Clinical Endoscopy

내시경 가이드라인의 법적 의미: Korean J Gastrointest Endosc 2004;29(4):161-174. Published online October 30, 2004

PDF

1,425 View
4 Download

Analysis of Gastrointestinal Transit Rate in Capsule Endoscopy: Bora Keum, M.D., Hoon Jai Chun, M.D., Sung Woo Jung, M.D., Sung Chul Park, M.D, Rok Son Choung, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hong Sik Lee, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D., Ho Sang Ryu; Korean J Gastrointest Endosc 2004;29(4):175-180. Published online October 30, 2004

Abstract PDF: Background
/Aims: Capsule endoscope (CE) is a new method of investigating entire small bowel (SB). Some reported that current battery time was sufficient for observing entire SB, but others reported negatively. The aims of this study were to determine the factors influencing the entire SB transit rate. Methods: From Sep. 2002 to Aug. 2003, CE was performed in 197 cases and they were devided into complete/incomplete transit according to getting ileocecal valve image within battery time. sixteen cases were excluded due to anatomical abnormality or artificial procedure. one hundred eighty one cases were analyzed with multiple logistic regression. Results: The complete SB transit rate was 63.5%. Mean battery time was 7½ hrs. Gastric transit time (GTT) was significantly shorter in complete group than in incomplete group but the other factors (age, sex, preparation, symptom) were not significant. Mean small bowel transit time in complete group was 4½ hrs and ranged from 1 to 8 hrs. In incomplete group (66 cases), 2 cases were reached to distal jejunum, 11 cases to proximal ileum, and the other 53 cases to distal ileum. Conclusions: Complete SB transit rate of CE was 63.5% in the 181 cases under current battery time. GTT was the only significant factor influencing gastrointestinal transit rate of CE. (Korean J Gastrointest Endosc 2004;29:175⁣180)

2,156 View
7 Download

Relationship between Age and Site of Colorectal Cancer Based on Colonoscopic Findings: Hang Lak Lee, M.D., Dong Soo Han, M.D., Dae Won Jun, M.D., Jong Pyo Kim, M.D.,Jin Bae Kim, M.D., Joo Hyun Sohn, M.D. and Joon Soo Hahm, M.D.; Korean J Gastrointest Endosc 2004;29(4):181-184. Published online October 30, 2004

Abstract PDF: Background
/Aims: Colorectal cancer occurs more frequently in old age. Therefore, it is important to understand the clinical characteristics of colon cancer in old age. There have been some reports stating that frequency of right side colon cancer increased with aging. Therefore, we conducted a study about the distribution of colorectal cancer according to difterent age group. Methods: We retrospectively reviewed medical records of colorectal cancer patients diagnosed by colonoscopy between January 1999 to September 2003. The location of colorectal cancer was categorized into 2 groups: right-sided colon cancer (proximal to and including the splenic flexure), left-sided colon cancer (descending, sigmoid and rectum). Results: Total 185 colorectal cancer patients were included in this study: 103 (55.7%) in men and 82 (44.3%) in women. The median age was 60.7⁑14.0 years. The proportion of patients with right-sided colon cancer increased with aging: ＜60 years, 20.3% (15/74); 60∼69 years, 35.9% (23/64); 70∼79 years, 43.3% (13/30); 80∼89 years, 47.1% (8/17). Conclusions: The frequency of right- sided colon cancer increases with age. Therefore, we think that, in screening colorectal cancer, colonoscopy should be preferred to sigmoidoscopy, especially in old age group. (Korean J Gastrointest Endosc 2004;29:181⁣184)

1,996 View
12 Download

The Usefulness of Endoscopic Ultrasonography in the Diagnosis of Diseases of Liver, Biliary Tree, Gallbladder and around Distal Common Bile Duct: Young Sup Kim, M.D., Eun Young Kim, M.D., Jong-Woon Cheon, M.D., Ji-Young Kim, M.D., Jung-Hyun Seo, M.D., Jin Hyang Shin, M.D., Wan Suk Lee, M.D., Jin Tae Jung, M.D., Joong Goo Kwon, M.D., Chang Hyeong Lee, M.D. and Ho Gak Kim, M.D.; Korean J Gastrointest Endosc 2004;29(4):185-192. Published online October 30, 2004

Abstract PDF: Background
/Aims: Endoscopic ultrasonography (EUS) is now accepted as an essential tool for the diagnosis and the therapy of various gastrointestinal diseases. With regard to the biliary system, its high diagnostic sensitivity and specificity were reported recently. We assessed the clinical usefulness of EUS for the diagnosis of diseases of the liver, biliary tree, gallbladder and distal common bile duct. Methods: We sent questionnaires about the clinical usefulness of EUS to the doctors who requested EUS examination for 32 patients with suspected diseases of the liver, gallbladder and around extrahepatic biliary tree from Aug. 2001 to Aug. 2002. We evaluated the answers and clinical characteristics of the patients. Results: Patients were 17 males and 15 females with mean age of 61.8 years old. All received abdominal computed tomography (CT) before EUS and some had abdominal ultrasonography (USG) or endoscopic retrograde cholangiopancreatography (ERCP). EUS was more accurate and informative than other imaging modalities and gave definite final diagnosis for 31.2%. In 40.6%, EUS was helpful as an additional diagnostic tool. Conclusions: EUS was useful in 71.8% of the cases for the diagnosis of diseases of the liver, biliary tree, gallbladder and around distal common bile duct. EUS can be used as an important adjunct to USG, CT and ERCP. (Korean J Gastrointest Endosc 2004;29:185⁣192)

1,915 View
4 Download

Secondary Esophageal Cancer Originated from Rectal Cancer: Jea Wook Roh, M.D., Sang Eun Lee, M.D., Ung Ryu, M.D., Byung Wook Lim, M.D.,Hynn Bae Son, M.D., Kyung Ah Kim, M.D., Jeon Ho Yang, M.D.,Young Soo Moon M.D. and Han Sung Kim, M.D.*; Korean J Gastrointest Endosc 2004;29(4):193-198. Published online October 30, 2004

Abstract PDF: Secondary esophageal carcinoma usually originates from a primary site in either the lung or breast. Only one case of metastatic esophageal cancer with a radiologic evidence that it was originated from the rectal cancer had been reported. We report an unusual case of a 80-year-old man with secondary esophageal carcinoma originated from the rectal cancer. It was diagnosed by histopathologic confirmation using immunohistochemical staining including CK20 and CK7 by comparing the histopathologic findings of surgical specimen of rectal cancer and endoscopic biopsy tissue from the esophagus. To the best of our knowledge, this is the first case of secondary esophageal cancer arising from rectum in Korea. (Korean J Gastrointest Endosc 2004;29:193⁣198)

1,666 View
4 Download

A Case of Henoch-Schönlein Purpura Associated with Gastric Ulcer Bleeding: Eun Jung Kim, M.D., Woo-Chul Chung, M.D., Kang Moon Lee, M.D., Jin Sun Lee, M.D., U-Im Chang, M.D., Hyun Mi Cho, M.D., Jin Mo Yang, M.D., Sung Kyoung Kim, M.D.,Jong Myoung Nah, M.D. and In Sik Chung, M.D.; Korean J Gastrointest Endosc 2004;29(4):199-203. Published online October 30, 2004

Abstract PDF: Henoch-Schönlein purpura is a systemic leukoclastic vasculitis that predominantly affects small vessels. This results in purpura, abdominal pain, arthralgia and occasional sometimes nephritis. Gastrointestinal involvement occurs in 50∼75% of the patients. The small bowel and colon are relatively commonly affected, but the gastric involvement is rare. Endoscopic findings include mucosal edema, hemorrhagic changes, erosions and superficial ulcers. However, deep gastric ulcers are rarely observed in Henoch-Schönlein purpura and have not been reported yet. We report a patient with typical Henoch-Schönlein purpura who presented with melena due to bleeding from multiple deep gastric ulcers and got improved with administration of high dose corticosteroid. (Korean J Gastrointest Endosc 2004;29:199⁣203)

2,086 View
10 Download

A Case of Small Bowel Polyp Bleeding Diagnosed by Capsule Endoscopy: Joo Hyun Shim, M.D., Hwi Young Kim, M.D., Joo Kyung Park, M.D., Jeong Hoon Lee, M.D.,Chang Soo Lee, M.D., Su Youn Nam, M.D., Kee Don Choi, M.D., Ho June Song, M.D.,Sang Gyun Kim, M.D., Joo Sung Kim, M.D., Hyun Chae Jung, M.D.and In Sung Song, M.D.; Korean J Gastrointest Endosc 2004;29(4):204-208. Published online October 30, 2004

Abstract PDF: Small bowel diseases are uncommon and difficult to be diagnosed by conventional methods such as endoscopy and radiologic study. Recently, wireless capsule endoscopy has been known as a new diagnostic method to detect the small bowel diseases, especially in patients with obscure gastrointestinal bleeding. A 48-year-old male patient admitted our hospital with signs of gastrointestinal bleeding and iron deficiency anemia. There was no evidence of bleeding in upper and lower endoscopic exams. Finally, wireless capsule endoscopy demonstrated small bowel polyp as a cause of obscure gastrointestinal bleeding. We report a case of small bowel polyp bleeding diagnosed by wireless capsule endoscopy with a review of relevant literatures. (Korean J Gastrointest Endosc 2004;29:204⁣208)

1,939 View
4 Download

A Case of Mantle Cell Lymphoma with Feature of Colitis Involving Duodenum and Colon: Hyun-Sook Kim, M.D., Sang-Hoon Lee, M.D., Seok Ho Dong, M.D., Hyo Jong Kim, M.D., Byoung Ho Kim, M.D., Young Woon Chang, M.D., Jung Il Lee, M.D. and Rin Chang, M.D.; Korean J Gastrointest Endosc 2004;29(4):209-212. Published online October 30, 2004

Abstract PDF: Mantle cell lymphoma (MCL) of the gastrointestinal tract is a rare form of primary gastrointestinal lymphoma. MCL of the gastrointestinal tract can involve the stomach, small intestine or colon. The major subtype of MCL is characterized by the presence of multiple lymphomatous polyps along the gastrointestinal tract. So multiple lymphomatous polyposis (MLP) has been considered as a variant form of MCL. The diagnosis of high-grade variants of MCL is a particular challenge, as these tumors exhibit a broad spectrum of morphologic findings that can be misinterpreted as other type of NHL. The development of immunohistochemical and molecular assays for MCL has allowed more accurate diagnosis of cases. We report a case of MCL with feature of colits involving duodenum, colon and rectum observed in a 60-year-old man who complained of low abdominal discomfort. (Korean J Gastrointest Endosc 2004;29:209⁣212)

1,798 View
7 Download

A Case of Successful Endoscopic Therapy in Iatrogenic Perforation of the Colon during Colonoscopy: Jai Gyu Lee, M.D., Jin Woong Cho, M.D., Paul Kim, M.D., Ji Eun Lee, M.D., Jin Gyu Lee, Sung Min Lim, M.D., In Seok Seo, M.D., Yang Ho Kim, M.D. and Yong Ung Lee, M.D. M.D.,; Korean J Gastrointest Endosc 2004;29(4):213-216. Published online October 30, 2004

Abstract PDF: Colonoscopy is a safe and standard procedure for diagnosis and therapy of colonic disorders. Iatrogenic colonic perforation during diagnostic colonoscopy, a rare abdominal emergency, has an 0.3∼0.8% incidence rate. The choice of treatment for this complication remains controversial. Prompt operative intervention is preferred to minimize morbidity and mortality. However, operative intervention is invasive and needs a long-term recovery period. Conservative treatment is less invasive but can lead to more extensive surgery in case of treatment failure. Very important point on the treatment of iatrogenic perforation of the colon during diagnostic colonoscopy is to avoid the leaking of intestinal contents into the intraperitoneal cavity. We report here a case in which an iatrogenic perforation of the colon during diagnostic colonoscopy was successfully treated by endoscopic clip therapy. (Korean J Gastrointest Endosc 2004;29:213⁣216)

2,118 View
9 Download

Upper Gastrointestinal Hemorrhage from Pancreatic Pseudocyst Involving the Duodenum: A Case Report: Chan Ran You, M.D., Seung Whan Shin, M.D., Bo In Lee, M.D., Jeong Seon Ji, M.D., Byung Wook Kim, M.D., Hwang Choi, M.D., Se Hyun Cho, M.D., Hiun Suk Chae, M.D., Kyu Yong Choi, M.D. and In Sik Chung, M.D.; Korean J Gastrointest Endosc 2004;29(4):217-221. Published online October 30, 2004

Abstract PDF: Most pancreatic pseudocysts are located in or around the pancreas, but they can be found in all the potential spaces around viscera in and outside of the abdominal cavity. The complications of pancreatic pseudocysts are infection, rupture, fistula, obstruction and hemorrhage. However, an upper gastrointestinal bleeding caused by pancreatic pseudocyst is rare. Pseudocysts with complication like hemorrhage require percutaneous, endoscopic or surgical treatment. We report a case of the pancreatic pseudocyst involving duodenal wall with upper gastrointestinal hemorrhage, which was improved by conservative treatment. (Korean J Gastrointest Endosc 2004;29: 217⁣221)

1,845 View
5 Download

A Case of Duodenal Perforation during Endoscopic Hemostasis in EST Site Bleeding: Yeong Seok Lee, M.D., Byoung Kuk Jang, M.D., Woo Jin Chung, M.D., Kyung Sik Park, M.D., Kwang Bum Cho, M.D., Jae Seok Hwang, M.D., Sung Hoon Ahn, M.D., Jung Hyeok Kwon, M.D.* and Gab Chul Kim, M.D.*; Korean J Gastrointest Endosc 2004;29(4):222-227. Published online October 30, 2004

Abstract PDF: The endoscopic retrograde cholangiopancreatography (ERCP) has become a commonly performed endoscopic procedure in biliary pathology. ERCP is a relatively safe procedure. however, there are chance of potentially severe complications; pancreatitis, hemorrhage, infection, and perforation. Duodenal perforation, uncommon but severe complication of ERCP, occurred in less than 1% of most series. According to the related mechanism, anatomical location, and the severity of injury, three to four distinct types of perforations have been described. We experienced the barotrauma associated duodenal perforation during endoscopic hemostasis in patient with EST site bleeding. This duodenal perforation was related with excessive air inflation to maintain the patency of a lumen. Endoscopists performing ERCP should bear in mind that continued air inflation may lead to duodenal perforation. (Korean J Gastrointest Endosc 2004;29:222⁣227)

1,900 View
6 Download

A Case of Gallstone Ileus Following Endoscopic Sphincterotomy: Byung Chang Kim, M.D., Hee Man Kim, M.D., Chang Mo Moon, M.D., Jeong Hun Suh, M.D.*, Yong Seok Cho, M.D.*, Chun Gyun Lee, M.D.*, Sun Young Won, M.D.*, In Suh Park, M.D.* and Seong Hyeun Yun, M.D.^†; Korean J Gastrointest Endosc 2004;29(4):228-231. Published online October 30, 2004

Abstract PDF: Gallstone ileus is caused by mechanical obstruction of the gastrointestinal tract by the gallstone and accounts for 1∼3% of all intestinal obstructions. Endoscopic sphincterotomy (EST) is the accepted treatment of choice for choledocholithiasis. Recognized complications of EST include bleeding, acute pancreatitis, retroperitoneal perforation. However, gallstone ileus is a rare complication of EST. A 70-year-old woman was admitted to our hospital with right upper quadrant pain. Abdominal ultrasound revealed single common bile duct (CBD) stone. ERCP was performed to remove the large CBD stone without mechanical lithotripsy. Nausea, vomiting and abdominal pain were developed after stone removal. Plain abdomen X-ray and computerized tomography represented marked dilatation of small bowel loops without definite obstructive lesion. Because the mechanical obstruction was sustained, explorolaparotomy was performed. On the operation, single stone was impacted at the distal ileum, narrowed by previous radiotheraphy. We reported a case of gallstone ileus after the removal of CBD stone following EST without lithotripsy. (Korean J Gastrointest Endosc 2004;29:228⁣231)

2,237 View
3 Download

Previous issues