Yukiya Yoshida

COMPARISON OF ENDOSCOPIC DETECTION RATE OF EARLY GASTRIC CANCER AND GASTRIC ADENOMA USING TRANSNASAL EGD WITH THAT OF TRANSORAL EGD

Background:  To investigate the influence of the reduced image quality of transnasal esophagogastroduodenoscopy (EGD) with the ultrathin endoscope (transnasal EGD) on endoscopic diagnoses, we compared the detection rate (DR) of early gastric cancer and gastric adenoma by transnasal EGD with that of transoral EGD using a standard endoscope.

Ectopic Sebaceous Glands in the Esophagus: Report of Two Cases

Abstract: Reports of ectopic sebaceous glands in the esophagus are rare. Six postmortem cases and eight antemortem cases have been reported. In 1990, we studied two patients with ectopic sebaceous glands in the esophagus that were found during endoscopy and confirmed histologically. These lesions macro‐scopically resembled gastric xanthomas.

A Case of Hemophilia B with Esophageal Varices Treated by Sclerotherapy with Factor‐IX Complex

A 64‐year‐old man with hemophilia B and HCV‐positive chronic hepatitis who had been followed at our hospital presented with hematemesis. Gastrointestinal fiber‐scopy (GIF) demonstrated a small active gastric ulcer (Az stage) at the pyloric ring and esophageal varices (F1 Lm Cw RC(+)). He was admitted and the esophageal varices were safely and successfully treated by sclerotheapy. Sclerotherapy was performed by in‐traluminal injection of 4 mL 5% ethanolamine oleate with sufficient supplementation of factor‐lX complex (PPSB ‐HT) for four days to a total amount of 24,000 U. The patient was followed with GIF and endoscopic ultrasonography. Sclerotherapy proved effective after six months. We report a rare case of hemophilia B with esophageal varices successfully treated by sclerotherapy.

Gastrojejunal fistula caused by gastric ulcer

Abstract: We report a case of gastrojejunal fistula caused by benign gastric ulcer, a very rare condition. The patient was an 81-year-old-woman who had had multiple recurrences of gastric ulcer. She also had diabetes mellitus. She was admitted to our hospital because of a left femoral head fracture, necessitating a mechanical bone head exchange operation. She had severe abdominal pain and anemia on the 48th postoperative day. Gastroendoscopic examination revealed a giant ulcer with a long-axis diameter of more than 5 cm on the lesser curvature of the gastric body. She was treated with intravenous famotidine and all oral intake was restricted; her symptoms were alleviated. Two weeks later, a fistula had formed between the stomach and the jejunum just anal to the duodeno-jejunal flexure. She was placed on an ulcer diet, and was discharged with no symptoms on the 151st postoperative day. She has remained asymptomatic for 1½ years to date. Lack of H2-antagonist administration, operative stress, and administration of ipriflavone appeared to have induced gastric ulcer recurrence, and formation of the fistula between the stomach and the jejunum seemed to have been facilitated by the patient being very lean and having minimal mesenteric adipose tissue.

A Case of Spontaneous Regression of Primary Malignant Lymphoma of the Stomach

A 62‐year‐old female who complained of discomfort in her upper abdominal region and a poor appetite had an endoscopically documented polypoid lesion with a shallow irregular central depression at the lesser curvature of the angulus. A diagnosis of malignant lymphoma was made following a gastric biopsy. A gastric endoscopy performed about 20 days later revealed a marked increase in size with an ulcerated surface the margin of which had an auricle‐like shape. These findings were compatible with a diagnosis of malignant lymphoma of the stomach. No medical therapy, such as antineoplastic agents, was given during the follow‐up period. A gastric resection was performed 1.5 months after the initial endoscopy. A detailed histopathological examination of the resected gastric specimen revealed a U1‐II type ulcer scar but no malignant lymphoma cells. Very few cases of a complete spontaneous regression of a malignant lymphoma of the stomach have been reported either within or outside of Japan though it is well known that lymphomas show rapid morphological changes in some patients who are followed‐up without any specific therapy. These rare case reports in the literature are reviewed and discussed together with our present case.