increased with the widespread use of eradication therapy. Because the detection and endoscopic diagnosis of GEN-FGML are difficult, an effective observation method in screening endoscopy is required. We investigated whether texture and color enhancement imaging (TXI) improved the visibility of GEN-FGML compared with white light imaging (WLI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this single-center prospective clinical study, 50 GEN-FGML lesions (35 patients) treated at our hospital between October 2020 and June 2023 were analyzed. The endoscopic images of GEN-FGML obtained using WLI, TXI mode 1 (TXI-1), TXI mode 2 (TXI-2), and narrow-band imaging were compared by 10 endoscopists. We analyzed the visibility score and inter-rater reliability (intraclass correlation coefficient and conducted an objective evaluation based on <i>L* a* b*</i> color values and the color difference (Δ<i>E*</i>) in the CIE LAB color space system.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histologically, GEN-FGML was classified as gastric adenocarcinoma of fundic-gland type (<i>n</i> = 45) and gastric adenocarcinoma of fundic-gland mucosa type (<i>n</i> = 5). The total visibility score for all endoscopists was significantly higher for TXI than for WLI (<i>p</i> &lt; 0.01); and for TXI-1 than for TXI-2 (<i>p</i> &lt; 0.01). The intraclass correlation coefficients for TXI-1 and TXI-2 were “almost perfect” and “substantial,” respectively, for all endoscopists. Δ<i>E*</i> was significantly higher for TXI than for WLI (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>TXI improved the visibility of GEN-FGML for all endoscopists compared with WLI when evaluated subjectively and objectively.</p>\u0000 </section>\u0000 </div>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801689","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}

{"title":"A case report of Barrett's esophageal adenocarcinoma in a young adult aged 20 years","authors":"Takayuki Ohi,&nbsp;Fumisato Sasaki,&nbsp;Nobuhisa Maeda,&nbsp;Shohei Uehara,&nbsp;Hidehito Maeda,&nbsp;Akihito Tanaka,&nbsp;Shuji Kanmura,&nbsp;Akihiro Yamasuji,&nbsp;Akio Ido","doi":"10.1002/deo2.70111","DOIUrl":"https://doi.org/10.1002/deo2.70111","url":null,"abstract":"<p>In Japan, the prevalence of Barrett's esophageal adenocarcinoma (BEA) has recently increased owing to a decrease in the number of patients with <i>Helicobacter pylori</i> infection, westernization of the diet, and an increase in obesity prevalence. However, BEA in patients in their 20s is extremely rare. Our patient was a 20-year-old Japanese woman with chief complaints of vomiting and nausea. Esophagogastroduodenoscopy was performed to investigate the cause of vomiting, and a raised lesion was found in the gastroesophageal junctional zone. In the magnified observation, the mucosal pattern of the lesion was partially invisible, and the vascular pattern was irregular; the lesion was diagnosed based on the Japan Esophageal Society classification for Barrett's esophagus -related superficial neoplasia. Endocytoscopic observations revealed a highly irregular glandular structure. Computed tomography showed no distant metastasis. Based on these results, we diagnosed BEA as short-segment Barrett's esophagus and performed an endoscopic submucosal dissection. The pathological diagnosis was pT1a-DMM. It was a well-differentiated adenocarcinoma and was treated with curative resection.</p><p>BEA is extremely rare in young adults in their 20s. Nonetheless, appropriate surveillance is required for patients with multiple risk factors, including obesity and exposure to acid and bile resulting from persistent vomiting.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70111","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793556","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}

{"title":"An unusual case of polyp with multiple appears honeycomb-like depressions","authors":"Makoto Koda,&nbsp;Ikuro Koba,&nbsp;Taku Morita,&nbsp;Kazuhide Shimamatsu,&nbsp;Araki Toshihiro,&nbsp;Takumi Kawaguchi,&nbsp;Takuji Torimura","doi":"10.1002/deo2.70106","DOIUrl":"https://doi.org/10.1002/deo2.70106","url":null,"abstract":"<p>The patient is a 63-year-old woman. She underwent lower gastrointestinal endoscopy at her local doctor, and a serrated lesion with a honeycomb-like depression in the surface mucosa of the ascending colon measuring 35 mm in size was observed. The lesion was thought to be a sessile serrated lesion (SSL), but since there was a lot of mucus and it was difficult to observe the inside of the depression, SSL with dysplasia was also mentioned as a possible diagnosis. The patient was referred to our department and underwent endoscopic submucosal dissection of the colon. The pathological results showed no dysplasia component, and the diagnosis of SSL with inverted growth was made. Inverted SSL has been reported in the past, but a lesion with a honeycomb-like depression has never been reported before, making this an interesting lesion. We report here the mechanism of the depression and the morphology of the depression, together with a review of the literature.</p>","PeriodicalId":93973,"journal":{"name":"DEN open","volume":"5 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/deo2.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740983","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}