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A Case of Suspicious Allergic Reaction to Peracetic Acid Following Endoscopy
Naohiko Harada,Manami Hirowatari,Eikichi Ihara,Etsuko Ishihara,Mitsuko Inoue,Tomoya Miyamura,Makoto Nakamuta 대한소화기내시경학회 2020 Clinical Endoscopy Vol.53 No.6
A 43-year-old man with rheumatic arthritis was admitted to our hospital for symptoms of cough, left chest pain, and leftelbow pain, and further examination revealed an elevated level of C-reactive protein. On day 2 after admission, he underwentesophagogastroduodenoscopy. On the morning of day 7, he developed a high fever of 39.7°C, several hours after bronchoscopy. Onday 13, he underwent colonoscopy. Five minutes after the colonoscopy, he developed a high fever of 39.9°C, accompanied by stridor,indicating a decrease in arterial oxygen saturation level. An intradermal test for peracetic acid which was used for cleaning flexibleendoscopy was positive. We suspect that he suffered from an allergic reaction to peracetic acid following the flexible endoscopy. This is the first case reported on suspicious allergic reaction to peracetic acid following a flexible endoscopy procedure.
Akihisa Ohno,Nao Fujimori,Toyoma Kaku,Masayuki Hijioka,Ken Kawabe,Naohiko Harada,Makoto Nakamuta,Takamasa Oono,Yoshihiro Ogawa 대한소화기내시경학회 2022 Clinical Endoscopy Vol.55 No.6
Background/Aims: Patients with acute cholecystitis (AC) after metallic stent (MS) placement for malignant biliary obstruction (MBO)have a high surgical risk. We performed percutaneous transhepatic gallbladder aspiration (PTGBA) as the first treatment for AC. Weaimed to identify the risk factors for AC after MS placement and the poor response factors of PTGBA. Methods: We enrolled 401 patients who underwent MS placement for MBO between April 2011 and March 2020. The incidence of ACwas 10.7%. Of these 43 patients, 37 underwent PTGBA as the first treatment. The patients’ responses to PTGBA were divided into goodand poor response groups. Results: There were 20 patients in good response group and 17 patients in poor response group. Risk factors for cholecystitis after MSplacement included cystic duct obstruction (p<0.001) and covered MS (p<0.001). Cystic duct obstruction (p=0.003) and uncovered MS(p=0.011) demonstrated significantly poor responses to PTGBA. Cystic duct obstruction is a risk factor for cholecystitis and poor re-sponse factor for PTGBA, whereas covered MS is a risk factor for cholecystitis and an uncovered MS is a poor response factor of PTG-BA for cholecystitis. Conclusions: The onset and poor response factors of AC after MS placement were different between covered and uncovered MS. PTG-BA can be a viable option for AC after MS placement, especially in patients with covered MS.
Hiroki Fukuya,Yoichiro Iboshi,Masafumi Wada,Yorinobu Sumida,Naohiko Harada,Makoto Nakamuta,Hiroyuki Fujii,Eikichi Ihara 대한소화기내시경학회 2023 Clinical Endoscopy Vol.56 No.6
We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapythat was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of mele-na. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4b-N1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-linetherapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which neces-sitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopyrevealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonicstenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.