Clinical Endoscopy

Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss: Larrite Reed, Hawa Edriss, Kenneth Nugent; Clin Endosc 2018;51(6):584-586. Published online June 1, 2018; DOI: https://doi.org/10.5946/ce.2018.038

Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015–2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.

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Acute Gastric Injury Caused by Undissolved Sodium Picosulfate/Magnesium Citrate Powder: Eun Young Ze, Chang Hwan Choi, Jeong Wook Kim; Clin Endosc 2017;50(1):87-90. Published online October 12, 2016; DOI: https://doi.org/10.5946/ce.2016.081

Abstract PDF PubReader ePub

Sodium picosulfate/magnesium citrate (SPMC) is a widely used oral bowel cleansing agent considered to be relatively safe. However, partially dissolved or undissolved SPMC powder may cause severe injuries of the esophagus and stomach. We report a very rare case of acute gastric injury without esophageal damage caused by the ingestion of undissolved SPMC powder. A 69-year-old man experienced epigastric pain after swallowing SPMC powder without dissolving it in water in preparation for a screening colonoscopy. He realized his mistake immediately and subsequently drank 2 L of water. The esophagogastroduodenoscopy conducted after 12 hours indicated an acute gastric ulceration without injury of the esophagus or duodenum. The endoscopy conducted after 6 weeks of oral proton pump inhibitor treatment showed healing of the gastric injury. This suggested that drinking large amounts of water after ingesting partially dissolved or undissolved SPMC powder can prevent serious esophageal injury, but offers no preventive benefit for acute gastric injury.

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Salvador Machlab, Esther Francia, Juanjo Mascort, Pilar García-Iglesias, Juan Manuel Mendive, Francesc Riba, Carles Guarner-Argente, Mònica Solanes, Jordi Ortiz, Xavier Calvet
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Salvador Machlab, Esther Francia, Juanjo Mascort, Pilar García-Iglesias, Juan Manuel Mendive, Francesc Riba, Carles Guarner-Argente, Mònica Solanes, Jordi Ortiz, Xavier Calvet
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Jin Young Yoon, Su Bee Park, Moon Hyung Lee, Min Seob Kwak, Jae Myung Cha
The Korean Journal of Gastroenterology.2024; 84(4): 177. CrossRef
Quality of bowel preparation in patients with inflammatory bowel disease undergoing colonoscopy: What factors to consider?
Antonietta Gerarda Gravina, Raffaele Pellegrino, Mario Romeo, Giovanna Palladino, Marina Cipullo, Giorgia Iadanza, Simone Olivieri, Giuseppe Zagaria, Nicola De Gennaro, Antonio Santonastaso, Marco Romano, Alessandro Federico
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Journal of Medical Sciences.2019; 39(5): 251. CrossRef
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A Case of Cytomegalovirus Gastric Ulcer Mimicking Gastric Cancer in an: Lae Hyun Phyun, M.D., Kwang Hyun Ko, M.D., Esther Kim, M.D., Sun Young Kwak, M.D.,; Korean J Gastrointest Endosc 2004;28(2):92-96. Published online March 1, 2004

Abstract PDF: A 27-year-old woman presented with epigastric pain. Abdominal computed tomography revealed an irregular ulcer with circumferential thickening of the gastric antral wall. An endoscopy suggested advanced gastric cancer or gastric lymphoma. Biopsy of the lesion showed an inclusion body of the cytomegalovirus and positive immunohistochemical staining of the infected cell for cytomegalovirus. A thorough evaluation of her immune system revealed no abnormality. General supportive treatment for gastric ulcer did not relieve her symptoms. Intravenous infusion of ganciclovir improved her symptoms and healed the ulcer. We report a case of cytomegalovirus-associated gastric ulcer mimicking malignancy in an immunocompetent woman. (Korean J Gastrointest Endosc 2004;28: 92⁣96)

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이중유문 ( Double Pylorus ) - 선 , 후천적 이중유문 증례보고와 그 문헌적 고찰 - ( Two case reports and review of the literature ): Korean J Gastrointest Endosc 1993;13(1):45-49. Published online November 30, 1992

Abstract PDF: The double pylorus-is a fistulous communication between the gastric antrum and duodenal bulb, usually extending from the lesser curvature of the stomach to the superior aspect of the duodenal bulb, and seperated by septum or bridge of normal mucosa. Although its incidence is rare, reports concerning double pylorus are increasing with the recent development of upper gastrointestinal endoscopy and more awareness of this abnormality. We recently experienced two cases of double pylorus; an aquired one in 72-year old male who had an another opening with healing ulcer at the superior aspect of the original pyloric channel, central erosion with clubbing and fusion of mucosal folds at the greater curvature of the lower body and a 3 x 4 cm sized ulcer at the lesser curvature of the lower body, and the other congenital one in 53-year old male who had an another opening at the superior aspect of the original pyloric channel with histologically intact muscularis mucosa in the pyloric septum with no evidence of chronic peptic ulcer scarring. We report here two cases of double pylorus, one-acquired, and the other-congenital, with a review of the literature.

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