Clinical Endoscopy

Case Report

Intestinal Perforation Caused by Lumboperitoneal Shunt Insertion Repaired with an Over-the-Scope Clip: Naoki Ishizuka, Eiji Komatsu; Clin Endosc 2022;55(1):146-149. Published online March 3, 2021; DOI: https://doi.org/10.5946/ce.2020.293

Lumboperitoneal or ventriculoperitoneal shunt insertion is a standard therapy for hydrocephalus that diverts cerebrospinal fluid from the subarachnoid space into the peritoneal cavity. Gastrointestinal perforations due to this procedure occur rarely; however, accepted treatment strategies have not yet been established. Hence, the most common treatment approaches are open surgery or spontaneous closure without endoscopy. We report the case of a small intestinal perforation in a 73-year-old-woman that occurred after the insertion of a lumboperitoneal shunt. A positive cerebrospinal fluid culture and high cerebrospinal fluid white blood cell count indicated a retrograde bacterial infection, and computed tomography revealed that the peritoneal tip of the shunt catheter was located in the lumen of the gastrointestinal tract. We repaired the perforation endoscopically using an over-the-scope clip, and the patient’s recovery was uneventful. Use of an over-the-scope clip could be an effective and minimally invasive treatment for intestinal perforations caused by lumboperitoneal or ventriculoperitoneal shunt insertion.

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Progress in Surgical Treatment of Traffic Hydrocephalus
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Advances in Clinical Medicine.2021; 11(09): 3942. CrossRef

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A Case of Gastrointestinal Stromal Tumor of the Jejunum with Obscure Gastrointestinal Hemorrhage Diagnosed by Exploratory Laparotomy: Hae Bin Jung, M.D., Sun Young Kim, M.D., Shin Ae Park, M.D., Sang Mi Park, M.D., Kon Ho Shim, M.D., Eui Hyung Kim, M.D., Eun Jung Jeon, M.D., Jung Hwan Oh, M.D., Jeong Jo Jeong, M.D. and Sang Wook Choi, M.D.; Korean J Gastrointest Endosc 2007;34(6):334-338. Published online June 30, 2007

Abstract PDF: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract, and they represent about 2% of all neoplasms of the gastrointestinal tract. GISTs primarily affect the stomach (50∼60%), but they can also affect the small intestine (20∼30%), large intestine (7%) and esophagus (1%). The clinical manifestations of GISTs vary according to the location and size of the mass. GISTs are generally KIT (CD117)-positive and are diagnosed by immunohistochemistry. Tumor size and mitotic activity are the best predictive prognostic features. The treatment of choice for primary GIST is complete surgical resection with a negative margin. A 78-year-old man who presented with melena and diffuse abdominal pain was admitted to our hospital. Esophagogastroduodenoscopy, colonoscopy, angiography and an RBC scan were performed but we were unable to locate the focus of the hemorrhage. A gastrointestinal stromal tumor (GIST) of the jejunum was diagnosed after laparotomy.

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