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Chronological Endoscopic and Pathological Observations in Russell Body Duodenitis
Atsushi Goto,Takeshi Okamoto,Masaharu Matsumoto,Hiroyuki Saito,Hideo Yanai,Hiroshi Itoh,Isao sakaida 대한소화기내시경학회 2016 Clinical Endoscopy Vol.49 No.4
A 64-year-old man was found to have a nodule in his right lung. He also complained of nausea and abdominal pain during the clinical course. Esophagogastroduodenoscopy revealed a duodenal ulcer associated with severe stenosis and a suspicion of malignancy. However, three subsequent biopsies revealed no evidence of malignancy. The fourth biopsy showed scattered large eosinophilic cells with an eccentric nucleus, leading to a diagnosis of Russell body duodenitis (RBD). RBD is an extremely rare disease, and little is known about its etiology and clinical course. The pathogenesis of RBD is discussed based on our experience with this case.
Hirofumi Harima,Kouichi Hamabe,Fusako Hisano,Yuko Matsuzaki,Tadahiko Itoh,Kazutoshi Sanuki,Isao Sakaida 대한소화기내시경학회 2018 Clinical Endoscopy Vol.51 No.6
An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a priorWhipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy(PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. Thestones located in the B2 segment were diffcult to remove because the endoscope could not be inserted deeply into this segment due to thesmall size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioningthe endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residualstones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases ofPDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.