Clinical Endoscopy

Case Report

Endoscopic Treatment of Jejunal Heterotopic Gastric Mucosa that Caused Recurrent Intussusception: Ke Ryun Ahn, Ja Seol Koo, Hwan Il Kim, Ji Hye Kim, Jee Hyun Lee, Seung Young Kim, Sung Woo Jung, Sang Woo Lee; Clin Endosc 2017;50(6):605-608. Published online October 18, 2017; DOI: https://doi.org/10.5946/ce.2017.026

Heterotopic gastric mucosa (HGM) is a rare anomaly in the small bowel and may be the cause of intussusception when it gets a lead point in the jejunum. All cases of intussusception due to intestinal HGM have been treated with surgical resection. A 5-year-old girl presented with chief complaints of vomiting and abdominal pain for 2 weeks. A computed tomography scan of the abdomen showed intussusception at the proximal jejunal loops. Three air reductions and one saline reduction were attempted without success. She continued to be symptomatic, and endoscopic evaluation was performed. Enteroscopy revealed some variable-sized polypoid mucosal lesions with erosions on the proximal jejunum. Endoscopic mucosal resection was performed using a snare. The resected tissues histologically showed a hyperplastic polyp arising from the HGM. Her symptoms did not recur within 1 year after the treatment. Our case showed that enteroscopy could be useful for the diagnosis and management of jejunal intussusception caused by HGM.

Citations

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Endoscopic Mucosal Resection in Children
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Journal of Pediatric Gastroenterology and Nutrition.2022; 74(1): 20. CrossRef
Life-threatening gastrointestinal bleeding caused by jejunal heterotopic gastric mucosa in an adult dog: a rare case report
Roxana Merca, Barbara Richter
BMC Veterinary Research.2022;[Epub] CrossRef
Rare polypoid gastric mucosa induced small bowel intussusception in a toddler
Brianna M. Bowman, Suy sen Hung Fong, Joel M. Prince, Subhasis Misra, Thomas Abbruzzese, Drew Rideout
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Intraoperative Endoscopy in Transient Adult Jejunojejunal Intussusception
Takeshi Okamoto, Hidekazu Suzuki, Katsuyuki Fukuda, Yoshihiro Moriwaki
Case Reports in Gastrointestinal Medicine.2021; 2021: 1. CrossRef
Heterotopic Gastric Mucosa in Adolescent Girl
Esra Polat, Rahşan Özcan, Nuray Kepil, Mine Güllüoğlu, Sevinç Kalin
Journal of Pediatric Gastroenterology and Nutrition.2020;[Epub] CrossRef
Jejunal Polyps out of Place: A Case of Gastric Heterotopia of the Jejunum
Siri A. Urquhart, Nayantara Coelho-Prabhu
Case Reports in Gastrointestinal Medicine.2020; 2020: 1. CrossRef
Heterotopic Gastric Mucosa Presenting as Lower Gastrointestinal Bleeding: An Unusual Case Report
Syed Muhammad Ali, Ayman Abdelhafiz Ahmed, Leena Amin Hussain Saaid, Gihan Mustafa Kamal Mohamed, Amjad Ali Shah, Mohannad Al-Tarakji, Zia Aftab, Inamulla, Sameera Rashid
Case Reports in Surgery.2019; 2019: 1. CrossRef

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Original Article

Is There a Change in Patient Preference for a Female Colonoscopist during the Last Decade in Korea?: Jung Min Lee, Eun Sun Kim, Hoon Jai Chun, In Kyung Yoo, Jae Min Lee, Seung Han Kim, Hyuk Soon Choi, Bora Keum, Yeon Seok Seo, Hong Sik Lee, Yoon Tae Jeen, Jong-Jae Park, Sang Woo Lee, Soon Ho Um, Chang Duck Kim; Clin Endosc 2018;51(1):72-79. Published online October 10, 2017; DOI: https://doi.org/10.5946/ce.2017.057

Abstract PDF PubReader ePub

Background
/Aims: Patients may feel embarrassed during colonoscopy. Our study aimed to assess changes in patient preference, over the past decade, for the sex of their colonoscopist.
Methods
Prospective studies were performed at a single health center from July to September 2008, and from July to September 2016. Subjects included colonoscopy patients (2008: 354, 2016: 304) who were asked to complete a questionnaire before colonoscopy.
Results
In 2016, 69 patients (24.9%) expressed a sex preference, compared with 46 patients (14.6%) in 2008. By 2016, female patient preference for a female colonoscopist had significantly increased to 95% (odds ratio [OR], 2.678; 95% confidence interval [CI], 1.418– 5.057; P=0.002). In multivariate analysis, patient sex (OR, 4.404; P=0.000), patient age (OR, 0.977; 95% CI, 0.961–0.992; P=0.004), and year of procedure (OR, 1.674; 95% CI, 1.028–2.752) were statistically significant factors in sex preference. Between 2008 and 2016, female patients preferred a female colonoscopist because of embarrassment. Male patients also preferred a male colonoscopist, and the primary reason shifted from expertise to patient embarrassment (2008: 29%, 2016: 63%).
Conclusions
Patients have an increased gender preference for the colonoscopist because of embarrassment. Taking this into account can increase patient satisfaction during colonoscopy.

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Special Issue Articles of IDEN 2012

Management of Non-Variceal Upper Gastrointestinal Bleeding: Seung Young Kim, Jong Jin Hyun, Sung Woo Jung, Sang Woo Lee; Clin Endosc 2012;45(3):220-223. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.220

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Upper gastrointestinal bleeding (UGIB) is a critical condition that demands a quick and effective medical management. Non-variceal UGIB, especially peptic ulcer bleeding is the most significant cause. Appropriate assessment and treatment have a major influence on the prognosis of patients with UGIB. Initial fluids resuscitation and/or transfusion of red blood cells are necessary in patients with clinical evidence of intravascular volume depletion. Endoscopy is essential for diagnosis and treatment of UGIB, and should be provided within 24 hours after presentation of UGIB. Pre-endoscopic use of intravenous proton pump inhibitor (PPI) can downstage endoscopic signs of hemorrhage. Post-endoscopic use of high-dose intravenous PPI can reduce the risk of rebleeding and further interventions such as repeated endoscopy and surgery. Eradication of Helicobacter pylori and withdrawal of non-steroidal anti-inflammatory drugs are recommended to prevent recurrent bleeding.

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Case Report

Rifampin-induced Pseudomembranous Colitis with Rectosigmoid Sparing: Sun Young Yim, Ja Seol Koo, Ye Ji Kim, Sang Jung Park, Jin Nam Kim, Sung Woo Jung, Hyung Joon Yim, Sang Woo Lee, Jai Hyun Choi, Chang Duck Kim; Clin Endosc 2011;44(2):137-139. Published online December 31, 2011; DOI: https://doi.org/10.5946/ce.2011.44.2.137

Abstract PDF PubReader ePub

Pseudomembranous colitis (PMC) is known to be associated with antibiotic treatment, but is not commonly related to antitubercular (anti-TB) agent, rifampin. PMC is frequently localized to rectum and sigmoid colon, which can be diagnosed with sigmoidoscopy. We report a case of rifampin-induced PMC with rectosigmoid sparing in a pulmonary tuberculosis patient. An 81-year-old man using anti-TB agents was admitted with a 30-day history of severe diarrhea and general weakness. On colonoscopy, nonspecific findings such as mucosal edema and erosion were found in sigmoid colon, whereas multiple yellowish plaques were confined to cecal mucosa only. Biopsy specimen of the cecum was compatible with PMC. Metronidazole was started orally, and the anti-TB medications excluding rifampin were readministerred. His symptoms remarkably improved within a few days without recurrence. Awareness of rectosigmoid sparing PMC in patients who develop diarrhea during anti-TB treatment should encourage early total colonoscopy.

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European Journal of Clinical Microbiology & Infectious Diseases.2013; 32(8): 1027. CrossRef

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