Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology
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Nihon Shokakibyo Gakkai Zasshi · Mar 2011
Case Reports[Successful conservative therapy for mediastinitis caused by multiple esophageal perforations].
A 77-year-old man was admitted to our hospital on a diagnosis of acute mediastinits, 17 days after he had high fever. Computed tomography of the chest revealed an abscess cavity in the left upper mediastinum. Endoscopic examination showed multiple pin-hole perforations in the upper esophagus from 23 to 24cm distal from the incisors and drainage through the perforation. ⋯ Oral intake was restarted on the 17th day because radiological examination showed the esophageal perforation had closed. The patient was discharged on the 36th day from admission. Although mediastinitis caused by esophageal perforation often demands surgical treatment, conservative nonoperative therapy was successful in this patient.
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Nihon Shokakibyo Gakkai Zasshi · Dec 2010
Review Case Reports[Case of visceral varicella-zoster virus infection after autologous peripheral blood stem cell transplantation in which severe abdominal pain preceded the skin rash].
We report a 54-year-old man who developed visceral varicella-zoster virus (VZV) infection after autologous peripheral blood stem cell transplantation (auto-PBSCT) without using immunosuppressive agents for multiple myeloma. He suffered from severe abdominal pain 2 months after auto-PBSCT, and morphine chloride was needed to control it. ⋯ This may also result in devastating delays in effective antiviral treatment. The increase in fat density around the celiac trunk and the root of the superior mesenteric artery on computed tomography shown in this case may has contributed to the correct diagnosis of visceral VZV infection.
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Nihon Shokakibyo Gakkai Zasshi · Sep 2010
Case Reports[A case of lipoma of the lesser omentum with torsion of the pedicle in a twenty-eight-year-old woman].
A 28-year-old woman was admitted to our hospital with abdominal pain. Abdominal CT scan demonstrated a well-demarcated heterogeneous lipid tumor about 8 cm in diameter anterior to the stomach. Abdominal ultrasonography (US) revealed a low echoic mass without enhancement of vascular images. ⋯ Finally the tumor was diagnosed as a lipoma of the lesser omentum with torsion of the pedicle. This is the third reported case of torsion of a lipoma. In addition, this case is considered as the first such case of lipoma of the lesser omentum.
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Nihon Shokakibyo Gakkai Zasshi · Jul 2010
Review Case Reports[A patient who developed diaphragmatic hernia 20 months after percutaneous radiofrequency ablation for hepatocellular carcinoma].
A 50-year-old man underwent radiofrequency ablation (RFA) for a hepatocellular carcinoma, located in the S8 area adjacent to the diaphragm. 20 months later, he was admitted because of severe right hypochondralgia and dyspnea. Computed tomography revealed a prolapsed large intestine through a defect on the right diaphragm, and emergency surgery was performed. Patients who have undergone RFA for a hepatic tumor adjacent to the diaphragm should be carefully followed up for possible diaphragmatic hernia, even after a long postoperative interval.