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Volume 12(2); December 1992
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말기 신부전환자에서의 상부위장관 내시경 소견 ( Upper Gastrointestinal Endoscopic Findings in Chronic Renal Failure Patients )
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Korean J Gastrointest Endosc 1992;12(2):215-220. Published online November 30, 1991
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- It has been well known that variable complications oecur in multiple organs in chronic renal failure patients. Of them gastrointestinal complications are also variable including nausea, vomiting, gastritis, peptic ulcer, gastrointestinal bleeding, hepatitis, pancreatitis, telangiectasia, angiody- splasia etc. Of such complications the incidence of peptic ulcer had been known to be high, but after endoscopic study, the incidence of nonulcer mueosal lesion has been more common. So we evaluated tbe upper gastrointestinal mucosal lesion in chronic renal failure patients by endoscopic examination. 129 subjects(mean age, 42 years, creatinine clearance ratio<10 ml/min) participated in this study. After overnight fasting the subjects were premedicated with simethicon and benoxinate. The mucosal lesion was diagnosed by two endoscopists with observing the TV monitor of electronic endoscope Fujinon EVG-FP. Of the 129 patients, 78 patients(76%) were revealed to abnormal endoscopic finding. Of the abnormal findings, the incidence of gastritis was most common in 34.9%, and then gastic erosion, duodenal erosion, gastric petechiae, gastric telangiectasia, duodenitis, gastric ulcer, gastric xanthoma, esophageal erosion, duodenal ulcer, esophageal uicer in orders. There was no difference in abnormal finding according to therapeutic type. From our study, we conclude that the incidence of nonulcer mucosal lesion is higher than ulcer disease in chronic renal failure patient, moreover those lesion can be diagnosed only by endoseopy. So we think that upper gastrointestinal endoscopy is necessory for evaluation of upper gastrointestinal tract in chronic renal failure patient.
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식도 기관지 누공을 동반한 악성식도협착에서 Cuffed 인공식도관의 내시경적 삽관술 ( Endoscopic Treatment with a Cuffed Prosthesis for Malignant Esophago - Bronchial Fistula )
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Korean J Gastrointest Endosc 1992;12(2):221-226. Published online November 30, 1991
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- Malignant esophago-bronchial fistula is an incurable and distressing condition. The passage of swallowed saliva and solid or liquid food into the bronchial tree causes coqghing and frequent pulmonary infection and collapse. Most patients are unfit for major surgery, but intubation offers a quick, simple and effective treatment with improved length and quality of life. However, intubation with simple esophageal tubes are liable to result in failure to occlude the fistela, migration of the tube, erosion, and in the case of latex tubes, disintegration. To overcome these problems, the fistula is intubated perorally with a prosthesis surrounded by a foam rubber cuff contained ia silicone sheath, in which vacuum can be created. This cuffed prosthesis is the most satisfactory design for the treatment of malignant esophago-bronchial fistula with effiective and gentle occlusion of the fistula without risk of pressure necrosis. We experienced a case of the endoscopic treatment with a cuffed prosthesis for malignant esophago-bronchial fistula. So we report this case with brief review of the previous literatures.
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상부 위장관 이물질의 내시경적 적출 ( Endoscopic Removal of Upper Gastrointestinal Tract Foreign Body )
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Korean J Gastrointest Endosc 1992;12(2):227-230. Published online November 30, 1991
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- The clinical review was done on 17 cases with the foreign body in the upper gastrointestinal tract who underwent endoscopic removal of foreign body at Kang Nam Sacred Heart Hospital from Dec. 1981 to Dec. 1991. The results were as follows: 1) The age distribution varies from 3 months to 72 years of age, being most prevalent under 5 years of age. 2) The incidence of foreign body in the order of frequency was coin, fish bone, safety pinring, peanut, keyring, food bolus, artificial teeth and medal. Among 17 cases, 9 cases(53.0%) were lodged in the esophagus and 8 cases(47.0%) were lodged in the stomach. 3) Dysphagia or globus was the common symptom in 8 cases(47.2%), followed by absence of symptom in 7 cases(41.2%), upper abdominal discomfort in 1 case(5.8%) and vomiting in 1 case (5.8%). 4) l0 cases(58.8%) of foreign body were removed within 72 hours and 7 cases(41.2%) of foreign body were removed after 72 hours.
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상부위장관을 침범한 H-S Purpura 1예 ( A Case of Henoch - Schoenlein Purpura Involving upper GI Tract )
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Korean J Gastrointest Endosc 1992;12(2):231-235. Published online November 30, 1991
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- Henoch-Schonlein purpura(anaphylactoid purpura) is a necrotizing vasculitis of small vessels in which systemic manifestation include palpable purpura on the lower extremities and buttocks due to leukocytoclastic vasculitis of dermal vessels; arthralgia of large joints, usually the knees and ankles; gastronitestinal involvement with colic and bleeding; and renal ievolvement, usually with a focal necrotizing glomerulonephritis. Gastrointestinal involvement occurs in about two thirds of all pediatric cases and in about,one third of adult cases, Any bowel segment may be involved, but the jejunum and ileum are most frequently affected. With a brief review of the literature, we report a case of H-S purpura involving stomach and duodenum.
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악성종양 환자에서 발생한 Cytomegalovirus ( CMV ) 감염과 관련된 위궤양 2예 ( Cytomegalovirus ( CMV ) - associated Gastric Ulcer Proved by Dot - blot Hybridization )
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Korean J Gastrointest Endosc 1992;12(2):237-242. Published online November 30, 1991
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- In gastrointestinal tract CMV has been implicated in inducing mucosal inflammatory and ulcerative lesions. More recently, increasing number of patients with CMV-associated gut lesions have been reported primarily in immunocompromised patients or occasionally in normal hosts. The colon is the most common site of the infection, although it might occur in other gastrointestinal tract such as esophagus, stomach, duodenum and terminal ileum. The diagnosis of CMV infection can often be difficult and must await serological conversian or viral cultures. (continue...)
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전이성 위선암 1예 ( A Case of the Poorly Differentiated Metastatic Adenocarcinoma with Unknown Origin in Stomach )
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Korean J Gastrointest Endosc 1992;12(2):243-248. Published online November 30, 1991
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- Metastatic cancer with unknown origin(MUO) is not a rare disease in general hospitals and cancer therapeutic centers with a overall incidence of 4-10%. Although there is no universally accepted definition of MUO, an adequate definition includes any case with histologically confirmed metaetatie Carcinoma in which no primary site has been identified inspite of a thorough history; careful physical examinations, and screening tests. Tha diagnostic procedures are important because of therapeutic plans and the prognosis are more dependent upon the cancer tissue type rather than any other factors. Metastasis to the stomach is much more rare occasion in clinical situations of cancer metastasis. We experienced a case of poorly differentiated metastatic adenocarcinoma in stomach which showed: multiple doughnut-like submucosal tumors with central ulceration by gastrofiberscopy and could not identified the primary site in spite of a thorough diagnostic studies including immunochemical histology.
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위의 사중암 1예 ( A Case of Synchronous Four Gastric Cancer )
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Korean J Gastrointest Endosc 1992;12(2):249-252. Published online November 30, 1991
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- The incidence of synchronous gastric cancer is variously reported to be 2.07%, 5.22%, 6.5%, 8.6%, or 9% and has been increasing recently, probably with advance in the diagnosis of gastric cancer. Our case in presentation is a 70-year-old male patient who had total gastrectomy and esopbagiojunostomy done for synchronous four gastric cancer. Each has different histologic types, Some of these lesions are not suspected before operation and are found almost by chance during histologic examinations after surgery performed only to remove main lesion. So we report this case with a review of literatures.
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위암과 동반된 Sweet 증후군 1예 ( A Case of Sweet's Syndrome Associated with Gastric Adenocarcinoma )
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Korean J Gastrointest Endosc 1992;12(2):253-257. Published online November 30, 1991
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- Sweets syndrome has 4 cardinal features, that is, fever, neutrophil polymorphonuclear leukocytosis of the blood, raised painful plaques on the limbs, face and neck, histologically a dense dermal infiltration with mature neutrophil polymorphs. Hematologic malignancies are associated with 10-15% of cases, but gastric adenocarcinoma associated case is very rare. A 57-year-old male patient admitted to Korea University affiliated hospital because of fever and painful erythematous plaques of both limbs. No response to antibiotics and antihistamines for 1 week, so we referred to dermatologic department for skin biopsy. After then under the impression of Sweet's syndrome, oral prednisolone 60 mg/day prescribed and skin lesions were progressively regressed. For the purpose of screening of associated disease, we did abdominal CT scan and panendoscopy with biopsy which revealed adenocarcinoma of stomach. We couldn't find out any other etiologic agents.
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소아에서 발생한 조기위암 1예 ( A Case of Early Gastric Cancer in Childhood )
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Korean J Gastrointest Endosc 1992;12(2):259-261. Published online November 30, 1991
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- The incidence of gastric cancer is high in old age group and low in young age group, extremely rare in child age. So the diagnosis of gastric cancer in young age is often delayed, and this, with other factors such as poorly differentiated histopathologic tendency and rapid growing nature, makes the prognosis poorer than in other age guoup. Therefore it should always be remembered that the young who has gastric symptom may have malignancy in his stomach in spite of the age. We report a case of early gastric cancer in a 16-years old male with the review of the literature.
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토혈을 동반한 십이지장결핵 1예 ( A Case of Duodenal Tuberculosis Associated with Hematemesis )
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Korean J Gastrointest Endosc 1992;12(2):263-266. Published online November 30, 1991
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- Despite the marked decreased frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is considered to be relativeiy frequent in developing countries. Tuberculosis of the duodenum is rare, little reported in the literature. The prevalenoe rates in reports dealing with necropsy observations in patient with pulmonary tuberculosis range from 0.36%-2.3%. Definitive diagnosis will require endoscopic or surgical biopsy because of inconsistent clinical findings, Recently, we experienced a case of duodenal tuberculosis with massive UGI bleeding, masquering as a duodenal ulcer bleeding, and diagnostic confirmation was attained by histologic findings of endoscpic biopsy. A 65-year-old woman was admitted with 3 months history of epigastric discomfort, 1 day history of hematemesis and melena. Urgent endoscopy revealed active bleeding from a large ulcer causing obstruction of the 2 nd portion of duodenum and endoscopic electrocoagulation was performed with success. After a reasonable medical trial, follow-up endascopic examinations of lesion showed no response. So, endoscopic biopsies was done and histopathology revealed multiple granuloma with central necrosis.
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Billroth Ⅱ 위절제술 환자에서의 내시경적 역행성 췌담관 조영술 및 유두부 절개술 ( Endoscopic Retrograde Cholangiopancreatography and Endoscopic Sphincterotomy in Patients with a Previous Billroth-Ⅱ Resection )
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Korean J Gastrointest Endosc 1992;12(2):267-269. Published online November 30, 1991
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- Endoscopic retrograde cholangiopancreatography(ERCP) and its therapeutic developments have become popular in the managemtnt of patients with biliary and pancreatic disease. But certain to anatomical arrangements such as Billroth II partial gastrectomy may cause technical difficulty In the patients with a previous Billroth-II resection, it may be difficult to enter the afferent loop Selectively; and to reach and identify the papilla. Cannulation and sphincterotomy are more difficult because of the direction of approach. Endoscopic retrograde cholangiopancreatography(ERCP) and/or endoscopic sphineterotomy (EST) was perfomed on 12 patients, who had received Billroth II gastrectomy. We could achieve successful cholangiogram in 9 patients(75%) out of 12 patients, And EST was done successfully in 5 patients(83%) out of 6 patients.
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Billroth-Ⅱ 위절제술 환자에서 치료 내시경적 역행성 담관췌관조영술 ( Therapeutic Endoscopic Retrograde Cholangiography in Patients with a Billroth Ⅱ Gastrectomy - 2 cases of ERBD & 1 case of endoscopic stone retrievial - )
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Korean J Gastrointest Endosc 1992;12(2):271-277. Published online November 30, 1991
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- Endoscopic retrograde cholangiopancreatography(ERCP) procedures are more difficult in patients who have undergone partial gastrectomy with Billroth II anastomosis. Because its altered anatomical relationship. the endoscopist is presented with additional problems: (i) Dfficulties in entering the afferent loop, depending on the surgical techiques used. (ii) The endoscope may be too sort to reach the papillary region unless the loops are suecessfully straightened out. (iii) Difficulties in passing the ligament of Treitz, especially in patients with Braun's anastomosis, (iv) Problems in cannulating the papilla and especially the common bile duct from a reversed position. (v) Problems in carrying out a papillotomy in a correct position. We attempted endoscopic sphincterotomy in 3 opatients previously subjected to gastrectomy with needle knife, and succeeded in 2 of them. In the two patients, successful billary drainage was achieved. And one patients with Billroth II gastrectomy, presented with CBD stone and cholangit, was successfully treated with endoscopic stone retriveial. The patient with a Billroth-II operation may unergo endscopic diagnostic as well as thera peutic procedures with a high rate of success, and can be suitable candidates for ERCP and endoscopic sphincterotomy
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경피경간 담낭경검사법 ( Percutaneous Transhepatic Cholecystoscopy ; PTCCS ) 을 이용한 담낭결석 제거술 ( Nonsurgical Treatment of Gallbladder Stones with Percutaneous Transhepatic Cholecystoscopy )
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Korean J Gastrointest Endosc 1992;12(2):279-284. Published online November 30, 1991
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- With the technical development of ultrasonically guided punture of the gallbladder, percutaneous transhepatic cholecystoscopy(PTCCS) was first performed in 1981 by Inui et al. and Ichikawa et al. This procedure useful for preoperative, accurate diagnosis of carcinoma and nonsurgical treatment of high-risk patients with gallbladder stones. PTCCS-lithotripsy(PTCCS-L) is one of the non-surgical treatment modalities for gallbladder stones, and is a safe, reliable and technically easy therapeutic procedure through improvement in PTCCS-L manipulation and the development of new devices for this technique. PTCCS-L is performed when the patients with gallbladder stones cannot be operated on because of the risk of complications, such as renal failure, congestive heart failure etc. In this report, we present the proeedures of PTCCS-L for the the nonoperative treatment of gallbladder stones in the patient with cholangitis and cholecystitis because of common bile duct stone and gallbladder stones. Since a sinus tract of about 5 mm in diameter was needed to pass an endoscope, the sinus tract of percutaneous cholecystostomy was dilated immediately upto 18 French in diameter in a single step following percutaneous cholecystostomy itself, using a dilator set containing 10, 14, 16 and 18 French dilators and 18 French sheath. And then PTCCS-L with electrohydraulic lithotripter was successfully performed with a complete removal of gallbladder stones. There- after endoscopic sphincterotomy and mechanical lithotripsy was successfully done for the removal of common bile duct stone. There has been no recurrence of gall stones for up to 1 year.
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담관 낭종에 대한 임상적 고찰 ( A Clinical Analysis of Choledochal Cyst )
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Korean J Gastrointest Endosc 1992;12(2):285-291. Published online November 30, 1991
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- Cystic dilatation of bile duct, so called choledochal cysts are a well documented abnormalities. Although choledochal cyst is a relatively rare disease, the number of reports have been increasing especially in tht Orient. It may be easily overlooked by the conventional diagnostic methods, such as upper gastrointestinal series, intravenous cholangiography and abdominal ultrasonogrsphy. Recent advances on diagnostic methods, such as endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography had been helpful in demonstrating choledochal cysts. 29 patients with choledochal cysts who had been admitted in Hanyang Universty Hospital between September l981 and August 1991 were reviewed and the clinical endoseopic and rediographic findings were discussed comparing with that from foreign literatures. (continue...)
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복강경 담낭절제술 300예의 임상분석 ( A Clinical Analysis of 300 Case of Laparoscopic Cholecystectomy )
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Korean J Gastrointest Endosc 1992;12(2):293-301. Published online November 30, 1991
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- With advancement of endoscopical instruments and technique, gallstone diseases can be managed with laparoscopic cholecystectomy which has rapidly and radically changed the surgical treatment of gallstone diseases. The ideas of laparoscopic surgery was introduced by Germany gynecologist Semm, in 1967 and was first performed by French surgeon Mouret, Dubois in 1987. Although many reports of early laparoscopic cholecystectomy were excellent, many surgeons want to know the surgical results of laparoscopic cholecystectomy are enough good to perform comparing with the conventional cholecystectomy, especially in early complications and late complications. (continue...)
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방사선성 직장선암 1예 ( A Case of Radiation Induced Rectal Adenocarcinoma )
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Korean J Gastrointest Endosc 1992;12(2):303-306. Published online November 30, 1991
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- The development of colorectai cancer following pelvic irradiation has been a much less common event. A 58-years-old woman presented with tenesmus for 5 months. She had a stage IIb, carcinoma of the cervix for which she underwent radiation therapy in 27 years before. Colonscopic findings revealed polypoid mass and irregular ulceration on the rectum and proctitis associated with stricture that was compatible with her previous history of radiation. Histoyathological examination of the polypectomy specimen disclosed adenocarcinoma. So we reported a case of radiation induced carcinoma of reotum which might be the first case in Korean literature. It therefore, behooves the clinician who follows patients whose carcinoma of the cervix or corpus uteri has been cured by radiation therapy to be vigilant for the subsequent development of colon and rectal cancer.
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맹장의 스파르가눔증 ( Sparganosis ) 1예 ( Cecal Sparganosis Manifested as Chronic Intestinal Obstruction - Case report - )
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Korean J Gastrointest Endosc 1992;12(2):307-310. Published online November 30, 1991
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- Sparganosis is a parasitic infectious disease by sparganum which is a plerocercoid larva of spirometra, a kind of cestode. We experienced a case of intramural sparganosis of cecum presenting as chronic intermittent abdominal pain. A 39 year old man was hospitalized due to intermittent abdominal pain for 6 months and the operation was done under the impreesion of the intestinal tuberculosis or submucosal tumor of cecum after diagnostic work-up. Resected cecum revealed diffuse wall thickening and luminal narrowing. The microscopic findings showed a degenerated larva in the muscle layer with typical tissue reaction which was basically noncaseating cavitary granulomatous inflammation and many calcareous corpuscles which were pathognomonic features of cestode were prominent within the degenerated worm.
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 간흡충증으로 인한 담낭내 가성종양
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Korean J Gastrointest Endosc 1992;12(2):318-319. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 식도 편평 상피암
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Korean J Gastrointest Endosc 1992;12(2):318-318. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : Oddi 괄약근 기능이상으로 발생된 재발성 급성췌장염
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Korean J Gastrointest Endosc 1992;12(2):319-320. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 장협착을 동반한 스파르가눔증
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Korean J Gastrointest Endosc 1992;12(2):320-321. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 십이지장 다발성 림프성 용종증
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Korean J Gastrointest Endosc 1992;12(2):321-322. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 악성변화를 동반한 가족성 선종성 용종증
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Korean J Gastrointest Endosc 1992;12(2):322-323. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 위 십이지장 및 회장에 전이된 선암
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Korean J Gastrointest Endosc 1992;12(2):323-324. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 국소위암이 포함된 위선종
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Korean J Gastrointest Endosc 1992;12(2):324-325. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 위강내 외부압박상을 보인 간세포암
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Korean J Gastrointest Endosc 1992;12(2):324-324. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 상부위장관을 침범한 H-S Purpura 1예
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Korean J Gastrointest Endosc 1992;12(2):325-326. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 유전성 출혈성 모세혈관 확장증
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Korean J Gastrointest Endosc 1992;12(2):326-327. Published online November 30, 1991
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제32회 대한소화기내시경학회 춘계학술대회 / 구연 : 위매독
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Korean J Gastrointest Endosc 1992;12(2):327-327. Published online November 30, 1991
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