Clinical Endoscopy

Case Report

Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy: Kyunghwan Oh, Kee Don Choi, Hyeong Ryul Kim, Tae Sun Shim, Byong Duk Ye, Suk-Kyun Yang, Sang Hyoung Park; Clin Endosc 2023;56(2):239-244. Published online December 21, 2021; DOI: https://doi.org/10.5946/ce.2021.215

Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient’s condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

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(Re-)introduction of TNF antagonists and JAK inhibitors in patients with previous tuberculosis: a systematic review
Thomas Theo Brehm, Maja Reimann, Niklas Köhler, Christoph Lange
Clinical Microbiology and Infection.2024; 30(8): 989. CrossRef
Azathioprine/infliximab/methylprednisolone

Reactions Weekly.2023; 1963(1): 114. CrossRef

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Original Article

Endoscopic Mucosal Resection with Circumferential Mucosal Incision for Colorectal Neoplasms: Comparison with Endoscopic Submucosal Dissection and between Two Endoscopists with Different Experiences: Dong-Hoon Yang, Min-Seob Kwak, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Hyun Gun Kim, Shai Friedland; Clin Endosc 2017;50(4):379-387. Published online March 7, 2017; DOI: https://doi.org/10.5946/ce.2016.058

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Background
/Aims: Endoscopic mucosal resection with circumferential mucosal incision (CMI-EMR) may offer benefits comparable to those of endoscopic submucosal dissection (ESD), while requiring less technical proficiency than ESD.
Methods
We retrospectively compared the outcomes of CMI-EMR (n=34) and size-matched ESD (n=102), which were performed by a Korean endoscopist for colorectal epithelial lesions of 20–35 mm. Procedural parameters of CMI-EMRs performed by an American ESD novice ((n=30) were compared with those performed by the Korean endoscopist.
Results
The lesion size was 22.3±3.9 mm and 22.9±2.4 mm in the CMI-EMR and size-matched ESD groups, respectively (p=0.730). The resection time was 12.7±7.0 minutes in the CMI-EMR group and 45.6±30.1 minutes in the ESD group (p<0.001). The en bloc resection rate was 94.1% in the CMI-EMR group and 100% in the ESD group (p=0.061). There were no differences in the en bloc resection and complication rates of CMI-EMRs between a Korean and an American endoscopist.
Conclusions
For the treatment of moderate-size colorectal lesions, CMI-EMR showed a trend toward lower en bloc resection rate, but required shorter procedure time than ESD. CMI-EMR outcomes were similar when performed by a Korean ESD expert and an American ESD novice.

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Endoscopic mucosal resection with a circumferential incision in the removal of colon neoplasms. Results of a randomized trial.
E. U. Abdulzhalieva, A. A. Likutov, V. V. Veselov, D. A. Mtvralashvili, O. M. Yugai, E. A. Khomyakov, S. V. Chernyshov, O. I. Sushkov
Koloproktologia.2024; 23(1): 21. CrossRef
Approaches and considerations in the endoscopic treatment of T1 colorectal cancer
Yunho Jung
The Korean Journal of Internal Medicine.2024; 39(4): 563. CrossRef
Hybrid Endoscopic Resection With Endo-knife and Snare for Colorectal Lesions: A Systematic Review and Meta-analysis
Shinji Yoshii, Takefumi Kikuchi, Yuki Hayashi, Masahiro Nojima, Hiro-o Yamano, Hiroshi Nakase
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(2): 135. CrossRef
Multicenter evaluation of recurrence in endoscopic submucosal dissection and endoscopic mucosal resection in the colon: A Western perspective
Mike T Wei, Margaret J Zhou, Andrew A Li, Andrew Ofosu, Joo Ha Hwang, Shai Friedland
World Journal of Gastrointestinal Endoscopy.2023; 15(6): 458. CrossRef
Comparison of precutting endoscopic mucosal resection and endoscopic submucosal dissection for large (20–30 mm) flat colorectal lesions
Chang Kyo Oh, Young Wook Cho, In Hyoung Choi, Han Hee Lee, Chul‐Hyun Lim, Jin Su Kim, Bo‐In Lee, Young‐Seok Cho
Journal of Gastroenterology and Hepatology.2022; 37(3): 568. CrossRef
A systematic review and meta-analysis of endoscopic mucosal resection vs endoscopic submucosal dissection for colorectal sessile/non-polypoid lesions
Endrit Shahini, Roberto Passera, Giacomo Lo Secco, Alberto Arezzo
Minimally Invasive Therapy & Allied Technologies.2022; 31(6): 835. CrossRef
Endoscopic mucosal resection with a circumferential incision in the removal of colorectal neoplasms (preliminary results of the prospective randomized study)
A. U. Abdulzhalieva, A. A. Likutov, D. A. Mtvralashvili, V. V. Veselov, Yu. E. Vaganov, S. V. Chernyshov, O. A. Mainovskaya, O. I. Sushkov
Koloproktologia.2022; 21(4): 21. CrossRef
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Shinji Yoshii, Marina Kubo, Mio Matsumoto, Takefumi Kikuchi, Yasunari Takakuwa
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Soo Min Noh, Jin Yong Kim, Jae Cheol Park, Eun Hye Oh, Jeongseok Kim, Nam Seok Ham, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
International Journal of Colorectal Disease.2020; 35(7): 1283. CrossRef
Long‐term clinical outcomes of endoscopic submucosal dissection for colorectal neoplasia with or without the hybrid technique
DU Kang, JC Park, SW Hwang, SH Park, DH Yang, KJ Kim, BD Ye, SJ Myung, SK Yang, JS Byeon
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Joon Seop Lee, Yong Hwan Kwon
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Michael X. Ma, Michael J. Bourke
Digestive Endoscopy.2018; 30(3): 310. CrossRef
Introduction of endoscopic submucosal dissection in the West
David Friedel, Stavros Nicholas Stavropoulos
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Filling the Technical Gap between Standard Endoscopic Mucosal Resection and Full Endoscopic Submucosal Dissection for 20–35 mm Sized Colorectal Neoplasms
Sung Noh Hong
Clinical Endoscopy.2017; 50(4): 313. CrossRef

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Case Report

Unusual Local Recurrence with Distant Metastasis after Successful Endoscopic Submucosal Dissection for Colorectal Mucosal Cancer: Hyo Jeong Lee, Byong Duk Ye, Jeong-Sik Byeon, Jihun Kim, Young Soo Park, Yong Sang Hong, Yong Sik Yoon, Dong-Hoon Yang; Clin Endosc 2017;50(1):91-95. Published online August 22, 2016; DOI: https://doi.org/10.5946/ce.2016.054

Abstract PDF PubReader ePub

Intramucosal colorectal cancer (CRC) is thought not to metastasize because the colonic lamina propria lacks lymphatics. Only a few recent case reports have suggested lymph node metastasis from intramucosal CRC, but there is no clear evidence supporting the metastatic potential of intramucosal CRC. Hence, endoscopic resection is regarded as curative treatment for intramucosal CRC. This report describes two cases of unusual local recurrence with distant metastasis in patients who had previously undergone successful endoscopic submucosal dissection for intramucosal CRC. The recurrent colorectal lesions developed at the site of the previous endoscopic submucosal dissection scars in a relatively short-term period, and the pathologic findings showed an “undermining” invasion pattern without surrounding mucosal change. Based on the clinical course and pathological findings, we concluded that the second colorectal lesions were recurrences rather than de novo cancers.

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Seohyun Lee, Jihun Kim, Jae Seung Soh, Jungho Bae, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
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Original Article

Indications for Detection, Completion, and Retention Rates of Small Bowel Capsule Endoscopy Based on the 10-Year Data from the Korean Capsule Endoscopy Registry: Yun Jeong Lim, Oh Young Lee, Yoon Tae Jeen, Chi Yeon Lim, Dae Young Cheung, Jae Hee Cheon, Byong Duk Ye, Hyun Joo Song, Jin Su Kim, Jae Hyuk Do, Kwang Jae Lee, Ki-Nam Shim, Dong Kyung Chang, Cheol Hee Park, Byung Ik Jang, Jeong Seop Moon, Hoon Jai Chun, Myung-Gyu Choi, Jin Oh Kim, Korean Gut Image Study Group; Clin Endosc 2015;48(5):399-404. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.399

Abstract PDF PubReader ePub

Background/Aims

Capsule endoscopy (CE) is widely used. However, CE has limitations including incomplete examination, inadequate bowel preparation, and retention. The aim of this study was to estimate the indications for and detection, completion, and retention rates of small intestine CE based on the 10-year data from the Korean Capsule Endoscopy Registry.

Methods

Twenty-four hospitals participated in this study. Clinical information, such as reasons for CE, method and quality of bowel preparation, and incomplete examination and capsule retention rates, was collected and analyzed.

Results

A total of 2,914 CEs were registered. The most common reason for CE was obscure gastrointestinal bleeding (59%). Significant lesions were detected in 66% of cases. Positive CE diagnosis occurred in 63% of cases. The preparation method did not significantly affect the quality of bowel preparation for CE. The overall incomplete rate was 33%, and was high in the elderly and those with poor bowel preparation. Capsule retention was 3% and high in patients with small bowel tumors and Crohn's disease and in children under 10 years of age.

Conclusions

CE is a valuable technique; while the overall detection rate is high, incompletion and retention rates are also relatively high. CE should be carefully considered in the elderly and children less than 10 years of age, as well as in patients with small bowel tumors and Crohn's disease.

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Review

Guidelines for Video Capsule Endoscopy: Emphasis on Crohn's Disease: Soo-Kyung Park, Byong Duk Ye, Kyeong Ok Kim, Cheol Hee Park, Wan-Sik Lee, Byung Ik Jang, Yoon Tae Jeen, Myung-Gyu Choi, Hyun Jung Kim, The Korean Gut Image Study Group; Clin Endosc 2015;48(2):128-135. Published online March 27, 2015; DOI: https://doi.org/10.5946/ce.2015.48.2.128

Abstract PDF PubReader ePub

Video capsule endoscopy (VCE) is an ingestible video camera that transmits high-quality images of the small intestinal mucosa. This makes the small intestine more readily accessible to physicians investigating the presence of small bowel disorders, such as Crohn's disease (CD). Although VCE is frequently performed in Korea, there are no evidence-based guidelines on the appropriate use of VCE in the diagnosis of CD. To provide accurate information and suggest correct testing approaches for small bowel diseases, the Korean Gut Image Study Group, part of the Korean Society of Gastrointestinal Endoscopy, developed guidelines on VCE. Teams were set up to develop guidelines on VCE. Four areas were selected: diagnosis of obscure gastrointestinal bleeding, small bowel preparation for VCE, diagnosis of CD, and diagnosis of small bowel tumors. Three key questions were selected regarding the role of VCE in CD. In preparing these guidelines, a systematic literature search, evaluation, selection, and meta-analysis were performed. After writing a draft of the guidelines, the opinions of various experts were solicited before producing the final document. These guidelines are expected to play a role in the diagnosis of CD. They will need to be updated as new data and evidence become available.

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Takeru Okuhira, Atsushi Yoden, Tomoki Aomatsu, Masano Akamatsu, Keisuke Inoue, Emiri Kaji, Kimitaka Takitani, Hiroshi Tamai
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Dario Sorrentino, Vu Q. Nguyen, Maithili V. Chitnavis
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Libin Huang, Zhiyin Huang, Yang Tai, Pu Wang, Bing Hu, Chengwei Tang
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Che-Yung Chao, Carl Frederic Duchatellier, Ernest G. Seidman
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10,582 View
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Original Articles

Postpolypectomy Fever, a Rare Adverse Event of Polypectomy: Nested Case-Control Study: Seung-Hoon Lee, Kyung-Jo Kim, Dong-Hoon Yang, Kee Wook Jeong, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Clin Endosc 2014;47(3):236-241. Published online May 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.3.236

Abstract PDF PubReader ePub

Background/Aims

Although postpolypectomy fever (PPF) without colon perforation or hemorrhage is rare, its incidence and risk factors have not been investigated. The objective of this study was to analyze the incidence and risk factors for PPF among inpatients.

Methods

Seven patients with PPF were matched with 70 patients without PPF from a total of 3,444 patients who underwent colonoscopic polypectomy. The PPF incidence during index hospitalization after colonoscopy was calculated, and univariate and multivariate analyses were performed to calculate the adjusted odds ratios (ORs) for risk factors.

Results

PPF without bleeding or perforation in the colon occurred in seven patients (0.2%). The median age was 58 years for cases and 61 years for controls. The median interval from polypectomy to occurrence of fever was 7 hours, and the median duration of fever was 9 hours. Polyp size >2 cm (adjusted OR, 1.08; 95% confidence interval [CI], 1.01 to 1.15; p=0.02) and hypertension (adjusted OR, 14.40; 95% CI, 1.23 to 180.87; p=0.03) were associated with a significantly increased risk of PPF. PPF increased the length of hospitalization.

Conclusions

Although the crude incidence of PPF is low, PPF may prolong hospitalization. Risk factors for PPF include hypertension and large polyps.

Citations

Citations to this article as recorded by

Cold Endoscopic Mucosal Resection (c-EMR) of Nonpedunculated Colorectal Polyps ≥20 mm
Daryl Ramai, Benjamin Clement, Marcello Maida, Melissa Previtera, Olivia W. Brooks, Yichen Wang, Saurabh Chandan, Banreet Dhindsa, Smit Deliwala, Antonio Facciorusso, Mouen Khashab, Andrew Ofosu
Journal of Clinical Gastroenterology.2024; 58(7): 661. CrossRef
Cold Snare Cut Versus Avulsion for Colonic Mucosal Resection: A Randomized Ex Vivo Porcine Study (the CONVINCE Study)
Neal A. Mehta, James K. Stone, Roberto Trasolini, Yuho Ono, Mandeep S. Sawhney
Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 315. CrossRef
Risk factors of medication‐related osteonecrosis of the jaw in preventive tooth extraction before bone resorption inhibitor administration: A multicenter nested case–control study
Taro Saito, Atsushi Nishikawa, Yuko Hara‐Saito, Andrea Rei Estacio Salazar, Akira Kurokawa, Akihiko Iida, Masahiro Yamaga, Hiroyuki Kano, Yusuke Kato, Yoshiyuki Takata, Hideyoshi Nishiyama, Nobutaka Kitamura, Takahiro Tanaka, Ritsuo Takagi
Oral Science International.2022; 19(2): 79. CrossRef
Postpolypectomy fever in patients with serious infection: a report of two cases
Wang Jing, Li Qinghua, Yang Zhiwen
BMC Gastroenterology.2022;[Epub] CrossRef
RoboCap: Robotic mucus-clearing capsule for enhanced drug delivery in the gastrointestinal tract
Shriya S. Srinivasan, Amro Alshareef, Alexandria V. Hwang, Ziliang Kang, Johannes Kuosmanen, Keiko Ishida, Joshua Jenkins, Sabrina Liu, Wiam Abdalla Mohammed Madani, Jochen Lennerz, Alison Hayward, Josh Morimoto, Nina Fitzgerald, Robert Langer, Giovanni T
Science Robotics.2022;[Epub] CrossRef
Pylephlebitis after sigmoid colonic polypectomy
Yuna Saito, Toshinori Nishizawa, Hiroko Arioka
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Management of Pediatric Postendoscopy Fever
Julia M. Boster, Melissa Iwanowski, Robert E. Kramer
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Cold versus hot polypectomy/endoscopic mucosal resection–A review of current evidence
Raquel Ortigão, Jochen Weigt, Ahmed Afifi, Diogo Libânio
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Periprocedural adverse events after endoscopic resection of T1 colorectal carcinomas
Steffi E.M. van de Ven, Yara Backes, Mirrian Hilbink, Tom C.J. Seerden, Koen Kessels, Wouter H. de Vos tot Nederveen Cappel, John N. Groen, Frank H.J. Wolfhagen, Joost M.J. Geesing, Frank ter Borg, Jeroen van Bergeijk, B.W.M. Spanier, Marco W. Mundt, H.J.
Gastrointestinal Endoscopy.2020; 91(1): 142. CrossRef
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María Luisa García-García, Miguel Ángel Jiménez-Ballester, Enrique Girela-Baena, José Luis Aguayo-Albasini
Gastroenterología y Hepatología.2017; 40(7): 463. CrossRef
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Vicente Lorenzo‐Zúñiga, Jaume Boix, Vicente Moreno de Vega, Ignacio Bon, Ingrid Marín, Ramón Bartolí
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Pujan Kandel, Michael B. Wallace
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María Luisa García-García, Miguel Ángel Jiménez-Ballester, Enrique Girela-Baena, José Luis Aguayo-Albasini
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Michael X. Ma, Michael J. Bourke
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Hyung Wook Kim
Clinical Endoscopy.2014; 47(3): 205. CrossRef

8,066 View
95 Download
16 Web of Science
15 Crossref

Learning Curve of Capsule Endoscopy: Korean Gut Image Study Group, Yun Jeong Lim, Young Sung Joo, Dae Young Jung, Byong Duk Ye, Ji Hyun Kim, Jae Hee Cheon, Seong Eun Kim, Jae Hyuk Do, Byung Ik Jang, Jeong Seop Moon, Jin Oh Kim, Hoon Jae Chun, Myung-Gyu Choi; Clin Endosc 2013;46(6):633-636. Published online November 19, 2013; DOI: https://doi.org/10.5946/ce.2013.46.6.633

Abstract PDF PubReader ePub

Background/Aims

Capsule endoscopy (CE) has become an important tool for the diagnosis of small bowel disease. Although CE does not require the skill of endoscope insertion, the images should be interpreted by a person with experience in assessing images of the gastrointestinal mucosa. This investigation aimed to document the number of cases needed by trainees to gain the necessary experience for CE competency.

Methods

Fifteen cases were distributed to 12 trainees with no previous experience of CE during their gastroenterology training as clinical fellows. Twelve trainees and an expert were asked to read CE images from one patient each week for 15 weeks. The diagnosis was reported using five categories (no abnormalities detected, small bowel erosion or ulcer, small bowel tumor, Crohn disease, and active small bowel bleeding with no identifiable source). We then examined, using the κ coefficient, how the degree of mean agreements between the trainees and the expert changed as the training progressed each week.

Results

The agreement rate of CE diagnosis increased as the frequencies of interpretation increased. Most of the mean κ coefficients were >0.60 and >0.80 after week 9 and 11, respectively.

Conclusions

Experience with approximately 10 cases of CE is appropriate for trainees to attain CE competency.

Citations

Citations to this article as recorded by

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