Clinical Endoscopy

Endoscopic Treatment of a Symptomatic Ileal Lipoma with Recurrent Ileocolic Intussusceptions by Using Cap-Assisted Colonoscopy: Eun Sung Lee, Kang Nyeong Lee, Kyung Soo Choi, Hang Lak Lee, Dae Won Jun, Oh Young Lee, Byung Chul Yoon, Ho Soon Choi; Clin Endosc 2013;46(4):414-417. Published online July 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.4.414

A 73-year-old woman presented with intermittent abdominal pain and weight loss of 15 kg for 2 years. Colonoscopy revealed an erythematous polypoid tumor with a long and wide stalk in the cecum, but with air inflation, it abruptly went away through the ileocecal valve (ICV). An abdominal computed tomography showed a well-demarcated pedunculated subepithelial mass of 2.6×2.7 cm size with fat attenuation in the terminal ileum. It was an intussusceptum of the ileal lipoma through the ICV. This ileal lipoma was causing her symptoms because repeated ileocolic intussusceptions resulted in intermittent intestinal obstructions. In order to avoid surgical sequelae of ileal resection, snare polypectomy using cap-assisted colonoscopy technique was performed within the ileum without complications. The histopathology report confirmed it as a subepithelial lipoma. After endoscopic resection of the ileal lipoma, the patient has been free of symptoms and was restored to the original weight.

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Extraction of terminal ileal lipomas to cecum can facilitate endoscopic resection: A case series with video
Hiroshi Yamazaki, Yohei Minato, Deepak Madhu, Toshifumi Iida, Susumu Banjyoya, Tomoya Kimura, Koichi Furuta, Shinya Nagae, Yohei Itou, Nao Takeuchi, Shunya Takayanagi, Yoshiaki Kimoto, Yuki Kano, Takashi Sakuno, Kohei Ono, Ken Ohata
DEN Open.2025;[Epub] CrossRef
A Rare Case of Multiple Ileal Lipoma in A Young Male
Ramprashanth MP
Journal of Surgery Research and Practice.2024; : 1. CrossRef
Terminal Ileum Lipoma Causing Ileocolic Intussusception: A Case Report and Literature Review
Siddhant Dogra, Jason Wei, Benjamin Wadowski, Virginia Devi-Chou, Leandra Krowsoski, Rajiv R Shah
Cureus.2023;[Epub] CrossRef
Successful endoscopic management of adult ileocecal intussusception secondary to a large ileal lipoma
Akira Teramoto, Seiji Hamada, Takahiro Utsumi, Daizen Hirata, Yasushi Sano
VideoGIE.2021; 6(4): 187. CrossRef
Life‐threatening gastrointestinal bleeding from a giant ileal lipoma
Amy Donovan, Sandun Abeyasundara, Hajir Nabi
ANZ Journal of Surgery.2020;[Epub] CrossRef
Intususcepción íleo-cólica de lipoma ileal como causa de hemorragia digestiva baja
Eduardo Valdivielso Cortázar, María López Álvarez, Alberto Guerrero Montañes, Loreto Yañez González-Dopeso, Jesus Ángel Yañez López, Pedro Antonio Alonso Aguirre
Gastroenterología y Hepatología.2017; 40(7): 457. CrossRef
Ileocolic intussusception of ileal lipoma as a cause of lower gastrointestinal bleeding
Eduardo Valdivielso Cortázar, María López Álvarez, Alberto Guerrero Montañes, Loreto Yañez González-Dopeso, Jesus Ángel Yañez López, Pedro Antonio Alonso Aguirre
Gastroenterología y Hepatología (English Edition).2017; 40(7): 457. CrossRef
Unroofing Technique as an Option for the Endoscopic Treatment of Giant Gastrointestinal Lipomas
Marcela Kopáčová, Stanislav Rejchrt, Jan Bureš
Acta Medica (Hradec Kralove, Czech Republic).2015; 58(4): 115. CrossRef

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Xanthogranulomatous Inflammation in Terminal Ileum Presenting as an Appendiceal Mass: Case Report and Review of the Literature: Jun Sik Yoon, Yong Cheol Jeon, Tae Yeob Kim, Dong Soo Han, Joo Hyun Sohn, Kil Woo Nam, Young Su Nam, Ju Yeon Pyo; Clin Endosc 2013;46(2):193-196. Published online March 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.2.193

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Xanthogranulomatous inflammation (XGI) is a rare benign inflammatory disease characterized by aggregation of lipid-laden foamy macrophages. This disease entity has been described in various organs but most commonly in the kidney and gallbladder. The occurrence of this disease in the lower gastrointestinal tract is extremely rare. Its clinical importance is that it can be misdiagnosed as an infiltrative cancer. In this case report, a 52-year-old male complained of right lower quadrant abdominal pain for a period of 3 months. Abdominal computed tomography revealed appendiceal mass and colonoscopy revealed multiple erythematous nodular lesions in the terminal ileum and appendiceal orifice, mimicking appendiceal cancer. Right hemicolectomy was done and the pathological specimen revealed XGI of the terminal ileum. To our knowledge, this is the first case of XGI in terminal ileum presenting as abdominal pain and the appendiceal mass on radiologic findings.

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Imaging and Clinical Findings of Xanthogranulomatous Inflammatory Disease of Various Abdominal and Pelvic Organs: A Pictorial Essay
Se Jin Lee, Dal Mo Yang, Hyun Cheol Kim, Sang Won Kim, Kyu Yeoun Won, So Hyun Park, Woo Kyoung Jeong
Journal of the Korean Society of Radiology.2024; 85(1): 109. CrossRef
Xanthogranulomatous inflammation and spindle cell proliferation in response to silicone breast implant leakage
Kyra Ji-Young Lee, Jue Li Seah, Sandra O’Toole, Sanjay Warrier
BMJ Case Reports.2023; 16(1): e252091. CrossRef
Xanthogranulomatous inflammation requiring small bowel anastomosis revision: A case report
William Wang, Maria Korah, Kovi E Bessoff, Jeanne Shen, Joseph D Forrester
World Journal of Gastrointestinal Surgery.2023; 15(3): 488. CrossRef
Xanthogranulomatous Oophoritis in the Setting of Post-IVF Twin Pregnancy with History of Endometriosis: A Rare Case Report with Review of Literature
Chinmay Shrikrishna Pendharkar, Sunita B.S, Ganesh Pendkur, Dheeraj J. Nandagawe
Indian Journal of Medical and Paediatric Oncology.2022; 43(03): 314. CrossRef
Xanthogranulomatous appendicitis diagnosed on routine PET scan: a case report
Alexandra C Skoczek, Dennis L Fernandez
Journal of Surgical Case Reports.2022;[Epub] CrossRef
A Case of Xanthogranulomatous Inflammation of Terminal Ileum Presenting as a Mass in a Woman with Severe Obesity
Hyung Ku Chon, Sang Wook Kim
The Korean Journal of Gastroenterology.2016; 67(5): 277. CrossRef
Abdominal manifestations of histiocytic disorders in adults: imaging perspective
Abhijit Sunnapwar, Christine O Menias, Vijaynadh Ojili, Maria Policarpio Nicolas, Rashmi Katre, Kiran Gangadhar, Arpit Nagar
The British Journal of Radiology.2016; 89(1065): 20160221. CrossRef
Small Bowel Obstruction due to Intestinal Xanthomatosis
L. E. Barrera-Herrera, F. Arias, P. A. Rodríguez-Urrego, M. A. Palau-Lázaro
Case Reports in Pathology.2015; 2015: 1. CrossRef
Positron Emission Tomography/Computed Tomography False Positivity for Xanthogranulomatous Inflammation in an Adolescent with Hodgkin's Lymphoma
Jui-Ting Yu, Chieh-Lin Jerry Teng, Ying-Chu Lin, Ren-Ching Wang, Wen-Li Hwang
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Xanthogranulomatous capsulitis mimicking a polypoid neoplasm disease: an unusual presentation of ruptured Poly Implant Prothèse (PIP) breast implant
Fernando Hernanz, Sara Baeza, Eduardo Serna, Manuel Gómez-Fleitas
European Journal of Plastic Surgery.2013; 36(12): 797. CrossRef

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Two Cases of Ileal Dieulafoy Lesion with Massive Hematochezia Treated by Single Balloon Enteroscopy: Young Chul Choi, Sang Hyun Park, Byoung Wook Bang, Kye Sook Kwon, Hyung Gil Kim, Yong Woon Shin; Clin Endosc 2012;45(4):440-443. Published online November 30, 2012; DOI: https://doi.org/10.5946/ce.2012.45.4.440

Abstract PDF PubReader ePub

Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature.

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A diagnostic dilemma: a case report of concomitant duodenal Dieulafoy lesion and gastric ulcer
Lauren Wallace, Peter J Gallagher
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Stitch in time saves nine
Aisha Rummaan, Irene Lee, Deepa Rattehalli, Prajesh Kumar, Sauid Ishaq
Frontline Gastroenterology.2023; 14(3): 265. CrossRef
Ileal Dieulafoy Lesion: a rare case report
Aleena Jain, Manjusha Karegar, Amita Joshi, Amey Rojekar
Surgical and Experimental Pathology.2018;[Epub] CrossRef
The Role of Emergency Endoscopy in Small Bowel Bleeding: A Review
Enrique Pérez-Cuadrado-Robles, Enrique Pérez-Cuadrado-Martínez
GE Portuguese Journal of Gastroenterology.2016; 23(2): 84. CrossRef
An Unusual Cause of Torrential Lower Gastrointestinal Hemorrhage
Terence C. Chua, Anthony J. Gill, Jaswinder S. Samra
Gastroenterology.2015; 148(5): e10. CrossRef

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Simultaneous Melanosis Duodeni and Melanosis Ilei in a Patient Taking Oral Iron: Kyoung Won Lee, M.D., Woo Jin Jeong, M.D., Joung Hwa Lee, M.D., Jong Won Kang, M.D., Kyeong Hee Jang, M.D., Koon Hee Han, M.D., Gil Hyun Kang, M.D.* and Gab Jin Cheon, M.D.; Korean J Gastrointest Endosc 2010;41(5):308-311. Published online November 30, 2010

Abstract PDF: Melanosis means the accumulation of brown or black pigment in an organ. Melanosis can be observed in virtually all parts of the gastrointestinal tract. However, it most frequently affects the colon. It is said that melanosis in small intestine is very rare, and no case has been reported in which melanosis was simultaneously noted in duodenum and ileum without involving the colonic mucosa. Here we report a case of melanosis duodeni and melanosis ilei which were found simultaneously in a 56-year-old female patient with chronic renal failure and heart failure who had been taking oral ferrous sulfate for 3 years. (Korean J Gastrointest Endosc 2010;41:308-311)

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Two Cases of Melanosis Ilei Developed after Long-standing Charcoal Ingestion: Myung Suk Kim, M.D., Yong Bum Park, M.D., Byeong Wha Ha, M.D., Dae Young Cheung, M.D., Jin Il Kim, M.D., Se Hyun Cho, M.D., Soo-Heon Park, M.D. and Jae Kwang Kim, M.D.; Korean J Gastrointest Endosc 2008;36(1):36-39. Published online January 30, 2008

Abstract PDF: Melanosis ilei is an extremely rare condition in which black pigment, consisted of aluminum, magnesium, or silicon, accumulate in the terminal ileal mucosa. Medical treatment with charcoal enhances the neutralization of the toxic material and elimination of many drugs. In addition, it has been used as a traditional remedy in some oriental countries to relieve chronic diarrhea, abdominal pain, or acute enterocolitis, which is made up carbon, oxygen, aluminum, magnesium, silicon, calcium, and palladium. Two patients taking the charcoal for a long time underwent a colonoscopy to evaluate chronic diarrhea or abdominal pain. The colonoscopy revealed a normal colonic mucosa and multiple geographic black-pigmented mucosal changes at the terminal ileum. Therefore, it was assumed that melanosis ilei can develop in patients with long-standing charcoal ingestion. To the best of our knowledge, this is the first case of melanosis ilei associated with the ingestion of charcoal. (Korean J Gastrointest Endosc 2008;36:36-39)

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56세 남자, 하복부 동통과 설사: Korean J Gastrointest Endosc 2003;26(5):354-354. Published online May 30, 2003

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Endoscopic Hemoclipping in a Terminal Ileal Dieulafoy's Lesion: Man Jo Kim, M.D., Jung Sup Eum, M.D., Hae Dong Park, M.D., Soo Hyun Kim, M.D., Sung Min Kim, M.D., Mi Ae Jo, M.D., Dong Ju Song, M.D., Se Lim Choi, M.D., Hee Seung Park, M.D. and Seong Ho Choi, M.D.; Korean J Gastrointest Endosc 2003;26(2):106-109. Published online February 28, 2003

Abstract PDF: Dieulafoy's lesion is an uncommon source of massive gastrointestinal hemorrhage. The lesion predominantly occurs in the proximal stomach, but may occur in all parts of the gastrointestinal tract including small bowel, colon and rectum. We herein report a case of a patient who presented with hematochezia from Dieulafoy's lesion of the terminal ileum with adherent blood clots. Bleeding was successfully controlled with endoscopic treatment by utilizing hemoclipping. (Korean J Gastrointest Endosc 2003;26:106⁣109)

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내시경적 전기응고술로 치료한 회장 말단의 Dieulafoy 양 병변 1 예 ( A Case of Dieulafoy`s Lesion of the Terminal Ileum Treated by Colonoscopic Electrocoagulation ): Korean J Gastrointest Endosc 2001;23(6):499-502. Published online November 30, 2000

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성인에서 발생한 소장의 Burkitt 림프종 1 예 ( A Case of Small Intestinal Burkitt`s Lymphoma in an Adult ): Korean J Gastrointest Endosc 2001;22(6):435-439. Published online November 30, 2000

Abstract PDF: Burkitt`s lymphoma is a rare disease that belongs to the aggressive non-Hodgkin`s lymphomas. Burkitt`s lymphoma usually occurs in children or younger persons. There is a strong association between endemic Burkitt's lymphoma and Epstein-Barr virus, whereas the association is weaker in the sporadic form occurring in Western countries. Burkitt`s lymphoma of the gastrointestinal tract occurring in adults has not been reported in Korea. We herein report an unusual case of Burkitt's lymphoma presenting with a palpable abdominal mass in a 52-year-old man infected with Epstein-Barr virus. A computed tomographic scan showed marked low density wall thickening of the terminal ileum. An endoscopy revealed a narrow lumen, shallow ulcerations, and irregular nodularity of the terminal ileum. Small bowel resection and hemicolectomy were performed and a histologic examination of the resected specimen confirmed the diagnosis. Six cycles of adjuvant chemotherapy were given and the patient has been doing well without evidence of recurrence. (Korean J Gastrointest Endosc 2001;22:435-439)

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구연 / 포스터 : Small Bowel Bezoar Complicated with Intestinal Obstruction: Korean J Gastrointest Endosc 2001;22(5):361-361. Published online November 30, 2000

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대장내시경으로 확인된 악성 림프종의 내시경적 분류와 임상병리학적 고찰 ( Clinicopathological Features of Malignant Lymphoma Detected by Colonoscopy : An Analysis According to the Endoscopic Classification ): Korean J Gastrointest Endosc 2001;23(1):21-27. Published online November 30, 2000

Abstract PDF: Background
/Alms: There have been only a few endoscopic s0dies of lower intestinal lesions of malignsnt lymphoma. The aims of this study were to classify the ileocolonic 1ymphomas according to the colonoscopic fhgdings and to reveal the dinicopathological relationship according to the classes. Methods: Subjects were 24 cases of ileocolonic lymphomas. We evaluated the clinicopathological features according to their endoscopic fmdings. Results: The chief complaints were abdominal pain, bleeding, and abdomina1 mess, Twenty-six lesions from 22 patients, excluding 2 multiple lymphomatous polyposis, were endoscopically classfled as follows. Fungating (10 lemons), ulcerofungating (7 lesions), inflltrative (5 lesions), ulceroinfiltrative (3 lesions), and ulcerative (1 lesion). The 1ocafim of the lesions was the terminal ileum in 11 lesions, the colon in 10 lesions, and both regions in 5 lesions. Within the 1arge bowel, the cecum was involved most frequently, followed by the ascending colon and the remainder. Most of pathological types were the diffuse large cell and the large cell immunoblastic. There was no relationship between the endoscopic findings and the histologic types. Eight eases were manifested as intussusceptlon. Conclasions: Ileocolonic lymphomas can be classified endoscopically into five types. Among the types, fungating and ulcerofungating types axe the most frequent. (Korean J Gastrointest Eadosc 2001;23:21-27)

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메켈씨 장석(Meckel's Enterolith) 1예 ( A Case of Meckel's Enterolith ): Korean J Gastrointest Endosc 1999;19(4):643-651. Published online November 30, 1998

Abstract PDF: Most intussusceptions occur in children under 1 year of age whereas 5%∼10% occurs in adults. Although intussusception has an acute occurrence in children, symptoms in adults may be subacute or chronic, and the diagnosis is often delayed. In contrast to adults, intussusception in children is the most common cause of intestinal obstruction, and one of the most frequent causes of surgical emergencies. While idiopathic cases account for more than 90% of those seen in children, many cases in adults are generally related to neoplasm. However, intussusception due to a primary malignant lymphoma of the small intestine is a rare clinical condition. There is little information on the role of colonoscopy in colonic intussusception. Two cases are herein reported, of malignant lymphoma in the ileocecal region causing intussusceptions in which the diagnosis and reduction of intussusception were made by colonoscopy. Colonoscopy plays a useful role in the diagnosis and management of intussusception. The clinical, radiographic, endoscopic, and pathologic findings are described with brief reviews of related literature. (Korean J Gastrointest Endosc 19: 650∼655, 1999)

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증례 : 식도 위장관 ; 위와 회장말단부에 발생한 Hodgkin 씨병 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Hodgkin's Disease Involved in the Stomach and Terminal Ileum ): Korean J Gastrointest Endosc 1998;18(6):922-929. Published online November 30, 1997

Abstract PDF: Cases with extranodal Hodgkin's disease located in sites outside those defined as lymphatic structure are quite rare. The exact incidence of this localized form of Hodgkin's disease is unknown, but it is estimated to be only 0.25% for overall incidence of Hodgkin's disease. Localized primary extranodal Hodgkin's disease seems to have an excellent prognosis in some cases including skin, tongue, lung, stomach, small bowel, and thyroid. We report a case of primary gastrointestinal Hodgkin's disease involved in the stomach and terminal ileum in 48-year-old man with 7 kg of weight loss for 3 months, fever with chills for 1 week, and intermittent epigastric pain for 1 year. The histologic type of this case was lymphocyte predominance, which was diagnosed by biopsy of the stomach and terminal ileum with immnophenotyping study. And the stage of this case was IIE. We tried combination chemotherapy with adriamycin, bleomycin, vinblastin, and dacabazine with excellent response. For its rarity, we report this case with review of literatures. (Korean J Gastrointest Endosc 18: 922-927, 1998)

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증례 : 식도 위장관 ; 결핵성 임파선염을 동반하고 상하부 장관을 광범위하게 침범한 장결핵 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Intestinal Tuberculosis Extensively Involving the Upper and Lower Intestinal Tract , Accompanied by Tuberculous Lymphadenitis ): Korean J Gastrointest Endosc 1998;18(3):408-415. Published online November 30, 1997

Abstract PDF: The prevalence of intestinal tuberculosis has been markedly decreased with the development of anti-tuberculous chemotherapy, preventive medicine, vaccinations, early detection and treatment of pulmonary tuberculosis, and improved eeonomic conditions. Nowadays, intestinal tuberculosis is a disease that should be differentiated from the inflammatory bowel diseases such as Crohn's disease and ulcerative colitis, Behcet's disease, and colon cancer and amebic colitis. This disease also has a new clinical significance in that it has an increased infection rate and unfavorable outcomes in patients infected by HIV or in those who undergo organ transplantation or receive immunosuppressive agents. Tuberculosis of the duodenum was a rare disease and was not reported in the last decade. Moreover Intestinal tuberculosis extensively involving the small bowel including the duodenum and colon was very rarely reported in the various relateid literature. Recently we experienced a case of advanced intestinal tuberculosis involving the duodenum, jejunum, ileum, and colon accompanied by tuberculous cervical and abdominal lymphadenopathies, in a 49-year-old woman who manifested profound general weakness, diarrhea, and marked weight loss. She was diagnosed pathologically by upper gastrointestinal endoscopy, colonoscopy, and fine needle aspiration cytology as well as by roentgenologic examination. The patient was given antituberculous medication which resulted in dramatic clinical improvement. In this report, we present this case with review of the related literature. (Korean J Gastrointest Endosc 18: 408-414, 1998)

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