A case of small intestinal ileus caused by migration of gastric bezoars, which was successfully treated by dissolution therapy with cola through an ileus tube.

A 60-year-old woman with a history of distal gastrectomy for gastric cancer presented with a chief complaint of epigastric pain. Duodenal ileus due to the migration of a gastric bezoar was diagnosed, and she was hospitalized. We performed endoscopic lithotripsy and injection of cola, but the bezoar migrated toward the anus. Her abdominal pain worsened the following day, and she was diagnosed with ileus induced by the gastric bezoar. After decompression with an ileus tube, 1000ml/day of cola was injected via the ileus tube, and the ileus resolved on the 5th day of therapy. Based on this experience, we believe that dissolution therapy with cola via an ileus tube is effective in the treatment of bezoar-induced small bowel ileus.

Matrix metalloproteinase-2 in pancreatic juice for diagnosis of pancreatic cancer.

INTRODUCTION: Matrix metalloproteinase-2 (MMP-2) has an activity to degrade type IV collagen and is associated with invasion angiogenesis of malignant tumor. AIM: A diagnostic value of MMP-2 in pancreatic juice was studied in the diagnosis of pancreatic cancer. METHODOLOGY: Using gelatin zymography, active MMP-2 and proMMP-2 were determined in pancreatic juice obtained endoscopically from 12 patients with pancreatic cancer, 11 with chronic pancreatitis, and 7 control subjects. RESULTS: ProMMP-2 was detected in 12 of 12 patients (100%) with pancreatic cancer, 6 of 11 (54.5%) with chronic pancreatitis, and 3 of 7 (42.9%) controls. Active MMP-2 was detected in 11 patients (91.6%) with pancreatic cancer, 2 (18.2%) with chronic pancreatitis, and none of the control subjects. An activation ratio of MMP-2 (active MMP-2/total MMP-2) in pancreatic juice is significantly higher in pancreatic cancer (23.4 +/- 4.4%, mean +/- SE) than in chronic pancreatitis (2.1 +/- 1.7%) and controls (0%) (p < 0.01). Active MMP-2 was also detected in pancreatic juice from three cases of small pancreatic cancer (tumor <2 cm in diameter). CONCLUSION: Our observation suggests that detection of active MMP-2 in pancreatic juice using gelatin zymography may be useful for the diagnosis of pancreatic cancer.