Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
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Case Reports
Extended hemangioma from pharynx to esophagus that could be misdiagnosed as an esophageal varix on endoscopy.
Giant hemangioma in the neck and head is an uncommon vascular neoplasm and has an unpredictable clinical behavior. We report a hemangioma that extended from the pharynx to the esophagus that could have been misdiagnosed as an esophageal varix. A 42-year-old man with dilated varices-like vessels on his esophagus that were incidentally detected by endoscopy was referred to our hospital for further evaluation. ⋯ We planned regular 6-month follow ups. We report a case of extended hemangioma that could possibly have been misdiagnosed as an esophageal varix on endoscopy. Even if head and neck hemangioma is uncommon, careful consideration during endoscopy is required to avoid the misdiagnosis of varices or hemangioma.
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The potential severity of postoperative pancreatic fistula (POPF) after laparoscopy-assisted gastrectomy (LAG) necessitates efforts to identify predictive factors for POPF. The aim of the present study was to identify predictive factors for POPF and to establish a predictive scoring system for POPF after LAG. ⋯ This study demonstrated that POPF after LAG is associated with specific preoperative and postoperative factors. With a simple predictive scoring system, patients at high risk for POPF can be accurately identified. This simple predictive scoring system will be useful for many clinicians to assess the risk of POPF after LAG and start treating at-risk patients earlier.
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Randomized Controlled Trial Comparative Study
Prospective, randomized, double-blind, placebo-controlled trial of ulinastatin for prevention of hyperenzymemia after double balloon endoscopy via the antegrade approach.
Double balloon endoscopy (DBE) allows the entire small intestine to be viewed using a combination of antegrade and retrograde approaches. Acute pancreatitis is a serious complication of antegrade DBE with no effective prophylactic treatment currently available. Ulinastatin has been shown to be effective for the prevention of pancreatitis following endoscopic retrograde cholangiopancreatography. We therefore assessed the efficacy of ulinastatin for hyperenzymemia after antegrade DBE. ⋯ The results of this trial suggest that ulinastatin does not prevent hyperenzymemia following antegrade DBE.
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The aim of the present study was to investigate whether it is reasonable to insert an endoscopic nasobiliary drainage (ENBD) tube in patients with endoscopic sphincterotomy (EST) and repeated clearance of common bile duct (CBD) stones. ⋯ ENBD significantly reduces the incidence of hyperamylasemia and decreases the length of hospital stay in patients with EST and repeated stone extraction. ENBD should be considered for patients with large or multiple CBD stones.
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Gastrointestinal bleeding in individuals with Turner syndrome is relatively rare and there have been only a handful of reported cases in the literature. Here, we present two patients with Turner syndrome who were evaluated for obscure gastrointestinal bleeding. ⋯ Our second patient had a history of unexplained recurrent melena and iron deficiency anemia, with previously normal esophagogastroduodenoscopies, colonoscopies and a Meckel's diverticulum scan. Both patients were subsequently diagnosed with gastrointestinal vascular malformations via capsule endoscopy.