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New stent exchange technique following endoscopic ultrasound‐guided nasobiliary drainage (with video)
Author(s) -
Kawakami Hiroshi,
Kuwatani Masaki,
Sakamoto Naoya
Publication year - 2013
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12051
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , forceps , tube (container) , stent , surgery , radiology , mechanical engineering , pancreatitis , engineering
pp65 antigen-positive cells also reappeared in the blood (14 among 50 500 leukocytes), confirming the diagnosis of the relapse of CMV gastritis. We consider that the endoscopic findings changed remarkably during the course of CMV gastritis. CMV gastritis is a well-recognized complication in patients taking steroids or immunomodulatory drugs or suffering from immunodeficiency diseases. Its endoscopic findings are known to be non-specific and diverse. There have been a few reports describing polypoid lesions caused by CMV infection, but such endoscopic morphological change as found in the present study has never been described, even though modification by antiviral treatments cannot be denied. However, one of 10 transplanted patients with acquired hyperplastic gastric polyps reportedly revealed CMV infection. In addition, it has been pointed out that there remains a good possibility of under-recognition due to the low sensitivity of detection methods. Our case suggests that we should consider CMV gastritis in immunosuppressed patients with multiple gastric polyps as well as ulcerous lesions.