Clinical Endoscopy

An Unusual Case of Ovarian Carcinomatosis with Microscopic Tumor Embolism Leading to Rectal Ischemia and Perforation: Man Hon Tang, Jason Lim, Inny Bushmani, Chee Yung Ng; Clin Endosc 2018;51(3):294-298. Published online February 22, 2018; DOI: https://doi.org/10.5946/ce.2017.152

We present an unusual case of advanced ovarian carcinoma with postoperative complications of ischemia and perforation of the rectum as a result of tumor embolism. The interval progression from ischemia to infarction of the rectum was captured in repeated sigmoidoscopies. A brief discussion on tumor embolism and management of this case is also included.

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Arterial Embolism in Malignancy: The Role of Surgery
Patrick Harnarayan, Shariful Islam, Vijay Naraynsingh
Therapeutics and Clinical Risk Management.2021; Volume 17: 635. CrossRef

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Ischemic Necrosis of the Gastric Remnant without Splenic Infarction Following Subtotal Gastrectomy: Hwan Hee Park, Hee Sung Lee, Ju Seok Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, Ji Young Sul; Clin Endosc 2018;51(3):289-293. Published online August 24, 2017; DOI: https://doi.org/10.5946/ce.2017.099

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Gastric remnant necrosis after a subtotal gastrectomy is an extremely uncommon complication due to the rich vascular supply of the stomach. Despite its rareness, it must be carefully addressed considering the significant mortality rate associated with this condition. Patients vulnerable to ischemic vascular disease in particular need closer attention and should be treated more cautiously. When gastric remnant necrosis is suspected, an urgent endoscopic examination must be performed. We report a case of gastric remnant necrosis following a subtotal gastrectomy and discuss possible risk factors associated with this complication.

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Gastric remnant necrosis secondary to cholesterol crystal embolization after distal gastrectomy in a gastric cancer patient: a case report
Jumpei Shibata, Motoi Yoshihara, Takehito Kato
BMC Surgery.2020;[Epub] CrossRef
Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery
Cheong-Il Shin, Se Hyung Kim
Korean Journal of Radiology.2020; 21(7): 793. CrossRef
Successful management of gastric remnant necrosis after proximal gastrectomy using a double elementary diet tube: a case report
Atsushi Gakuhara, Shuichi Fukuda, Tomoyuki Tsujimoto, Hideo Tomihara, Katsuya Ohta, Kotaro Kitani, Kazuhiko Hashimoto, Hajime Ishikawa, Jin-ichi Hida, Masao Yukawa
Surgical Case Reports.2020;[Epub] CrossRef
Necrosis of the Gastric Remnant after Distal Gastrectomy for Gastric Carcinoma—A Case Report—
Daisuke SHIRAI, Naoshi KUBO, Katsunobu SAKURAI, Yutaka TAMAMORI, Kiyoshi MAEDA
Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association).2019; 80(8): 1487. CrossRef

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"Cat Scratch Colon" in a Patient with Ischemic Colitis: Eui Ju Park, Joon Seong Lee, Tae Hee Lee, Dae Han Choi, Eui Bae Kim, Seong Ran Jeon, Su Jin Hong, Jin-Oh Kim; Clin Endosc 2015;48(2):178-180. Published online March 27, 2015; DOI: https://doi.org/10.5946/ce.2015.48.2.178

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"Cat scratch colon" is a gross finding characterized by hemorrhagic mucosal scratches on colonoscopy. It is usually associated with a normal colon and is rarely associated with collagenous colitis. In a previous report, cat scratch colon was noted in the cecum and ascending colon, but has also been observed in the distal transverse colon. The patient in this study was also diagnosed with ischemic colitis that may have played a role in the development of cat scratch colon.

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An unexpected finding of cat scratch colon in a screening colonoscopy
Natalia Mora Cuadrado, Noelia Alcaide Suárez, Beatriz Antolín Melero, Beatriz Burgueño Gómez, Miguel Durà Gil, Luis Ignacio Fernández Salazar, José Manuel González Hernández
Gastroenterología y Hepatología (English Edition).2019; 42(3): 172. CrossRef
Hallazgo inesperado de colon en arañazo de gato en una colonoscopia de cribado
Natalia Mora Cuadrado, Noelia Alcaide Suárez, Beatriz Antolín Melero, Beatriz Burgueño Gómez, Miguel Durà Gil, Luis Ignacio Fernández Salazar, José Manuel González Hernández
Gastroenterología y Hepatología.2019; 42(3): 172. CrossRef

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Acute Duodenal Ischemia and Periampullary Intramural Hematoma after an Uneventful Endoscopic Retrograde Cholangiopancreatography in a Patient with Primary Myelofibrosis: Chang Ho Jung, Jong Jin Hyun, Dae Hoe Gu, Eul Sun Moon, Jae Seon Kim, Hong Sik Lee, Chang Duck Kim; Clin Endosc 2014;47(3):270-274. Published online May 31, 2014; DOI: https://doi.org/10.5946/ce.2014.47.3.270

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Acute duodenal ischemia and periampullary intramural hematoma are rare complications after endoscopic retrograde cholangiopancreatography (ERCP). A 77-year-old man with splenomegaly complained of abdominal pain caused by common bile duct (CBD) stone. After successful removal of the CBD stone without immediate complications, the patient developed intramural hematoma around the ampulla of Vater along with diffuse duodenal edema. The findings were compatible with acute intestinal ischemia, and further evaluation revealed that he had underlying primary myelofibrosis. Myeloproliferative diseases are known to be significantly associated with an increased risk of thrombohemorrhagic complications. Therefore, particular attention should be given to this group of patients when a high-risk procedure such as ERCP is performed.

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Ischemic duodenitis after endoscopic retrograde cholangiopancreatography‐related procedure
Yuki Tanisaka, Akashi Fujita, Shomei Ryozawa
Digestive Endoscopy.2022; 34(6): 1264. CrossRef
Ruptured Dissecting Intramural Duodenal Hematoma Following Endoscopic Retrograde Cholangiopancreatography
Eric Weiss, Madeline Tadley, Pak S. Leung, Mark Kaplan
ACG Case Reports Journal.2017; 4(1): e70. CrossRef

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Hepatic and Splenic Infarction and Bowel Ischemia Following Endoscopic Ultrasound-Guided Celiac Plexus Neurolysis: Hee Yoon Jang, Sang-Woo Cha, Byung Hoo Lee, Ho Eun Jung, Jin Woo Choo, Yun-Ju Cho, Hye Young Ju, Young Deok Cho; Clin Endosc 2013;46(3):306-309. Published online May 31, 2013; DOI: https://doi.org/10.5946/ce.2013.46.3.306

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Endoscopic ultrasound-guided celiac plexus neurolysis (EUS-CPN) is a well-established intervention to palliate malignant pain. We report a patient who developed hepatic and splenic infarction and bowel ischemia following EUS-CPN. A 69-year-old man with known lung cancer and pancreatic metastasis was transferred for debilitating, significant epigastric pain for several months. The patient underwent EUS-CPN to palliate the pain. After the procedure, the patient complained continuously of abdominal pain, nausea, and vomiting; hematemesis and hematochezia were newly developed. Abdominal computed tomography revealed infarction of the liver and spleen and ischemia of the stomach and proximal small bowel. On esophagogastroduodenoscopy, hemorrhagic gastroduodenitis, and multiple gastric ulcers were noted without active bleeding. The patient expired on postoperative day 27 despite the best supportive care.

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Endoscopic Management of Pain due to Chronic Pancreatitis
Arjun Kundra, Daniel S. Strand, Vanessa M. Shami
Gastrointestinal Endoscopy Clinics of North America.2024; 34(3): 433. CrossRef
Endoscopic Ultrasound-Guided Celiac Plexus Block Can Be a Useful Procedure for Pain Relief in Chronic Pancreatitis When Used Selectively
Nikhil Sonthalia, Vikram Patil, Awanish Tewari, Akash Roy, Mahesh Kumar Goenka
Journal of Digestive Endoscopy.2023; 14(04): 203. CrossRef
Endoscopic ultrasound-guided celiac plexus neurolysis for managing abdominal pain related with advanced cancer
Ryota Nakano, Hideyuki Shiomi, Shogo Ota, Hiroko Iijima
International Journal of Gastrointestinal Intervention.2022; 11(3): 126. CrossRef
Computed Tomography-Guided Celiac Plexus Block in the Setting of Pancreatic Cancer: Case Study and Review
David Weinstein, Sophie Gonzalez, David Sacks
Journal of Radiology Nursing.2022; 41(3): 159. CrossRef
Endoscopic Ultrasound-Guided Celiac Plexus Interventions
Pedro Moutinho-Ribeiro, Pedro Costa-Moreira, Ana Caldeira, Sílvia Leite, Susana Marques, Teresa Moreira, Nuno Nunes, Miguel Bispo
GE - Portuguese Journal of Gastroenterology.2021; 28(1): 32. CrossRef
Endoscopic ultrasonography-guided celiac plexus neurolysis in patients with unresectable pancreatic cancer: An update
Guillermo Pérez-Aguado, Diego Martinez-Acitores de la Mata, Carlos Marra-López Valenciano, Ignacio Fernandez-Urien Sainz
World Journal of Gastrointestinal Endoscopy.2021; 13(10): 460. CrossRef
Efficacy of EUS-guided celiac plexus neurolysis compared with medication alone for unresectable pancreatic cancer in the oxycodone/fentanyl era: a prospective randomized control study
Yoshihide Kanno, Shinsuke Koshita, Kaori Masu, Takahisa Ogawa, Hiroaki Kusunose, Toji Murabayashi, Toshitaka Sakai, Fumisato Kozakai, Kei Ito
Gastrointestinal Endoscopy.2020; 92(1): 120. CrossRef
Alleviating Pancreatic Cancer-Associated Pain Using Endoscopic Ultrasound-Guided Neurolysis
Kosuke Minaga, Mamoru Takenaka, Ken Kamata, Tomoe Yoshikawa, Atsushi Nakai, Shunsuke Omoto, Takeshi Miyata, Kentaro Yamao, Hajime Imai, Hiroki Sakamoto, Masayuki Kitano, Masatoshi Kudo
Cancers.2018; 10(2): 50. CrossRef
Consensus guidelines on the optimal management in interventional EUS procedures: results from the Asian EUS group RAND/UCLA expert panel
Anthony Y B Teoh, Vinay Dhir, Mitsuhiro Kida, Ichiro Yasuda, Zhen Dong Jin, Dong Wan Seo, Majid Almadi, Tiing Leong Ang, Kazuo Hara, Ida Hilmi, Takao Itoi, Sundeep Lakhtakia, Koji Matsuda, Nonthalee Pausawasdi, Rajesh Puri, Raymond S Tang, Hsiu-Po Wang, A
Gut.2018; 67(7): 1209. CrossRef
Celiac Plexus Block and Neurolysis
Amit H. Sachdev, Frank G. Gress
Gastrointestinal Endoscopy Clinics of North America.2018; 28(4): 579. CrossRef
Eus-guided therapy for pancreatic pain: easy, effective and safe. why isn´t the first therapeutic approach?
Pilar Castro Carbajo, Lydia Elena Pradera Andrés, Carolina Navarro, Luis Ramón Rábago Torres
Gastroenterology & Hepatology: Open Access.2018;[Epub] CrossRef
Endoscopic ultrasound‐guided celiac plexus block and neurolysis
Ichiro Yasuda, Hsiu‐Po Wang
Digestive Endoscopy.2017; 29(4): 455. CrossRef
Endoscopic Palliation of Pancreatic Cancer
Vishal B. Gohil, Jason B. Klapman
Current Treatment Options in Gastroenterology.2017; 15(3): 333. CrossRef
EUS-guided celiac plexus neurolysis
Ichiro YASUDA, Shinpei DOI, Masatoshi MABUCHI
Suizo.2015; 30(2): 191. CrossRef
Therapeutic role of endoscopic ultrasound in pancreaticobiliary disease: A comprehensive review
Fan-Sheng Meng
World Journal of Gastroenterology.2015; 21(46): 12996. CrossRef

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A Case of Idiopathic Mesenteric Phlebosclerosis: Chang Jae Hur, M.D., Eun Young Kim, M.D., Jang Seok Oh, M.D., Byung Seok Kim, M.D., Ji Min Han, M.D., Jin Tae Jung, M.D., Joong Goo Kwon, M.D. and Ho Gak Kim, M.D.; Korean J Gastrointest Endosc 2009;38(6):352-355. Published online June 30, 2009

Abstract PDF: Idiopathic mesenteric phlebosclerosis (IMP) is a rare disease of chronic mesenteric ischemia characterized by a thickening of the colonic wall with fibrosis and calcification of the affected veins, which causes ischemic colitis. While the pathogenesis of IMP is unknown, characteristic radiographic, colonoscopic and histologic findings are evident. We report a case of IMP presenting with right lower abdominal pain and diarrhea in a 69-year-old woman. A plain abdominal radiograph revealed thread-like calcification in the colon. Colonoscopy showed dark purple-colored edematous mucosa and erosions in the colon. Histologic examination showed calcification in and around the submucosa and vascular wall. A barium enema demonstrated narrowing and thumb-printing from the ascending to the transverse colon. Abdominal CT disclosed a thickened colonic wall with intramural calcification and calcified mesenteric veins in the colon. (Korean J Gastrointest Endosc 2009;38:352-355)

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증례 : 식도 위장관 ; 복부외상에 의한 장허혈증 1예 보고 ( Case Reports : Esophagus , Stomach & Intestine ; Bowel Ischemia by Blunt Abdominal Trauma ): Korean J Gastrointest Endosc 1996;16(4):651-657. Published online November 30, 1995

Abstract PDF: The intestine is the third most commonly injured abdominal organ in blunt trauma. But we had a paucity of experience with these injuries. We experienced bowel ischemia in 55 year-old woman after motor-vehicle accident. She complained nausea, vomiting and weight, loss after traffic accident. We found mucosal hyperemia and intraluminal stenosis of duodenal second portion by the gastroscopy. So, we performed hypotonic duodenography and SMA and celiac angiograpby. Hypotonie duodenography showed a luminal narrowing from duodenojejunal junction to proximal jejunum and proximal dilatation, and SMA angiography showed 10 cm segment hypervascular staining of contrast medium in proximal portion. Therefore we performed jejunal loop segmentectomy. After operation she was discharged without complication. (Korean J Gastrointest 16: 651~657, 1996)

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