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Review
Recent advances in surveillance colonoscopy for dysplasia in inflammatory bowel disease
Soo-Young Na, Won Moon
Clin Endosc 2022;55(6):726-735.   Published online November 18, 2022
DOI: https://doi.org/10.5946/ce.2022.132
AbstractAbstract PDFPubReaderePub
Inflammatory bowel disease (IBD) has a global presence with rapidly increasing incidence and prevalence. Patients with IBD including those with ulcerative colitis and Crohn’s disease have a higher risk of developing colorectal cancer (CRC) compared to the general population. Risk factors for CRC in patients with IBD include long disease duration, extensive colitis, primary sclerosing cholangitis, family history of CRC, stricture, and prior dysplasia. Surveillance colonoscopy for CRC in patients with IBD should be tailored to individualized risk factors and requires careful monitoring every year to every five years. The current surveillance techniques are based on several guidelines. Chromoendoscopy with targeted biopsy is being recommended increasingly, and high-definition colonoscopy is gradually replacing standard-definition colonoscopy. However, it remains unclear whether chromoendoscopy, virtual chromoendoscopy, or white-light endoscopy has better efficiency when a high-definition scope is used. With the development of new endoscopic instruments and techniques, the paradigm of surveillance strategy has gradually changed. In this review, we discuss cutting-edge surveillance colonoscopy in patients with IBD including a review of literature.

Citations

Citations to this article as recorded by  
  • Inflammatory bowel disease and primary sclerosing cholangitis: One disease or two?
    Kim N. van Munster, Annika Bergquist, Cyriel Y. Ponsioen
    Journal of Hepatology.2024; 80(1): 155.     CrossRef
  • Extrachromosomal Circular DNA: An Emerging Potential Biomarker for Inflammatory Bowel Diseases?
    Valentina Petito, Federica Di Vincenzo, Lorenza Putignani, Maria T. Abreu, Birgitte Regenberg, Antonio Gasbarrini, Franco Scaldaferri
    Genes.2024; 15(4): 414.     CrossRef
  • A Review of Colonoscopy in Intestinal Diseases
    Seung Hong, Dong Baek
    Diagnostics.2023; 13(7): 1262.     CrossRef
  • Potential Oral Microbial Markers for Differential Diagnosis of Crohn’s Disease and Ulcerative Colitis Using Machine Learning Models
    Sang-Bum Kang, Hyeonwoo Kim, Sangsoo Kim, Jiwon Kim, Soo-Kyung Park, Chil-Woo Lee, Kyeong Ok Kim, Geom-Seog Seo, Min Suk Kim, Jae Myung Cha, Ja Seol Koo, Dong-Il Park
    Microorganisms.2023; 11(7): 1665.     CrossRef
  • Update on Endoscopic Dysplasia Surveillance in Inflammatory Bowel Disease
    Nayantara Coelho-Prabhu, James D. Lewis
    American Journal of Gastroenterology.2023;[Epub]     CrossRef
  • 3,287 View
  • 209 Download
  • 5 Web of Science
  • 5 Crossref
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Case Report
Management of Biliopancreatic Limb Bleeding after Roux-en-Y Gastric Bypass: A Case Report
Christophe Riquoir, Luis Antonio Díaz, David Chiliquinga, Roberto Candia, Fernando Pimentel, Alex Arenas
Clin Endosc 2021;54(5):754-758.   Published online May 25, 2021
DOI: https://doi.org/10.5946/ce.2021.060
AbstractAbstract PDFPubReaderePub
The Roux-en-Y gastric bypass is one of the most extensive surgical treatments for obesity. The treatment of upper gastrointestinal bleeding after Roux-en-Y gastric bypass is complex due to the difficulty of accessing the excluded gastric antrum and duodenal bulb. There is no consensus regarding the management of this complication. While various techniques have been described to access the biliopancreatic limb, double-balloon enteroscopy is the most commonly used. If double-balloon enteroscopy is unavailable, a pediatric colonoscope may be used as an alternative; however, its use in such cases has not been described. We report the case of a 50-year-old male patient who underwent gastric bypass 13 years ago and was admitted for a second episode of upper gastrointestinal bleeding. The initial approach using upper endoscopy, colonoscopy, and abdominal computed tomography angiography did not reveal the cause of gastrointestinal hemorrhage; therefore, an endoscopic study of the biliopancreatic limb was performed using a pediatric colonoscope. A Forrest Ib ulcer was found in the duodenal bulb, and endoscopic therapy was administered. The evolution was found to be satisfactory.

Citations

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  • Endoscopic management of postoperative bleeding
    Sung Hyeok Ryou, Ki Bae Bang
    Clinical Endoscopy.2023; 56(6): 706.     CrossRef
  • 3,339 View
  • 75 Download
  • 1 Web of Science
  • 1 Crossref
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Original Articles
The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer
Waseem M. Seleem, Amr Shaaban Hanafy
Clin Endosc 2021;54(6):864-871.   Published online May 25, 2021
DOI: https://doi.org/10.5946/ce.2021.004
AbstractAbstract PDFPubReaderePub
Background
/Aims: Peptic ulcer bleeding is the most common cause of upper gastrointestinal tract bleeding. Platelet-rich plasma (PRP) enhances tissue repair, and is therefore used in various medical treatments. A combination of mechanical or electrothermal hemostasis has been recommended for upper gastrointestinal tract bleeding treatment. This study evaluated the additive efficacy of PRP in bleeding peptic ulcer hemostasis and recovery.
Methods
Eighty patients with peptic ulcer bleeding were initially treated by hemoclipping, and were randomly chosen for either additional PRP (n=40) or additional epinephrine (n=40) injections. Both groups were compared with regard to achieving hemostasis and the frequency of complications.
Results
Hemostasis was immediately achieved in both groups. Two patients (5%) in the PRP group and 8 (20%) patients in the epinephrine group experienced rebleeding after 15.9±2.8 and 12.3±3.7 days, respectively. They were managed by PRP injection in addition to proton pump inhibitor infusion. Hemoglobin was substantially increased in the PRP-treated group with full recovery occurring in 60.5% compared to 31.3% of patients in the epinephrine group (p=0.001). There was no recurrent bleeding in the PRP group, but 4/32 (12.5%) patients in the epinephrine group exhibited rebleeding.
Conclusions
PRP showed additional benefit in reducing peptic ulcer bleeding with no reported significant complications. Clinical trial (NCT03733171).

Citations

Citations to this article as recorded by  
  • The impact of submucosal PRP injection on wound healing after endoscopic sinus surgery: a randomized clinical trial
    Konstantina Dinaki, Nikolaos Grigoriadis, Ioannis S. Vizirianakis, Jannis Constantinidis, Stefanos Triaridis, Petros Karkos
    European Archives of Oto-Rhino-Laryngology.2024; 281(7): 3587.     CrossRef
  • 3,932 View
  • 90 Download
  • 1 Web of Science
  • 1 Crossref
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Endoscopic Factors that Can Predict Histological Ulcerations in Early Gastric Cancers
Jaesin Lee, Byung-Wook Kim, Cheal Wung Huh, Joon Sung Kim, Lee-So Maeng
Clin Endosc 2020;53(3):328-333.   Published online January 7, 2020
DOI: https://doi.org/10.5946/ce.2019.133
AbstractAbstract PDFPubReaderePub
Background
/Aims: Predicting histological ulceration in early gastric cancer (EGC) during endoscopic examination is crucial for endoscopists deciding on the treatment modality. The aim of this study was to investigate the endoscopic factors that can predict histological ulcerations in EGCs.
Methods
We retrospectively analyzed patients who underwent endoscopic submucosal dissection (ESD) for EGC. Clinical features and endoscopic characteristics of EGC such as location, histological differentiation, longest diameter, tumor morphology, mucosal break, converging fold, color change, and surface irregularity were reviewed. Histological ulceration was defined based on ESD specimens.
Results
A total of 633 EGC lesions from 613 patients were included and histological ulcerations were found in 90 lesions (14.2%). Presence of converging folds, tumor morphology, and color changes on endoscopic examination were related to histological ulceration in the univariate analysis and converging folds along with color changes were statistically significant factors in the multivariate analysis. Kaplan–Meier analysis showed that patients with histological ulcerations in EGCs tended to have higher marginal recurrence rates.
Conclusions
Mucosal breaks are not equivalent to histological ulcerations. Rather, the existence of converging folds and color changes during endoscopic examination suggest histological ulcerations. Endoscopists should consider these factors when they decide the treatment modality for EGCs.

Citations

Citations to this article as recorded by  
  • Clinical Impact of Proton Pump Inhibitor and Potassium-Competitive Acid Blocker for Predicting the Curability of Endoscopic Resection in Ulcerative Early Gastric Cancer
    Konomu Uno, Takaya Shimura, Shingo Inaguma, Keita Kuroyanagi, Ruriko Nishigaki, Takuya Kanno, Makiko Sasaki, Shigeki Fukusada, Naomi Sugimura, Yusuke Mizuno, Takayuki Nukui, Yuki Kojima, Mamoru Tanaka, Keiji Ozeki, Eiji Kubota, Satoru Takahashi, Hiromi Ka
    Digestion.2024; 105(3): 192.     CrossRef
  • Identification of maximal tumor size associated with negligible lymph node metastasis for endoscopic submucosal dissection of undifferentiated-type early gastric cancer
    Sung Eun Oh, Soomin Ahn, Kyoung-Mee Kim, Min-Gew Choi, Jun Ho Lee, Tae Sung Sohn, Jae Moon Bae, Ji Yeong An
    Gastric Cancer.2024; 27(4): 850.     CrossRef
  • Endoscopic diagnosis of early gastric cancer
    Dong Chan Joo, Gwang Ha Kim
    Journal of the Korean Medical Association.2022; 65(5): 267.     CrossRef
  • Therapeutic approach to non-curative resection after endoscopic treatment in early gastric cancer
    Eun Jeong Gong, Chang Seok Bang
    Journal of the Korean Medical Association.2022; 65(5): 284.     CrossRef
  • Construction and analysis of an ulcer risk prediction model after endoscopic submucosal dissection for early gastric cancer
    San-Dong Gong, Huan Li, Yi-Bin Xie, Xiao-Hui Wang
    World Journal of Gastrointestinal Oncology.2022; 14(9): 1823.     CrossRef
  • Long‑term outcome of the endoscopic submucosal dissection of early gastric cancer: A comparison between patients with and without liver cirrhosis
    Seung Kim, Moon Joo, Ah-Young Yoo, Seong Kim, Won Kim, Beom Lee, Jong Park, Hoon Chun, Sang Lee
    Oncology Letters.2022;[Epub]     CrossRef
  • Discrepancy between endoscopic and pathological ulcerative findings in clinical intramucosal early gastric cancer
    Yohei Yabuuchi, Kohei Takizawa, Naomi Kakushima, Noboru Kawata, Masao Yoshida, Yoichi Yamamoto, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Hirotoshi Ishiwatari, Kinichi Hotta, Hiroyuki Matsubayashi, Etsuro Bando, Masanori Terashima, Takashi Sugino, Hiro
    Gastric Cancer.2021; 24(3): 691.     CrossRef
  • What is the Most Precise Endoscopic Finding for Predicting the Clinicopathological Behaviors in Ulcerative Early Gastric Cancer?
    Youngdae Kim
    Clinical Endoscopy.2020; 53(3): 249.     CrossRef
  • 4,922 View
  • 135 Download
  • 8 Web of Science
  • 8 Crossref
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Focused Review Series: Endoscopic Hemostasis: An Overviews of Principles and Recent Applications
Endoscopic Management of Peptic Ulcer Bleeding: Recent Advances
Philip WY Chiu
Clin Endosc 2019;52(5):416-418.   Published online August 13, 2019
DOI: https://doi.org/10.5946/ce.2018.182
AbstractAbstract PDFPubReaderePub
Bleeding peptic ulcers remained as one of the commonest causes of hospitalization worldwide. While endoscopic hemostasis serves as primary treatment for bleeding ulcers, rebleeding after endoscopic hemostasis becomes more and more difficult to manage as patients are usually poor surgical candidates with multiple comorbidities. Recent advances in management of bleeding peptic ulcers aimed to further reduce the rate of rebleeding through—(1) identification of high risk patients for rebleeding and mortality; (2) improvement in primary endoscopic hemostasis and; (3) prophylactic angiographic embolization of major arteries. The technique and clinical evidences for these approaches will be reviewed in the current article.

Citations

Citations to this article as recorded by  
  • Diagnostic yield of bidirectional endoscopy for iron deficiency anemia in young patients
    Binyamin R. Abramowitz, Helena Saba, Ayse Aytaman, Daniel A. DiLeo, Bani Chander Roland
    BMC Gastroenterology.2024;[Epub]     CrossRef
  • Management of severe peri-operative bleeding: Guidelines from the European Society of Anaesthesiology and Intensive Care
    Sibylle Kietaibl, Aamer Ahmed, Arash Afshari, Pierre Albaladejo, Cesar Aldecoa, Giedrius Barauskas, Edoardo De Robertis, David Faraoni, Daniela C. Filipescu, Dietmar Fries, Anne Godier, Thorsten Haas, Matthias Jacob, Marcus D. Lancé, Juan V. Llau, Jens Me
    European Journal of Anaesthesiology.2023; 40(4): 226.     CrossRef
  • Aspirin vs Clopidogrel: Antiplatelet Agent of Choice for Those With Recent Bleeding or at Risk for Gastrointestinal Bleed
    Siddharth Gosavi, Gokul Krishnan, Raviraja V Acharya
    Cureus.2023;[Epub]     CrossRef
  • Effect of nano silver on gastroprotective activity against ethanol-induced stomach ulcer in rats
    Ibrahim Abdel Aziz Ibrahim, Abbas I. Hussein, Mahmoud S. Muter, Abdulalah T. Mohammed, Morteta H. Al-Medhtiy, Suhayla Hamad Shareef, Peshawa Yunis Aziz, Nabaz Fisal Shakir Agha, Mahmood Ameen Abdulla
    Biomedicine & Pharmacotherapy.2022; 154: 113550.     CrossRef
  • Protective Effects of Radix Sophorae Flavescentis Carbonisata-Based Carbon Dots Against Ethanol‐Induced Acute Gastric Ulcer in Rats: Anti-Inflammatory and Antioxidant Activities
    Jie Hu, Juan Luo, Meiling Zhang, Jiashu Wu, Yue Zhang, Hui Kong, Huihua Qu, Guoliang Cheng, Yan Zhao
    International Journal of Nanomedicine.2021; Volume 16: 2461.     CrossRef
  • 6,855 View
  • 279 Download
  • 5 Web of Science
  • 5 Crossref
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Endoscopic Hemostasis for Non-Variceal Upper Gastrointestinal Bleeding: New Frontiers
Adam Kichler, Sunguk Jang
Clin Endosc 2019;52(5):401-406.   Published online July 16, 2019
DOI: https://doi.org/10.5946/ce.2018.103
AbstractAbstract PDFPubReaderePub
Non-variceal upper gastrointestinal bleeding (NVUGIB) refers to blood loss from the gastrointestinal tract proximal to the ligament of Treitz due to lesions that are non-variceal in origin. The distinction of the bleeding source as non-variceal is important in numerous aspects, but none more so than endoscopic approaches for successful hemostasis. When a patient presents with acute overt blood loss, NVUGIB is a medical emergency, which requires immediate intervention. There have been major strides in pharmacologic and endoscopic interventions for successful induction and remission of hemostasis in the last two decades. Despite achieving tangible improvements, the burden of the disease and the consequent mortality remain high. To address endoscopic outcomes better, several new technologies have emerged and have been subsequently incorporated to the armamentarium of hemostatic tools. This study aims to provide a succinct review on novel technologies for endoscopic hemostasis.

Citations

Citations to this article as recorded by  
  • Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis
    Xiao-Juan Wang, Yu-Peng Shi, Li Wang, Ya-Ni Li, Li-Juan Xu, Yue Zhang, Shuang Han
    World Journal of Clinical Cases.2024; 12(9): 1597.     CrossRef
  • MODERN TRENDS IN ENDOSCOPIC HEMOSTASIS IN PATIENTS WITH EROSIVE-ULCERATIVE GASTROINTESTINAL BLEEDING WITH PREROGATIVE USE OF ARGON PLASMA COAGULATION AND TAKING INTO ACCOUNT THE SPECIAL CONDITIONS OF THE ENDOSCOPY DEPARTMENT IN WARTIME
    V. V. Boiko, V. H. Hroma, I. A. Taraban, Y. V. Hroma
    Kharkiv Surgical School.2024; (1): 62.     CrossRef
  • Neutrophil-lymphocyte ratio predict outcome of upper gastrointestinal bleeding in emergency
    Xinyi Chen, Xinqun Li, Guangju Zhao, Wen Xu
    Frontiers in Medicine.2024;[Epub]     CrossRef
  • Progress in Diagnosis and Treatment of Acute Upper Gastrointestinal Bleeding
    泗云 李
    Advances in Clinical Medicine.2024; 14(08): 1674.     CrossRef
  • Short Peptide Nanofiber Biomaterials Ameliorate Local Hemostatic Capacity of Surgical Materials and Intraoperative Hemostatic Applications in Clinics
    Zehong Yang, Lihong Chen, Ji Liu, Hua Zhuang, Wei Lin, Changlong Li, Xiaojun Zhao
    Advanced Materials.2023;[Epub]     CrossRef
  • Accessory Splenic Artery Causing Massive Gastrointestinal Bleed
    Priyesh Patel, Pravallika Chadalavada, Amandeep Singh, Ram Kishore Gurajala, Jean-Paul Achkar
    ACG Case Reports Journal.2021; 8(3): e00550.     CrossRef
  • Diode Laser—Can It Replace the Electrical Current Used in Endoscopic Submucosal Dissection? (with Video)
    Yunho Jung, Gwang Ho Baik, Weon Jin Ko, Bong Min Ko, Seong Hwan Kim, Jin Seok Jang, Jae-Young Jang, Wan-Sik Lee, Young Kwan Cho, Sun Gyo Lim, Hee Seok Moon, In Kyung Yoo, Joo Young Cho
    Clinical Endoscopy.2021; 54(4): 555.     CrossRef
  • In Vivo Investigation of Noncontact Rapid Photothermal Hemostasis on Venous and Arterial Bleeding
    Myeongjin Kim, Van Gia Truong, Sungwon Kim, Hyejin Kim, Thomas Hasenberg, Hyun Wook Kang
    IEEE Transactions on Biomedical Engineering.2021; 68(9): 2689.     CrossRef
  • Comparison of high and low-dose epinephrine & endoclip application in peptic ulcer bleeding
    Tamer Akay, Metin Leblebici
    Medicine.2021; 100(52): e28480.     CrossRef
  • Endoscopic Ultrasound-Guided Treatments for Non-Variceal Upper GI Bleeding: A Review of the Literature
    Claudio Giovanni De Angelis, Pablo Cortegoso Valdivia, Stefano Rizza, Ludovica Venezia, Felice Rizzi, Marcantonio Gesualdo, Giorgio Maria Saracco, Rinaldo Pellicano
    Journal of Clinical Medicine.2020; 9(3): 866.     CrossRef
  • Preparation and Study of Hemostatic Materials Based on Chitosan and Chitin Nanofibrils
    E. N. Maevskaia, E. N. Dresvyanina, A. S. Shabunin, I. P. Dobrovol’skaya, M. B. Paneyah, A. M. Fediuk, P. L. Sushchinskii, G. P. Smirnov, V. E. Yudin, E. V. Zinoviev
    Nanotechnologies in Russia.2020; 15(7-8): 466.     CrossRef
  • 9,506 View
  • 483 Download
  • 10 Web of Science
  • 11 Crossref
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Case Report
Massive Duodenal Bleeding after the Migration of Endovascular Coils into the Small Bowel
Chung-Jo Choi, Hyun Lim, Dong-Suk Kim, Yong-Seol Jeong, Sang-Young Park, Jeong-Eun Kim
Clin Endosc 2019;52(6):612-615.   Published online May 20, 2019
DOI: https://doi.org/10.5946/ce.2019.020
AbstractAbstract PDFPubReaderePub
Among gastrointestinal emergencies, acute upper gastrointestinal bleeding remains a challenging clinical problem owing to significant patient morbidity and costs involved in management. Endoscopic hemostatic therapy is the mainstay of treatment and decreases the incidence of re-bleeding, the need for surgery, morbidity, and mortality. However, in 8%–15% of patients with upper gastrointestinal bleeding, endoscopic hemostatic therapy does not successfully control bleeding. Trans-arterial coil embolization is an effective alternative treatment for endoscopic hemostatic failure; however, this procedure can induce adverse outcomes, such as non-target vessel occlusion, vessel dissection and perforation, and coil migration. Coil migration is rare but causes severe complications, such as re-bleeding and bowel ischemia. However, in most cases, coil migration is local and involves spontaneous healing without serious complications. Here, we report the case of a patient who underwent trans-arterial coil embolization of the gastroduodenal artery with the purpose of controlling massive duodenal bleeding, resulting in a fatal outcome caused by coil migration.

Citations

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  • Pulsation of visible vessel or adherent clot in duodenal ulcer may indicate pseudoaneurysm: Case series
    Jiayu Ju, Ziyao Cheng, Qingliang Zhu, Mingming Deng, Hailong Zhang
    Medicine.2023; 102(5): e32819.     CrossRef
  • Rare but critical: Aberrant vascular communication leading to multiorgan ischemia after prophylactic gastroduodenal artery embolization for refractory upper gastrointestinal bleeding
    Muhammad Ibrahim Saeed, Amna Subhan Butt, Jahanzeb Shahid, Junaid Iqbal
    Radiology Case Reports.2023; 18(11): 3926.     CrossRef
  • Gastric Bleeding Caused by Migrated Coil: A Rare Complication of Splenic Artery Coil Embolization
    Tian Li, Bayan Alsuleiman, Manuel Martinez
    Gastro Hep Advances.2022; 1(1): 67.     CrossRef
  • Intraluminal Endovascular Coil Migration: A Rare Complication Post-Embolization of the Gastroduodenal Artery for a Previously Bleeding Duodenal Ulcer
    Yassin Naga, Mahendran Jayaraj, Yousif Elmofti, Annie Hong, Gordon Ohning
    Cureus.2021;[Epub]     CrossRef
  • Management of Gastroduodenal Artery Pseudoaneurysm Rupture With Duodenal Ulcer Complicated by Coil Migration
    Dennis Chang, Purvi Patel, Seth Persky, Joseph Ng, Alan Kaell
    ACG Case Reports Journal.2020; 7(4): e00347.     CrossRef
  • Persisting bleeding from the duodenal ulcer in patients with occlusion of the celiac trunk: a case report
    Andrzej Żyluk, Samir Zeair, Janusz Kordowski, Ewa Gabrysz-Trybek
    Polish Journal of Surgery.2020; 93(SUPLEMENT): 54.     CrossRef
  • 6,555 View
  • 113 Download
  • 5 Web of Science
  • 6 Crossref
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Original Article
Effectiveness of Autologous Platelet-Rich Plasma for the Healing of Ulcers after Endoscopic Submucosal Dissection
Eunju Jeong, In kyung Yoo, Ozlem Ozer Cakir, Hee Kyung Kim, Won Hee Kim, Sung Pyo Hong, Joo Young Cho
Clin Endosc 2019;52(5):472-478.   Published online May 17, 2019
DOI: https://doi.org/10.5946/ce.2018.152
AbstractAbstract PDFPubReaderePub
Background
/Aims: Platelet-rich plasma (PRP) has been used for wound healing in various medical fields. The aim of this study was to evaluate the clinical efficacy and safety of local PRP injections after endoscopic submucosal dissection (ESD).
Methods
Patients were non-randomly divided into the following two groups: (1) control group in which patients were administered only an intravenous proton pump inhibitor (PPI), and (2) a study group in which patients were administered an intravenous PPI and a topical PRP injection. We assessed the reduction in the ulcer area and stage of the ulcer after the procedure (24 hours, 48 hours, and 28 days after endoscopic surgery).
Results
We enrolled 7 study and 7 control patients. In the study group, the rate of ulcer reduction was 59% compared to 52% in the control group (p=0.372), 28 days after ESD. There were 5 patients in the S stage and 2 patients in the H stage in the study group compared to no patient in the S stage and 7 patients in the H stage in the control group (p=0.05), 28 days after ESD. There were no serious complications in either group.
Conclusions
The local injection of PRP is a safe and effective procedure for ulcer healing after ESD.

Citations

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  • Clinical efficacy of blood derivatives on wound healing: A systematic review and network meta‐analysis
    Yanhong Wu, Guang Peng, Yuzhi Wang, Jianwu Chen, Bin Zhang, Jianbing Tang, Biao Cheng
    International Wound Journal.2024;[Epub]     CrossRef
  • Endoscopic Shielding With Platelet-rich Plasma After Resection Of Large Colorectal Lesions
    Vicente Lorenzo-Zúñiga, Vicente Moreno de Vega, Ramón Bartolí
    Surgical Laparoscopy, Endoscopy & Percutaneous Techniques.2021; 31(3): 376.     CrossRef
  • The Additive Effect of Platelet-Rich Plasma in the Treatment of Actively Bleeding Peptic Ulcer
    Waseem M. Seleem, Amr Shaaban Hanafy
    Clinical Endoscopy.2021; 54(6): 864.     CrossRef
  • Endless Challenges in Overcoming Complications Associated with Endoscopic Submucosal Dissection
    Satoshi Ono, Shun Ito, Kenji Ogata
    Clinical Endoscopy.2019; 52(5): 395.     CrossRef
  • 6,837 View
  • 140 Download
  • 4 Web of Science
  • 4 Crossref
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Focused Review Series: Endoscopic Submucosal Dissection for Colorectal Tumors
Endoscopic Submucosal Dissection for Colitis-Associated Dysplasia
Dong-Hoon Yang, Imelda Rey
Clin Endosc 2019;52(2):120-128.   Published online March 27, 2019
DOI: https://doi.org/10.5946/ce.2019.047
AbstractAbstract PDFPubReaderePub
Dysplasia is a precancerous lesion of colorectal cancer in patients with long-standing inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease. Recent guidelines suggest endoscopic resection as a key modality for the treatment of endoscopically resectable dysplasia in patients with colitis. Endoscopic submucosal dissection (ESD) has been suggested as one of the therapeutic options for dysplasia that is potentially resectable but not suitable for the conventional endoscopic mucosal resection technique. Several recent studies supported the feasibility of ESD for the treatment of colitis-associated dysplasia in terms of the en bloc and complete resection rates and the risk of procedure-related complications. However, these studies were performed exclusively in expert centers. Moreover, the local and metachronous recurrence rates were relatively high, and long-term outcome data are still lacking. Endoscopists should be highly skilled in colorectal ESD and have an intensive understanding of not only the lesions but also the conditions of patients with IBDs. Therefore, the decision to perform ESD for colitis-associated dysplasia should be made scrupulously after careful discussion with patients, in collaboration with a multidisciplinary IBD team including physicians, surgeons, and pathologists specialized in IBDs.

Citations

Citations to this article as recorded by  
  • Characteristics of flat‐type ulcerative colitis‐associated neoplasia on chromoendoscopic imaging with indigo carmine dye spraying
    Kaoru Takabayashi, Shinya Sugimoto, Kosaku Nanki, Yusuke Yoshimatsu, Hiroki Kiyohara, Yohei Mikami, Tomohisa Sujino, Motohiko Kato, Naoki Hosoe, Masayuki Shimoda, Naohisa Yahagi, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai
    Digestive Endoscopy.2024; 36(4): 446.     CrossRef
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    M Bronswijk, G Rasschaert, Y Hayashi, H Yamamoto
    Acta Gastro Enterologica Belgica.2023; 86(1): 36.     CrossRef
  • Current Screening and Management Strategies for Dysplasia in IBD
    Dania Hudhud, Angela Wu, Raymond K. Cross
    Current Treatment Options in Gastroenterology.2023; 21(2): 218.     CrossRef
  • Beyond the SCENIC route: updates in chromoendoscopy and dysplasia screening in patients with inflammatory bowel disease
    Loren Galler Rabinowitz, Nikhil A. Kumta, James F. Marion
    Gastrointestinal Endoscopy.2022; 95(1): 30.     CrossRef
  • Colorectal Cancer in Inflammatory Bowel Disease: Mechanisms and Management
    Shailja C. Shah, Steven H. Itzkowitz
    Gastroenterology.2022; 162(3): 715.     CrossRef
  • Efficacy and Safety of Endoscopic Submucosal Dissection for Dysplasia in Ulcerative Colitis Patients: A Systematic Review and Meta-Analysis
    Qi-Shan Zeng, Zhi-Jing Zhao, Jiao Nie, Min Zou, Jia-Hui Yang, Jin-Zhi Zhang, Hua-Tian Gan, Fabiana Andréa Moura
    Gastroenterology Research and Practice.2022; 2022: 1.     CrossRef
  • Endoscopic Management of Colitis-Associated Neoplasia
    Nathaniel A. Cohen, David T. Rubin
    Gastrointestinal Endoscopy Clinics of North America.2022; 32(4): 863.     CrossRef
  • Role of Interventional Inflammatory Bowel Disease (IBD) in the Management of Complex IBD: Initial Prospective Experience from a Tertiary Center in India
    Partha Pal, Mohan Ramchandani, Rupa Banerjee, Pradev Inavolu, Zaheer Nabi, Hardik Rughwani, Aniruddha Pratap Haripal Singh, Rajendra Patel, Polina Vijayalaxmi, Jagdeesh Rampal Singh, Pradeep Rebala, Guduru Venkat Rao, D Nageshwar Reddy, Manu Tandan
    Journal of Digestive Endoscopy.2022; 13(04): 207.     CrossRef
  • An endoscopic treatment strategy for superficial tumors in patients with ulcerative colitis
    Masafumi Nishio, Kingo Hirasawa, Yuichiro Ozeki, Atsushi Sawada, Ryosuke Ikeda, Takehide Fukuchi, Ryosuke Kobayashi, Makomo Makazu, Chiko Sato, Reiko Kunisaki, Shin Maeda
    Journal of Gastroenterology and Hepatology.2021; 36(2): 498.     CrossRef
  • Endoscopic molecular imaging in inflammatory bowel disease
    Nam Seok Ham, Seung-Jae Myung
    Intestinal Research.2021; 19(1): 33.     CrossRef
  • AGA Clinical Practice Update on Endoscopic Surveillance and Management of Colorectal Dysplasia in Inflammatory Bowel Diseases: Expert Review
    Sanjay K. Murthy, Joseph D. Feuerstein, Geoffrey C. Nguyen, Fernando S. Velayos
    Gastroenterology.2021; 161(3): 1043.     CrossRef
  • Recent Advance in the Management of Dysplasia in the Ulcerative Colitis
    Dong-Hoon Yang
    Journal of Digestive Cancer Reports.2021; 9(2): 50.     CrossRef
  • Elevating the Technique: Resecting Complex Dysplastic Lesions of the Colon in Patients with Inflammatory Bowel Disease
    Eshandeep S. Boparai, Fernando S. Velayos, Abhik Roy, Carolyn Li, Ahmed S. Alkoraishi, Craig A. Munroe
    Digestive Diseases and Sciences.2020; 65(1): 78.     CrossRef
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Review
Chronological Review of Endoscopic Indices in Inflammatory Bowel Disease
Joon Seop Lee, Eun Soo Kim, Won Moon
Clin Endosc 2019;52(2):129-136.   Published online August 21, 2018
DOI: https://doi.org/10.5946/ce.2018.042
AbstractAbstract PDFPubReaderePub
Inflammatory bowel disease (IBD) is considered a chronic condition characterized by mucosal or transmural inflammation in the gastrointestinal tract. Endoscopic diagnosis and surveillance in patients with IBD have become crucial. In addition, endoscopy is a useful modality in estimation and evaluation of the disease, treatment results, and efficacy of treatment delivery and surveillance. In relation to these aspects, endoscopic disease activity has been commonly estimated in clinical practices and trials.
At present, many endoscopic indices of ulcerative colitis have been introduced, including the Truelove and Witts Endoscopy Index, Baron Index, Powell-Tuck Index, Sutherland Index, Mayo Clinic Endoscopic Sub-Score, Rachmilewitz Index, Modified Baron Index, Endoscopic Activity Index, Ulcerative Colitis Endoscopic Index of Severity, Ulcerative Colitis Colonoscopic Index of Severity, and Modified Mayo Endoscopic Score. Endoscopic indices have been also suggested for Crohn’s disease, such as the Crohn’s Disease Endoscopic Index of Severity, Simple Endoscopic Score for Crohn’s Disease, and Rutgeerts Postoperative Endoscopic Index. However, most endoscopic indices have not been validated owing to the complexity of their parameters and inter-observer variations. Therefore, a chronological approach for understanding the various endoscopic indices relating to IBD is needed to improve the management.

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Case Reports
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
AbstractAbstract PDFPubReaderePub
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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    Mahdieh Golzarand, Karamollah Toolabi, Reza Parsaei
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    B. Betzel, M. I. Cooiman, E. O. Aarts, I. M. C. Janssen, P. J. Wahab, M. J. M. Groenen, J. P. H. Drenth, F. J. Berends
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  • 3 Web of Science
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Management of Percutaneous Endoscopic Gastrostomy Site Gastric Ulcer in a Patient with an Esophageal Stricture and Hiatus Hernia
Clement C H Wu, James W Li, Keng Sin Ng, Daphne S Ang
Clin Endosc 2018;51(1):99-102.   Published online May 22, 2017
DOI: https://doi.org/10.5946/ce.2017.035
AbstractAbstract PDFPubReaderePub
Percutaneous endoscopic gastrostomy (PEG) is commonly performed for feeding difficulties, in patients suffering from complications of nasopharyngeal carcinoma (NPC) and its treatment, namely radiotherapy and surgery. This case report describes the challenges in hemostasis and subsequent re-establishment of enteral access for feeding, in an elderly patient with a history of NPC, treated surgically, followed by radiotherapy, who presented with massive hematemesis following reinsertion of her PEG shortly after an accidental dislodgement. Her previous nasopharyngectomy, wide field radiation therapy, and radical neck dissection precluded nasogastric tube (NGT) feeding, and the presence of a large hiatus hernia made reinsertion of a new PEG technically challenging. This case highlights the methods used to overcome the above challenges.

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  • Epicardial access complications during electrophysiology procedures
    Jorge Romero, Kavisha Patel, Dhanunjaya Lakkireddy, Isabella Alviz, Alejandro Velasco, Daniel Rodriguez, Joseph Karpenos, Xiao‐Dong Zhang, Andrea Natale, Luigi Di Biase
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  • 149 Download
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Original Articles
Can Endoscopic Ulcerations in Early Gastric Cancer Be Clearly Defined before Endoscopic Resection? A Survey among Endoscopists
Sung Min Park, Byung-Wook Kim, Joon Sung Kim, Young Wook Kim, Gi Jun Kim, Seung Ji Ryu
Clin Endosc 2017;50(5):473-478.   Published online April 24, 2017
DOI: https://doi.org/10.5946/ce.2016.143
AbstractAbstract PDFPubReaderePub
Background
/Aims: Early gastric cancer (EGC) with ulcerations can be treated via endoscopic resection (ER) when it is differentiated pathologically, limited to the mucosa, and <3 cm in diameter. The presence of ulceration is a key factor in deciding treatment strategies and is usually diagnosed during endoscopic examination. The aim of this study was to evaluate whether ulcerations in EGC can be clearly defined among endoscopists and which factors are related to the differences.
Methods
A survey questionnaire, composed of demographic features and endoscopic images of seven patients with EGC, was presented to the endoscopists via e-mail. The endoscopists were asked whether such patients have ulcerations in the lesions.
Results
The questionnaires were e-mailed to 197 endoscopists, and 103 doctors replied. The presence of an endoscopic ulceration was defined differently among the endoscopists, depending on the duration of endoscopic practice and the experience of endoscopic submucosal dissection (ESD). The differences were especially high in the lesions without mucosal breaks and converging folds, which were expected to be viewed as non-ulcerative.
Conclusions
Before ER, endoscopic ulcerations in EGC must be reviewed by experienced endoscopists to reduce overestimations, and adequate educational programs for trainees should be established.

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    Young Soo Park, Myeong-Cherl Kook, Baek-hui Kim, Hye Seung Lee, Dong-Wook Kang, Mi-Jin Gu, Ok Ran Shin, Younghee Choi, Wonae Lee, Hyunki Kim, In Hye Song, Kyoung-Mee Kim, Hee Sung Kim, Guhyun Kang, Do Youn Park, So-Young Jin, Joon Mee Kim, Yoon Jung Choi,
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    Yohei Yabuuchi, Kohei Takizawa, Naomi Kakushima, Noboru Kawata, Masao Yoshida, Yoichi Yamamoto, Yoshihiro Kishida, Sayo Ito, Kenichiro Imai, Hirotoshi Ishiwatari, Kinichi Hotta, Hiroyuki Matsubayashi, Etsuro Bando, Masanori Terashima, Takashi Sugino, Hiro
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    Clinical Endoscopy.2020; 53(3): 328.     CrossRef
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    Youngdae Kim
    Clinical Endoscopy.2020; 53(3): 249.     CrossRef
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    Myeong-Cherl Kook
    Clinical Endoscopy.2019; 52(1): 15.     CrossRef
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    Hang Lak Lee
    Clinical Endoscopy.2017; 50(5): 410.     CrossRef
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  • 150 Download
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  • 10 Crossref
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Risk Factors for the Presence of Symptoms in Peptic Ulcer Disease
Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim
Clin Endosc 2017;50(6):578-584.   Published online December 23, 2016
DOI: https://doi.org/10.5946/ce.2016.129
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Background
/Aims: Peptic ulcer disease (PUD) is a common condition, but is difficult to detect in asymptomatic individuals. We aimed to investigate the prevalence of symptomatic and asymptomatic PUD during screening endoscopy and to identify risk factors for the presence of symptoms in patients with PUD.
Methods
We investigated subjects who underwent a health inspection, including endoscopy of the upper gastrointestinal (GI) tract and a serum anti-Helicobacter pylori IgG assay, and who completed a self-report questionnaire about their symptoms.
Results
Of the 12,852 subjects included in the study, 124 (1.0%) had symptomatic PUD and 309 (2.4%) had asymptomatic PUD. Old age, current smoking, and H. pylori infection were independent risk factors for symptomatic and asymptomatic PUD. Use of non-steroidal anti-inflammatory drugs (NSAIDs) was an independent risk factor only for symptomatic PUD (p=0.040). Compared to subjects with asymptomatic PUD, subjects with symptomatic PUD were more likely to have active-stage ulcers (p=0.002) and to drink more heavily (p=0.005).
Conclusions
Use of NSAIDs is a risk factor for symptomatic PUD, but not for asymptomatic PUD. Excessive alcohol consumption and active-stage ulcers in patients with PUD are related to the presence of gastroduodenal symptoms.

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Case Report
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
AbstractAbstract PDFPubReaderePub
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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Reviews
Recent Developments in the Endoscopic Treatment of Patients with Peptic Ulcer Bleeding
Jae-Young Jang
Clin Endosc 2016;49(5):417-420.   Published online September 30, 2016
DOI: https://doi.org/10.5946/ce.2016.135
AbstractAbstract PDFPubReaderePub
Peptic ulcer bleeding is an internal medical emergency. Endoscopic hemostasis has been shown to improve the survival rate of patients with peptic ulcer bleeding. Although the established hemostatic modalities, including injection, thermal therapy, and mechanical therapy, are effective in controlling peptic ulcer bleeding, hemostasis can be difficult to achieve in some cases. As a result, recent, new endoscopic hemostatic modalities, including over-the-scope clips, topical hemostatic sprays, and endoscopic ultrasonography-guided angiotherapy, have been developed.

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Novel Therapeutic Strategies in the Management of Non-Variceal Upper Gastrointestinal Bleeding
Ari Garber, Sunguk Jang
Clin Endosc 2016;49(5):421-424.   Published online September 30, 2016
DOI: https://doi.org/10.5946/ce.2016.110
AbstractAbstract PDFPubReaderePub
Non-variceal upper gastrointestinal bleeding, the most common etiology of which is peptic ulcer disease, remains a persistent challenge despite a reduction in both its incidence and mortality. Both pharmacologic and endoscopic techniques have been developed to achieve hemostasis, with varying degrees of success. Among the pharmacologic therapies, proton pump inhibitors remain the mainstay of treatment, as they reduce the risk of rebleeding and requirement for recurrent endoscopic evaluation. Tranexamic acid, a derivative of the amino acid lysine, is an antifibrinolytic agent whose role requires further investigation before application. Endoscopically delivered pharmacotherapy, including Hemospray (Cook Medical), EndoClot (EndoClot Plus Inc.), and Ankaferd Blood Stopper (Ankaferd Health Products), in addition to standard epinephrine, show promise in this regard, although their mechanisms of action require further investigation. Non-pharmacologic endoscopic techniques use one of the following two methods to achieve hemostasis: ablation or mechanical tamponade, which may involve using endoscopic clips, cautery, argon plasma coagulation, over-the-scope clipping devices, radiofrequency ablation, and cryotherapy. This review aimed to highlight these novel and fundamental hemostatic strategies and the research supporting their efficacy.

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Endoscopic Diagnosis and Differentiation of Inflammatory Bowel Disease
Ji Min Lee, Kang-Moon Lee
Clin Endosc 2016;49(4):370-375.   Published online July 29, 2016
DOI: https://doi.org/10.5946/ce.2016.090
AbstractAbstract PDFPubReaderePub
Patients with inflammatory bowel disease have significantly increased in recent decades in Korea. Intestinal tuberculosis (ITB) and intestinal Behcet’s disease (BD), which should be differentiated from Crohn’s disease (CD), are more frequent in Korea than in the West. Thus, the accurate diagnosis of these inflammatory diseases is problematic in Korea and clinicians should fully understand their clinical and endoscopic characteristics. Ulcerative colitis mostly presents with rectal inflammation and continuous lesions, while CD presents with discontinuous inflammatory lesions and frequently involves the ileocecal area. Involvement of fewer than four segments, a patulous ileocecal valve, transverse ulcers, and scars or pseudopolyps are more frequently seen in ITB than in CD. A few ulcers with discrete margins are a typical endoscopic finding of intestinal BD. However, the differential diagnosis is difficult in many clinical situations because typical endoscopic findings are not always observed. Therefore, clinicians should also consider symptoms and laboratory, pathological, and radiological findings, in addition to endoscopic findings.

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Original Article
Efficacy of Albis for the Prevention of Gastric Mucosal Injury Concomitant with the Use of Low-Dose Aspirin: A Prospective, Randomized, Placebo-Controlled Study
Sang Gyun Kim, Nayoung Kim, Sung Kwan Shin, In Kyung Sung, Su Jin Hong, Hyo-Jin Park
Clin Endosc 2017;50(2):179-184.   Published online May 19, 2016
DOI: https://doi.org/10.5946/ce.2016.031
AbstractAbstract PDFPubReaderePub
Background
/Aims: Long-term use of aspirin can be a risk factor of peptic ulcer diseases. The aim of this study was to evaluate the efficacy of Albis (Daewoong Pharmaceutical Co., Ltd.) for the prevention of gastric mucosal injury caused by aspirin.
Methods
Aspirin users were enrolled and randomized into the Albis or placebo group. Screening and follow-up endoscopy were performed for modified Lanza scores (MLSs). Primary outcome was measured by the incidence rate of peptic ulcer, and secondary outcomes were measured by the incidence rate of gastritis, improvement in MLS and subjective symptoms.
Results
In total, 81 aspirin users were randomized, 43 in the Albis group and 38 in the placebo group. There was no incidence of peptic ulcer in both groups. The incidence of gastritis was significantly higher in the placebo group (44.4% vs. 10.0%, p=0.003); however, the scores of mucosal edema, hyperemia and hemorrhage were not statistically different between the two groups (p>0.05). The frequency of subjective symptoms were more improved in the Albis group than in the placebo group (p=0.023).
Conclusions
The incidence of gastritis was lower in the group that received low-dose aspirin and Albis. The development of peptic ulcer due to long-term use of aspirin might be prevented with concomitant use of Albis.

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Case Report
Chronological Endoscopic and Pathological Observations in Russell Body Duodenitis
Atsushi Goto, Takeshi Okamoto, Masaharu Matsumoto, Hiroyuki Saito, Hideo Yanai, Hiroshi Itoh, Isao sakaida
Clin Endosc 2016;49(4):387-390.   Published online March 21, 2016
DOI: https://doi.org/10.5946/ce.2015.131
AbstractAbstract PDFPubReaderePub
A 64-year-old man was found to have a nodule in his right lung. He also complained of nausea and abdominal pain during the clinical course. Esophagogastroduodenoscopy revealed a duodenal ulcer associated with severe stenosis and a suspicion of malignancy. However, three subsequent biopsies revealed no evidence of malignancy. The fourth biopsy showed scattered large eosinophilic cells with an eccentric nucleus, leading to a diagnosis of Russell body duodenitis (RBD). RBD is an extremely rare disease, and little is known about its etiology and clinical course. The pathogenesis of RBD is discussed based on our experience with this case.

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    Helena González Sánchez, Gloria Meijide Santos, Cristina Fuente Díaz, Olegario Castaño Fernández
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Reviews
Fecal Microbiota Transplantation: Current Applications, Effectiveness, and Future Perspectives
Hyun Ho Choi, Young-Seok Cho
Clin Endosc 2016;49(3):257-265.   Published online March 9, 2016
DOI: https://doi.org/10.5946/ce.2015.117
AbstractAbstract PDFPubReaderePub
Fecal microbiota transplantation (FMT) is the infusion of liquid filtrate feces from a healthy donor into the gut of a recipient to cure a specific disease. A fecal suspension can be administered by nasogastric or nasoduodenal tube, colonoscope, enema, or capsule. The high success rate and safety in the short term reported for recurrent Clostridium difficile infection has elevated FMT as an emerging treatment for a wide range of disorders, including Parkinson’s disease, fibromyalgia, chronic fatigue syndrome, myoclonus dystopia, multiple sclerosis, obesity, insulin resistance, metabolic syndrome, and autism. There are many unanswered questions regarding FMT, including donor selection and screening, standardized protocols, long-term safety, and regulatory issues. This article reviews the efficacy and safety of FMT used in treating a variety of diseases, methodology, criteria for donor selection and screening, and various concerns regarding FMT.

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Close layer
Diagnostic and Treatment Approaches for Refractory Peptic Ulcers
Heung Up Kim
Clin Endosc 2015;48(4):285-290.   Published online July 24, 2015
DOI: https://doi.org/10.5946/ce.2015.48.4.285
AbstractAbstract PDFPubReaderePub

Refractory peptic ulcers are defined as ulcers that do not heal completely after 8 to 12 weeks of standard anti-secretory drug treatment. The most common causes of refractory ulcers are persistent Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Simultaneous use of two or more H. pylori diagnostic methods are recommended for increased sensitivity. Serologic tests may be useful for patients currently taking proton pump inhibitors (PPIs) or for suspected false negative results, as they are not affected by PPI use. NSAID use should be discontinued when possible. Platelet cyclooxygenase activity tests can confirm surreptitious use of NSAIDs or aspirin. Cigarette smoking can delay ulcer healing. Therefore, patients who smoke should be encouraged to quit. Zollinger-Ellison syndrome (ZES) is a rare but important cause of refractory gastroduodenal ulcers. Fasting plasma gastrin levels should be checked if ZES is suspected. If an ulcer is refractory despite a full course of standard PPI treatment, the dose should be doubled and administration of another type of PPI considered.

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    V. T. Ivashkin, I. V. Maev, P. V. Tsar’kov, M. P. Korolev, D. N. Andreev, E. K. Baranskaya, S. G. Burkov, A. A. Derinov, S. K. Efetov, T. L. Lapina, P. V. Pavlov, S. S. Pirogov, A. V. Tkachev, A. S. Trukhmanov, E. D. Fedorov, A. A. Sheptulin
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Case Report
Cholangitis Secondary to Food Material Impaction in the Common Bile Duct through a Choledochoduodenal Fistula
Bong-Koo Kang, Sung Min Park, Byung-Wook Kim, Joon Sung Kim, Ji Hee Kim, Jeong-Seon Ji, Hwang Choi
Clin Endosc 2015;48(3):265-267.   Published online May 29, 2015
DOI: https://doi.org/10.5946/ce.2015.48.3.265
AbstractAbstract PDFPubReaderePub

Biliary-enteric communications caused by duodenal ulcers are uncommon, and choledochoduodenal fistula (CDF) is by far the most common type. Usually in this situation, food material does not enter the common bile duct because the duodenal lumen is intact. Here, we report a case in which cholangitis occurred due to food materials impacted through a CDF. Duodenal obstruction secondary to duodenal ulcer prevented food passage into the duodenum in this case. Surgical management was recommended; however, the patient refused surgery because of poor general condition. Consequently, the patient expired with sepsis secondary to ascending cholangitis.

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    Christienne Shams, Michael Cannon, Jared Bortman, Seifeldin Hakim
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    Hideki Mori, Moriya Zakimi, Shin Kato, Koki Yamada, Kenji Chinen, Tomiaki Kubota, Masayuki Arashiro, Susumu Shinoura, Kaoru Kikuchi
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  • 6,537 View
  • 64 Download
  • 2 Web of Science
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Focused Review Series: Endoscopic Management of Upper Gastrointestinal Bleeding
Endoscopic Management of Peptic Ulcer Bleeding
Joon Sung Kim, Sung Min Park, Byung-Wook Kim
Clin Endosc 2015;48(2):106-111.   Published online March 27, 2015
DOI: https://doi.org/10.5946/ce.2015.48.2.106
AbstractAbstract PDFPubReaderePub

Acute upper gastrointestinal bleeding is a common medical emergency around the world and the major cause is peptic ulcer bleeding. Endoscopic treatment is fundamental for the management of peptic ulcer bleeding. Despite recent advances in endoscopic treatment, mortality from peptic ulcer bleeding has still remained high. This is because the disease often occurs in elderly patients with frequent comorbidities and are taking ulcerogenic medications. Therefore, the management of peptic ulcer bleeding is still a challenge for clinicians. This article reviews the various endoscopic methods available for management of peptic ulcer bleeding and the techniques in using these methods.

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  • Characteristics of Bleeding Peptic Ulcers and the Outcome after Endoscopic Therapy at a Tertiary Care Centre of Pakistan
    Farwah Javed, Ghias Ul Hassan, Hafiz Habib Ur Rehman Khalil, Shafqat Rasool, Akif Dilshad, Bilal Nasir
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    Truman J. Milling, Majed A. Refaai, Neil Sengupta
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    Prashant Dorkar S, Prakash Gurav, Santosh Dalvi, Prachi Dharmadhikari, Anand Devraj H
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    M. Diakité, A. Toth’o, C. Assi, F. M. Bathaix, S. Koné, D. Bangoura, A. Koné, A. Ouattara, S. Doffou, A. Okon, N. N. Guessan, D. Soro, E. Allah-Kouadio, A. Coulibaly, A. M. J. Lohouès-Kouacou, B. M. Camara, H. Y. Kissi, A. K. Mahassadi, K. A. Attia, A. T.
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    Jussi M. Kärkkäinen, Sami Miilunpohja, Tuomo Rantanen, Jenni M. Koskela, Johanna Jyrkkä, Juha Hartikainen, Hannu Paajanen
    Digestive Diseases and Sciences.2015; 60(12): 3707.     CrossRef
  • Ulcères gastroduodénaux hémorragiques : étude prospective observationnelle multicentrique en Côte-d’Ivoire
    C. Assi, S. A. Thot’o, M. Diakité, M. F. Bathaix, S. Doffou, A. Ouattara, Y. H. Kissi, A. Coulibaly, D. Bangoura, D. Soro, E. Allah-Kouadio, K. A. Attia, M. J. Lohouès-Kouacou, T. Ndri-Yoman, B. M. Camara
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  • 13,901 View
  • 163 Download
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Case Report
Acute Pancreatitis Due to a Duodenal Ulcer
Sung Ik Pyeon, Jong Ho Hwang, Yong Tae Kim, Ban Seok Lee, Sang Ho Lee, Jae Nam Lee, Jae Hoon Cheong, Kong Jin Oh
Clin Endosc 2014;47(6):579-583.   Published online November 30, 2014
DOI: https://doi.org/10.5946/ce.2014.47.6.579
AbstractAbstract PDFPubReaderePub

Duodenal ulcers and acute pancreatitis are two of the most commonly encountered gastrointestinal diseases among the general population. However, duodenal ulcer-induced pancreatitis is very rarely reported worldwide. This report elaborates on a distinct medical treatment that contributes to partial or complete treatment of acute pancreatitis induced by a duodenal ulcer scar.

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  • Emphysematous pancreatitis associated with penetrating duodenal ulcer
    Claudio Tana, Mauro Silingardi, Maria Adele Giamberardino, Francesco Cipollone, Tiziana Meschi, Cosima Schiavone
    World Journal of Gastroenterology.2017; 23(48): 8666.     CrossRef
  • 5,485 View
  • 70 Download
  • 3 Web of Science
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Special Issue Article of IDEN 2013
Tissue Acquisition in Gastric Epithelial Tumor Prior to Endoscopic Resection
Chan Gyoo Kim
Clin Endosc 2013;46(5):436-440.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.436
AbstractAbstract PDFPubReaderePub

Endoscopic forceps biopsy is essential before planning an endoscopic resection of upper gastrointestinal epithelial tumors. However, forceps biopsy is limited by its superficiality and frequency of sampling errors. Histologic discrepancies between endoscopic forceps biopsies and resected specimens are frequent. Factors associated with such histologic discrepancies are tumor size, macroscopic type, surface color, and the type of medical facility. Precise targeting of biopsies is recommended to achieve an accurate diagnosis, curative endoscopic resection, and a satisfactory oncologic outcome. Multiple deep forceps biopsies can induce mucosal ulceration in early gastric cancer. Endoscopic resection for early gastric cancer with ulcerative findings is associated with piecemeal resection, incomplete resection, and a risk for procedure-related complications such as bleeding and perforation. Such active ulcers caused by forceps biopsy and following submucosal fibrosis might also be mistaken as an indication for more aggressive procedures, such as gastrectomy with D2 lymph node dissection. Proton pump inhibitors might be prescribed to facilitate the healing of biopsy-induced ulcers if an active ulcer is predicted after deep biopsy. It is unknown which time interval from biopsy to endoscopic resection is appropriate for a safe procedure and a good oncologic outcome. Further investigations are needed to conclude the appropriate time interval.

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    Ping Wang, Peng Li, Yingxuan Chen, Li Li, Yuanyuan Lu, Weixun Zhou, Liqun Bian, Beihua Zhang, Xiaolan Yin, Junxiang Li, Jie Chen, Shutian Zhang, Yongquan Shi, Xudong Tang
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    Jun-Hyung Cho, Seong Ran Jeon, So-Young Jin
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    Seong Hwan Park, Kee Don Choi, Kyoungwon Jung, Yangsoon Park, Sunpyo Lee, Eun Jeong Gong, Hee Kyong Na, Ji Yong Ahn, Kee Wook Jung, Jeong Hoon Lee, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
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    Maurice B Loughrey, Brian T Johnston
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    Jung Ho Kim
    World Journal of Gastroenterology.2014; 20(34): 12233.     CrossRef
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Focused Review Series: A Perspective: Endoscopy and Imaging in Inflammatory Bowel Disease
The Role of Colonoscopy in Inflammatory Bowel Disease
Yong Gil Kim, Byung Ik Jang
Clin Endosc 2013;46(4):317-320.   Published online July 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.4.317
AbstractAbstract PDFPubReaderePub

An endoscopic evaluation, particularly ileocolic mucosal and histological findings, is essential for the diagnosis of inflammatory bowel disease (IBD). The introduction of antitumor necrosis factor agents has changed the therapeutic paradigm of patients with IBD, but an endoscopic evaluation is more important to guide therapeutic decision-making. In the future, endoscopy with a histological evaluation will be increasingly used in patients with IBD. Both Crohn colitis and ulcerative colitis result in an increased incidence of colorectal carcinoma. Thus, surveillance colonoscopy is important to detect early neoplastic lesions. Surveillance ileocolonoscopy has also changed recently from multiple random biopsies to pancolonic dye spraying with targeted biopsies of abnormal areas.

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Special Issue Articleses of IDEN 2012
Colonoscopic Cancer Surveillance in Inflammatory Bowel Disease: What's New Beyond Random Biopsy?
James E. East
Clin Endosc 2012;45(3):274-277.   Published online August 22, 2012
DOI: https://doi.org/10.5946/ce.2012.45.3.274
AbstractAbstract PDFPubReaderePub

Colonoscopy based colitis surveillance is widely accepted to try to prevent development of and ensure early detection of colitis-associated colorectal cancer. Traditionally this has been performed with quadrantic random biopsies throughout the colon. Chromoendoscopy "dye-spray" with targeted biopsies only has been shown to increase dysplasia detection 4 to 5 fold on a per lesion basis. It has therefore been suggested that random biopsies should be abandoned as they do not increase dysplasia detection nor change patient clinical course. Recent British guidelines for colitis surveillance have strongly endorsed chromoendoscopy. This short review summarizes current international guidelines and looks at how to optimize white light colonoscopy in colitis considering: bowel preparation, withdrawal time, high definition, and structure enhancement. Data for advanced imaging techniques are reviewed including positive evidence in favor of chromoendoscopy, and limited data suggesting autofluoresence imaging may be promising. Narrow band imaging does not increase dysplasia detection in colitis. Confocal endomicroscopy might potentially reduce biopsies beyond that of chromoendoscopy but does not offer a clear detection advantage. Pan-colonic chromoendoscopy with targeted biopsies increases dysplasia detection and is the standard of care in the United Kingdom. It is likely that the use of chromoendoscopy for colitis surveillance will become widely accepted internationally.

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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
AbstractAbstract PDFPubReaderePub

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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A Case of Duodenal Mucosa-associated Lymphoid Tissue Lymphoma Presenting as a Refractory Ulcer
Min Keun Song, M.D., Hyoun Woo Kang, M.D., Jae Hak Kim, M.D., Jun Kyu Lee, M.D., Yun Jeong Lim, M.D., Moon Soo Koh, M.D., Jin Ho Lee, M.D. and Eo Jin Kim, M.D.*
Korean J Gastrointest Endosc 2011;43(1):9-12.   Published online July 28, 2011
AbstractAbstract PDF
Mucosa-associated-lymphoid-tissue (MALT) lymphomas are the most common primary gastrointestinal lymphomas. The stomach is the most common site of involvement in the GI tract. However, MALT lymphoma of the duodenum is rare. The differential diagnosis in a refractory peptic ulcer are current smoking, NSAID use, hypersecretory conditions (gastrinoma and Zollinger-Ellison syndrome), neoplasms, infection (cytomegalovirus, syphilis, and tuberculosis), and Crohn's disease. Endoscopic findings of duodenal MALT lymphoma are classified as ulcerative, polypoid, and diffuse types. The ulcerative type is the most common type of duodenal MALT lymphoma. Here, we report a case of a 64-year-old male with a history of a refractory duodenal ulcer who was diagnosed with a duodenal MALT lymphoma by immunohistochemical staining. (Korean J Gastrointest Endosc 2011;43:9-12)
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