Clinical Endoscopy

Gastric cancer presenting with ramucirumab-related gastrocolic fistula successfully managed by colonic stenting: a case report: Hiroki Fukuya, Yoichiro Iboshi, Masafumi Wada, Yorinobu Sumida, Naohiko Harada, Makoto Nakamuta, Hiroyuki Fujii, Eikichi Ihara; Clin Endosc 2023;56(6):812-816. Published online May 11, 2023; DOI: https://doi.org/10.5946/ce.2022.117

We report a rare case of gastric cancer presenting with a gastrocolic fistula during ramucirumab and paclitaxel combination therapy that was successfully managed with colonic stenting. A 75-year-old man was admitted to our hospital with the chief complaint of melena. Esophagogastroduodenoscopy revealed a large ulcerated tumor in the lower stomach, judged by laparoscopy as unresectable (sT4bN1M0). After four cycles of first-line chemotherapy with S-1 plus oxaliplatin, the patient showed disease progression, and second-line therapy with ramucirumab and paclitaxel was started. At the end of the third cycle, the patient had gastric antral stenosis, which necessitated the placement of a gastroduodenal stent. When the patient complained of diarrhea 10 days later, esophagogastroduodenoscopy revealed a fistula between the greater curvature of the stomach and the transverse colon. The fistula was covered by double colonic stenting, with a covered metal stent placed within an uncovered metal stent, after which leakage from the stomach to the colon stopped.

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Ramucirumab

Reactions Weekly.2024; 1989(1): 189. CrossRef
Metastatic bladder cancer forming a sigmoidorectal fistula after enfortumab vedotin therapy: a case report
Shinji Tamada, Daiki Ikarashi, Naoki Yanagawa, Moe Toyoshima, Kenta Takahashi, Tomohiko Matsuura, Shigekatsu Maekawa, Renpei Kato, Mitsugu Kanehira, Ryo Takata, Wataru Obara
Frontiers in Oncology.2023;[Epub] CrossRef

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Non-atrophic gastric mucosa is an independently associated factor for superficial non-ampullary duodenal epithelial tumors: a multicenter, matched, case-control study: Azusa Kawasaki, Kunihiro Tsuji, Noriya Uedo, Takashi Kanesaka, Hideaki Miyamoto, Ryosuke Gushima, Yosuke Minoda, Eikichi Ihara, Ryosuke Amano, Kenshi Yao, Yoshihide Naito, Hiroyuki Aoyagi, Takehiro Iwasaki, Kunihisa Uchita, Hisatomi Arima, Hisashi Doyama; Clin Endosc 2023;56(1):75-82. Published online January 5, 2023; DOI: https://doi.org/10.5946/ce.2022.059

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Background
/Aims: The etiology of superficial non-ampullary duodenal epithelial tumors (SNADETs) remains unclear. Recent studies have reported conflicting associations between duodenal tumor development and Helicobacter pylori infection or endoscopic gastric mucosal atrophy. As such, the present study aimed to clarify the relationship between SNADETs and H. pylori infection and/or endoscopic gastric mucosal atrophy.
Methods
This retrospective case-control study reviewed data from 177 consecutive patients with SNADETs who underwent endoscopic or surgical resection at seven institutions in Japan over a three-year period. The prevalence of endoscopic gastric mucosal atrophy and the status of H. pylori infection were compared in 531 sex- and age-matched controls selected from screening endoscopies at two of the seven participating institutions.
Results
For H. pylori infection, 85 of 177 (48.0%) patients exhibited SNADETs and 112 of 531 (21.1%) control patients were non-infected (p<0.001). Non-atrophic mucosa (C0 to C1) was observed in 96 of 177 (54.2%) patients with SNADETs and 112 of 531 (21.1%) control patients (p<0.001). Conditional logistic regression analysis revealed that non-atrophic gastric mucosa was an independent risk factor for SNADETs (odds ratio, 5.10; 95% confidence interval, 2.44–8.40; p<0.001).
Conclusions
Non-atrophic gastric mucosa, regardless of H. pylori infection status, was a factor independently associated with SNADETs.

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Endoscopic Resection for Superficial Non-Ampullary Duodenal Epithelial Tumors
Hye Kyung Jeon, Gwang Ha Kim
Gut and Liver.2025; 19(1): 19. CrossRef
Site of Biopsy and Its Accuracy in Preoperative Diagnosis of Superficial Nonampullary Duodenal Epithelial Tumors: Retrospective Study
Yukihisa Fujinaga, Akira Mitoro, Hitoshi Mori, Satoshi Iwai, Takahiro Kubo, Misako Tanaka, Aritoshi Koizumi, Fumimasa Tomooka, Shohei Asada, Koh Kitagawa, Norihisa Nishimura, Shinya Sato, Kosuke Kaji, Tadashi Namisaki, Hitoshi Yoshiji
Journal of Clinical Medicine.2025; 14(8): 2579. CrossRef
Current Management of Duodenal Neoplasia: Endoscopic Treatment for Large Superficial Non-Ampullary Duodenal Epithelial Tumor
Kurato Miyazaki, Naohisa Yahagi, Motohiko Kato
Digestion.2025; 107(3): 282. CrossRef
Endoscopic diagnosis and treatment of superficial nonampullary duodenal epithelial neoplasms: Current status and future perspectives
Yu Zhang, Man-Li Cui, Ming-Xin Zhang, Chao Sun
World Chinese Journal of Digestology.2025; 33(8): 609. CrossRef

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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; Clin Endosc 2020;53(6):743-745. Published online March 16, 2020; DOI: https://doi.org/10.5946/ce.2019.129

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A 43-year-old man with rheumatic arthritis was admitted to our hospital for symptoms of cough, left chest pain, and left elbow pain, and further examination revealed an elevated level of C-reactive protein. On day 2 after admission, he underwent esophagogastroduodenoscopy. On the morning of day 7, he developed a high fever of 39.7°C, several hours after bronchoscopy. On day 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 flexible endoscopy 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.

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Investigation of the current status of peracetic acid residues in flexible endoscopes and analysis of influencing factors
S. Zhu, Q. Wang, J. Hu, X. Chen, M. Hendi, L. Tong
Journal of Hospital Infection.2026; 168: 178. CrossRef
Irritant and sensitizing potential of antiseptics and disinfectants: an overview
Maria M. LAURIOLA, Monica CORAZZA
Italian Journal of Dermatology and Venereology.2026;[Epub] CrossRef
Exposure to Oxycide™ Disinfectant in Dental Practices: Occupational Symptoms and Risk Factors
Ramona-Camelia Anculia, Viorel Jinga, Diana Marian, Ramona Amina Popovici, Mariana Pacurar, Norina Forna, Dana Emanuela Pitic (Cot), Alexandru Blidaru
Applied Sciences.2025; 15(10): 5641. CrossRef
Побічні ефекти сучасних хімічних дезінфектантів та антисептиків. Частина 2. Неалергічна та алергічна дія внаслідок їх інгаляційного проникнення в організм
В. М. Брицун, І. В. Попова, С. О. Ковальова, Т. В. Петренко
Asthma and Allergy.2024; 23(3): 62. CrossRef
The Economics of Cystoscopy: A Microcost Analysis
Alexander P. Kenigsberg, Samuel Gold, Lorie Grant, Yair Lotan
Urology.2021; 157: 29. CrossRef

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