Jejunal varices are a rare manifestation of portal hypertension, and they are associated with a high mortality and poor prognosis when bleeding occurs. A bleeding jejunal varix is much more challenging to diagnose and manage because of its anatomic location. Herein, we describe the case of a 62-year-old man with active jejunal variceal bleeding who presented with massive hematochezia and hypovolemic shock. He was treated successfully with a high volume and concentration of a glue mixture as endoscopic sclerotherapy using single-balloon enteroscopy in the intensive care unit. Enteroscopic sclerotherapy is an effective option for jejunal variceal bleeding.

The early detection rate of superficial pharyngeal squamous cell carcinoma (SPSCC) by using narrow-band imaging is increasing. Importantly, endoscopic submucosal dissection (ESD) provides promising outcomes by experienced endoscopists. The aims of this study were to clarify the feasibility of ESD for SPSCC and its safety and outcomes. In total, 10 patients with 11 lesions were treated by ESD between January 2015 and June 2019. We assessed tumor size, macroscopic type, endoscopic methods, procedure time, histopathologic results, resection results, local recurrence, and adverse events. En bloc resection rate and complete resection rate are 91% (10/11) and 36% (4/11), respectively. Two patients encountered laryngeal edema and one had subcutaneous emphysema. All the three patients recovered after conservative treatment and discharged uneventfully. There was one patient with local recurrence but all 10 of our patients survived (100%) during follow-up. ESD for superficial pharyngeal cancer is a safe and feasible treatment with satisfactory and promising outcome.

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The efficacy of tenofovir disoproxil fumarate (TDF) for previously nucleos(t) ide analogs (NA)-treated patients in Taiwan is limited. In this retrospective study, our aim is to evaluate the efficacy of TDF in chronic hepatitis B (CHB) with suboptimal response (SR) to non-TDF NA therapy. We retrospectively analyzed CHB patients with SR to non-TDF NA treatment, in Show Chwan Memorial Hospital, Changhua, Taiwan, from September 2011 to December 2018. The primary endpoint was defined as achieving complete virological response (CVR) during TDF therapy. Twenty-eight patients were included in this study. Sixteen (57.1%) patients achieved CVR at a median duration of 135 weeks of TDF therapy. Nine patients (32.1%) achieved CVR early at 24-weeks treatment. One patient developed virological breakthrough during TDF treatment, which was due to poor drug adherence. The remainders had marked HBV DNA virological suppression (HBV DNA < 1000 IU/mL) after TDF treatment. One patient had renal function deterioration after 144 weeks of TDF therapy. Three of 17 (17.6%) patients developed HBeAg seroconversion after TDF treatment. TDF monotherapy is a potent rescue therapy for CHB patients with SR to non-TDF NA. Closely monitor renal function is necessary especially in patient with renal dysfunction initially.