: Here we report the cases of eight patients who developed small bowel obstruction and/or gastric ulcers after ingesting rice cake, the traditional Asian food, and were managed conservatively. This report adds to the existing literature on gastrointestinal disorders induced by rice cake ingestion, which are characterized by gastrointestinal obstruction, perforation, and ulceration and are occasionally accompanied by peritonism. These conditions tend to occur in 50-60-year-old males who wear dentures or eat rapidly. Therapeutically, hard rice cake remnants in the upper gastrointestinal tract can be broken up by endoscopic snaring and can be detected by computed tomography as homogeneous high-density material at approximately 145 (range:120-206) Hounsfield units.
{"title":"餅により消化管障害（イレウス，潰瘍）をきたした8症例の検討―CT診断の有用性―","authors":"明彦 岡, 祐二 天野, 靖 内田, 幸司 香川, 健人 高取, 直人 北嶋, 浩紀 園山, 育賢 多田, 龍策 楠, 暢彦 福庭, 直樹 大嶋, 一郎 森山, 崇史 結城, 耕作 川島, 俊治 石原, 芳一 木下","doi":"10.11405/NISSHOSHI.110.1804","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1804","url":null,"abstract":": Here we report the cases of eight patients who developed small bowel obstruction and/or gastric ulcers after ingesting rice cake, the traditional Asian food, and were managed conservatively. This report adds to the existing literature on gastrointestinal disorders induced by rice cake ingestion, which are characterized by gastrointestinal obstruction, perforation, and ulceration and are occasionally accompanied by peritonism. These conditions tend to occur in 50-60-year-old males who wear dentures or eat rapidly. Therapeutically, hard rice cake remnants in the upper gastrointestinal tract can be broken up by endoscopic snaring and can be detected by computed tomography as homogeneous high-density material at approximately 145 (range:120-206) Hounsfield units.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"131 32","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"113939970","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}
: We monitored the management of acute cholecystitis in a rural area of Japan to determine the effectiveness of new guidelines for the management of acute cholecystitis and cholangitis. Between January 2000 and September 2011, 366 patients were treated for acute cholecystitis. Of these, 59 had common bile duct stones (CBDS) and 307 did not. Patients in both groups were further subdivided into two groups: a before guidelines group (BGG; n=153) and an after guideline group (AGG; n=154). Among the patients without CBDS, early cholecystectomy was more common in the AGG group (n=53) than in the BGG group. Furthermore, the length of hospital stay was four days shorter in the AGG group than in the BGG group (n=23). Among the patients with CBDS, the timing of cholecystectomy after endoscopic retrograde cholangiography was seven days earlier in the AGG group than in the BGG group. Even in a rural area of Japan, early cholecystectomy appears safe and can decrease the length of hospital stay.
{"title":"当院における急性胆嚢炎診療の現状―急性胆管炎・胆嚢炎の診療ガイドラインの影響―","authors":"泰史 山崎, 龍太 竹中, 倫子 岡崎, 雄己 馬場, 健太 濱田, 裕基 高山, 浩二 竹本, 明彦 平良, 浩史 柘野, 康浩 窪田, 同輔 林, 茂篤 藤木","doi":"10.11405/NISSHOSHI.110.1774","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1774","url":null,"abstract":": We monitored the management of acute cholecystitis in a rural area of Japan to determine the effectiveness of new guidelines for the management of acute cholecystitis and cholangitis. Between January 2000 and September 2011, 366 patients were treated for acute cholecystitis. Of these, 59 had common bile duct stones (CBDS) and 307 did not. Patients in both groups were further subdivided into two groups: a before guidelines group (BGG; n=153) and an after guideline group (AGG; n=154). Among the patients without CBDS, early cholecystectomy was more common in the AGG group (n=53) than in the BGG group. Furthermore, the length of hospital stay was four days shorter in the AGG group than in the BGG group (n=23). Among the patients with CBDS, the timing of cholecystectomy after endoscopic retrograde cholangiography was seven days earlier in the AGG group than in the BGG group. Even in a rural area of Japan, early cholecystectomy appears safe and can decrease the length of hospital stay.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"88 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114700510","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}
: A 23-year-old woman was admitted with a relapse of ulcerative colitis. Tacrolimus therapy was initiated following inadequate response to corticosteroid therapy. Although the symptoms partially improved, she suddenly developed severe pain localized to the lower limbs on day 16 of tacrolimus therapy. By day 17, she was unable to move. Magnetic resonance imaging revealed born marrow edema in the lower limbs. We suspected calcineurin-inhibitor induced pain syndrome (CIPS) due to tacrolimus therapy. The pain improved within approximately four weeks of tacrolimus cessation. CIPS that is not associated with organ transplantation is a rare occurrence. Here we report a rare case of CIPS that was caused by tacrolimus therapy in a patient with ulcerative colitis.
{"title":"潰瘍性大腸炎治療中にcalcineurin-inhibitor induced pain syndrome（CIPS）を合併した1例","authors":"敏浩 只野, 広喜 高橋, 菅原 かおり, 杉村 美華子, 正広 岩渕, 浩 真野, 克明 鵜飼, 慶一 田所, 芳正 森","doi":"10.11405/NISSHOSHI.110.1783","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1783","url":null,"abstract":": A 23-year-old woman was admitted with a relapse of ulcerative colitis. Tacrolimus therapy was initiated following inadequate response to corticosteroid therapy. Although the symptoms partially improved, she suddenly developed severe pain localized to the lower limbs on day 16 of tacrolimus therapy. By day 17, she was unable to move. Magnetic resonance imaging revealed born marrow edema in the lower limbs. We suspected calcineurin-inhibitor induced pain syndrome (CIPS) due to tacrolimus therapy. The pain improved within approximately four weeks of tacrolimus cessation. CIPS that is not associated with organ transplantation is a rare occurrence. Here we report a rare case of CIPS that was caused by tacrolimus therapy in a patient with ulcerative colitis.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"315 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116119799","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}
Pub Date : 2013-09-05DOI: 10.11405/NISSHOSHI.110.1640
T. Ogura, Y. Kurisu, Daisuke Masuda, Y. Inoue, M. Takii, Akira Imoto, S. Edogawa, H. Ohama, M. Teranishi, M. Hayashi, E. Umegaki, K. Uchiyama, K. Higuchi
An elderly man in his 70s presented with pain in the right hypochondrium. Computed tomography revealed thickening of the gall bladder wall and liver invasion. In addition, fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed an abnormal accumulation in the gall bladder, leading to a suspicion of gall bladder carcinoma. To confirm the diagnosis, endoscopic ultrasound-guided fine-needle aspiration was performed, which revealed a diagnosis of xanthogranulomatous cholecystitis (XGC). FDG-PET revealed decreased wall thickness and standardized uptake value a month later. Cholecystectomy was performed on the basis of a histological and clinical diagnosis of XGC. Histological examination revealed inflammatory and foamy cells and exuberant granulation of the gall bladder wall, confirming XGC.
{"title":"EUS-FNAで診断し，FDG-PETによる経時的変化を観察しえた黄色肉芽腫性胆嚢炎の1例","authors":"T. Ogura, Y. Kurisu, Daisuke Masuda, Y. Inoue, M. Takii, Akira Imoto, S. Edogawa, H. Ohama, M. Teranishi, M. Hayashi, E. Umegaki, K. Uchiyama, K. Higuchi","doi":"10.11405/NISSHOSHI.110.1640","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1640","url":null,"abstract":"An elderly man in his 70s presented with pain in the right hypochondrium. Computed tomography revealed thickening of the gall bladder wall and liver invasion. In addition, fluorine-18-fluorodeoxyglucose positron emission tomography (FDG-PET) revealed an abnormal accumulation in the gall bladder, leading to a suspicion of gall bladder carcinoma. To confirm the diagnosis, endoscopic ultrasound-guided fine-needle aspiration was performed, which revealed a diagnosis of xanthogranulomatous cholecystitis (XGC). FDG-PET revealed decreased wall thickness and standardized uptake value a month later. Cholecystectomy was performed on the basis of a histological and clinical diagnosis of XGC. Histological examination revealed inflammatory and foamy cells and exuberant granulation of the gall bladder wall, confirming XGC.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"146 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116501983","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}
Pub Date : 2013-08-05DOI: 10.11405/NISSHOSHI.110.1439
修 新井, 貴之 飯田, 仁郎 阿部, 文利 渡邊, 眞一 中村, 洋行 花井
: We describe a rare case of ulcerative colitis (UC) with lymphoid follicular proctitis (LFP) extending discontinuously from the rectum to the ascending colon. The patient was a 42-year-old female presenting with a positive fecal occult blood test. Colonoscopy revealed erosions and disappearance of vascular patterns in the ascending colon and lower rectum, together with circumferential, uniform, granular lesions in the lower rectum. Histological examinations of the rectal biopsy specimens revealed lymphoid follicles, hyperplasia, and infiltration of chronic inflammatory cells. We suspected rectal and segmental UC with LFP. Initially, the patient was managed conservatively because of the lack of symptoms; however, on developing mucoid stools and haematochezia, mesalazine administration was started. Her symptoms and endoscopic findings resolved completely. LFP is closely associated with UC. Therefore, while diagnosing and managing LFP, it is necessary to ascertain or rule out potential complications.
{"title":"Lymphoid follicular proctitisをともなった潰瘍性大腸炎の1例","authors":"修 新井, 貴之 飯田, 仁郎 阿部, 文利 渡邊, 眞一 中村, 洋行 花井","doi":"10.11405/NISSHOSHI.110.1439","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1439","url":null,"abstract":": We describe a rare case of ulcerative colitis (UC) with lymphoid follicular proctitis (LFP) extending discontinuously from the rectum to the ascending colon. The patient was a 42-year-old female presenting with a positive fecal occult blood test. Colonoscopy revealed erosions and disappearance of vascular patterns in the ascending colon and lower rectum, together with circumferential, uniform, granular lesions in the lower rectum. Histological examinations of the rectal biopsy specimens revealed lymphoid follicles, hyperplasia, and infiltration of chronic inflammatory cells. We suspected rectal and segmental UC with LFP. Initially, the patient was managed conservatively because of the lack of symptoms; however, on developing mucoid stools and haematochezia, mesalazine administration was started. Her symptoms and endoscopic findings resolved completely. LFP is closely associated with UC. Therefore, while diagnosing and managing LFP, it is necessary to ascertain or rule out potential complications.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129363598","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}
Reports of pyogenic liver abscess (PLA) caused by the Streptococcus anginosus group (SAG) have increased. Coinfection with SAG and anaerobic bacteria enhances the tendency for abscess formation. Furthermore, it has been reported that SAG infection results in pylethrombophlebitis as a complication. We experienced 3 cases of PLA caused by SAG: one case was complicated by the development of pylethrombophlebitis and the other 2 cases had coinfection with anaerobic bacteria. We report these cases together with bibliographic consideration of 23 cases previously reported in Japan.
{"title":"Streptococcus anginosus groupによる化膿性肝膿瘍の3症例","authors":"隆太 重福, 通博 鈴木, 稔 小林, 陽介 路川, 哲也 平石, 裕喜 池田, 秀明 高橋, 松永 光太郎, 俊哉 石井, 伸行 松本, 千晃 奥瀬, 明弘 佐藤, 文生 伊東","doi":"10.11405/NISSHOSHI.110.1468","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1468","url":null,"abstract":"Reports of pyogenic liver abscess (PLA) caused by the Streptococcus anginosus group (SAG) have increased. Coinfection with SAG and anaerobic bacteria enhances the tendency for abscess formation. Furthermore, it has been reported that SAG infection results in pylethrombophlebitis as a complication. We experienced 3 cases of PLA caused by SAG: one case was complicated by the development of pylethrombophlebitis and the other 2 cases had coinfection with anaerobic bacteria. We report these cases together with bibliographic consideration of 23 cases previously reported in Japan.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"238 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116391640","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}
Pub Date : 2013-08-01DOI: 10.11405/NISSHOSHI.110.1481
T. Tomoda, T. Ueki, S. Saito, M. Tatsukawa, Toru Nawa, Hiromi Hamamoto, H. Endo, K. Yabushita, T. Shimoe, K. Sakaguchi
: We report a case of a 47-year-old female patient with ceftriaxone (CTRX)-associated pseudolithiasis. CTRX was administered at a dosage of 2g/day for 8 days because of colonic diverticulitis. A routine abdominal computed tomography (CT) scan was performed to investigate the diverticulitis. However, the CT scan demonstrated stones and sludge in the gallbladder, which had not been present before CTRX administration. Therefore, we diagnosed the patient with pseudolithiasis caused by CTRX and stopped CTRX administration. The stones and sludge disappeared 6 days after stopping CTRX administration. This underreported adverse effect of CTRX should be considered when treating both children and adult patients.
{"title":"薬剤中止により速やかに消失したセフトリアキソン（CTRX）による偽胆石の1成人例","authors":"T. Tomoda, T. Ueki, S. Saito, M. Tatsukawa, Toru Nawa, Hiromi Hamamoto, H. Endo, K. Yabushita, T. Shimoe, K. Sakaguchi","doi":"10.11405/NISSHOSHI.110.1481","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.1481","url":null,"abstract":": We report a case of a 47-year-old female patient with ceftriaxone (CTRX)-associated pseudolithiasis. CTRX was administered at a dosage of 2g/day for 8 days because of colonic diverticulitis. A routine abdominal computed tomography (CT) scan was performed to investigate the diverticulitis. However, the CT scan demonstrated stones and sludge in the gallbladder, which had not been present before CTRX administration. Therefore, we diagnosed the patient with pseudolithiasis caused by CTRX and stopped CTRX administration. The stones and sludge disappeared 6 days after stopping CTRX administration. This underreported adverse effect of CTRX should be considered when treating both children and adult patients.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116861839","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}
The perivascular epithelioid cell family of tumors (PEComas) includes common lesions such as angiomyolipomas, lymphangioleiomyomas, and clear cell "sugar" tumors of the lung. Less frequently, PEComas arise in various other locations throughout the body, including the soft tissue, bone, and the visceral organs. We report the case of a 64-year-old man who underwent total cystectomy because of a primary malignant PEComa of the bladder in August 2010. The patient was treated with the mammalian target of rapamycin inhibitor for lung and bone metastasis from April 2011 and showed stable disease. Computed tomography showed a growing mass in the neck of the gallbladder 5 months later, which was suspected to be gallbladder cancer. Cholecystectomy and lymphadenectomy was performed in February 2012, and histopathological examination indicated gallbladder metastasis from the primary malignant PEComa of the bladder. This is, to our knowledge, the first report of malignant PEComa metastasis to the gallbladder.
{"title":"膀胱原発悪性血管周囲類上皮細胞腫瘍（PEComa）胆嚢転移の1例","authors":"宏義 千堂, 仁稔 原田, 寛 長谷川, 貴志 安田, 忠敬 大原, 太郎 押切, 賢一 田中, 泰宏 藤野, 正寛 富永","doi":"10.11405/NISSHOSHI.110.861","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.861","url":null,"abstract":"The perivascular epithelioid cell family of tumors (PEComas) includes common lesions such as angiomyolipomas, lymphangioleiomyomas, and clear cell \"sugar\" tumors of the lung. Less frequently, PEComas arise in various other locations throughout the body, including the soft tissue, bone, and the visceral organs. We report the case of a 64-year-old man who underwent total cystectomy because of a primary malignant PEComa of the bladder in August 2010. The patient was treated with the mammalian target of rapamycin inhibitor for lung and bone metastasis from April 2011 and showed stable disease. Computed tomography showed a growing mass in the neck of the gallbladder 5 months later, which was suspected to be gallbladder cancer. Cholecystectomy and lymphadenectomy was performed in February 2012, and histopathological examination indicated gallbladder metastasis from the primary malignant PEComa of the bladder. This is, to our knowledge, the first report of malignant PEComa metastasis to the gallbladder.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123829680","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}
Pub Date : 2013-05-05DOI: 10.11405/NISSHOSHI.110.825
M. Natsume, Hitoshi Sano, Shigeki Fukusada, Kenta Kachi, T. Inoue, Kaiki Anbe, Hirotada Nishie, Yuji Nishi, Norihiro Yoshimura, Takashi Mizushima, Fumihiro Okumura, Katsuyuki Miyabe, Itaru Naitoh, K. Hayashi, Takahiro Nakazawa
Diagnosis and treatment of biliary tract disease requires an intraductal radiocontrast agent. Although iodine-based contrast medium is commonly used, some patients show severe allergy to iodinated contrast agent. We have retrospectively reviewed the usefulness and safety of gadolinium as an alternative radiocontrast agent in 3 patients with allergy to iodine-based contrast medium in the diagnosis and treatment of biliary tract diseases. In case 1, percutaneous transhepatic biliary drainage and cholangiography were performed successfully and it was possible to visualize an intrahepatic bile duct stone. Percutaneous transhepatic cholangioscopic lithotomy was performed and the intrahepatic bile duct stone was removed. In case 2, endoscopic biliary lithotripsy was performed. In case 3, percutaneous transhepatic cholangiography and cholangioscopy provided a diagnosis of moderately differentiated carcinoma. He underwent pancreatoduodenectomy. Postoperative cholangiograms were also obtained successfully. Gadolinium contrast agent is an alternative to iodine-based cholangiography for the patients with allergy to iodine.
{"title":"ヨードアレルギーを有する胆道疾患診断治療におけるガドリニウム造影剤 (ガドペンテト酸ジメグルミン) の使用経験","authors":"M. Natsume, Hitoshi Sano, Shigeki Fukusada, Kenta Kachi, T. Inoue, Kaiki Anbe, Hirotada Nishie, Yuji Nishi, Norihiro Yoshimura, Takashi Mizushima, Fumihiro Okumura, Katsuyuki Miyabe, Itaru Naitoh, K. Hayashi, Takahiro Nakazawa","doi":"10.11405/NISSHOSHI.110.825","DOIUrl":"https://doi.org/10.11405/NISSHOSHI.110.825","url":null,"abstract":"Diagnosis and treatment of biliary tract disease requires an intraductal radiocontrast agent. Although iodine-based contrast medium is commonly used, some patients show severe allergy to iodinated contrast agent. We have retrospectively reviewed the usefulness and safety of gadolinium as an alternative radiocontrast agent in 3 patients with allergy to iodine-based contrast medium in the diagnosis and treatment of biliary tract diseases. In case 1, percutaneous transhepatic biliary drainage and cholangiography were performed successfully and it was possible to visualize an intrahepatic bile duct stone. Percutaneous transhepatic cholangioscopic lithotomy was performed and the intrahepatic bile duct stone was removed. In case 2, endoscopic biliary lithotripsy was performed. In case 3, percutaneous transhepatic cholangiography and cholangioscopy provided a diagnosis of moderately differentiated carcinoma. He underwent pancreatoduodenectomy. Postoperative cholangiograms were also obtained successfully. Gadolinium contrast agent is an alternative to iodine-based cholangiography for the patients with allergy to iodine.","PeriodicalId":341053,"journal":{"name":"The Japanese journal of gastro-enterology","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2013-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114091746","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}
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