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Case Reports
A large and pedunculated inflammatory pseudotumor with pseudosarcomatous change of the cecum mimicking a malignant polyp: a case report and literature review
Jong Suk Oh, Hyung Wook Kim, Su Bum Park, Dae Hwan Kang, Cheol Woong Choi, Su Jin Kim, Hyeong Seok Nam, Dae Gon Ryu
Clin Endosc 2023;56(1):119-124.   Published online July 19, 2021
DOI: https://doi.org/10.5946/ce.2021.081
AbstractAbstract PDFPubReaderePub
Inflammatory pseudotumor (IPT) is a rare benign tumor of unknown etiology that can occur in almost any organ system. It has neoplastic features such as local recurrence, invasive growth, and vascular invasion, leading to the possibility of malignant sarcomatous changes. The clinical presentations of colonic IPT may include abdominal pain, anemia, a palpable mass, and intestinal obstruction. A few cases of colonic IPT have been reported, but colonic IPT with pedunculated morphology is very rare. Furthermore, since it can mimic malignant polyps, understanding the endoscopic findings of colonic IPT is important for proper treatment. Herein, we present a case of colonic IPT with pseudosarcomatous changes, presenting as a large polyp, mimicking a malignant polyp in the cecum, along with a literature review.
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An Extremely Rare Case of Gastric Subepithelial Tumor: Gastric Endometriosis
Jong Kun Ha, Cheol Woong Choi, Hyung Wook Kim, Dae Hwan Kang, Su Bum Park, Su Jin Kim, Jeong Beom Hong
Clin Endosc 2015;48(1):74-77.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.74
AbstractAbstract PDFPubReaderePub

Endometriosis is a disease characterized by the presence of endometrial tissue outside of the uterine cavity. It is common in women of childbearing age, and is most frequently located in the pelvic cavity. Approximately 10% of endometriosis cases occur outside of the pelvic cavity in locations such as the intestines, genitourinary system, kidneys, lungs, and skin. However, there have been few reports of endometriosis in the stomach. Here, we report a rare case of endometriosis that presented as a subepithelial stomach tumor.

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  • Gastric Endometriosis
    Bendeguz Metz, Yael Tovia, Dimitrios R. Kalaitzopoulos, Nicolas Samartzis
    Journal of Minimally Invasive Gynecology.2024; 31(8): 633.     CrossRef
  • Müllerian‐type carcinosarcoma arising in gastric endometriosis: Case report and review of the literature
    Rayne Peerenboom, Sabrina Wang, Ryan Morgan, Seth Sankary, Lindsay Yassan, Katherine Kurnit, Mitchell C. Posner
    Clinical Case Reports.2024;[Epub]     CrossRef
  • Gastric wall endometriosis: A case report
    Meng Chieh Chou
    Tungs' Medical Journal.2024; 18(2): 121.     CrossRef
  • Transcoelomic and Lympho-Hematogenous Dissemination of Endometrioid Heterotopias – the Mechanism of Extragenital Endometriosis Formation
    R. V. Ukrainets, Yu. S. Korneva
    Journal of Anatomy and Histopathology.2021; 10(1): 85.     CrossRef
  • Molecular and Cellular Changes in the Pathogenesis of Endometriosis
    K. A. Toniyan, O. I. Orlov, V. V. Boyarintsev, I. V. Ogneva
    Human Physiology.2021; 47(6): 690.     CrossRef
  • Imaging of gastrointestinal endometriosis: what the radiologist should know
    Adrian Jaramillo-Cardoso, Anuradha S. Shenoy-Bhangle, Wendaline M. VanBuren, Giancarlo Schiappacasse, Christine O. Menias, Koenraad J. Mortele
    Abdominal Radiology.2020; 45(6): 1694.     CrossRef
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Original Article
Endoscopic Mucosal Resection with Circumferential Incision for the Treatment of Large Sessile Polyps and Laterally Spreading Tumors of the Colorectum
Young Mi Hong, Hyung Wook Kim, Su Bum Park, Cheol Woong Choi, Dae Hwan Kang
Clin Endosc 2015;48(1):52-58.   Published online January 31, 2015
DOI: https://doi.org/10.5946/ce.2015.48.1.52
AbstractAbstract PDFPubReaderePub
Background/Aims

Endoscopic mucosal resection (EMR) is the standard treatment for colorectal polyps such as adenomas and early cancers with no risk of lymph node metastasis. However, endoscopic resection of large colorectal polyps (≥20 mm diameter) is difficult to perform. We evaluated the clinical outcomes of EMR with circumferential incision (EMR-CI) for the resection of large sessile polyps (Is) and laterally spreading tumors (LSTs) in the colorectum.

Methods

Between February 2009 and March 2011, we resected 80 large colorectal polyps by EMR-CI. We retrospectively investigated the en bloc resection rate, histologic complete resection rate, recurrence rate, and complications.

Results

The median polyp size was approximately 25 mm (range, 20 to 50), and the morphologic types included Is (13 cases), LST-granular (37 cases), and LST-nongranular (30 cases). The en bloc and complete histologic resection rates were 66.3% and 45.0%, respectively. The recurrence rate was 0% (median follow-up duration, 23 months), and perforation occurred in five cases (6.3%).

Conclusions

EMR-CI is an effective treatment modality for 20 to 30 mm-sized colorectal polyps, and may be considered as a second line therapeutic option if ESD is difficult.

Citations

Citations to this article as recorded by  
  • Hybrid endoscopic submucosal dissection as a salvage option for difficult colorectal conventional endoscopic submucosal dissection
    Shin Morimoto, Hidenori Tanaka, Yudai Takehara, Noriko Yamamoto, Fumiaki Tanino, Yuki Kamigaichi, Ken Yamashita, Hidehiko Takigawa, Ryo Yuge, Yuji Urabe, Shiro Oka
    Surgical Endoscopy.2024; 38(1): 222.     CrossRef
  • Endoscopic resection of large non-pedunculated colorectal polyps: current standards of treatment
    Mahsa Taghiakbari, Dong Hyun Danny Kim, Roupen Djinbachian, Daniel von Renteln
    eGastroenterology.2024; 2(2): e100025.     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
  • Endoscopic Submucosal Dissection, Endoscopic Mucosal Resection, and Transanal Minimally Invasive Surgery for the Management of Rectal and Anorectal Lesions: A Narrative Review
    Pedro Moreira, Pedro Cardoso, Guilherme Macedo, João Santos-Antunes
    Journal of Clinical Medicine.2023; 12(14): 4777.     CrossRef
  • Indications and outcomes of colorectal hybrid endoscopic submucosal dissection: a large multicenter 10-year study
    Yuki Okamoto, Shiro Oka, Shinji Tanaka, Shinji Nagata, Masaki Kunihiro, Toshio Kuwai, Yuko Hiraga, Seiji Onogawa, Takeshi Mizumoto, Hideharu Okanobu, Morihisa Akagi, Kazuaki Chayama
    Surgical Endoscopy.2022; 36(3): 1894.     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
  • Cap-assisted EMR versus standard inject and cut EMR for treatment of large colonic laterally spreading tumors: a randomized multicenter study (with videos)
    Massimo Conio, Raffaele Manta, Rosa Angela Filiberti, Todd H. Baron, Luigi Pasquale, Mario Marini, Antonella De Ceglie
    Gastrointestinal Endoscopy.2022; 96(5): 829.     CrossRef
  • Endoscopic techniques to reduce recurrence rates after colorectal EMR: systematic review and meta-analysis
    Gijs Kemper, Ayla S. Turan, Erik J. Schoon, Ruud W. M. Schrauwen, Ludger S. M. Epping, Christian Gerges, Torsten Beyna, Horst Neuhaus, Ufuk Gündug, Peter D. Siersema, Erwin J. M. van Geenen
    Surgical Endoscopy.2021; 35(10): 5422.     CrossRef
  • Indications and outcomes of endoscopic resection for non-pedunculated colorectal lesions: A narrative review
    Endrit Shahini, Diogo Libânio, Giacomo Lo Secco, Antonio Pisani, Alberto Arezzo
    World Journal of Gastrointestinal Endoscopy.2021; 13(8): 275.     CrossRef
  • Endoscopic mucosal resection versus endoscopic submucosal dissection for colorectal laterally spreading tumors: a meta-analysis
    Hongjing Zhao, Jie Yin, Cuiying Ji, Xin Wang, Na Wang
    Revista Española de Enfermedades Digestivas.2020;[Epub]     CrossRef
  • Efficacy of hybrid endoscopic submucosal dissection (ESD) as a rescue treatment in difficult colorectal ESD cases
    Koichi Okamoto, Naoki Muguruma, Kaizo Kagemoto, Yasuhiro Mitsui, Daisaku Fujimoto, Shinji Kitamura, Tetsuo Kimura, Masahiro Sogabe, Hiroshi Miyamoto, Tetsuji Takayama
    Digestive Endoscopy.2017; 29(S2): 45.     CrossRef
  • 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
    Clinical Endoscopy.2017; 50(4): 379.     CrossRef
  • Local recurrence and subsequent endoscopic treatment after endoscopic piecemeal mucosal resection with or without precutting in the colorectum
    Myeongsook Seo, Eun Mi Song, Gwang Un Kim, Sung Wook Hwang, Sang Hyoung Park, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jeong-Sik Byeon
    Intestinal Research.2017; 15(4): 502.     CrossRef
  • How to deal with large colorectal polyps
    Selvi Thirumurthi, Gottumukkala S. Raju
    Current Opinion in Gastroenterology.2016; 32(1): 26.     CrossRef
  • Endoscopic mucosal resection and endoscopic submucosal dissection for colorectal lesions: A systematic review
    Antonella De Ceglie, Cesare Hassan, Benedetto Mangiavillano, Takahisa Matsuda, Yutaka Saito, Lorenzo Ridola, Pradeep Bhandari, Federica Boeri, Massimo Conio
    Critical Reviews in Oncology/Hematology.2016; 104: 138.     CrossRef
  • Should antibiotics be administered after endoscopic mucosalresection in patients with colon polyps?
    Zhimeng SHI, Hui QIU, Huangang LIU, Honggang YU
    TURKISH JOURNAL OF MEDICAL SCIENCES.2016; 46: 1486.     CrossRef
  • Endoscopic Approach for Superficial Colorectal Neoplasms
    Jun-feng Xu, Lang Yang, Peng Jin, Jian-qiu Sheng
    Gastrointestinal Tumors.2016; 3(2): 69.     CrossRef
  • Many Options to Manage Laterally Spreading Tumors
    Dong Kyung Chang
    Clinical Endoscopy.2015; 48(1): 4.     CrossRef
  • 10,270 View
  • 127 Download
  • 22 Web of Science
  • 18 Crossref
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Case Report
Gastric Squamous Papilloma in a 52-Year-Old Female Patient
Hyung Ha Jang, Hyung Wook Kim, Su Jin Kim, Choel Woong Choi, Su Bum Park, Byeong Jun Song, Dong Hoon Shin, Dae Hwan Kang
Clin Endosc 2014;47(6):571-574.   Published online November 30, 2014
DOI: https://doi.org/10.5946/ce.2014.47.6.571
AbstractAbstract PDFPubReaderePub

A papilloma is a benign epithelial lesion characterized by finger-like projections of tissue lined by an overgrowth of squamous cells and a core of connective tissue. We report a case of squamous papilloma on the cardia in a 52-year-old asymptomatic female. Endoscopy showed a 1-cm sized is polyp with hyperemic change originating from the cardia adjacent to the esophagogastric junction, the biopsy of which suggested a diagnosis of squamous papilloma. Endoscopic mucosal resection was performed to obtain a definite diagnosis and the polyp was completely removed. The histological result was compatible with squamous papilloma, and its surrounding tissues showed foveolar epithelium, which suggested a stomach origin. This is the first report of endoscopic resection of a gastric squamous papilloma. Squamous papilloma should be considered in the differential diagnosis of a gastric polyp, especially one in the cardia. As the prognostic value of a squamous papilloma is not well known, we recommend endoscopic resection to treat a gastric squamous papilloma, when possible.

Citations

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  • Overexpression of Neutrophil MMP-9 and HIF-1α May Contribute to the Finger-Like Projections Formation and Histo-Pathogenesis in Nasal Inverted Papilloma
    Tao Li, Kai Sen Tan, Yan Yi Tu, Li Zhao, Jing Liu, Hsiao Hui Ong, De Yun Wang, Li Shi
    Journal of Inflammation Research.2021; Volume 14: 2979.     CrossRef
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Commentary
What Is Different between Postpolypectomy Fever and Postpolypectomy Coagulation Syndrome?
Hyung Wook Kim
Clin Endosc 2014;47(3):205-206.   Published online May 31, 2014
DOI: https://doi.org/10.5946/ce.2014.47.3.205
PDFPubReaderePub

Citations

Citations to this article as recorded by  
  • Delayed Perforation After Endoscopic Resection of Upper Gastrointestinal Tumors
    Subin Heo, Jimi Huh, Jai Keun Kim, Ki Myung Lee
    Journal of Clinical Gastroenterology.2024;[Epub]     CrossRef
  • Fatal outcome of postpolypectomy syndrome: A case report
    Kenji Ohira, Yo Kawarada, Ryoko Iwata, Mitsuo Satake
    Radiology Case Reports.2024; 19(12): 6131.     CrossRef
  • Endoscopic Recognition and Resection of Malignant Colorectal Polyps
    Natalie Wilson, Moamen Gabr, Mohammad Bilal
    Techniques and Innovations in Gastrointestinal Endoscopy.2023; 25(4): 385.     CrossRef
  • A Case Report of Tension Hydrothorax Incited by Bowel Perforation
    Kyle J. Sanchez, Elisa C. Walsh, Edward A. Bittner, Katarina J. Ruscic
    A&A Practice.2023; 17(12): e01729.     CrossRef
  • Postpolypectomy fever in patients with serious infection: a report of two cases
    Wang Jing, Li Qinghua, Yang Zhiwen
    BMC Gastroenterology.2022;[Epub]     CrossRef
  • Colo-colonic intussusception with post-polypectomy electrocoagulation syndrome: A case report
    Jae Young Moon, Min-Ro Lee, Sung Kyun Yim, Gi Won Ha
    World Journal of Clinical Cases.2022; 10(25): 8939.     CrossRef
  • Post-polypectomy syndrome—a rare complication in colonoscopy procedures: a case report
    Julián A Romo, Jorge David Peña, Laura A López, Carlos Figueroa, Horacio Garzon, Andrea Recamán
    Journal of Surgical Case Reports.2022;[Epub]     CrossRef
  • Post-polypectomy coagulation syndrome: a tricky to diagnose hot snare problem that can be eliminated thanks to cold snare revolution
    Maria Zachou, Konstantinos Pikramenos, Georgios Mpetsios
    Archive of Clinical Cases.2022; 9(4): 170.     CrossRef
  • Antimicrobial prophylaxis in patients undergoing endoscopic mucosal resection for 10- to 20-mm colorectal polyps: A randomized prospective study
    Linfu Zheng, Liping Jiang, Dazhou Li, Longping Chen, Chuanshen Jiang, Longke Xie, Linxin Zhou, Jianxiao Huang, Meiyan Liu, Wen Wang
    Medicine.2022; 101(50): e31440.     CrossRef
  • Post-endoscopic submucosal dissection electrocoagulation syndrome: a clinical overview
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    Expert Review of Gastroenterology & Hepatology.2022; 16(11-12): 1079.     CrossRef
  • Management of Pediatric Postendoscopy Fever
    Julia M. Boster, Melissa Iwanowski, Robert E. Kramer
    Journal of Pediatric Gastroenterology and Nutrition.2021; 72(2): 250.     CrossRef
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    Daniel Matz, Oleg Heizmann
    Surgical Case Reports.2019; : 1.     CrossRef
  • A randomized controlled trial of prophylactic antibiotics in the prevention of electrocoagulation syndrome after colorectal endoscopic submucosal dissection
    Sang Pyo Lee, In-Kyung Sung, Jeong Hwan Kim, Sun-Young Lee, Hyung Seok Park, Chan Sup Shim, Hyun Kyun Ki
    Gastrointestinal Endoscopy.2017; 86(2): 349.     CrossRef
  • Management of Polypectomy Complications
    Selvi Thirumurthi, Gottumukkala S. Raju
    Gastrointestinal Endoscopy Clinics of North America.2015; 25(2): 335.     CrossRef
  • Post-polypectomy electrocoagulation syndrome: a rare cause of acute abdominal pain
    Asad Jehangir, Kyle M. Bennett, Andrew C. Rettew, Opeyemi Fadahunsi, Bilal Shaikh, Anthony Donato
    Journal of Community Hospital Internal Medicine Perspectives.2015; 5(5): 29147.     CrossRef
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  • 12 Web of Science
  • 15 Crossref
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Case Reports
Duodenal Mucosa-Associated Lymphoid Tissue Lymphomas: Two Cases and the Evaluation of Endoscopic Ultrasonography
Su Jin Kim, Hyung Wook Kim, Choel Woong Choi, Jong Kun Ha, Young Mi Hong, Jin Hyun Park, Soo Bum Park, Dae Hwan Kang
Clin Endosc 2013;46(5):563-567.   Published online September 30, 2013
DOI: https://doi.org/10.5946/ce.2013.46.5.563
AbstractAbstract PDFPubReaderePub

Mucosa-associated lymphoid tissue lymphoma mainly arises in the stomach, with fewer than 30% arising in the small intestine. We describe here two cases of primary duodenal mucosa-associated lymphoid tissue lymphoma which were evaluated by endoscopic ultrasonography. A 52-year-old man underwent endoscopy due to abdominal pain, which demonstrated a depressed lesion on duodenal bulb. Endoscopic ultrasonographic finding was hypoechoic lesion invading the submucosa. The other case was a previously healthy 51-year-old man. Endoscopy showed a whitish granular lesion on duodenum third portion. Endoscopic ultrasonography image was similar to the first case, whereas abdominal computed tomography revealed enlargement of multiple lymph nodes. The first case was treated with eradication of Helicobacter pylori, after which the mucosal change and endoscopic ultrasound finding were normalized in 7 months. The second case was treated with cyclophosphamide, vincristine, prednisolone, and rituximab every 3 weeks. After 6 courses of chemotherapy, the patient achieved complete remission.

Citations

Citations to this article as recorded by  
  • Primary Gastric and Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma With Symptomatic Anemia
    Abdulla Alabed, Faisal Abubaker, Omar Sharif, Alddana Zayed, Eman Aljufairi
    ACG Case Reports Journal.2024; 11(7): e01438.     CrossRef
  • Review of lymphoma in the duodenum: An update of diagnosis and management
    Masaya Iwamuro, Takehiro Tanaka, Hiroyuki Okada
    World Journal of Gastroenterology.2023; 29(12): 1852.     CrossRef
  • Synchronous duodenal mucosa-associated lymphoid tissue lymphoma and gastric cancer
    Keiichiro Yokota, Tsutomu Namikawa, Masahiro Maeda, Nobuhisa Tanioka, Jun Iwabu, Sunao Uemura, Masaya Munekage, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki
    Clinical Journal of Gastroenterology.2021; 14(1): 109.     CrossRef
  • Early, Isolated Duodenal Mucosa-Associated Lymphoid Tissue Lymphoma Presenting without Symptoms or Grossly Apparent Endoscopic Lesions and Diagnosed by Random Duodenal Biopsies
    Mihajlo Gjeorgjievski, Issa Makki, Pradeep Khanal, Mitual B. Amin, Ann Marie Blenc, Tusar Desai, Mitchell S. Cappell
    Case Reports in Gastroenterology.2016; 10(2): 323.     CrossRef
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A Gastric Composite Tumor with an Adenocarcinoma and a Neuroendocrine Carcinoma: A Case Report
Jae Hyung Lee, Hyung Wook Kim, Dae Hwan Kang, Cheol Woong Choi, Su Bum Park, Suk Hun Kim
Clin Endosc 2013;46(3):280-283.   Published online May 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.3.280
AbstractAbstract PDFPubReaderePub

A 70-year-old woman was admitted to our department with epigastric discomfort and nausea over the duration of 1 month. An esophagogastroduodenoscopy showed the presence of a 1.0×1.0 cm-sized flat lesion with central ulceration at the greater curvature side of the antrum. A biopsy demonstrated the presence of an adenocarcinoma of well differentiated, intestinal type in the stomach. Endoscopic submucosal dissection was done and the diagnosis of a composite neuroendocrine carcinoma with an adenocarcinoma of the stomach was confirmed. We report a case of a gastric composite tumor with an adenocarcinoma and neuroendocrine carcinoma confirmed by endoscopic submucosal dissection with a review of the literature.

Citations

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    The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2021; 21(4): 343.     CrossRef
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    Toshihiro Kitajima, Sachiko Kaida, Seigi Lee, Shusuke Haruta, Hisashi Shinohara, Masaki Ueno, Koichi Suyama, Yasunori Oota, Takeshi Fujii, Harushi Udagawa
    World Journal of Surgical Oncology.2013; 11(1): 218.     CrossRef
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Focused Review Series: Optical Diagnosis and New Management Strategy of Colorectal Polyps
Introduction: What Are New Roles of Current Colonoscopy?
Hyung Wook Kim
Clin Endosc 2013;46(2):118-119.   Published online March 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.2.118
AbstractAbstract PDFPubReaderePub

The recent advances in endoscopic imaging technologies make great changes in the management of colorectal polyps. These changes include optical histologic diagnosis with high definition colonscopy, new management strategies such as resect and discard or do not resect, and differentiation of depth of submucosal invasion. In this focused review series, these new paradigms in management of colorectal polyps are discussed by three, world famous authors. First, Amit Rastogi explained optical diagnosis of small colorectal polyp with high definition colonoscopy using narrow band imaging. Second, Cesare Hassan explained new paradigms for colonoscopic management of diminutive colorectal polyps: resect and discard or do not resect. In the last, Shinji Tanaka described, in detail, endoscopic assessment of invasive colorectal cancer: slight vs. deep submucosal invasion. These focused review series introduce the new roles of current colonoscopy to readers and will help the readers to know how to use the new imaging technologies and paradigms in clinical practices.

Citations

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  • Protein-Based Nanoplatform for Detection of Tumorigenic Polyps in the Colon Via Noninvasive Mucosal Routes
    Chun-Chieh Chen, Mo A Baikoghli, R Holland Cheng
    Pharmaceutical Patent Analyst.2021; 10(1): 13.     CrossRef
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Original Article
Usefulness of Percutaneous Transhepatic Cholangioscopic Lithotomy for Removal of Difficult Common Bile Duct Stones
Jae Hyung Lee, Hyung Wook Kim, Dae Hwan Kang, Cheol Woong Choi, Su Bum Park, Suk Hun Kim, Ung Bae Jeon
Clin Endosc 2013;46(1):65-70.   Published online January 31, 2013
DOI: https://doi.org/10.5946/ce.2013.46.1.65
AbstractAbstract PDFPubReaderePub
Background/Aims

Approximately 5% to 10% of common bile duct (CBD) stones are difficult to remove by conventional endoscopic methods. Percutaneous transhepatic cholangioscopic lithotomy (PTCSL) can be an alternative method for this condition, but is not well established yet. The aim of this study was to evaluate the clinical efficacy and safety of PTCSL for removal of difficult CBD stones.

Methods

This study is a retrospective review of 34 consecutive patients who underwent unsuccessful removal of CBD stones using conventional endoscopic methods between December 2008 and July 2010 and were subsequently treated using PTCSL.

Results

Among 443 patients with CBD stones, 34 patients (7.8%) failed to achieve stone removal using conventional endoscopic methods. Of these 34 patients, 33 were treated using PTCSL. In all 33 cases (100%), complete stone removal was achieved using PTCSL. Most complications (15/17, 88.2%) were mild and transient. Major complications occurred in two patients (6.1%) who experienced hemobilia, and percutaneous transhepatic biliary drainage tract disruption, respectively; which were fully recovered without mortality.

Conclusions

Despite prolonged hospital stay and temporary decline of quality of life, PTCSL is an effective and safe method in the management of difficult CBD stones, especially in patients with difficulty in approaching the affected bile duct.

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Commentary
Inadequate Bowel Preparation Increases Missed Polyps
Hyung Wook Kim
Clin Endosc 2012;45(4):345-346.   Published online November 30, 2012
DOI: https://doi.org/10.5946/ce.2012.45.4.345
PDFPubReaderePub

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Case Reports
A Case of Endoscopic Treatment for Gastrocolocutaneous Fistula as a Complication of Percutaneous Endoscopic Gastrostomy
Jong Ho Hwang, Hyung Wook Kim, Dae Hwan Kang, Choel Woong Choi, Soo Bum Park, Tae Ik Park, Woo Sung Jo, Dong Hyuk Cha
Clin Endosc 2012;45(1):95-98.   Published online March 31, 2012
DOI: https://doi.org/10.5946/ce.2012.45.1.95
AbstractAbstract PDFPubReaderePub

As a rare complication of percutaneous endoscopic gastroscopy (PEG), a gastrocolocutaneous fistula may occur after PEG placement. This paper reports an interesting case which PEG tube unintentionally penetrated transverse colon during PEG. A 72-year-old female patient who suffered from medullary infarction underwent PEG procedure for enteral nutrition, and fecal materials were observed 6 days after the procedure. Transverse colon located in antero-superior site of stomach was observed through abdominal computed tomography, and also the wrong inserted tube was found through gastroscopy and colonoscopy. Endoscopic treatment for the fistula was performed by the use of hemo-clip and detachable snare, closure of the fistula was finally confirmed 6 days after the endoscopic procedure. Therefore, the gastrocolocutaneous fistula should be considered as one of the complications of PEG when fecal material is observed through PEG tube in a few days after PEG procedure and endoscopic treatment can be feasible in this case.

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A Case of Clonorchiasis with Focal Intrahepatic Duct Dilatation Mimicking an Intrahepatic Cholangiocarcinoma
Bong Gap Kim, Dae Hwan Kang, Cheol Woong Choi, Hyung Wook Kim, Jae Hyung Lee, Suk Hun Kim, Hye Ju Yeo, Soo Yong Lee
Clin Endosc 2011;44(1):55-58.   Published online September 30, 2011
DOI: https://doi.org/10.5946/ce.2011.44.1.55
AbstractAbstract PDFPubReaderePub

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.

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