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1.
Nihon Shokakibyo Gakkai Zasshi ; 120(5): 423-432, 2023.
Artículo en Japonés | MEDLINE | ID: mdl-37183036

RESUMEN

A 79-year-old male patient underwent esophagogastroduodenoscopy, which revealed a reddish lesion, 10mm in diameter, presenting as a surface recess in the angular incisure. He was diagnosed with gastric follicular lymphoma. Positron emission tomography-computed tomography revealed metastasis to the mediastinal lymph node, although the tumor size was small. Hence, we did not administer any treatment and continued following up. After 8 months, multiple enlarged lymphoma lesions in the stomach and a mass with ulceration on the oral side of the duodenal papilla were observed. The tumor had transformed into diffuse large B-cell lymphoma; therefore, chemotherapy was initiated. The patient has remained recurrence-free for 55 months after treatment.


Asunto(s)
Linfoma Folicular , Linfoma de Células B Grandes Difuso , Linfoma no Hodgkin , Masculino , Humanos , Anciano , Linfoma Folicular/diagnóstico por imagen , Linfoma Folicular/tratamiento farmacológico , Linfoma no Hodgkin/patología , Linfoma de Células B Grandes Difuso/diagnóstico por imagen , Linfoma de Células B Grandes Difuso/tratamiento farmacológico , Linfoma de Células B Grandes Difuso/patología , Estómago/patología
2.
Nihon Shokakibyo Gakkai Zasshi ; 119(9): 858-867, 2022.
Artículo en Japonés | MEDLINE | ID: mdl-36089362

RESUMEN

A 57-year-old man with fatigue was admitted to our hospital. Abdominal contrast computed tomography indicated the presence of a 35mm tumor in the pancreatic head and dilation of the main pancreatic duct from its body to the tail. Endoscopic ultrasonography revealed that the tumor had infiltrated and occupied the main pancreatic duct, and endoscopic retrograde pancreatography confirmed that the tumor was present in the main pancreatic duct. Tumor biopsy via endoscopic retrograde cholangiopancreatography demonstrated the proliferation of spindle and pleomorphic cells. Therefore, the patient was diagnosed with anaplastic pancreatic carcinoma and underwent subtotal stomach-preserving pancreaticoduodenectomy. Histological analysis showed the prevalence of adenocarcinoma and anaplastic carcinoma cells in the pancreatic parenchyma and main pancreatic duct, respectively. Anaplastic carcinoma cells showed a decrease in E-cadherin staining. In conclusion, tumor cell proliferation and lack of cell adhesion may have caused the infiltration into the main pancreatic duct.


Asunto(s)
Adenocarcinoma , Neoplasias Pancreáticas , Adenocarcinoma/diagnóstico por imagen , Adenocarcinoma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Pancreatectomía , Conductos Pancreáticos/diagnóstico por imagen , Conductos Pancreáticos/patología , Neoplasias Pancreáticas/diagnóstico por imagen , Neoplasias Pancreáticas/cirugía , Neoplasias Pancreáticas
3.
Nihon Shokakibyo Gakkai Zasshi ; 115(1): 117-125, 2018.
Artículo en Japonés | MEDLINE | ID: mdl-29353848

RESUMEN

A 78-year-old woman was found to have gallbladder wall thickening on ultrasonography during a routine health check-up and was referred to our clinic. On contrast-enhanced endoscopic ultrasonography, a papillary lesion measuring 14mm was detected in the fundus, which showed a heterogeneous enhancement at the early phase. She underwent cholecystectomy and gallbladder bed resection. Histological examination revealed that the tumor consisted of mucinous atypical cells, regularly arranged in a high-papillary architecture with delicate fibrovascular cores, which led to the diagnosis of intracholecystic papillary neoplasm of the gallbladder.


Asunto(s)
Adenocarcinoma Papilar/diagnóstico , Endosonografía , Neoplasias de la Vesícula Biliar/diagnóstico , Adenocarcinoma Papilar/terapia , Anciano , Colecistectomía , Femenino , Neoplasias de la Vesícula Biliar/terapia , Humanos , Ultrasonografía
4.
Am J Case Rep ; 23: e935121, 2022 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-35167511

RESUMEN

BACKGROUND Cisplatin/5-fluorouracil therapy is the standard therapy for unresectable and recurrent esophageal cancer. Cisplatin-based chemotherapy often causes adverse effects, such as nausea, vomiting, and renal dysfunction, which may necessitate dose modification or treatment prolongation. Therefore, novel combination therapies are urgently needed to improve the efficacy and overcome drug toxicity in this setting. CASE REPORT A 77-year-old man with advanced esophageal cancer received cisplatin/5-fluorouracil therapy as neoadjuvant chemotherapy. On day 8 of administration, the patient had lightheadedness, diaphoresis, and nausea and became unconscious and developed severe hyponatremia. We diagnosed the patient with cisplatin-induced syndrome of inadequate antidiuretic hormone secretion (SIADH). Subsequently, water restriction was started, and treatment with a salt-added diet and 3% hypertonic saline infusion was initiated. The hyponatremia improved and the patient was discharged on day 16 of administration. Therefore, neoadjuvant chemotherapy was discontinued, and surgical treatment was performed. However, the tumor recurred and chemotherapy was required. The patient developed severe hyponatremia while receiving neoadjuvant chemotherapy; hence, folinic acid, fluorouracil, and oxaliplatin therapy (FOLFOX) were administered as an alternative treatment. The patient completed the FOLFOX therapy without developing SIADH. CONCLUSIONS The cisplatin/5-fluorouracil therapy is currently the standard chemotherapy regimen for esophageal cancer. However, SIADH is a known adverse effect when using cisplatin. In patients with esophageal cancer, oxaliplatin appears to have a lower risk of SIADH than cisplatin, suggesting that oxaliplatin can be a therapeutic option for patients with esophageal cancer who are at high risk of SIADH.


Asunto(s)
Neoplasias Esofágicas , Síndrome de Secreción Inadecuada de ADH , Anciano , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Cisplatino/efectos adversos , Neoplasias Esofágicas/tratamiento farmacológico , Fluorouracilo/efectos adversos , Humanos , Síndrome de Secreción Inadecuada de ADH/inducido químicamente , Leucovorina/uso terapéutico , Masculino , Terapia Neoadyuvante , Recurrencia Local de Neoplasia/tratamiento farmacológico , Oxaliplatino , Vasopresinas
5.
Am J Case Rep ; 20: 1320-1324, 2019 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-31488806

RESUMEN

BACKGROUND Bouveret syndrome is a rare complication of cholelithiasis that often leads to symptoms of gastric outlet obstruction. CASE REPORT An 84-year-old woman developed acute abdominal symptoms due to impaction of a gallstone in the horizontal part of the duodenum. The diagnosis was supported by abdominal computed tomography and double balloon endoscopy. Considering her advanced age and the position of the calcified gallstone, we decided to perform electrohydraulic lithotripsy using double balloon endoscopy for treatment. Finally, the impacted stone was removed with reduced size. She was discharged home 10 days after admission without recurrence. CONCLUSIONS This case illustrates that electrohydraulic lithotripsy using double balloon endoscopy is very effective, especially for treatment of Bouveret syndrome caused by gallstone impaction in the horizontal part of the duodenum.


Asunto(s)
Obstrucción Duodenal/terapia , Endoscopía/instrumentación , Cálculos Biliares/terapia , Litotricia/métodos , Abdomen Agudo/etiología , Anciano de 80 o más Años , Obstrucción Duodenal/etiología , Endoscopía/métodos , Femenino , Cálculos Biliares/complicaciones , Humanos
6.
Am J Case Rep ; 19: 1495-1498, 2018 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-30552312

RESUMEN

BACKGROUND Adenomatous polyposis coli is an autosomal dominant hereditary disorder. Duodenal adenocarcinoma and adenoma, which are extracolonic lesions, not only affect the prognosis of patients but also cause acute pancreatitis. CASE REPORT We present the case of a 73-year-old male. He had undergone proctocolectomy for familial adenomatous polyposis and distal gastrectomy (Billroth II reconstruction with Braun anastomosis) for gastric ulcer; he presented with acute pancreatitis caused by ampullary duodenum adenoma. Double-balloon endoscopy showed 2 adenomatous polyps in the major papilla and descending limb of the duodenum. Based on the findings of endoscopy and biopsy, the duodenal polyps were diagnosed as adenomas and classified as Spigelman stage II. CONCLUSIONS Our case report suggests that duodenal surveillance is necessary for patients with adenomatous polyposis coli. In addition, surveillance using double-balloon endoscopy is useful for patients with an altered gastrointestinal anatomy.


Asunto(s)
Adenoma/cirugía , Poliposis Adenomatosa del Colon/cirugía , Ampolla Hepatopancreática/cirugía , Neoplasias Duodenales/cirugía , Gastrectomía/efectos adversos , Pancreatitis/etiología , Anciano , Gastroenterostomía , Humanos , Masculino , Complicaciones Posoperatorias
7.
Clin J Gastroenterol ; 11(5): 433-436, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29564813

RESUMEN

Omental abscess due to a spilled gallstone is extremely rare after laparoscopic cholecystectomy. Herein, we report a 68-year-old man who presented with left upper abdominal pain after laparoscopic cholecystectomy for gangrenous cholecystitis. Seven months prior to admission, gallbladder perforation with spillage of pigment gallstones and bile occurred during laparoscopic cholecystectomy. The spilled gallstones were retrieved through vigorous peritoneal lavage. Abdominal computed tomography showed a 3 × 2.5 cm intra-abdominal heterogeneous mass, suspected to be an omental abscess, and ascites around the spleen. Exploratory laparoscopy revealed an inflammatory mass within the greater omentum. Laparoscopic partial omentectomy and abscess drainage were performed, and a small black pigment gallstone was unexpectedly found in the whitish abscess fluid. Abscess fluid culture results were positive for extended-spectrum ß-lactamase-producing Escherichia coli and Streptococcus salivarius, which were previously detected in the gangrenous gallbladder abscess. The histopathological diagnosis was abscess in the greater omentum. Postoperative course was uneventful, and the patient was discharged 13 days later. In conclusion, we report a successful case of laparoscopic management of an omental abscess due to a spilled gallstone after LC. It is important to attempt to retrieve spilled gallstones during LC because they may occasionally result in serious complications.


Asunto(s)
Absceso/etiología , Colecistectomía Laparoscópica/efectos adversos , Cálculos Biliares/cirugía , Epiplón , Enfermedades Peritoneales/etiología , Absceso/diagnóstico , Absceso/terapia , Anciano , Infecciones por Escherichia coli/diagnóstico , Infecciones por Escherichia coli/etiología , Infecciones por Escherichia coli/terapia , Cálculos Biliares/patología , Gangrena/patología , Humanos , Masculino , Enfermedades Peritoneales/diagnóstico , Enfermedades Peritoneales/terapia , Complicaciones Posoperatorias , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/etiología , Infecciones Estreptocócicas/terapia , Streptococcus salivarius
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