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Volume 27(3); September 2003
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A Case of Tubular Esophageal Duplication Presenting with Hematemesis
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Ik Yoon, M.D., Jae Hyun Choi, M.D., Ju young Kim, M.D., Sun Min Park, M.D., Chul Young Kim, M.D., Rok Son Choung, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hong Sik Lee, M.D., Hun Jai Jeun, M.D., Sang Woo Lee, M.D., Chang Duck Kim, M.D., Ho Sang Ryu,
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Korean J Gastrointest Endosc 2003;27(3):133-136. Published online September 30, 2003
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Abstract
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- A 35-year old male developed epigastric pain and hemate]mesis one week before admission. Esophagogastroduodenoscopy was performed and a communication between the esophagus and another opening was discovered. On a follow- up CT and barium esophagogram, a tubular duplication was suspected and the patient was referred to the department of cardio-thoracic surgery. A pathological diagnosis of esophageal duplication (tubular type) was established. The patient was discharged and is currently being followed up. Eso-phageal duplication is a rare congenital malformation. Moreover, it has not heen reported in Korea that esophageal duplication presents with hematemesis.
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A Case of Mucosa-Associated Lymphoid Tissue Lymphoma in the Esophagus Accompanied by Bronchus-Associated Lymphoid Tissue Lymphoma
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Chang Mo Moon, M.D., Hee Man Kim, M.D., Jong Won Choi, M.D., Jung Hun Seo, M.D.*, Sun Young Won, M.D.*, Chun Gyun Lee, M.D.*, In Suh Park, M.D.*, Jin Suk Kim, M.D.†, Jung Hye Ki, M.D.‡ and Yong Suk Cho, M.D.*
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Korean J Gastrointest Endosc 2003;27(3):137-142. Published online September 30, 2003
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Abstract
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- Mucosa-associated lymphoid tissue (MALT) is specially adapted component of the immune system protecting the permeable surface of the gastrointestinal mucosa, bronchial mucosa and other mucosa. Chronic infection of the stomach by Helicobacter pylori, Hashimoto's thyroiditis, Sjögren syndrome in the salivary gland and other chronic inflammatory and autoimmune disease lead to the accumulation of MALT in the mucosa and MALT lymphoma arises from this acquired MALT. MALT lymphoma is histologically characterized by proliferation of centrocyte-like cells that invade the epithelium and lymphoepithelial lesion form. Gastrointestinal MALT lymphoma is clinically important because it is a localized, slow progressive disease and has a long survival and favorable clinical course compared with other lymphoma. Esophageal MALT lymphoma is extremely rare, so we report, radiologic, endoscopic and pathological findings and clinical course in a case of esophageal MALT lymphoma with brouchas-associated lymphoid tissue (BALT) lymphoma with a review of literature.
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A Case of Primary Esophageal Bezoar
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Ji Hyang Yoon, M.D., Ok Jae Lee, M.D., Eun Jung Lee, M.D., Hong Jun Kim, M.D., Hyung Jun Kim, M.D., Hyun Jin Kim, M.D., Tae Hyo Kim, M.D. and Woon Tae Jung, M.D.
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Korean J Gastrointest Endosc 2003;27(3):143-147. Published online September 30, 2003
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- Bezoar is a persistent concretion of indigestible materials, usually found in the stomach, and most cases have been managed by surgical methods. Esophageal bezoars are very rare and have been mainly reported in patients with esophageal motility or anatomical abnormalities. We experienced a case of primary esophageal bezoar dissolved with pancreatic enzyme extracts. A 79-year-old man complained of dysphagia of a 15-day duration. Esophagoscopy revealed a large, yellow-brownish, round, hard mass obstructing the esophageal lumen and a deep ulcer, 30 cm from the incisor teeth. Multiple attempts to break or retrieve it were tried, but failed. He accepted surgical treatment and took a pancreatic enzyme preparation during preoperative evaluation of his heart problem. After 20 days, his symptom was relieved, and bezoar disappeared completely on a follow-up endoscopy. Esophageal manometry disclosed nonspecific esophageal motility disorder.
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A Case of Kaposi's Sarcoma of the Stomach and Duodenum in an AIDS Patient
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Hee Seok Moon, M.D., Ki Oh Park, M.D., Yeum Seok Lee, M.D., Sun Moon Kim, M.D., Jae Kyu Sung, M.D., Yean Sook Kim, M.D., Geu Sang Song, M.D.* and Hyun Yong Jeong, M.D.
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Korean J Gastrointest Endosc 2003;27(3):148-152. Published online September 30, 2003
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- Kaposi's sarcoma, a rare tumor, usually presents itself with skin lesions. There is, however, an increased incidence in patients using immunosupressive drugs and with the acquired immunodeficiency syndrome (AIDS). Gastrointestinal Kaposi's sarcoma is usually asymptomatic, but may cause massive intestinal hemorrhage, perforation, intestinal obstruction, intussusception, protein-losing enteropathy, or sepsis. The gastroscopic appearances of Kaposi's sarcoma range from reddish purple maculopapules to polypoid, umbilicated nodule. In Korea, 3 case's of gastrointestinal kaposi's sarcoma have been reported so far. We experienced a 45-year-old man, who was positive for human immunodeficiency virus (HIV) antibodiy and developed Kaposi's sarcoma. A case of gastrointestinal Kaposi's sarcoma treated with paclitaxel is herein reported with the endoscopic findings before and after chemotherapy.
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A Case of Adenocarcinoma Arising in Hyperplastic Polyp in the Stomach
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Soo Jin Park, M.D., Hyun Gun Kim, M.D., Jae Hoon Yang, M.D., Hae Jung Song, M.D., So Young Jin, M.D.*, Chang Beom Ryu, M.D., Jin Oh Kim, M.D., Joo Young Cho, M.D., Joon Seong Lee, M.D., Moon Sung Lee, M.D. and Chan Sup Shim, M.D.
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Korean J Gastrointest Endosc 2003;27(3):153-157. Published online September 30, 2003
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Abstract
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- Epithelial gastric polyps can be categorized as hyperplastic or adenomatous polyps. Hyperplastic polyps are predominant, comprising 75 to 90% of gastric polyps. It has been generally accepted that adenomatous gastric polyps exhibit malignant change. However, potential of malignant transformation of hyperplastic gastric polyps was originally denied and have been rarely reported, the incidence varying from 1.5 to 2.1%. The size and the associated dysplasia of polyps seem to be important in transformation to gastric carcinoma. Most of the reported cases of hyperplastic gastric polyps with transformation to adenocarcinoma were histopathologically well differentiated. We report a rare case of moderately differentiated adenocarcinoma arising in a hyperplastic polyp on the greater curvature of the midbody in the stomach with a brief review of the literatures.
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Four Cases of Trichuris Trichiura Infection in the Colon
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Ji Sup Kim, M.D., Jae Suk Park M.D., Yong Wuk Kim, M.D., Ji Hye Suk, M.D., Jung Choi, M.D., Choong Hwan Kwak, M.D., Seung Keun Park, M.D., Hee Ug Park, M.D. and Hye Sook Kim, M.D.*
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Korean J Gastrointest Endosc 2003;27(3):158-161. Published online September 30, 2003
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- Trichuris trichiura (whipworm) is a ubiquitous parasite that resides in the human intestinal tract, and it is known as whipworm because of its whip-like appearance. Trichuriasis is rare in developed countries, but it is more prevalent in tropical countries and areas with suboptimal sanitation. In most patient, whipworm infection is asymtomatic but patient with heavy infection present with anemia, diarrhea, trichuris dysentery syndrome, abdominal pain, weight loss, appendicitis and rectal prolapse. It is characterized by the invasion of the colonic mucosa by the adult Trichuris and produces minor inflammatory changes at the sites of localization. Its diagnosis is usually made by identification of football-shaped eggs in the stool or by confirming adult whipworm during colonoscopy. We report four cases of whipworm infection that were incidentally diagnosed on colonoscopy.
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A Case of Ischemic Colitis Following Colonoscopy
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Byung Oh Lee, M.D., Hwang Choi, M.D., In Jung Kang, M.D., Ki Young Kim, M.D., Ho Il Lee, M.D., Jeong Pyo Kim, M.D., Bo In Lee, M.D., Byung Wook Kim, M.D., Se Hyun Cho, M.D., Kyu Yong Choi, M.D., In Sik Chung, M.D. and Sang Bok Cha, M.D.
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Korean J Gastrointest Endosc 2003;27(3):162-165. Published online September 30, 2003
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Abstract
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- Ischemic colitis can be caused either by vascular or colonic wall factor or by both. Shunting of blood away from the mucosa may contribute to ischemia of the colon, but the mechanism of ischemia is not known. Ischemic colitis precipitated by colonoscopy has rarely been reported. Potentially air insufflation or mechanical effect during colonoscopic examination can cause ischemic colitis as a colonic wall factor. Recently, we experienced a case of ischemic colitic, which had been developed several hours after colonoscopic polypectomy. So we report this case with brief review of literature.
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A Case of Ischemic Colitis due to Falling Down
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Young Sik Woo, M.D., Jong Myung Na, M.D., Kang Hyun Choi, M.D., Jin Sun Lee, M.D., U Im Jang, M.D., Woo Chul Chung, M.D., Kang Moon Lee, M.D., Jin Mo Yang, M.D., In Sik Chung, M.D. and Hee Sik Sun, M.D.
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Korean J Gastrointest Endosc 2003;27(3):166-170. Published online September 30, 2003
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- Ischemic colitis, the most common form of acute mesenteric ischemia, is encountered primarily in elderly patients, and frequently presents with abdominal cramping pain and hematochezia. Both occlusive and nonocclusive underlying mechanisms have been proposed, but the precise pathophysiology remains unknown. On colonoscopy, the earlier signs of ischemic colitis are mucosal hyperemia, edema, and hemorrhagic nodules representing submucosal bleeding. It is followed by well-demarcated elongated ulcerations covered with exudate. In most cases, the clinical course is transient and self-limiting. After conservative treatment with hydration, cessation of food, and broad-spectrum antibiotics, clinical symptoms improve within several days. Recently, we have experienced a case of ischemic colitis following falling down and report this case with a review of the literature.
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A Case of Hemobilia due to Gallbladder Carcinoma
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Heok Soo Ahn, M.D., Byoung Sik Mun, M.D., So Ri Kim, M.D., Soo Teik Lee, M.D. and Seung Ok Lee, M.D.
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Korean J Gastrointest Endosc 2003;27(3):171-174. Published online September 30, 2003
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- Gallbladder carcinoma is an uncommon neoplasm, and hemobilia caused by this disease is rare. We present a case of hemobilia in a patient with gallbladder carcinoma, which was recognized at forward duodenoscopy. A 42-year-old man visited our hospital due to intermmittent right upper quadrant pain. Duodenoscopy revealed blood clots with bile juice around the ampulla of Vater and the second portion of the duodenum. Endoscopic ultrasonography for the gallbladder showed a dumbell-shaped mass with a homogenous internal echogenicity on the body of the gallbladder. MR cholangiography showed a lobulated mass with low-signal intensity in the T1-weighted and T2-weighted images. Subsequently, laparoscopic cholecystectomy with regional lymph node dissection was performed, and adenocarcinoma was confirmed.
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A Case of Gastric Ectopic Pancreas Complicated by Pancreatitis and Pseudocyst Formation
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Joon Ho Wang, M.D., Jae Dong Lee, M.D., Chong Ju Kim, M.D., Hyung Seok Park, M.D., Chun Jo Jin, M.D., Mun Su Kang, M.D.*, Hi Young Sin, M.D., Keung Bin No, M.D., Keung Sub Song, M.D. and Hwa Suk Jung, M.D.
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Korean J Gastrointest Endosc 2003;27(3):175-179. Published online September 30, 2003
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- Ectopic pancreas rarely produces clinical symptoms. Most commonly reported symptoms were abdominal pain, epigastric discomfort, nausea, vomiting, and bleeding. However, presentation of specific symptoms due to its size and location, including obstructive jaundice, and pyloric obstruction are possible. Ectopic pancreas is subject to various pathological changes occurring in the pancreas itself; namely, cyst, pancreatitis, hemorrhage, necrosis, and neoplastic change. We present a case of 60-year old woman with right upper quadrant pain in whom the surgical pathologic diagnosis was ectopic pancreas of the stomach complicated by pancreatitis and pseudocyst formation.
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