A 74-year-old male patient with upper abdominal pain visited the outpatient clinic. A computed tomography scan revealed pancreatic enlargement, increased density of the surrounding fatty tissue, and retroperitoneal emphysema, which collectively indicated to emphysematous pancreatitis. Upper gastrointestinal endoscopy revealed no gastrointestinal perforation. His treatment regimen included fasting, fluid replacement, antibiotics, and total parenteral nutrition. Temporary encapsulation was observed, but eventually improved. A common bile duct stone was later discovered, and thus endoscopic lithotripsy was performed. Acute pancreatitis-induced retroperitoneal emphysema is referred to as emphysematous pancreatitis and is considered a subtype of necrotizing pancreatitis. Emphysematous pancreatitis is a rare disease with a poor prognosis;nonetheless, early diagnosis including confirmation of gastrointestinal perforation, and antibiotic administration along with drainage are required.
{"title":"[Emphysematous pancreatitis improved by conservative treatment: a case report].","authors":"Soshi Oyama, Hidekazu Horiuchi, Shotaro Akiba, Kazuo Okumoto, Shigemi Hachinohe","doi":"10.11405/nisshoshi.123.66","DOIUrl":"10.11405/nisshoshi.123.66","url":null,"abstract":"<p><p>A 74-year-old male patient with upper abdominal pain visited the outpatient clinic. A computed tomography scan revealed pancreatic enlargement, increased density of the surrounding fatty tissue, and retroperitoneal emphysema, which collectively indicated to emphysematous pancreatitis. Upper gastrointestinal endoscopy revealed no gastrointestinal perforation. His treatment regimen included fasting, fluid replacement, antibiotics, and total parenteral nutrition. Temporary encapsulation was observed, but eventually improved. A common bile duct stone was later discovered, and thus endoscopic lithotripsy was performed. Acute pancreatitis-induced retroperitoneal emphysema is referred to as emphysematous pancreatitis and is considered a subtype of necrotizing pancreatitis. Emphysematous pancreatitis is a rare disease with a poor prognosis;nonetheless, early diagnosis including confirmation of gastrointestinal perforation, and antibiotic administration along with drainage are required.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"66-72"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960493","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 72-year-old male patient with jaundice and hilar bile duct stenosis, initially suspected to have cholangiocarcinoma, was referred to our hospital. Subsequent cholangiography revealed bile duct stenosis improvement, and intraductal ultrasonography demonstrated homogeneous bile duct wall thickening. The increased serum immunoglobulin G4 (IgG4) levels and the presence of other organ lesions possibly indicated to IgG4-related sclerosing cholangitis (IgG4-SC). After 2 months, the patient developed acute cholecystitis. Endoscopic ultrasonography revealed circumferential wall thickening that extended from the common bile duct to the cystic duct. Cholangiography demonstrated cholecystic duct stenosis. The cholecystitis might have originated from bile stasis caused by cystic duct stenosis associated with IgG4-SC. Consequently, both IgG4-SC and the cholecystitis improved with steroid treatment.
{"title":"[Acute cholecystitis associated with IgG4-related sclerosing cholangitis: a case report].","authors":"Shoichiro Yoneyama, Ichitaro Horiuchi, Nobukazu Sasaki, Masafumi Minamisawa, Shohei Kondo, Takumi Yanagisawa, Masato Kamakura, Yasuhiro Kuraishi, Akira Nakamura","doi":"10.11405/nisshoshi.123.57","DOIUrl":"https://doi.org/10.11405/nisshoshi.123.57","url":null,"abstract":"<p><p>A 72-year-old male patient with jaundice and hilar bile duct stenosis, initially suspected to have cholangiocarcinoma, was referred to our hospital. Subsequent cholangiography revealed bile duct stenosis improvement, and intraductal ultrasonography demonstrated homogeneous bile duct wall thickening. The increased serum immunoglobulin G4 (IgG4) levels and the presence of other organ lesions possibly indicated to IgG4-related sclerosing cholangitis (IgG4-SC). After 2 months, the patient developed acute cholecystitis. Endoscopic ultrasonography revealed circumferential wall thickening that extended from the common bile duct to the cystic duct. Cholangiography demonstrated cholecystic duct stenosis. The cholecystitis might have originated from bile stasis caused by cystic duct stenosis associated with IgG4-SC. Consequently, both IgG4-SC and the cholecystitis improved with steroid treatment.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"57-65"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960405","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 67-year-old man with complaints of dark red stools was admitted to the hospital. Capsule endoscopy, computed tomography enterography (CTE) with amidotrizoic acid meglumine solution (AM), and transanal double-balloon enteroscopy revealed a diverticulum in the ileum, which was accompanied by an ulcer in the vicinity. A partial ileal resection was performed laparoscopically, and the intraoperative and pathological findings indicated that the patient had a duplicated intestinal tract. Intriguingly, we identified a few reports on preoperative diagnosis of ileal duplication;however, we experienced such a case wherein the combination of capsule endoscopy and CTE using AM aided in its diagnosis.
{"title":"[Adult ileal duplication diagnosis using combined capsule endoscopy and computed tomography enterography with amidotrizoic acid meglumine solution: a case report].","authors":"Kaho Hamamoto, Shinichi Hashimoto, Yuko Yamaoka, Shunsuke Ito, Atsushi Goto, Koichi Hamabe, Jun Nishikawa, Hiroo Kawano, Taro Takami","doi":"10.11405/nisshoshi.123.49","DOIUrl":"https://doi.org/10.11405/nisshoshi.123.49","url":null,"abstract":"<p><p>A 67-year-old man with complaints of dark red stools was admitted to the hospital. Capsule endoscopy, computed tomography enterography (CTE) with amidotrizoic acid meglumine solution (AM), and transanal double-balloon enteroscopy revealed a diverticulum in the ileum, which was accompanied by an ulcer in the vicinity. A partial ileal resection was performed laparoscopically, and the intraoperative and pathological findings indicated that the patient had a duplicated intestinal tract. Intriguingly, we identified a few reports on preoperative diagnosis of ileal duplication;however, we experienced such a case wherein the combination of capsule endoscopy and CTE using AM aided in its diagnosis.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"49-56"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960403","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 : 2026-01-01DOI: 10.11405/nisshoshi.123.13
Hisashi Hidaka, Shuichirou Iwasaki, Chika Kusano
{"title":"[Current status and challenges of interventional radiology (IVR) in the portal hypertension disorders].","authors":"Hisashi Hidaka, Shuichirou Iwasaki, Chika Kusano","doi":"10.11405/nisshoshi.123.13","DOIUrl":"https://doi.org/10.11405/nisshoshi.123.13","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"13-18"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960501","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 : 2026-01-01DOI: 10.11405/nisshoshi.123.7
Masahito Shimizu, Takao Miwa, Yohei Shirakami
{"title":"[Frontiers of portal hypertension treatment:interpreting the Baveno VII consensus statement].","authors":"Masahito Shimizu, Takao Miwa, Yohei Shirakami","doi":"10.11405/nisshoshi.123.7","DOIUrl":"https://doi.org/10.11405/nisshoshi.123.7","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"7-12"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960423","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 : 2026-01-01DOI: 10.11405/nisshoshi.123.1
Takanori Kanai
{"title":"[Gastroenterology connected by organs].","authors":"Takanori Kanai","doi":"10.11405/nisshoshi.123.1","DOIUrl":"https://doi.org/10.11405/nisshoshi.123.1","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960466","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 : 2026-01-01DOI: 10.11405/nisshoshi.123.30
Hironao Okubo
{"title":"[Pathophysiology and nutrition for portal hypertension].","authors":"Hironao Okubo","doi":"10.11405/nisshoshi.123.30","DOIUrl":"https://doi.org/10.11405/nisshoshi.123.30","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"123 1","pages":"30-39"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960416","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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