Pub Date : 2025-01-01DOI: 10.11405/nisshoshi.122.529
Taku Aoki
{"title":"[Trends of treatments for gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN)].","authors":"Taku Aoki","doi":"10.11405/nisshoshi.122.529","DOIUrl":"10.11405/nisshoshi.122.529","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 8","pages":"529-533"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822788","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 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.
{"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}
A male patient in his 70s visited our hospital with persistent vomiting and hiccups. The barium enema demonstrated poor extension from the hepatic flexure to the middle of the transverse colon, with a fold companion on the side of the mesenteric attachment and lateral deformity. A colonoscopy revealed ulceration and submucosal tumor-like elevation, and the lumen was laterally deformed, indicating metastatic malignancy with peritoneal tumor dissemination. A computed tomography scan revealed fatty tissue opacity in the mesentery of the transverse colon and mild lymphadenopathy with heterogeneous contrast effect. Biopsy was suspicious of neuroendocrine carcinoma, and laparoscopically-assisted extended right semicolon resection was performed. Macroscopically, the tumor protruded on the serosal surface and invaded the colonic wall, probably causing digestive symptoms. Microscopically, the tumor was composed of sheets or nests or cribriform structures of atypical epithelioid cells, together with areas of the spindle or stellate-shaped cells with myxoid stroma. Immunohistochemically, the tumor cells were positive for cytokeratin, calretinin, WT-1, and D2-40 and negative for CEA, p63, and claudin-4. The histopathological diagnosis included biphasic malignant mesothelioma.
{"title":"[Malignant peritoneal mesothelioma detected by endoscopy after intractable stuttering:a case report].","authors":"Chiaki Toh, Yutaro Ihara, Hiroyuki Kawano, Shinichiro Yada, Yoshihiro Matsumoto, Masanori Hisaoka, Shinichiro Kawatoko, Takehiro Torisu","doi":"10.11405/nisshoshi.122.505","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.505","url":null,"abstract":"<p><p>A male patient in his 70s visited our hospital with persistent vomiting and hiccups. The barium enema demonstrated poor extension from the hepatic flexure to the middle of the transverse colon, with a fold companion on the side of the mesenteric attachment and lateral deformity. A colonoscopy revealed ulceration and submucosal tumor-like elevation, and the lumen was laterally deformed, indicating metastatic malignancy with peritoneal tumor dissemination. A computed tomography scan revealed fatty tissue opacity in the mesentery of the transverse colon and mild lymphadenopathy with heterogeneous contrast effect. Biopsy was suspicious of neuroendocrine carcinoma, and laparoscopically-assisted extended right semicolon resection was performed. Macroscopically, the tumor protruded on the serosal surface and invaded the colonic wall, probably causing digestive symptoms. Microscopically, the tumor was composed of sheets or nests or cribriform structures of atypical epithelioid cells, together with areas of the spindle or stellate-shaped cells with myxoid stroma. Immunohistochemically, the tumor cells were positive for cytokeratin, calretinin, WT-1, and D2-40 and negative for CEA, p63, and claudin-4. The histopathological diagnosis included biphasic malignant mesothelioma.</p>","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 7","pages":"505-511"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601766","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":"[Advances in gastric cancer treatment and revision of treatment guidelines].","authors":"Yoshihiko Kawaguchi, Katsutoshi Shoda, Daisuke Ichikawa","doi":"10.11405/nisshoshi.122.659","DOIUrl":"https://doi.org/10.11405/nisshoshi.122.659","url":null,"abstract":"","PeriodicalId":35808,"journal":{"name":"Japanese Journal of Gastroenterology","volume":"122 10","pages":"659-665"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145287442","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}
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.
{"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}
Pub Date : 2025-01-01DOI: 10.11405/nisshoshi.122.319
Norio Akuta
{"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}
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