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Volume 6(1); December 1986
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상부 위장관 출혈 환자에서 99.5% 에탄올에 의한 지혈효과 ( Effect of Endoscopic Ethanol Injection in Upper G-I Bleeding )
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Korean J Gastrointest Endosc 1986;6(1):1-4. Published online November 30, 1985
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- Upper G-I bleeding is a dangerous situation and effeetive control method without surgery is desirable. A hemostatic technique utilizing the dehydrating and fixative properties of pure ethanol was developed in Japan. This technique was performed through an endoscopic injector, in divided dose of 0,1 ~ 0.2 ml into several spots in the area surrounding the bleeding vessel in patients upper G-I bleeding excluding esophageal varies. We applieii this technique in treatment of 11 cases showing active bleeding of fresh blood clots. Rebleeding occurred in 2 cases(20%) and complete hemostasis was achieved in 9 cases(80%). We think this technique is safe and simple as an endoscopic hemostatic measure.
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대장내시경 검사에 관한 임상적 고찰 ( Clinical Study of Colonofiberscopic Findings )
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Korean J Gastrointest Endosc 1986;6(1):5-13. Published online November 30, 1985
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- Comparison between Americans colonic diseases are much less prevalence in Korea. But, recent days much increased incidence in these disases caused by changes of food habits and development of diagnostic methods. We studied 1456 cases who complained colonic symptoms and colonofiberscopic biopsy was taken from 1981 to 1985 at Han Yang Univ. Hospital, Age, Sex, elinical symptoms, histopathological findings, location and relation between of barium study were analized for 1002 cases wha confirmed by biopsy. (continue...)
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내시경적 절제술로 치유된 용종양 식도 평활근종 1예 ( Endoscopically Removed Polypoid Esophageal Leiomyoma )
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Korean J Gastrointest Endosc 1986;6(1):15-18. Published online November 30, 1985
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- Leiomyoma is the most common benign tumor of the esophagus, but it still occurs rarely, as compared with the incidence of cacinoma. There are no geographic or racial differences and manifestations are unusual and inconsistent. About 97% of the esophageal leiomyoma may oecur in intramural type and 1 of the tumor may be polypoid type. Considerable diagnostic problems may arise as well as problems of proper surgical management. We experienced a case of a 47-year old female with esophageal leiomyoma in the mid- point of the esophagus. The patient complained of substernal discomfort for 1 month and routine examinatian and gastrofiberscope were performed. The gastrofiberscopic finding was asmoothly protruded, round bean-sized polypoid mass in the midpoint of the esophagus which was removed by polypectomy. There were no other complications. So we reported this case with review of literature.
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전이성 수막암종증을 일으킨 표재확장성 조기위암 1예 ( A Case of Leptomeningeal Carcinomatosis on Superficial Spreading Carcinoma of the Stomach )
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Korean J Gastrointest Endosc 1986;6(1):19-23. Published online November 30, 1985
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- Meningeal carcinomatosis is an important neurological complication of systemic cancer, and is increasingly being recognized as a cause of reurologic disability in life. Also there is evidenee that the incidence of this form of metastasis is increasing. We reported a case of 52-year-old female patient, who was diagnosed as early gastric cancer by biopsy under gastrofiberscopy. Other Lab. findings were all normal range except high alkaline phosphatase level. And then performed Billroth II operation. On 7th post-operative day, she was encountered severe headache and insomnia. Abnormal neurologic signs and subjective symptoms were developed and progressed, Repeated lumbar punture was done and CSF was examed. There findings were abnormal, but no specific finding of certain disease. She died of severe neurologic deficit and sudden respiratory arrest. Autopsy was done, and confirmed leptomeningeal carcinomatosis.
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Diffuse Lymphoid Hyperplsia of Gastric Antrum 3예 ( Diffuse Lymphoid Hyperplsia of Gastric Antrum )
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Korean J Gastrointest Endosc 1986;6(1):25-26. Published online November 30, 1985
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- We experienced three young patients with diffuse lymphoid hyperplasia of the gastric antrum. The peculiar nodularity of the stomach in tliese patients is another cause of etat mammelanne in addition to hypertrophic gastritis and prominence of the areae gastricae. The etiology of the diffuse lymphoid hyperplasia of the gastric antrum is not known. The symptqm is not specific and not related to hitologic and gastroscopic finding but rather to psychological disturbance. We propose longstanding observation for the change of the nodularity.
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Dieulafoy's Disease 3예 ( Three Cases of Dieulafoy's Disease )
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Korean J Gastrointest Endosc 1986;6(1):27-30. Published online November 30, 1985
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- Dieulafoys lesion consists of abnormally large gastric submucosal artery which ruptures into the stomach causing massive or recurrent intragikstric bleeding. The lesion is very small and easily overlooked even at laparatomy and aan only be correctly diagnosed by endoscopy or arteriography if the patient is actively bleeding. Three patients who were admitted with bleeding of upper gastrointestinal tract and eventually diagnosed as having Dieulafoys lesions were analysed. All were men with age range of 44 to 55 years. All patient were asymptomatic before presenting with hematemesis. Two of the three patients had had history of upper Gl bleeding. One patient used analgesics daily for ureteral colic and two patient drank alcohol excessively. Gastroscopy was performed during the bleeding episode in all three patients. Dieulafoy's lesion was seen in all three cases and in the second case, there was concomittent diffuse petechia in the whole stomach. The lesion was situated on the posterior wall of upper body in one, on anterior wall of upper body in another, lesser curvature side of gastric fundus in the other case. All three patient underwent laparotomy for persistent bleeding and the lesion was suture ligated only in two patients while in one patient vagotomy and pyloroplasty was added. Resection biopsy was performed in two cases and both revealed only normal gastric mucosa. All patients discharged after complete recover.
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십이지장 결핵 1예 ( A Case of Tuberculosis of the Duodenum )
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Korean J Gastrointest Endosc 1986;6(1):31-34. Published online November 30, 1985
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- Tuberculosis of the duodenum is rare event in patients with pulmonary or intestinal tuberculoais. It is very difficult to diagnose duodenal tuberculosis because of inconaiatent symptoms and nonspecific duodenal lesioa. Although fiberoptic endoscopy has been used, there is the limitation of fiberoptic endoscopy ia diagnosingthis disease and the diagnoais require laparotomy with biopsy. Recently we experienced a case of duodenal tuberculosis with duodenoscopic findings of the submucosal tumor of duaidenum. We report a case with review of literatures.
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Crohn's Disease 1예에 대한 임상보고 ( A Case Report of Crohn's Disease )
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Korean J Gastrointest Endosc 1986;6(1):35-38. Published online November 30, 1985
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- Crohn's disease is an acute or chronic inflammatory disorder, characteristically non- specific granuloxaatous neerotiziag, cicatrical low grade inflammation, occuring in various portions of the entire oro-gastraintestinal tract. The etiology is not clearly defined and rather uncertain. The disease is a heterogenous & dubious entity with multiple systemic manifestations. The incidence of the disease is geographically unequal in world wide distrihution. And male and female are equally involve. In June, 1985, a case of 17-year-old female patient, who was diagnosed by clinico-micro- scopic examination at Han Yang Univ. hospital. And then, we report with a review of world literatare.
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폐쇄성 대장암 상부에 동반된 Ischemic Colitis 1예 ( A Case of Ischemic Colitis Proximal to Obstructing Cancer of Colon )
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Korean J Gastrointest Endosc 1986;6(1):39-42. Published online November 30, 1985
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- 56-year-old Korean male had complained of abdominal pain and bloody diarrhea who showed a wide area of isehemic colitis above obstructing colon cance due to distention. Ischemic lesions of the distended colon are clinically important because it so often remain unrecognized and can result in anastomotic leakage, fecal fistula and peritonitis after operation. Involvement of the colon by ischemic damage is usually segmental or localized. We experienced unusual case of iachemic colitis proximal to obstructive colon cancer in which the entire colon except ileocecal region was affected. We reported a case with literature review.
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가족성 다발성 대장 용종증 1예 ( A Case of Familial Multiple Polyposis of the Colon )
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Korean J Gastrointest Endosc 1986;6(1):43-47. Published online November 30, 1985
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- Familial polyposis is inherited as an autosomal dominant trait. It is characterized by the progressive development of hundreds to thousands of adenomsteus polyps in the large intestine. A patient who inherited the gene for familial polyposis is asually asymptomatic until after puberty, at which time polyps begin to appear. The disease at first non-malignant but after an interval of a few months or years, the development of colon cancer is inevitable. In Korea, several cases were reported, but almost all of the cases had incomplete familial histories. We experienced one case of familial polypasis in 33-year old Korean male who had no malignant changes in the adenomatous polyps. Among his family, his father and his brother have adenomatous polps in the colon and the rectum confirmed through total colonoscopy with biopsy. We report a case of familial polyposis of colon with a brief review of literatures.
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전역위증을 동반한 횡행결장의 원발성 악성임파종 1예 ( A Case of Malignant Lymphoma ( Diffuse Histiocytic Type ) in Transverse Colon with Situs Inversus Totalis )
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Korean J Gastrointest Endosc 1986;6(1):49-53. Published online November 30, 1985
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- A case of malignant lymphoma of the transverse colon with situs inversus totalis is presented. A 52 year-old male was admitted to this hospital with a 4-months history of right upper quadrant pain and palpable mass. This patient was performed herniorrhaphy due to right inguinal hernia at 4 months ago, and then, was diagnosed situs inversus totalis. (continue...)
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대장내시경으로 진단된 급성충수염 5예 ( Acute Appendicitis Diagnosed by Colonoscopy )
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Korean J Gastrointest Endosc 1986;6(1):55-58. Published online November 30, 1985
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- Acute appendicitis is the most common operative disease in general surgery, but it is not also rate disease to see in other clinical department such as Internal Medicine and Obstetric and Gynecology, because it reqnires to differenciate from many other diseases which have similar symptoms. Expecially, because the clipical aymptoms of acute appendicitis are not typieal in children, elderly, and women, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease. We performed colonoscopy due to be interpretated aa one of the colon diseases rather than acute appendicitis. But in colonoscopic findings, there were hyperemie and edematous change on the appendiceal orifice of cecum(cherry or acorn shape). So we report 5 cases of acute appendicitis diagnosed br colonoscopy.
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대장 아메바종과 간농양을 동반한 아메바증 1예 ( A Case of Amebic Colitis Complicated with Ameboma and Liver Abscess )
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Korean J Gastrointest Endosc 1986;6(1):59-62. Published online November 30, 1985
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- A patient with amebic colitis in which the rare complication of ameboma developed accompanying liver abscess is presented. The diagnosis was made by colonic mucosal biopsy and microscopic stool examination which revealed hematophagous trophzoites of Entamoeba histolytica. All rnanifestations of this patient's illness, including liver abscess, completley reverted to normal after appropriate therapy.
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위 이소성췌장 3예 ( Three Cases of Heterotopic Pancreas of the Stomach )
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Korean J Gastrointest Endosc 1986;6(1):63-66. Published online November 30, 1985
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- Heterotopic panereas is pancreactie tissue occuring outside its normal anatomical location and without any connection and normal pancreas and it is a developmental anormaly. The most commen site is stomach(esp. greater curvature of the antrum), duodenum and jejunum, In majority of cases heterotopic pancreas does not produce symptoms. When it produces complications, the symptoms depend on the site of lesion and the size of mass. Pathologically, the heterotopic pancreatic tissue is subject to all the lesions found in the normally placed pancreas. Tbe smooth broad base intramural defect with central niche ie typical radiologic fiadings of heterotoPic pancreas. Gastrofiberscopy revealed a small round, submucosal projection with a central umblication. The lesions are frequently confused with polys, lymphoma, in.tramural neoplasm and gastric uleer. Accurate diagnosis may prevent needless surgical procedures. Three cases of heterotopic pancreas of stomach were reported and the pertinent literature were reviewed briefly.
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진단적 유두부절개술 2예 ( Diagnostic Endoscopic Sphinteropapillotomy ( E.S.T. ) - An analysis of two cases - )
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Korean J Gastrointest Endosc 1986;6(1):67-70. Published online November 30, 1985
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- E.S.T. is performed not only for the treatment but also for the diagnosis of biliary tract diseases. E.S.T. serves as a diagnostic aid for some of biliary tract diseases which require such procedures as a peroral cholangioscopy or biopsy of the biliary duct for precise diagnosis and further differential diagnosis. The diseases of our patients were diagnosed by clinical findings and such diagnostic maneuvers as abdominal ultrasonography, intravenous cholangiography, percutaneous transhepatic chorangiography(P.T.C.), endoscopic retrograde chorangiopancreatography(E.R.C.P.), In all the two cases, abdominal ultrasonography revealed dilated extrahepatic duct, but biliary trees were not visualized at E.R.C.P. In one of the two cases, P.T.C. revealed a filling defect with dilated common bile ducts(CBD) but we could not make a differential diagnosis of CBD stone from CBD cancer. In another of the two cases, on which intravenous cholangiography was done, we could not see CBD. For the purpuse of precise diagnosis and further differential diagnosis, we performed EST and then ERCP thraugh widened papillae. With those procedures, CBD stones were shown.
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