古市　好宏    Department   School of Medicine(Tokyo Women's Medical University Adachi Medical Center), School of Medicine    Position   Associate Professor
Article types	Case report
Language	English
Peer review	Peer reviewed
Title	Narrow-band imaging can increase the visibility of fibrin caps after bleeding of esophageal varices: a case with extensive esophageal candidiasis.
Journal	Formal name：Clinical journal of gastroenterology Abbreviation：Clin J Gastroenterol ISSN code：18657265/18657265
Domestic / Foregin	Foregin
Volume, Issue, Page	10(4),pp.331-335
Author and coauthor	Furuichi Yoshihiro, Kasai Yoshitaka, Takeuchi Hirohito, Yoshimasu Yuu, Kawai Takashi, Sugimoto Katsutoshi, Kobayashi Yoshiyuki, Nakamura Ikuo, Itoi Takao
Publication date	2017/08
Summary	A 58-year-old man with hepatitis B cirrhosis noticed black stools and underwent an endoscopy at a community hospital. The presence of esophageal varices (EVs) was confirmed, but the bleeding point was not found. He was referred to our institution and underwent a second endoscopy. Extensive white patches of esophageal candidiasis were visible on endoscopy by white-light imaging (WLI), but it was difficult to find the fibrin cap of the EVs. This was easier under narrow-band imaging (NBI), however, as the color turned red from absorption by hemoglobin adhered to it. We retrospectively measured the color differences (CD) between the fibrin cap and the surrounding mucosa 10 times using the CIE (L*a*b*) color space method. The median value of CD increased after NBI (13.9 → 43.0, p < 0.001), with increased visibility. However, the median CD between the white patch and surrounding mucosa decreased after NBI (44.8 → 30.3, p < 0.001). The fibrin cap was paler than the white patch of candidiasis, but the increased visibility of the fibrin cap by NBI enabled it to be found more easily. This is the first report of a case in which NBI was helpful in locating a fibrin cap of EVs.
DOI	10.1007/s12328-017-0745-0
PMID	28500570