Clinical Endoscopy

원발성 (原發性) 십이지장암의 내시경적 진단 ( Endoscopic Diagnosis of Primary Duodenal Cancers ): Korean J Gastrointest Endosc 1981;1(1):1-7. Published online November 30, 1980

Abstract PDF: Primary cancer af the duodenum is rare. An extensive experience with fiberoptic eaophag-ogastro-duodenoscopy in our institution has indicated that duodenal cancer may be more frequent thsn suspeeted and readily diagnesed by this modality, With this in mied, clinical, pathological, diagnostic and therapeetie aspects of the 26 patients with primary duodenal cancer which had been endoscopically diugnosed were reviewed. The results obtained were as follows: 1) Ages ranged from 16 to 75, with the mean of 55.2 years. Seventeen patients were men and nine patients women being l. 9:1 of male-female ratio. 2) Hndoscoyic findings were 46. 1 percent ulcerative anld 34. 8 per cent ulcerative-infiltrative, 3) The diatribution within the duodenum was 50 per cent suprapapillary, 42. 4 per cent peri- papillary aecl 7. 6 per cent infrapapillary. 4) The twenty-three patients had adenocarcinoma, two patients leiomyosarcoma and 1 patient lymphoma. 5) Twenty patients were confirmed by duodenoseopic biipsies and six patients by operations. 6) The mast common presenting mmyliiints were abdominal pain, chronic blood lais leading anemia, jaundice, anorexia, indigestion, weight lass and palpable abdominal mass. 7) Of the 26 patients, eight patients underwent attempted curative resection, six patients underwent palliative bypasa procedures or exploratory laparotomy.

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결핵성 대장염의 내시경적 소견 ( Endoscopic Findings of Tuberculous Colitis ): Korean J Gastrointest Endosc 1981;1(1):8-12. Published online November 30, 1980

Abstract PDF: The purpose of this paper is to review the colonofiberscopic findings in the 21 patients with tuberculous colitis, diagnosed by colonofiberscopic findings including histopathology and by follow-up observation after anti-tuberculosis chemotherapy. The results are as follows: 1) The male to female ratio was l. 33(R:4) and the average age of the patiets were 34. 9 years in men and women respectively. 2) The chief complaints were abdominal pain in 15 cases(71.4%), diarrhea in 14(66.7%), weight loss in 12(57. 1%), anorexia in 8(38, 1%), and so on. 3) Anemia and an increase in ESR were major abnormalities in hemogram. 4) On the chest X-ray examination, 65% of the cases showed active tuberculous lesions and the barium enema disclosed the changes suggesting tuberculous colitis in 52. 6% of the cases. 5) On colonofiberscopy 8 cases were ulcerative, 6 were hypertropbic and 7 were ulcerohypertrophic. 6) Histopathologic examination of the biopsy material from the colonofiberscopy revealed granulomata with caseation necrosis in 2 cases, granulomata without caseation necrosis in 8 cases, and the findings of chronic inflammation in 11 cases. 7) This study suggests importance of colonoscopic examination including histopathologic study of the biopsy material in the diagnosis of tuberculous colitis. The diagnostic efficieocy would be much improved if bacteriological examinations of the specimen could be developed.

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위용종 (胃茸腫) ( Gastric Polyps ): Korean J Gastrointest Endosc 1981;1(1):13-22. Published online November 30, 1980

Abstract PDF: Gastric polyp is a cinical term without any pathological significance. lt referes merely to any benign, mucosal lesions that protrudes in to the gastric lumen, but conventlonaily it includes a malignaiit lesion which seems to be degenerated from benign one. (continue...)

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십이지장염의 임상적 고찰 ( A Clinical Observation of the Duodenitis ): Korean J Gastrointest Endosc 1981;1(1):23-28. Published online November 30, 1980

Abstract PDF: A clinieal Observation was done on the 110 cases (male; 52 cases, female; 58 cases) of duodenitis under the gastroduodenoscopic examination among the patients who were performed endoscopic examination because of seeking for the cause of dyspepsia period from Aug. 1981 to Sep. 1981 at Department of lnteral Medicine of BNUH. The results were summerized as follow 1) Normal finding(Grade 0) was highest as 40% in the incidence according to grade of duodenits. Next was moderate (Grade II & II) as 24. 5%, the 3rd was mild(Grade I ) as 20% and lowest in severe(Grade IV) duadenitis as 15.5%, 2) Sex distribution of duodenitis showed 37 cases in male and 29 cases in female. And male was slightly higher in incidence than female. 3) Age distribution of duodenitis revealeii 3rd decade and 4th decade were highest in incidence, 30 cases and 28 cases respectively. The order of frequency was 5th decade, 6th decade, 1st decade and 7th decade. 4) Duodenitis was slightly higher in after 4th decade than before 4th decade. 5) The 56 cases of duodenitis except for 1 case were aasociated with gastroduodenal diseases such as gastritis, peptic ulcer or gastric carcinoma. Association of gastritis is highest as 79. 4%. 6) Acurracy of diagnosis in duodenitis on X-ray study was 3 cases in 20 cases. Generally X-ray study was little value in diagnosis of duodenitis.

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간흡충증 환자의 내시경적 역행성 담도조영술 소견 ( ERCP Findings in Clonorchiasis ): Korean J Gastrointest Endosc 1981;1(1):29-32. Published online November 30, 1980

Abstract PDF: We analyzed ERCP findings of 15 patients with clonorchiasis, that were confirmed by stool examination and operation from May, 1976 to September, 1980. The results were as follows. 1) Filling defects due to adult worm of clonorchis sinensis were significant direct findings of clonorchiasis. 2) Irregular stenosis, fuzziness, raggedness, peripheral dilation and disturbance of peripheral filling of intrahepatic bile ducts were significant indirect findings of clonorchiasis. 3) ERCP was excellent method to evaluate biliary tree in patients with clonorchiasis, who showed obstructive jaundice.

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내시경적 역행성 췌담관조영술로 진단된 총수담관낭종 (總輸膽管囊腫) 4례 ( Choledocal Cyst Diagnosed by Endoscopic Retrograde Cholangiopancreatography ): Korean J Gastrointest Endosc 1981;1(1):33-40. Published online November 30, 1980

Abstract PDF: Choledochal cyst of the common bile duct is usually considered to be large cystic dilatation that extends from the wall of the common bile duct. Choledochal cyst is a very rare cond.ition in adult, These cysts are commonly distinctive in childran under the age of ten. Even in this age group they are considered rare. The classicajl triad of a choledochal cyst inclule pain, jaundice and a palpable right upper quadrant mass. This triad was found in only 21~63% and the most common finding is jaundice. Diagnoais of choledochal cyst usually is made during laparotomy, In nonjaundiced patients, oral cholangiogram and/or intravenous cholangiogram may yield the diagnosis. In jaundiced patiente where the diagnosis may be more difficult to make, one may consider doing ERCP and/or percutaneous transhepatic cholangiogram. The percutaneous transhepatic cholangiogram seems to be very helpful in diagnosing jaundiced patients. It is being used more and more in recent years but this method is not without complication. With advent of ERCP, visualization of the biliary tree has become a simple procedure when performed by expert endoscopists. To our knowlege, no previous case of choledochal cyst diagnosed by ERCP has been reported. yet in our country This paper reports 4 cases of choledochal cyst diagnosed by ERCP.

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봉합사에 (縫合絲) 의한 수술후 위석의 (胃石) 내시경적 체험 1예 ( Postgastrectomy Bezoar Due to Suture Thread ): Korean J Gastrointest Endosc 1981;1(1):41-44. Published online November 30, 1980

Abstract PDF: There are various reports referring to the clinical siignificances and removal of postgastrectomy bezoar. In this case, suture thread were thought to he the important factor of the bezoar formation, This bezoar was removed intaetly uaing fiber-optic endoscope in patinet who had postgastrectomy bezoar, by cutting the thread by biopsy forceps.

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Double Pylorus 의 1예 ( Double Pylorus : A case report ): Korean J Gastrointest Endosc 1981;1(1):45-48. Published online November 30, 1980

Abstract PDF: A 63 year-old man was admatted to our hospital because of dulI epigastralgia. Upper G-I series reveaied the generalized thickened, tortuous mucosal folds in the stomach and duodenal bulb, Two ovold large pits on the antrum were observed endoscopically, Tha relevant literatures on the subject were reviewed.

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