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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The feasibility of percutaneous transhepatic gallbladder aspiration for acute cholecystitis after self-expandable metallic stent placement for malignant biliary obstruction: a 10-year retrospective analysis in a single center: Akihisa Ohno, Nao Fujimori, Toyoma Kaku, Masayuki Hijioka, Ken Kawabe, Naohiko Harada, Makoto Nakamuta, Takamasa Oono, Yoshihiro Ogawa; Clin Endosc 2022;55(6):784-792. Published online October 21, 2022; DOI: https://doi.org/10.5946/ce.2021.244

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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. We aimed 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 AC was 10.7%. Of these 43 patients, 37 underwent PTGBA as the first treatment. The patients’ responses to PTGBA were divided into good and poor response groups.
Results
There were 20 patients in good response group and 17 patients in poor response group. Risk factors for cholecystitis after MS placement 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 response factor for PTGBA, whereas covered MS is a risk factor for cholecystitis and an uncovered MS is a poor response factor of PTGBA for cholecystitis.
Conclusions
The onset and poor response factors of AC after MS placement were different between covered and uncovered MS. PTGBA can be a viable option for AC after MS placement, especially in patients with covered MS.

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Post-endoscopic retrograde cholangiopancreatography cholecystitis: A review of incidence, risk factors, prevention, and management
Suprabhat Giri, Shivaraj Afzalpurkar, Prasanna Gore, Gaurav Khatana, Saroj Kanta Sahu, Dibya Lochan Praharaj, Bipadabhanjan Mallick, Preetam Nath, Sridhar Sundaram, Manoj Kumar Sahu
World Journal of Gastrointestinal Endoscopy.2025;[Epub] CrossRef
Endeavors to prevent stent malfunction: new insights into the risk factors for recurrent biliary obstruction
Sung-Jo Bang
Clinical Endoscopy.2024; 57(1): 56. CrossRef
Endoscopic Ultrasound-Guided Naso-gallbladder Drainage Using a Dedicated Catheter for Acute Cholecystitis After Transpapillary Metal Stent Placement for Malignant Biliary Obstruction
Tadahisa Inoue, Rena Kitano, Mayu Ibusuki, Kazumasa Sakamoto, Satoshi Kimoto, Yuji Kobayashi, Yoshio Sumida, Yukiomi Nakade, Kiyoaki Ito, Masashi Yoneda
Digestive Diseases and Sciences.2023; 68(12): 4449. CrossRef
The writing on the wall: self-expandable stents for endoscopic ultrasound-guided hepaticogastrostomy?
Hyung Ku Chon, Shayan Irani, Tae Hyeon Kim
Clinical Endoscopy.2023; 56(6): 741. CrossRef
How should a therapeutic strategy be constructed for acute cholecystitis after self-expanding metal stent placement for malignant biliary obstruction?
Mamoru Takenaka, Masatoshi Kudo
Clinical Endoscopy.2022; 55(6): 757. 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
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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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