Clinical Endoscopy

A Case of Candida glabrata Esophagitis: Jung Hoon Lee, M.D., Ok Jae Lee, M.D., Hyun Joo Min, M.D., Do Yeon Kang, M.D., In Gyu Moon, M.D., Kee Dong Lee, M.D., Hyun Jeen Kim, M.D., Tae Hyo Kim, M.D. and Woon Tae Jung, M.D.; Korean J Gastrointest Endosc 2003;27(4):211-215. Published online October 31, 2003

Abstract PDF: Candida species are the most common cause of all cases of infectious esophagitis, and Candida albicans is the main causative organism of these infections. Candida glabrata has been considered a relatively nonpathogenic saprophyte of the normal flora of healthy individuals, rarely causing serious infection in human. However, following the widespread and increased use of broad-spectrum antibiotics and immunosuppressive therapy, the frequency of infections caused by C. glabrata has increased significantly. C. glabrata is of special importance because C. glabrata infections are associated with a highest mortality rate and resistant to azole antifungal agents, especially fluconazole. We report a case of C. glabrata esophagitis resistant to fluconazole but treated effectively with amphotericin B.

1,770 View
5 Download

A Case of Spontaneous Regression of Advanced Gastric Cancer: Hyun Wha Chung, M.D., Dong Kyun Son, M.D., Jeong Sun Ji, M.D., Dae Young Chung, M.D., Ji Sung Chung, M.D., Jin Il Kim, M.D., Soo-Heon Park, M.D., Joon-Yeol Han, M.D., Jae Kwang Kim, M.D., Kyu Won Chung, M.D. and Hee Sik Sun, M.D.; Korean J Gastrointest Endosc 2003;27(4):216-219. Published online October 31, 2003

Abstract PDF: Spontaneous regression may occur in malignancies such as hypernephroma, neuroblastoma, malignant melanoma, choriocarcinoma, and bladder tumor, but yet it is extremely rare in carcinoma of the stomach. So far, 19 cases have been reported in the English literature and the mechanisms underlying this intriguing phenomenon remain unknown. A 48- year-old man with histologically-verified advanced gastric carcinoma had received no treatment since its diagnosis. However, gastric carcinoma was no longer detectable by endoscopy and histology after 4 years. Thus, we report a case of spontaneous regression of carcinoma of the stomach with a brief review of relevant literatures.

2,373 View
18 Download

Hemoperitoneum Induced by Gastrointestinal Stromal Tumor Rupture of the Stomach: Eun Young Cho, M.D., Mi Ryeong Sim, M.D., Sang Jae Rhee, M.D., Hee Sik Kim, M.D., Joo Jin Yeom, M.D., Yong Sung Kim, M.D., Sang Wook Kim, M.D., Geom Suck Seo, M.D., Young Woo Son, M.D., Tae Hyeon Kim, M.D., Suck Chei Choi, M.D., Eun A Kim, M.D.*, Yong Ho; Korean J Gastrointest Endosc 2003;27(4):220-224. Published online October 31, 2003

Abstract PDF: Gastrointestinal stromal tumors (GIST) form a group of uncommon neoplasms originated from the pleuripotential mesenchymal cell. There is no final conclusion about accurate diagnosis and prognostic factors of GIST. Clinical presentation is not specific and intraperitoneal bleeding is a very rare complication. We report a case of a malignant GIST complicated by intraperitoneal hemorrhage, which was diagnosed by abdominal CT and EUS before operation. A subtotal gastrectomy was perfomed without complication. The patient is still alive without recurrence.

1,778 View
0 Download

A Case of a Y-shaped Pedunculated Gastric Polyp Presenting as an Upper Gastrointestinal Bleeding in a Patient with Chronic Renal Failure: Jin Seok Ko, M.D., In Sang Yun, M.D., Myong Sik Kim, M.D., Ilhyun Baek, M.D., Myung Seok Lee, M.D. and Chong Woo Yoo, M.D.*; Korean J Gastrointest Endosc 2003;27(4):225-228. Published online October 31, 2003

Abstract PDF: Upper gastrointestinal bleeding is one of the most common complications in patients with chronic renal failure. Common causes are peptic ulcer, gastritis, duodenitis, esophagitis, Mallory-Weiss tear, and angiodysplasia. However, gastric polyp is a rare cause of upper gastrointestinal bleeding. We diagnosed a bleeding hyperplastic polyp in chronic renal failure patient with melena. He had a bleeding polyp with a Y-shaped stalk. This polyp was treated effectively by endoscopic snare polypectomy.

1,816 View
1 Download

A Case of Primary Gastric Burkitt's Lymphoma: Sung Chul Choi, M.D., Jun Haeng Lee, M.D., Hyuk Lee, M.D., Jeong Hwan Kim, M.D., Min Hyung Kim, M.D., Poong-Lyul Rhee, M.D., Jae J. Kim, M.D., Jong Chul Rhee, M.D., Ki Hyun Kim, M.D., Yong-Heyh Ko, M.D.* and Chang Ok Sung, M.D.*; Korean J Gastrointest Endosc 2003;27(4):229-233. Published online October 31, 2003

Abstract PDF: Primary gastric lymphomas can be defined as lymphomas which are confined to the stomach without systemic metastasis. Primary gastric Burkitt's lymphoma is a rare disease that belongs to the aggressive non-Hodgkin's lymphomas. Chemotherapy is the mainstay of treatment, even in the localized disease. We report a case of primary gastric Burkitt's lymphoma in a 24-year-old female presenting with an intermittent epigastric pain for 3 months. Upper gastroduodenal endoscopy detected an ulcer with thickened folds on the greater curvature side of the lower body, and histologic examination of the biopsy specimens revealed infiltration of medium-sized lymphoblasts with characteristic "starry sky" macrophages. Abdominal CT scan demonstrated marked gastric wall thickening and regional lymph node enlargement.

1,613 View
2 Download

A Case of Amoxicillin-induced Segmental Hemorrhagic Colitis: Chung Hyeon Kim, M.D., Yun Ju Jo, M.D., Jeong Soo Cho, M.D., Eun Gyu Lee, M.D., Won Wook Choi, M.D., Tae Hun Kim, M.D., Yeon Ho Joo, M.D., Young Sook Park, M.D. and Wan Seop Kim, M.D.*; Korean J Gastrointest Endosc 2003;27(4):234-238. Published online October 31, 2003

Abstract PDF: Clinically, we often encounter patients who have symptoms of loose stool or diarrhea due to the use of antibiotics. Psuedomembranous colitis is the most frequent, but hemorrhagic colitis is rare. Penicillin-like-antibiotics-induced hemorrhagic colitis was infrequently reported in abroad, but in Korea, quinolone-induced colitis was reported. We found a case that the patient had the hematochezia after use of amoxicillin for eradication of H. pylori. Colonoscopic abnormalities showed superficial ulceration and mucosal edematous change without pseudomembrane on the ascending and transverse colon. We diagnosed the amoxicillin- induced hemorrhagic colitis by clinical course, colonoscopic findings, histologic findings and other laboratory results for differential diagnosis. This disease is rare but rapidly recovered after the withdrawal of the antibiotics and has a good prognosis. Therefore, we should differentiate this disease from hemorrhagic colitis of other causes by history taking.

1,966 View
4 Download

A Case of Primary Small Cell Neuroendocrine Carcinoma of the Rectum: Jeong Hwan Kim, M.D., Young-Ho Kim, M.D., Jae Hong Jung, M.D., Bong Geun Song, M.D., Sung Chul Choi, M.D., Poong-Lyul Rhee, M.D., Jae J. Kim, M.D. and Jong Chul Rhee, M.D.; Korean J Gastrointest Endosc 2003;27(4):239-243. Published online October 31, 2003

Abstract PDF: Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures. (Korean J Gastrointest Endosc 2003;27:239-243)

1,898 View
4 Download

A Case of Secondary Amyloidosis Associated with Intestinal Tuberculosis: Jungkwon Kim, M.D., Seung-Jae Myung, M.D., Jungjoon Choi, M.D., Gideog Kim, M.D., Dongryoul Oh, M.D., Sujin Koh, M.D., Won-Jang Kim, M.D., Jintae Park, M.D., Ginhyuk Lee, M.D., Suk-Kyun Yang, M.D., Weon-Seon Hong, M.D., Jin-Ho Kim, M.D., Young-Il Min, M.D; Korean J Gastrointest Endosc 2003;27(4):244-248. Published online October 31, 2003

Abstract PDF: The secondary amyloidosis (AA type), a complication of inflammation or infection, is caused by the deposition of serum amyloid protein A in various organs. The clinical manifestations of amyloidosis are various according to involved organs. The gastrointestinal tract is one of the commonly affected organs. However, the endoscopic findings of gastrointestinal amyloidosis are nonspecific, and symptoms are diverse. Hepatic involvement of amyloidosis rarely leads to hepatic dysfunction, threfore is not a clinical concern. We report a 54-year-old women with intestinal tuberculosis whose major symptom was watery diarrhea lasting several months. The amyloid deposits were histologically proven in the rectum of which mucosa showed redness and swelling endoscopically and hepatic involvement of amyloidosis was suspected on abdominopelvic CT scan. After anti-tuberculosis medication for 6 months, abdominopelvic CT scan showed resolution of hepatic involvement and colonoscopy revealed improvement of redness and loss of vascularity of the rectum.

2,047 View
7 Download

Papillary Stenosis and Cholangitis Caused by Endoscopic Mucosal Resection of Ampullary Adenoma: Jung Joon Choi, M.D., Myung-Hwan Kim, M.D., Gi Deog Kim, M.D., Jung Kwon Kim, M.D., Jin Tae Park, M.D., Dong Ryeul Oh, M.D., Wook Jang Seo, M.D., Won Jang Kim, M.D., Sung Koo Lee, M.D., Young Il Min, M.D., Eun Sil Yu, M.D.* and Mi Jung Kim, M.D.*; Korean J Gastrointest Endosc 2003;27(4):249-253. Published online October 31, 2003

Abstract PDF: Adenomas of the major duodenal papilla are rare but clinically important since they are a premalignant condition. Endoscopic mucosal resection has emerged as the first line therary for ampullary adenoma. However, various complications such as pancreatitis, bleeding or duodenal perforation have been reported after endoscopic mucosal resection. To our knowledge, cholangitis has not been reported as a complication of the procedure in the literature. We report a case of papillary stenosis and cholangitis caused by endoscopic mucosal resection of ampullary adenoma. We performed the endoscopic biliary spincterotomy followed by biliary stenting and cholangitis was successfully controlled.

1,663 View
8 Download

A Case of Biliary Cast with a Characteristic Finding on ERCP: Byoung Uk Lim, M.D., Hae Kyung Kim, M.D.*, Sun Ae Chae, M.D., Kwang Rhyul Rhu, M.D.*, Koo Young Kim, M.D.*, Young Woo Kwon, M.D.*, Byoung Won Huh, M.D.*, Ho Jung Kim, M.D.*, Sung Koo Lee, M.D.^† and Myung Hwan Kim, M.D.^†; Korean J Gastrointest Endosc 2003;27(4):254-257. Published online October 31, 2003

Abstract PDF: Cast formation of biliary sludge leading to obstruction and cholangitis have been reported in patients who received orthotopic liver transplantation. The pathogenesis of biliary cast after orthotopic liver transplantation appeared to be multifactorial. Cold ischemic damage, immunologic attack to the bile duct and bile stasis may have played a role. On the other hand, only three cases of biliary cast have been reported in non-transplanted patients. We described the successful endoscopic removal of this complication in a 70-year-old man whose biliary sludge aggregated into firm casts occupying the extrahepatic ducts which has been developed after cholecystectomy and segmentectomy for intrahepatic cholangiocarcinoma. We speculated on the hemolysis and prolonged fasing as the initiating events but the exact pathogenesis of biliary cast remains to be clarified.

2,059 View
3 Download

A Case of Acute Recurrent Pancreatitis Whose Etiology was Diagnosed by Endoscopic Ultrasonography: Sung Hoon Moon, M.D., Myung-Hwan Kim, M.D., Kyu-pyo Kim, M.D., Hyeong-Su Kim, M.D., Jin Woo Song, M.D., Chul Ho Hyung, M.D., Jin Tae Park, M.D., Dong Hoon Yang, M.D., Gi Deog Kim, M.D., Yoon Seon Lee, M.D., Sang Soo Lee, M.D., Dong Wan Seo, M.D., Sung Koo; Korean J Gastrointest Endosc 2003;27(4):258-262. Published online October 31, 2003

Abstract PDF: Acute recurrent pancreatitis results most commonly from gallstone disease. Although transabdominal ultrasound is a common procedure for evaluating biliary tract, it may not be effective in minilithiasis. We here report a case of acute recurrent pancreatitis, in which endoscopic ultrasonography revealed minilithiasis in the gallbladder with a review of the literature. A 57-year-old woman had suffered from idiopathic recurrent pancreatitis four times for the past 4 months. While transabdominal ultrasonography and abdominal computerized tomography revealed no evidence of bliary stones, but EUS exhibited minilithiasis in the gallbladder. After laparoscopic cholecystectomy, no further events of pancreatitis happened.

1,887 View
2 Download

Early Diagnosis of Adenocarcinoma of the Ampulla of Vater during Treatment of Herpes Zoster: Eun Sun Jin, M.D., Young-Woon Chang, M.D., Yong Hee Joung, M.D., Byoung Wook Lee, M.D., Yo Seb Han, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byung-Ho Kim, M.D., Joung Il Lee, M.D. and Rin Chang, M.D.; Korean J Gastrointest Endosc 2003;27(4):263-266. Published online October 31, 2003

Abstract PDF: Herpes zoster infection may herald the presence of a hidden malignancy. We encountered a case of a carcinoma of the ampulla of Vater in a 72-year-old female in which the ampullary lesion was found during a work-up for excluding certain causes of Herpes zoster infection. An esophagogastroduodenoscopy showed a polypoid mass at the ampulla of Vater. A pylorus-preserving pancreaticoduodenectomy was performed and the pathology of the resected specimen confirmed well differentiated adenocarcinoma in the background of villous adenoma. The stage of the tumor was T₂N₀M₀. This case illustrates that it may be necessary to do some diagnostic work-ups in patients with Herpes zoster infection to exclude underlying diseases. However, the extent of the work-ups should be determined in the future based on the cost-effectiveness data.

1,608 View
1 Download

Previous issues