Clinical Endoscopy

Prognosis of Korean patients with familial adenomatous polyposis who did not undergo colectomy: a retrospective study: Min Kwan Kwon, Jin Hee Noh, Ji Yong Ahn, Woochang Lee, Seok-Byung Lim, Yong Sang Hong, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang; Received June 18, 2025 Accepted August 23, 2025 Published online December 31, 2025; DOI: https://doi.org/10.5946/ce.2025.191 [Epub ahead of print]

Graphical Abstract Abstract PDF Supplementary Material PubReader ePub: Background
/Aims: The International Society for Gastrointestinal Hereditary Tumors polyposis scoring system (IPSS) categorizes familial adenomatous polyposis (FAP) according to the burden of colorectal polyps and histology. However, the prognosis of patients with uncolectomized FAP has not been established.
Methods
Medical records of patients diagnosed with FAP between 1991 and 2021 were reviewed, and the IPSS stage was determined. The cumulative upstaging rate and risk factors for IPSS upstaging during surveillance were analyzed in patients without colectomies.
Results
Among 237 patients, 35 (28.9%) with IPSS stages 0–2 did not undergo colectomy. The cumulative risk of upstaging was 0%, 31%, 54%, and 73% at 1, 3, 7, and 10 years after FAP diagnosis, respectively. In univariate analysis, age (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.01–1.08; p=0.014) and having an ampulla of Vater adenoma (HR, 3.95; 95% CI, 1.17–13.30; p=0.027) were associated with upstaging. Multivariate analysis revealed that each 1-year increase in age was an independent risk factor of upstaging (adjusted HR, 1.04; 95% CI, 1.01–1.09; p=0.027).
Conclusions
In our analysis, patients with uncolectomized FAP and IPSS stages 0–2 at diagnosis showed a time-dependent progression in the IPSS stage.

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Long-term outcome of grade 1 rectal neuroendocrine tumor ≤1 cm after incomplete endoscopic resection: Jong Sun Park, Hye Lynn Jeon, Bumhee Park, Jong Hoon Park, Gil Ho Lee, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Choong-Kyun Noh; Clin Endosc 2025;58(6):871-880. Published online July 22, 2025; DOI: https://doi.org/10.5946/ce.2025.043

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Background
/Aims: Surveillance strategies for small grade 1 rectal neuroendocrine tumors (G1 rNETs) after incomplete endoscopic resection (ER) remain controversial. We evaluated the long-term outcomes of patients with G1 rNET ≤1 cm after ER who did and did not undergo complete resection.
Methods
We retrospectively evaluated 441 patients with G1 rNETs measuring ≤1 cm after ER between 2011 and 2022. Patients were divided into complete and incomplete resection groups according to histopathological evaluation. Logistic regression analysis identified the risk factors for incomplete resection after ER.
Results
The mean follow-up intervals were 38.6 and 45.7 months in all patients and the incomplete resection group, respectively. No recurrences were observed during the follow-up period. The mean lesion size was 5.5 mm and the complete resection rate was 80.5% (n=355). In the logistic regression analysis, lesion size 5.1 to 10 mm (odds ratio [OR], 2.3; 95% confidence interval [CI], 1.245–4.203; p=0.008), multiple lesions (OR, 8.3; 95% CI, 1.247–54.774; p=0.029), and retroflexion view during the procedure (OR, 4.0; 95% CI, 1.668–9.615; p=0.002) were independent risk factors for incomplete resection.
Conclusions
The prognosis of G1 rNET ≤1 cm after ER was very good, regardless of the histopathological results.

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Prognostic Factors in Neuroendocrine Neoplasms of the Rectum
Frederike Butz, Charlotte Friederike Müller-Debus, Flora Georgina Ecseri, Gianna Sophia Mani, Elif Akgündüz, Agata Dukaczewska, Peter Richard Steinhagen, Uli Fehrenbach, Catarina A. Kunze, Henning Jann, Johann Pratschke, Eva Maria Dobrindt, Martina T. Mog
Cancers.2025; 17(17): 2841. CrossRef

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Efficacy of the pocket-creation method with a traction device in endoscopic submucosal dissection for residual or recurrent colorectal lesions: Daisuke Ide, Tomohiko Richard Ohya, Mitsuaki Ishioka, Yuri Enomoto, Eisuke Nakao, Yuki Mitsuyoshi, Junki Tokura, Keigo Suzuki, Seiichi Yakabi, Chihiro Yasue, Akiko Chino, Masahiro Igarashi, Akio Nakashima, Masayuki Saruta, Shoichi Saito, Junko Fujisaki; Clin Endosc 2022;55(5):655-664. Published online May 31, 2022; DOI: https://doi.org/10.5946/ce.2022.009

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Background
/Aims: Endoscopic submucosal dissection (ESD) for residual or recurrent colorectal lesions after incomplete resection is challenging because of severe fibrosis. This study aimed to compare the efficacy of the pocket-creation method (PCM) with a traction device (TD) with that of conventional ESD for residual or recurrent colorectal lesions.
Methods
We retrospectively studied 72 patients with residual or recurrent colorectal lesions resected using ESD. Overall, 31 and 41 lesions were resected using PCM with TD and conventional ESD methods, respectively. We compared patient background and treatment outcomes between the PCM with TD and conventional ESD groups, respectively. The primary endpoints were en bloc resection and R0 resection rates. The secondary endpoints were the dissection speed and incidence of adverse events.
Results
En bloc resection was feasible in all cases with PCM with TD, but failed in 22% of cases of conventional ESD. The R0 resection rates for PCM with TD and conventional ESD were 97% and 66%, respectively. Dissection was significantly faster in the PCM with TD group (13.0 vs. 7.9 mm2/min). Perforation and postoperative bleeding were observed in one patient in each group.
Conclusions
PCM with TD is an effective method for treating residual or recurrent colorectal lesions after incomplete resection.

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The clinical efficacy of pocket creation method ESD and conventional ESD in the treatment of early colorectal neoplasms: a meta-analysis
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Exploring different techniques for endoscopic submucosal dissection of gastrointestinal lesions: a review of the literature
Giulio Calabrese, Marcello Maida, Darshan Parekh, Yohei Minato, Alessandro Vitello, Alberto Murino, Rui Morais, Emanuele Sinagra, Daryl Ramai, Ken Ohata, Sandro Sferrazza
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Teppei Akimoto, Naohisa Yahagi, Motohiko Kato
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Zaheer Nabi, D. Nageshwar Reddy
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Emmanuel Palomera-Tejeda, Farhan Kawsar, Salmaan Jawaid
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Gaining Traction: Is the Traction-Assisted Method Superior to the Pocket-Creation Method for Colorectal Endoscopic Submucosal Dissection?
Kengo Kasuga, Toshio Uraoka
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Novel adjustable traction “noose knot” method for colorectal endoscopic submucosal dissection
Junki Tokura, Daisuke Ide, Keigo Suzuki, Chihiro Yasue, Akiko Chino, Masahiro Igarashi, Shoichi Saito
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Yunho Jung
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Juan Du, Ting Zhang, Lei Wang, Hao Zhang, Wenquan Yi
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Francesco Cocomazzi, Sonia Carparelli, Nunzia Labarile, Antonio Capogreco, Marco Gentile, Roberta Maselli, Jahnvi Dhar, Jayanta Samanta, Alessandro Repici, Cesare Hassan, Francesco Perri, Antonio Facciorusso
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The Derivation and External Validation of a Fibrosis Risk Model for Colorectal Tumours Undergoing Endoscopic Submucosal Dissection
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Ji Hyun Kim, Sung Chul Park
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Sukit Pattarajierapan, Hiroyuki Takamaru, Supakij Khomvilai
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Endoscopic full-thickness resection versus endoscopic submucosal dissection for challenging colorectal lesions: a randomized trial
Gianluca Andrisani, Cesare Hassan, Margherita Pizzicannella, Francesco Pugliese, Massimiliano Mutignani, Chiara Campanale, Giorgio Valerii, Carmelo Barbera, Giulio Antonelli, Francesco Maria Di Matteo
Gastrointestinal Endoscopy.2023; 98(6): 987. CrossRef
Combination of endoscopic submucosal dissection techniques, a practical solution for difficult cases
Dong-Hoon Yang
Clinical Endoscopy.2022; 55(5): 626. CrossRef

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Radiation Proctitis and Management Strategies: Dushyant Singh Dahiya, Asim Kichloo, Faiz Tuma, Michael Albosta, Farah Wani; Clin Endosc 2022;55(1):22-32. Published online November 18, 2021; DOI: https://doi.org/10.5946/ce.2020.288

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Radiotherapy (RT) is a treatment modality that uses high-energy rays or radioactive agents to generate ionizing radiation against rapidly dividing cells. The main objective of using radiation in cancer therapy is to impair or halt the division of the tumor cells. Over the past few decades, advancements in technology, the introduction of newer methods of RT, and a better understanding of the pathophysiology of cancers have enabled physicians to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues. However, RT has numerous complications, the most common being radiation proctitis (RP). It is characterized by damage to the rectal epithelium by secondary ionizing radiation. Based on the onset of signs and symptoms, post-radiotherapy RP can be classified as acute or chronic, each with varying levels of severity and complication rates. The treatment options available for RP are limited, with most of the data on treatment available from case reports or small studies. Here, we describe the types of RT used in modern-day medicine and radiation-mediated tissue injury. We have primarily focused on the classification, epidemiology, pathogenesis, clinical features, treatment strategies, complications, and prognosis of RP.

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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

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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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Efficacy of Precut Endoscopic Mucosal Resection for Treatment of Rectal Neuroendocrine Tumors: Hoonsub So, Su Hyun Yoo, Seungbong Han, Gwang-un Kim, Myeongsook Seo, Sung Wook Hwang, Dong-Hoon Yang, Jeong-Sik Byeon; Clin Endosc 2017;50(6):585-591. Published online October 12, 2017; DOI: https://doi.org/10.5946/ce.2017.039

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Background
/Aims: Endoscopic resection is the first-line treatment for rectal neuroendocrine tumors (NETs) measuring <1 cm and those between 1 and 2 cm in size. However, conventional endoscopic resection cannot achieve complete resection in all cases. We aimed to analyze clinical outcomes of precut endoscopic mucosal resection (EMR-P) used for the management of rectal NET.
Methods
EMR-P was used to treat rectal NET in 72 patients at a single tertiary center between 2011 and 2015. Both, circumferential precutting and EMR were performed with the same snare device in all patients. Demographics, procedural details, and histopathological features were reviewed for all cases.
Results
Mean size of the tumor measured endoscopically was 6.8±2.8 mm. En bloc and complete resection was achieved in 71 (98.6%) and 67 patients (93.1%), respectively. The mean time required for resection was 9.0±5.6 min. Immediate and delayed bleeding developed in six (8.3%) and 4 patients (5.6%), respectively. Immediate bleeding observed during EMR-P was associated with the risk of delayed bleeding.
Conclusions
Both, the en bloc and complete resection rates of EMR-P in the treatment of rectal NETs using the same snare for precutting and EMR were noted to be high. The procedure was short and safe. EMR-P may be a good treatment choice for the management of rectal NETs.

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Jung-Bin Park, Ga Hee Kim, Minjun Kim, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Seok-Byung Lim, Seung-Mo Hong, Dong-Hoon Yang
Digestive and Liver Disease.2025; 57(7): 1473. CrossRef
Submucosal saline injection and mini-probe endoscopic ultrasound to assess endoscopic resectability of colorectal subepithelial tumors
Jung-Bin Park, Ji Eun Baek, June Hwa Bae, Seung Wook Hong, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Dong-Hoon Yang
The Korean Journal of Internal Medicine.2025; 40(4): 592. CrossRef
Precut mucosectomy versus endoscopic resection techniques for colorectal lesions sized 10–30 mm: meta-analysis and systematic review
Miriam Chinzon, Mateus Bond Boghossian, Matheus de Oliveira Veras, Evellin Souza Valentim dos Santos, Daryl Ramai, Larissa Mercadante de Assis, Vitor Hernandes Lopes, Nelson Miyajima, Wanderley Marques Bernardo, Eduardo Guimarães Hourneaux de Moura
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Safety and Efficacy of Simplified EMR Versus ESD for Rectal Neuroendocrine Tumors ≤ 10 Mm: A Retrospective Cohort Study
Linfeng Zou, Long Zou, Yingyun Yang, Weixun Zhou, Xi Wu, Tao Guo, Qingwei Jiang, Yunlu Feng, Shengyu Zhang, Qiang Wang, Aiming Yang
Journal of Clinical Medicine.2025; 14(17): 6125. CrossRef
Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors
Seung Wook Hong, Dong-Hoon Yang, Yoo Jin Lee, Dong Hoon Baek, Jaeyoung Chun, Hyun Gun Kim, Sung Joo Kim, Seung-Mo Hong, Dae-Seong Myung
The Korean Journal of Internal Medicine.2024; 39(2): 238. CrossRef
Risk Factors for Lymph Node Metastasis and Oncologic Outcomes in Small Rectal Neuroendocrine Tumors with Lymphovascular Invasion
Seung-Joo Nam, Byung Chang Kim, Hee Jin Chang, Han Ho Jeon, Junho Kim, Su Young Kim
Gut and Liver.2022; 16(2): 228. CrossRef
EMR-P for small rectal neuroendocrine tumors: is it a preferred treatment?
Zhaohui Liu, Chunsi Zheng, Shihua Ding, Chong Chen, Jingbo Yang, Ruinuan Wu, Dayong Sun
Scandinavian Journal of Gastroenterology.2022; 57(12): 1503. CrossRef
Recurrence after endoscopic resection of small rectal neuroendocrine tumors: a retrospective cohort study
Sukit Pattarajierapan, Supakij Khomvilai
Annals of Coloproctology.2022; 38(3): 216. CrossRef
Endoscopic treatment for rectal neuroendocrine tumor: which method is better?
Seung Min Hong, Dong Hoon Baek
Clinical Endoscopy.2022; 55(4): 496. CrossRef
Diagnosis, treatment, and current concepts in the endoscopic management of gastroenteropancreatic neuroendocrine neoplasms
Giuseppe Iabichino, Milena Di Leo, Monica Arena, Giovanni Giuseppe Rubis Passoni, Elisabetta Morandi, Francesca Turpini, Paolo Viaggi, Carmelo Luigiano, Luca De Luca
World Journal of Gastroenterology.2022; 28(34): 4943. CrossRef
Comparison of conventional and modified endoscopic mucosal resection methods for the treatment of rectal neuroendocrine tumors
Hee Sung Lee, Hee Seok Moon, In Sun Kwon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong
Surgical Endoscopy.2021; 35(11): 6055. CrossRef
Diagnosis and Management of Rectal Neuroendocrine Tumors (NETs)
Francesco Maione, Alessia Chini, Marco Milone, Nicola Gennarelli, Michele Manigrasso, Rosa Maione, Gianluca Cassese, Gianluca Pagano, Francesca Paola Tropeano, Gaetano Luglio, Giovanni Domenico De Palma
Diagnostics.2021; 11(5): 771. CrossRef
Anchoring the snare tip is a feasible endoscopic mucosal resection method for small rectal neuroendocrine tumors
Jeongseok Kim, Jisup Kim, Eun Hye Oh, Nam Seok Ham, Sung Wook Hwang, Sang Hyoung Park, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Suk-Kyun Yang, Seung-Mo Hong, Dong-Hoon Yang
Scientific Reports.2021;[Epub] CrossRef
Safety and efficacy of tip‐in endoscopic mucosal resection for large sessile colorectal polyps: A single‐center experience in Taiwan
Chung‐Ying Lee, Ming‐Yao Chen, Hwai‐Jeng Lin, Hsi‐Yuan Chien
Advances in Digestive Medicine.2020; 7(2): 58. CrossRef
Incidental diagnosis of very small rectal neuroendocrine neoplasms: when should endoscopic submucosal dissection be performed? A single ENETS centre experience
Nico Pagano, Claudio Ricci, Nicole Brighi, Carlo Ingaldi, Francesco Pugliese, Donatella Santini, Davide Campana, Cristina Mosconi, Valentina Ambrosini, Riccardo Casadei
Endocrine.2019; 65(1): 207. CrossRef
Clinical outcomes of endoscopic mucosal resection for rectal neuroendocrine tumor
Jihye Kim, Jee Hyun Kim, Joo Young Lee, Jaeyoung Chun, Jong Pil Im, Joo Sung Kim
BMC Gastroenterology.2018;[Epub] CrossRef
Proper Treatment Option for Small Rectal Neuroendocrine Tumors Using Precut Endoscopic Mucosal Resection
Seun Ja Park
Clinical Endoscopy.2017; 50(6): 516. CrossRef

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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

Abstract PDF PubReader ePub

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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Aamir Saeed, Saira Yousuf, Ahmad Zain, Muhammad Kashif, Sultan Mahmood, Umar Hayat, Azizullah Beran, Nasir Saleem, Yasi Xiao, Anand Kumar, Alexander Schlachterman, Thomas Kowalski, Mark Radlinski, Thiruvengadam Muniraj, Faisal Kamal
European Journal of Gastroenterology & Hepatology.2026;[Epub] CrossRef
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
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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
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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
Efficacy and Safety of Complete Endoscopic Resection of Colorectal Neoplasia Using a Stepwise Endoscopic Protocol with SOUTEN, a Novel Multifunctional Snare
Shinji Yoshii, Marina Kubo, Mio Matsumoto, Takefumi Kikuchi, Yasunari Takakuwa
Clinical Endoscopy.2020; 53(2): 206. CrossRef
Tip-in versus conventional endoscopic mucosal resection for flat colorectal neoplasia 10 mm or larger in size
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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Pyogenic Liver Abscess Caused by Endoscopic Submucosal Dissection for Early Colon Cancer
Joon Seop Lee, Yong Hwan Kwon
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Endoscopic submucosal dissection in the West: Current status and future directions
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
World Journal of Gastrointestinal Endoscopy.2018; 10(10): 225. CrossRef
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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Colorectal Subepithelial Lesions: Tae Oh Kim; Clin Endosc 2015;48(4):302-307. Published online July 24, 2015; DOI: https://doi.org/10.5946/ce.2015.48.4.302

Abstract PDF PubReader ePub

Most of subepithelial lesion (SEL) being identified was accidentally discovered as small bulging lesion covered with normal mucosa from endoscopic screening. The type of treatment and prognosis vary depending on the type of tumor, it would be crucial to perform an accurate differential diagnosis. Since the differentiation of SEL relied on the indirect findings observed from the mucosal surface using an endoscopy only in the past, it was able to confirm the presence of lesion only but difficult to identify complex detailed nature of the lesion. However, after the endoscopic ultrasonography (EUS) was introduced, it became possible to identify extrinsic compression, and size of intramural tumors, internal properties and contour so that it gets possible to have differential diagnosis of lesions and prediction on the lesion whether it is malignant or benign. In addition, the use of EUS-guided fine needle aspiration and EUS-guided core biopsy made it possible to make histological differential diagnosis. This study intended to investigate endoscopic and EUS findings, histological diagnosis, treatment regimen and impression of colorectal SELs.

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Characteristics and diagnostic sensitivity of endoscopic ultrasound in lower gastrointestinal subepithelial lesions
Yu-Shiuan Liang, Li-Chun Chang, Weng-Fai Wong, Ming-Lun Han, Chieh-Chang Chen, Chien-Chuan Chen, Ping-Huei Tseng
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Hidetaka Hamamoto, Tomoki Matsuda, Mareyuki Endo
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Clinicopathologic and Endosonographic Characteristics of Colon Subepithelial Tumors Discovered Incidentally
Aryoung Kim, Sung Noh Hong, Dong Kyung Chang, Young-Ho Kim, Ji Eun Kim, Eun Ran Kim
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Jothinathan Muniandy, Cheng-Wei Huang, Tao-Wei Ke, William Tzu-Liang Chen
Diseases of the Colon & Rectum.2024; 67(5): e291. CrossRef
Colonoscopy-assisted laparoscopic wedge resection for a large symptomatic colonic lipoma
Julia Hanevelt, Wouter Hugo de Vos Tot Nederveen Cappel, Fiebo Johannes Cornelis ten Kate, Henderik Leendert van Westreenen
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Prince Addo Ameyaw, Harry R. Aslanian
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Seung Hong, Dong Baek
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Application of rubber band and clip traction for removal of a submucosal fecalith mimicking a submucosal tumor of the appendix under colonoscopy
Longping Chen, Linfu Zheng, Zhiping Chen, Dazhou Li, Wen Wang
Endoscopy.2023; 55(S 01): E835. CrossRef
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Anna Fábián, Renáta Bor, Zsófia Bősze, Tibor Tóth, Péter Bacsur, Anita Bálint, Klaudia Farkas, Tamás Resál, Mariann Rutka, Tamás Molnár, Zoltán Szepes
Orvosi Hetilap.2023; 164(30): 1176. CrossRef
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Toru Matsui, Eri Naitoh, Kengo Furutani, Tomoji Katoh, Katsuya Kobayashi, Kenichiro Sekigawa, Hiroshi Mitsui
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Lucile Héroin, Pierre Lafeuille, Thomas Lambin, Pierre Mayer, Martin Bordet, Florian Rostain, Mathieu Pioche
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An Atypical Presentation of a Colonic Lipoma: Avoiding Surgery with a Deeper Endoscopic Look
Mafalda João, Inês Cunha, Elisa Gravito-Soares, Marta Gravito-Soares, Pedro Amaro, Pedro Figueiredo
GE - Portuguese Journal of Gastroenterology.2022; 29(1): 45. CrossRef
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IrinaM Cazacu, BenS Singh, AdrianaA Luzuriaga Chavez, Pramoda Koduru, Shamim Ejaz, BrianR Weston, WilliamA Ross, JeffreyH Lee, Sinchita Roy-Chowdhuri, ManoopS Bhutani
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Cellular Angiofibroma Presenting as a Subepithelial Rectal Mass
Jennifer Bloom, Eric Jordan, Vanessa M. Baratta, Xuchen Zhang, Atin Saha, George Yavorek, Vadim Kurbatov
ACG Case Reports Journal.2020; 7(11): e00471. CrossRef
Should We Collect a Biopsy From This Submucosal Lesion in the Cecum?
Paul Vincent Co, Richard Benya, Mukund Venu
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Stephen Hasak, Vladimir Kushnir
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Current Status of Endoscopic Ultrasonography in Gastrointestinal Subepithelial Tumors
Sang Gyun Kim, Ji Hyun Song, Joo Ha Hwang
Clinical Endoscopy.2019; 52(4): 301. CrossRef
Radial Endoscopic Ultrasound for the Diagnosis of Chronic Schistosomiasis in the Colorectum
Chun-Hua Zhou, Wei-Xia Zhou, Duan-Min Hu
Clinical Gastroenterology and Hepatology.2017; 15(10): e151. CrossRef
Highlights from the 52nd Seminar of the Korean Society of Gastrointestinal Endoscopy
Eun Young Kim, Il Ju Choi, Kwang An Kwon, Ji Kon Ryu, Ki Baik Hahm
Clinical Endoscopy.2015; 48(4): 269. CrossRef

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Diminutive and Small Colorectal Polyps: The Pathologist's Perspective: Yun Kyung Kang; Clin Endosc 2014;47(5):404-408. Published online September 30, 2014; DOI: https://doi.org/10.5946/ce.2014.47.5.404

Abstract PDF PubReader ePub

Recent progress in advanced endoscopic imaging and electronic chromoendoscopy allows the real-time endoscopic estimation of the histologic type of polyps, mainly for the differentiation of adenomas from hyperplastic polyps. Accordingly, a "resect-and-discard" strategy applied to diminutive colorectal polyps is now one of the emerging issues among gastroenterologists. The strategy has a practical advantage in terms of the potential cost savings. However, it has a number of limitations in the medical, academic, and legal aspects. The major pitfalls include the endoscopic investigation of colorectal polyps with a wide variety of histogenetic origins, including serrated polyps, and the lack of a standardized method for polyp size measurement. Another issue is the importance of the pathologic diagnosis for legal purposes and medical research. Moreover, it is not certain whether the implementation of the strategy has economic benefit in countries with an undervalued reimbursement system for pathologic examination. There is no doubt that a highly confident optical diagnosis of polyp type is a novel valuable tool. It can provide a more steady symbiosis between gastroenterologists and pathologists to allow a more evident diagnosis and management of patients with colorectal polyps.

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Colorectal Polyp Image Detection and Classification through Grayscale Images and Deep Learning
Chen-Ming Hsu, Chien-Chang Hsu, Zhe-Ming Hsu, Feng-Yu Shih, Meng-Lin Chang, Tsung-Hsing Chen
Sensors.2021; 21(18): 5995. CrossRef
Virtual chromoendoscopy for the real-time assessment of colorectal polyps in vivo: a systematic review and economic evaluation
Joanna Picot, Micah Rose, Keith Cooper, Karen Pickett, Joanne Lord, Petra Harris, Sophie Whyte, Dankmar Böhning, Jonathan Shepherd
Health Technology Assessment.2017; 21(79): 1. CrossRef
Risk Factors of Advanced Adenoma in Small and Diminutive Colorectal Polyp
Yo Han Jeong, Kyeong Ok Kim, Chan Seo Park, Sung Bum Kim, Si Hyung Lee, Byung Ik Jang
Journal of Korean Medical Science.2016; 31(9): 1426. CrossRef
International Digestive Endoscopy Network 2014: Turnpike to the Future
Eun Young Kim, Kwang An Kwon, Il Ju Choi, Ji Kon Ryu, Ki Baik Hahm
Clinical Endoscopy.2014; 47(5): 371. CrossRef

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Diagnostic Yield and Therapeutic Impact of Rectal Retroflexion: A Prospective, Single-Blind Study Conducted in Three Centers: Félix Téllez-Ávila, Josué Barahona-Garrido, Sandra García-Osogobio, Gustavo López-Arce, Jesús Camacho-Escobedo, Angela Saúl, Salvador Herrera-Gómez, Javier Elizondo-Rivera, Rafael Barreto-Zúñiga; Clin Endosc 2014;47(1):79-83. Published online January 24, 2014; DOI: https://doi.org/10.5946/ce.2014.47.1.79

Abstract PDF PubReader ePub

Background/Aims

No clear data have been established and validated regarding whether rectal retroflexion has an important and therapeutic impact. The aim of the present study was to evaluate the diagnostic yield and therapeutic impact of rectal retroflexion compared with straight view examination.

Methods

A prospective single-blind study was conducted. Consecutive patients evaluated between October 2011 and April 2012 were included.

Results

A total of 934 patients (542 women, 58%) were included. The mean age was 57.4±14.8 years. Retroflexion was successful in 917 patients (98.2%). Distinct lesions in the anorectal area were detected in 32 patients (3.4%), of which 10 (1%) were identified only on retroflex view and 22 (2.4%) on both straight and retroflex views. Of the 32 identified lesions, 16 (50%) were polyps, nine (28.1%) were angiodysplasias, six (18.8%) were ulcers, and one (3.1%) was a flat lesion. All 10 patients (1%) in whom lesions were detected only by rectal retroflexion showed a therapeutic impact.

Conclusions

Rectal retroflexion has minimal diagnostic yield and therapeutic impact. However, its low rate of major complications and the possibility of detecting lesions undetectable by straight viewing justify its use.

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Long-term outcome of grade 1 rectal neuroendocrine tumor ≤1 cm after incomplete endoscopic resection
Jong Sun Park, Hye Lynn Jeon, Bumhee Park, Jong Hoon Park, Gil Ho Lee, Sun Gyo Lim, Sung Jae Shin, Kee Myung Lee, Choong-Kyun Noh
Clinical Endoscopy.2025; 58(6): 871. CrossRef
Consenso de endoscopia en enfermedad inflamatoria intestinal de la Organización Panamericana de Crohn y Colitis (PANCCO) y la Sociedad Interamericana de endoscopia (SIED)
Viviana Parra-Izquierdo, Fabio Leonel Gil-Parada, Fabian Juliao-Baños, Carolina Pavez-Ovalle, William Otero-Regino, Juan Sebastian Frías-Ordoñez, Asadur Tchekmedyian, Juan Eloy Paredes Mendez, Rodrigo Dorelo, Kenneth Ernest-Suarez, Marcos Leites Madera, M
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Unlocking quality in endoscopic mucosal resection
Eoin Keating, Jan Leyden, Donal B O'Connor, Conor Lahiff
World Journal of Gastrointestinal Endoscopy.2023; 15(5): 338. CrossRef
Detection of colorectal lesions during colonoscopy
Hiroaki Ikematsu, Tatsuro Murano, Kensuke Shinmura
DEN Open.2022;[Epub] CrossRef
Colonoscopy screening and surveillance guidelines
Yutaka Saito, Shiro Oka, Takuji Kawamura, Ryo Shimoda, Masau Sekiguchi, Naoto Tamai, Kinichi Hotta, Takahisa Matsuda, Masashi Misawa, Shinji Tanaka, Yosuke Iriguchi, Ryoichi Nozaki, Hironori Yamamoto, Masahiro Yoshida, Kazuma Fujimoto, Haruhiro Inoue
Digestive Endoscopy.2021; 33(4): 486. CrossRef
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Eelco C. Brand, Michael B. Wallace
Current Treatment Options in Gastroenterology.2017; 15(1): 184. CrossRef
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Jesse Samuel Moore, Tess Hannah Aulet
Surgical Clinics of North America.2017; 97(3): 487. CrossRef
Right-sided adenoma detection with retroflexion versus forward-view colonoscopy
Sujievvan Chandran, Frank Parker, Rhys Vaughan, Brent Mitchell, Scott Fanning, Gregor Brown, Jenny Yu, Marios Efthymiou
Gastrointestinal Endoscopy.2015; 81(3): 608. CrossRef
Rectal Retroflexion during Colonoscopy: A Bridge over Troubled Water
Kwang An Kwon, Ki Baik Hahm
Clinical Endoscopy.2014; 47(1): 3. CrossRef
Colite kystique profonde localisée : une cause inhabituelle de formation polypoïde pectinéale
R. Ennaifer, M. Chiekh, H. Romdhane, N. Bel Hadj, A. Lahmar, H. Ben Nejma
Acta Endoscopica.2014; 44(6): 385. CrossRef

8,361 View
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A Bowel Perforation That Developed during the Transanal Extraction of a Large Rectal Foreign Body: Keun-Suk Yang, M.D., Joung-Ho Han, M.D.^*, Sunyoung Kim, M.D., Woo Hyung Choi, M.D., Hong-Soon Jung, M.D., Eun Chung, M.D., HyenJeong Jeon, M.D.^* and Seijin Youn, M.D.^*; Korean J Gastrointest Endosc 2011;42(6):406-409. Published online May 25, 2011

Abstract PDF: Rectal foreign bodies are rare clinical problem in South Korea. Although many foreign bodies can be extracted safely using endoscopic procedures, some patients require surgery. Here we describe the case of a 35-year-old male who presented with a rectosigmoid foreign body, a large carrot measuring 28×7 cm. Sigmoidoscopy revealed a carrot in the upper rectum extending to the sigmoid colon. Endoscopic removal failed. The surgeon unsuccessfully attempted to extract the carrot using various tools without spinal anesthesia. During the extraction attempt, the patient complained of sudden abdominal pain, and a simple x-ray revealed pneumoperitoneum. An emergency colotomy and removal of the foreign body was performed, followed by primary repair of the perforation and a colostomy. Three months later, the colostomy was repaired.

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A Case of Rectal Metastasis from Primary Signet Ring Cell Carcinoma of the Colon: Kwan Mi Pack, M.D., Jae Myung Cha, M.D., Joung Il Lee, M.D., Kwang Ro Joo, M.D., Hyun Phil Shin, M.D., Jae Jun Park, M.D., Jung Won Jeon, M.D. and Gou Young Kim, M.D.*; Korean J Gastrointest Endosc 2010;41(6):373-377. Published online December 30, 2010

Abstract PDF: Rectal metastasis of colon cancer without peritoneal carcinomatosis is a rare condition whose initial clinical presentation may mimic inflammation. To the best of our knowledge, there was no report on such cases. A 45-year-old man with a history of left hemicolectomy and adjuvant chemotherapy for primary signet ring cell carcinoma (SRCC) of the descending colon, admitted to have constipation and abdominal pain for 3 weeks. His colonoscopic findings did not show local tumor recurrence at the anastomsis site, however, a hard, concentric luminal narrowing of the lower rectum was encountered. Endoscopic biopsies revealed chronic inflammations, and positron emission tomography with ¹⁸F-fluorodeoxyglucose revealed diffuse mildly hypermetabolic lesion in the rectum, suggesting inflammation. Magnetic resonance image showed submucosal wall thickening with multiple perirectal lymph nodes. Rectal metastasis of colon cancer was highly suspected clinically and a surgical biopsy confirmed SRCC which was surgically removed thereafter. (Korean J Gastrointest Endosc 2010;41:373-377)

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A Case of Rectal Implantation Cysts at an Anastomosis Site after Laparoscopic Low Anterior Resection for a Rectal Cancer: Hee Sun Lee, M.D., Geun Am Song, M.D., In Hye Hwang, M.D., Yang Seon Yi, M.D., Kyung Hwa Shin, M.D., Bo Kyung Choi, M.D., Gwang Ha Kim, M.D. and Do Youn Park, M.D.*; Korean J Gastrointest Endosc 2010;40(6):382-386. Published online June 30, 2010

Abstract PDF: Rectal implantation cysts can be caused by continued growth in the submucosa of traumatically misplaced columnar epithelium during previous surgery. Cases of implantation cyst occurring at the site of anastomosis have rarely been reported. Rectal implantation cysts occurring at an anastomosis site after a low anterior resection for rectal cancer need to be distinguished from locally recurrent rectal cancer. Here we present a case of rectal implantation cysts in a patient with rectal cancer who underwent laparoscopic low anterior resection 9 months previously. The diagnosis was made according to the characteristic image findings of endoscopic ultrasonography and enodsocopic ultrasonography-guided fine needle aspiration. This is the first case report of rectal implantation cyst in Korea. (Korean J Gastrointest Endosc 2010;40:382-386)

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Endoscopic Polypectomy of Primary Rectal Mature Teratoma: A Case Report: Jongha Park, M.D., Jeong-Sik Byeon, M.D., Jeong-Hyeon Jo, M.D.*, Kyung-Jo Kim, M.D., Byong Duk Ye, M.D., Seung-Jae Myung, M.D., Suk-Kyun Yang, M.D. and Jin-Ho Kim, M.D.; Korean J Gastrointest Endosc 2009;39(5):308-312. Published online November 30, 2009

Abstract PDF: Teratoma is a type of benign germ cell tumor that often contains several different types of tissue such as hair, muscle and bone, and these tissues arise from the three germinal layers. It occurs most often in the tailbones of children, the ovaries of women and the testicles of men. Primary rectal teratoma is extremely rare. We report here on a case of a 49-year-old woman with a primary rectal teratoma, and this was incidentally found during routine health screening. The rectal teratoma was a 15 mm-sized pedunculated polyp with a short stalk at the rectum, about 15 cm from anal verge as seen on CT colonography. On sigmoidoscopy and EUS, a fat and calcium containing well-defined polypoid lesion was noted in the upper rectum, with a narrow stalk attached to the colonic wall. The tumor was successfully excised by endoscopic polypectomy in order to obtain the histologic diagnosis and administer the proper treatment. (Korean J Gastrointest Endosc 2009;39:308-312)

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A Case of Rectal Suture Granuloma that was Suspected to be a Recurrent Rectal Carcinoma: Sang Pil Kim, M.D., Chang Kyun Lee, M.D., Jun Young Lee, M.D., Jin Woo Park, M.D., Tae Hoon Lee, M.D., Il-Kwun Chung, M.D., Sun-Joo Kim, M.D. and Sang Won Kim, M.D.*; Korean J Gastrointest Endosc 2009;39(1):46-49. Published online July 30, 2009

Abstract PDF: Suture granuloma is a benign, rare complication of surgical intervention and it is known to occur after the use of non-absorbable suture materials deep within the skin. Although suture granuloma can occur anywhere in the body after a variety of operations, its incidence has rapidly diminished in recent years since the widespread use of absorbable suture materials. Clinically, making the differential diagnosis with recurrent cancer is obviously important for a cancer patient because postoperative suture granuloma can mimic local tumor recurrence after surgical resection. We recently encountered a case of rectal suture granuloma in a patient with rectal cancer and who underwent low anterior resection 4 years previously. The diagnosis was made according to the characteristic image findings of endoscopic ultrasonography and the abdominal CT scan. The patient was successfully treated with broad-spectrum antibiotics, US-guided incision and drainage. We report here on a rare case of rectal suture granuloma and we briefly review the relevant literature. (Korean J Gastrointest Endosc 2009;39:46-49)

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Concurrent Malignant Carcinoid Tumor and Benign Carcinoid Tumor of the Rectum: Bong Hwan Kim, M.D., Seung Hee Yoo, M.D., Wee Sik Sohn, M.D., Sang Woon Park, M.D., Ki Baik Hahm, M.D., Il Dong Kim, M.D.*, Kye Won Kwon, M.D.^† and Kum Ho Yi, M.D.^‡; Korean J Gastrointest Endosc 2009;38(3):156-160. Published online March 30, 2009

Abstract PDF: Neuroendocrine cells are distributed throughout the body and they are found in the gastrointestinal tract, pancreas, lung, thyroid, adrenal gland and many other organs, and especially the gastrointestinal tract. As a consequence, neuroendocrine tumors of the colon and rectum are common neoplasm. Several cases of the benign carcinoid tumor and a few cases of the malignant carcinoid tumor of the colon and rectum have been reported. Yet there have been no reports on concurrent malignant carcinoid tumor and benign carcinoid tumor at the same site of the colon. A 60-year-old man presented with an asymptomatic rectal mass. After the mass was evaluated and operated on, it was confirmed to be a concurrent malignant carcinoid tumor and benign carcinoid tumor of the rectum, and metastasis to the liver was also found. (Korean J Gastrointest Endosc 2009;38: 156-160)

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A Case of a Small Rectal Carcinoid Tumor with Multiple Liver Metastasis: Eun Kyung Shin, M.D., Seun Ja Park, M.D., Kyu Jong Kim, M.D., Won Moon, M.D., Moo In Park, M.D., Dong Han Im, M.D., Jee Suk Lee, M.D. and Chan Bok Park, M.D.; Korean J Gastrointest Endosc 2009;38(2):103-106. Published online February 27, 2009

Abstract PDF: Carcinoid tumors originate from the enterochromaffin cells. Rectal carcinoid tumors comprise 12.6% of all carcinoid tumors and they represent the third largest group of the gut carcinoids. However, a recent report showed that the number of reported cases has increases rapidly, which is probably due to the increased number of colonoscopic examinations. The aggressiveness of rectal carcinoid tumors is determined by the depth of invasion and the presence of metastasis. The clinical course of rectal carcinoid is benign, but these tumors may have a malignant character when the lesion is larger than 2 cm in diameter. We have experienced a case of rectal carcinoid tumor smaller than 2 cm in diameter and the patient had multiple liver metastasis. (Korean J Gastrointest Endosc 2009;38:103-106)

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A Case of Small Rectal Carcinoid Tumor with Local Lymph Node Metastases: Jong Beom Park, M.D., Jae Myung Cha, M.D.*, Joung Il Lee, M.D.*, Jae Won Choe, M.D.*, Kwang Ro Joo, M.D.*, Sung Won Jung, M.D.*, Hyun Phil Shin, M.D.* and Suk Hwan Lee, M.D.^†; Korean J Gastrointest Endosc 2009;38(1):52-56. Published online January 30, 2009

Abstract PDF: Carcinoid tumors are rare and they arise from the enterochromaffin cells of the gastrointestinal tract. The rectum is the most common site for gastrointestinal carcinoids, and the majority of rectal carcinoids are found incidentally during colonoscopy. As the use of diagnostic colonoscopy has recently become more common, the number of cases with small rectal carcinoids resected by endoscopic resection has increased. However, distinguishing benign from malignant carcinoids is usually imposible based solely on the histology; therefore, evaluation for the local and distant metastases of rectal carcinoids is necessary even after complete endoscopic resection. We have experienced a case of small rectal carcinoid tumor that was endoscopically completely resected and surgical resection was done for the associated lymph node metastases. (Korean J Gastrointest Endosc 2009;38:52-56)

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A Case of Multiple Carcinoid Tumors of the Rectum: Jae Myung Cha, M.D., Joung Il Lee, M.D., Jae Won Choe, M.D., Kwang Ro Joo, M.D., Sung Won Jung, M.D., Hyun Phil Shin, M.D. and Jong Wook Hong, M.D.*; Korean J Gastrointest Endosc 2008;37(2):132-136. Published online August 30, 2008

Abstract PDF: Carcinoid tumors are rare and arise from enterochromaffin cells of the gastrointestinal tract. The rectum is the most common site for gastrointestinal carcinoids. The tumor usually present as small solitary submucosal nodules and multicentricity is rare, occurring in only a few percent of cases. The treatment for a rectal carcinoid tumor is based on the size of the lesion and depth of invasion. Although the present treatment guidelines for multiple rectal carcinoids are controversial, each small lesion of less than 1 cm without evidence of a metastasis can be adequately treated by local resection such as an endoscopic mucosal resection. We experienced a case of multiple rectal carcinoids that were completely resected after a hot biopsy and endoscopic mucosal resection. (Korean J Gastrointest Endosc 2008;37:132-136)

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A Case of Condyloma Acuminatum Presenting as a Rectal Polyp: Tae Sun Kim, M.D., Il Soon Whang, M.D., Yun Yong Seo, M.D., Su Hee Lee, M.D., Young Ho Hong, M.D., Sung Hoon Jung, M.D., Sung Ran Hong, M.D.* and Eun Ju Kim, M.D.; Korean J Gastrointest Endosc 2008;37(1):61-64. Published online July 30, 2008

Abstract PDF: Condyloma acuminatum, commonly known as anogenital warts, is caused by human papillomavirus (HPV). The most common location of condyloma acuminatum in women is the vulva. Other locations are the vagina, anus and perianal area, perineum and cervix. Condyloma acuminatum most commonly occur due to receptive anal intercourse, and can enlarge to form exophytic masses on the perianal skin, but rarely involve the rectum. We experienced an occurrence of a 12 mm polypoid lesion in the rectum of a heterosexual woman detected during a colonoscopy. The polypoid lesion was excised and was diagnosed as condyloma acuminatum. The lesion was positive for HPV type 11 based on the use of an HPV DNA chip test. (Korean J Gastrointest Endosc 2008;37: 61-64)

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A Case of Primary Rectal Diffuse Large B Cell Lymphoma Presented as Multiple Polypoid Lesions: Si Hyung Lee, M.D., Byung Ik Jang, M.D. and Tae Nyeun Kim, M.D.; Korean J Gastrointest Endosc 2008;36(5):302-306. Published online May 30, 2008

Abstract PDF: Primary gastrointestinal lymphoma is a rare disease, and a primary rectal diffuse large B cell lymphoma is rarely encountered. We report a case of a 60-year-old woman with diffuse large B cell lymphoma in the rectum. The patient underwent a low anterior resection six years ago due to a sigmoid colonic adenocarcinoma. The patient had multiple polypoid lesions on the rectum, and the patient was diagnosed with primary rectal diffuse large B cell lymphoma after a biopsy. There were no other lesions detected on a chest and abdomen CT scan. After the administration of combination chemotherapy, the polypoid lesions disappeared. (Korean J Gastrointest Endosc 2008;36: 302-306)

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A Case of Sarcoidosis Presenting as a Rectal Polyp: Wonseok Kang, M.D., Beom Kyung Kim, M.D., Min Ju Kim, M.D.^†, Jae Hee Cheon, M.D.*, Yong Chan Lee, M.D.*, Won Ho Kim, M.D.* and Sang Kil Lee, M.D.*; Korean J Gastrointest Endosc 2008;36(4):238-241. Published online April 30, 2008

Abstract PDF: Sarcoidosis is a multi-systemic syndrome with an unknown etiology that is characterized by the formation of multiple non-caseating granulomas that disrupts the architecture and function of the tissues. A 58-year-old woman was referred for a skin rash and papules. No specific findings were observed on the initial skin biopsy. On gastroscopy and colonoscopy, gastric erosion and rectal polyp were noted. The rectal biopsy revealed non-caseating granulomas without acid-fast bacilli, indicating a differential diagnosis of Crohn's disease and other granulomatous diseases. A repeat skin biopsy of the papular lesion showed non-caseating granulomas that was consistent with sarcoidosis. The chest x-ray and computed tomography (CT) revealed cardiomegaly without hilar lymphadenopathy. The serum angiotensin converting enzyme level was 122 U/L (normal: 8∼52 U/L) with normal liver chemistry as well as normal electrolyte, serum calcium and c-reactive protein levels. Finally, the patient was diagnosed with sarcoidosis with rectal involvement. We report this rare case of sarcoidosis that presented as a rectal polyp. (Korean J Gastrointest Endosc 2008;36:238-241)

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A Case of Primary B Cell Mucosa-associated Lymphoid Tissue Lymphoma Presenting as a Solitary Rectal Mass: Jong Hoon Kim, M.D., Young-Soo Moon, M.D., Seuk Hyun Lee, M.D., Jun Sup Park, M.D.*, Won Ki Bae, M.D., Nam-Hoon Kim, M.D., Sunhee Chang, M.D.^†, Kyung-Ah Kim, M.D., Hye Ran Lee, M.D. and June Sung Lee, M.D.; Korean J Gastrointest Endosc 2008;36(2):102-106. Published online February 27, 2008

Abstract PDF: Primary extranodal B cell lymphoma of mucosa- associated lymphoid tissue (MALT) can develop in diverse anatomic locations such as the stomach, salivary gland, thyroid, lung, and breast. Its distribution in the GI tract is as follows: 50∼60% in the stomach, 20∼30% in the small intestine and ileocecal area and 10% in the colorectal area. Although autoimmune and infectious diseases are known as the main etiologies, H. pylori infection has been clearly shown to play a causative role in lymphomagenesis, especially in the stomach. H. pylori eradication therapy only can induce disease remission nearly in 80% of the cases of gastric MALT lymphoma. However, there is lack of evidence for the extragastric area. In this case, a 71-year-old woman with low abdominal pain was diagnosed as having a rectal MALT lymphoma that was noted as a solitary rectal mass in a colonoscopic examination. Remission induction was commenced by H. pylori eradication and radiation therapy. (Korean J Gastrointest Endosc 2008;36:102-106)

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A Case of Primary Rectal MALT Lymphoma Presented as Multiple Submucosal Tumors: Hee Sun Mun, M.D., Hyo Jin Park, M.D., Ki Byung Lee, M.D., In Su Jung, M.D., Woo Ick Yang, M.D.*, Soon Won Hong, M.D.* and Jung Hwan Kim, M.D.^†; Korean J Gastrointest Endosc 2007;35(4):272-276. Published online October 30, 2007

Abstract PDF: MALT (mucosa-associated lymphoid tissue) lymphomas are the most common primary gastrointestinal (GI) lymphomas. MALT lymphomas of the GI tract tend to occur most commonly in the stomach, followed by the small intestine, ileocecal area, colon and the esophagus. However, MALT lymphomas of the large intestine are rare. Previously, a diagnosis was commonly established by the surgical specimens but endoscopic biopsy specimens are currently used to make a diagnosis. A 61-year-old woman was found to have multiple submucosal tumors of the rectum during a screening colonoscopy. The tumors were removed by a polypectomy. The histology revealed the diffuse infiltration of centrocyte-like cells and a lymphoepithelial lesion. Immunohistochemical staining confirmed the diagnosis of a low grade B cell lymphoma of the MALT type. No other site of involvement was identified on the CT of the chest, abdomen and pelvis. (Korean J Gastrointest Endosc 2007;35:272-276)

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A Case of Primary Follicular Lymphoma Arising in the Rectum: Bo Sung Kwon, M.D., Chang Duck Kim, M.D., Jae Youn Park, M.D., Moon Kyung Joo, M.D., Jin Su Jang, M.D., Jin Nam Kim, M.D., Seung Young Kim, M.D., Bora Keum, M.D., Youn Suk Seo, M.D., Yong Sik Kim, M.D., Yoon Tae Jeen, M.D., Hoon Jai Chun, M.D., Soon Ho Um; Korean J Gastrointest Endosc 2006;33(5):285-288. Published online November 30, 2006

Abstract PDF: Follicular lymphoma (FL) is one of the most common non-Hodgkin's lymphomas in the United States, but it is relatively rare in Asia. FL typically arises in lymph nodes together with spleen, liver, and bone marrow involvement. So, primary extra-nodal FL without peripheral nodal involvement is rare. Histologically, it shows nodular aggregates of lymphoma cells and positivity for CD 10, CD 20 and bcl-2. Not only the stage, but also the grade is associated with the survival rate. Grade 3 FL presents a worse prognosis than does grade 1 and 2 FL and this should be treated with an anthracycline based CHOP regimen. We report here on a case of primary follicular lymphoma arising in the rectum; this was observed in a 58-year-old woman who complained of anorexia, dyspepsia and diarrhea. (Korean J Gastrointest Endosc 2006; 33:285⁣288)

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A Case of Rectal Gastrointestinal Stromal Tumor (GIST) Presenting with Hematochezia: Eun Young Choi, M.D., Ho Kil, M.D., Won Joong Jeon, M.D., Seon Mee Park, M.D. Seok Hyung Kim, M.D.*, Kil Sun Park, M.D.^† and Sei Jin Youn, M.D.; Korean J Gastrointest Endosc 2006;33(2):110-115. Published online August 30, 2006

Abstract PDF: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms affecting the gastrointestinal tract. The main sites for GIST are the stomach and small intestine but they can also occur in the rectum, albeit rarely. We report a 58-year-old woman who presented with hematochezia. Endoscopically, a submucosal tumor with mucosal ulceration was located approximately 2 cm from the anal verge. The pelvic CT and MRI scanning findings demonstrated a large low-density lesion with intraluminal growth from the lower rectum and an absence of tumor infiltrations to other organs. The patient underwent an abdominoperineal resection of the rectum. A histopathological examination showed fascicular proliferation of spindle shaped cells. The mitotic rate was more than 30 mitotic figures per 50 high-power fields. A immunohistochemical examination revealed most of the tumor cells to be positive for the c-kit protein, CD34 and SMA (α-smooth muscle action). The tumor was diagnosed as a GIST of the rectum. (Korean J Gastrointest Endosc 2006;33:110⁣115)

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Two Cases of Rectal Dieulafoy's Lesion Treated Sucessfully with Hemoclip: Yong Sung Ahn, M.D., Ji Young Park, M.D., Jung Hyun Lee, M.D., Hyo Jin Jung, M.D., Tae Oh Kim, M.D., Gwang Ha Kim, M.D., Jeong Heo, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D. and Mong Cho, M.D.; Korean J Gastrointest Endosc 2006;33(1):54-57. Published online July 30, 2006

Abstract PDF: Dieulafoy's lesion is a rare cause of massive gastrointestinal bleeding. It is usually identified within the proximal stomach but has been reported in the esophagus, duodenum, small intestine, colon and rectum. Surgery was originally the treatment of choice for this lesion. However, recently, most case can be treated using endoscopic techniques including an injection of a sclerosing agent, clipping, band ligation, heater probe, and bipolar coagulation. We report 2 cases of a rectal Dieulafoy's lesion that were treated sucessfully by endoscopic clipping without complications. (Korean J Gastrointest Endosc 2006; 33:54⁣57)

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A Case of Colorectal Villous Adenoma Found with PET-CT: Tae Ho Kim, M.D., Soo-Heon Park, M.D., Hyun Jong Oh, M.D., Dae Young Cheung, M.D., So Yeon Lee, M.D., Jin Il Kim, M.D., Joon-Yeol Han, M.D., Jae Kwang Kim, M.D., Kyu Won Chung, M.D. and Hee Sik Sun, M.D.; Korean J Gastrointest Endosc 2005;31(4):263-267. Published online October 30, 2005

Abstract PDF: Adenomatous polyp in colorectal area is clinically important as being a precursor of colorectal cancer. Early detection of cancer reduces colorectal cancer mortality. Finding and removing precursor adenomas reduces colorectal cancer incidence especially in high risk groups. FDG-PET/CT is a new imaging technology in which a number of clinical applications has been recognized in oncologic imaging. FDG-PET has been shown to detect a wide variety of tumor foci including lymphoma, melanoma, lung cancer and colorectal cancer. Colorectal adenoma can also be detected by FDG-PET. In this case, we describe a colorectal villous adenoma, which was found by FDG-PET/CT. There was a mass of intensely increased FDG uptake in rectal area. The adenoma was confirmed with sigmoidoscopy and removed by polypectomy. (Korean J Gastrointest Endosc 2005;31:263⁣267)

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A Case of Rectal Gastrointestinal Stromal Tumor with Bleeding: Jeong Ah Shin, M.D., Seong Jun Kim, M.D., Won Chang Shin, M.D., Jin Ho Lee, M.D., Won Choong Choi, M.D., Kwan Yeop Kim, M.D., Myeong Ja Jeong, M.D.* and Sung-Jig Lim, M.D.^†; Korean J Gastrointest Endosc 2005;30(3):173-177. Published online March 31, 2005

Abstract PDF: Gastrointestinal stromal tumors (GIST), although uncommon mesenchymal tumors of the gastrointestinal tract, are occasionally encountered on endoscopic examination. GIST can be found all gastrointestinal tract, but rare in the rectum. We report a 72-year-old woman presented with intermittent bloody stool for a year. On rectal examination, a firm fixed mass was felt on the anterior wall of the rectum. Computed tomography revealed the 4.8⁓4.5 cm sized exophytic and centrally depressed mass on the rectum without the evidence of adjacent organ invasion or metastasis. On colonoscopic examination, there was a round elevated lesion having central ulcer with adherent blood clots. Endoscopic deep biopsy examination revealed a submucosal tumor consisting of spindle cells with elongated cigar-shaped nuclei arranged in fascicles and whorls. Mitotic counts were fewer than 5 per 50 high-power fields. The tumor cells were positive for KIT and CD34 immunohistostaining and negative for SMA. Local excision recommended, but the patient discharged against the advice. Korean J Gastrointest Endosc 2005;30:173⁣177)

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A Case of Malakoplakia Treated by Antibiotics in the Rectum: Dong Hyun Lee, M.D., Jong Yun Cheong, M.D., Won Il Park, M.D., Jin Hong Park, M.D., Hyong Wook Kim, M.D., Jeong Heo, M.D., Gwang Ha Kim, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D. and Mong Cho, M.D.; Korean J Gastrointest Endosc 2005;30(2):99-102. Published online February 27, 2005

Abstract PDF: Malakoplakia is a rare chronic inflammatory process, most commonly affecting the urinary tract. This entity was first described by Michaelis and Gutman in 1902. As of 1995, only 85 cases of malakoplakia of the gastrointestinal tract has been reported. The common sites of colonic involvement are the rectum, sigmoid, and right colon, in descending order of frequency. The most common disease associated with malakoplakia is colorectal carcinoma. Surgical resection is the treatement of choice for cases associated with carcinoma or complications. But in other cases, medical treatment could be attempted. Antimicrobial drugs, such as trimethoprime-sufamethoxazole, rifampin, or as recently suggested, ciprofloxacin can be used. We report a case of rectal malakoplakia treated by ciprofloxacin with a review of literatures. (Korean J Gastrointest Endosc 2005;30:99⁣102)

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A Case of Rectal Dieulafoy's Lesion Treated by Endoscopic Band Ligation: Won Min Hwang, M.D., Hoon Seop Kuh, M.D., Tae Hee Lee, M.D., Ki Se Lee, M.D., Euyi Hyeog Im, M.D., Kyu Chan Huh, M.D., Young Woo Choi, M.D. and Young Woo Kang, M.D.; Korean J Gastrointest Endosc 2004;29(2):99-102. Published online August 30, 2004

Abstract PDF: Dieulafoy's lesion is a relatively uncommon disease which is minor cause of massive acute lower gastrointestinal bleeding. The lesion comprises mainly of an abnormally exposed submucosal artery associated with a minute mucosal defect on the top in the stomach, and it is a rare cause of profuse but intermittent gastrointestinal bleeding. Less commonly, similar lesions have also been identified in the duodenum, jejunum, colon, and in rare cases, the rectum. In this report, 70 year-old man is described, who has an massive hematochezia from a small rectal mucosal defect with an exposed vessel. Control of the bleeding was successfully achieved with endoscopic band ligation. The fact that rectal Dieulafoy's disease is rare but one of the causes of massive hematochezia should serve as a reminder in the future cases in the elderly. (Korean J Gastrointest Endosc 2004;29:99⁣102)

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A Case of Cavernous Hemangioma of the Colon: Sang Won Lee, M.D.*, Jong Won Choi, M.D.*, Yong Suk Cho, M.D., Jung Hun Seo, M.D., Sun Young Won, M.D., Chun Gyun Lee, M.D. and In Suh Park, M.D.; Korean J Gastrointest Endosc 2004;28(1):47-51. Published online January 30, 2004

Abstract PDF: Gastrointestinal cavernous hemangiomas are rare, with an incidence of about 1 per 15,000 persons and the second most common vascular lesions of the colon. They are generally congenital, with their origin in embryologic sequestrations of mesodermal tissue. Enlargement occurs by projection of budding endothelial cells. These lesions are a significant cause of rectal bleeding with anemia, obstruction and rarely platelet sequestration, although approximately 10% of patients remain asymptomatic. On endoscopy, cavernous hemangiomas characteristically present as deep violet-blue nodular, compressible lesions that are associated with mucosal congestion and edema. Unfortunately chronic inflammatory changes often mask findings that could lead to proper diagnosis. The results of several kinds of treatment have not been satisfactory, although abdominoperineal resection is the most often recommended procedure. We report a case of relatively huge cavernous hemangioma of the colon that developed in an old aged patient with intermittent hematochezia. (Korean J Gastrointest Endosc 2004;28:47⁣51)

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A Case of Anorectal Actinomycosis: Soon Ok Oh, M.D., Sang Ho Moon, M.D., Su Ho Kim, M.D., Gwang Ho Baik, M.D., Jin Bong Kim, M.D., Dong Joon Kim, M.D., Hae Sung Kim, M.D.*, Hong Ki Kim, M.D.* and Young Hee Choi, M.D.†; Korean J Gastrointest Endosc 2003;27(6):553-557. Published online December 30, 2003

Abstract PDF: Actinomycosis is an indolent, slowly progressive infection caused by actinomyces species that normally colonize the mouth, colon, and vagina, characterized by sulfur granule formation. Actinomycosis can affect multiple organs, with local or systemic manifestations. The abdomen is involved in less than 20% of the cases with the ileocecal area being the site most frequently affected. The anorectal region is less frequently involved. We report a case of anorectal actinomycosis, which was diagnosed by histologic study of sigmoidoscopic biopsy. The patient was a 40-year-old man who took immunosuppressive agents after kidney transplantation. Adequate surgical excision was done, being followed by administration of massive dose of a penicillin. (Korean J Gastrointest Endosc 2003;27:553⁣557)

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A Case of Primary Small Cell Neuroendocrine Carcinoma of the Rectum: Jeong Hwan Kim, M.D., Young-Ho Kim, M.D., Jae Hong Jung, M.D., Bong Geun Song, M.D., Sung Chul Choi, M.D., Poong-Lyul Rhee, M.D., Jae J. Kim, M.D. and Jong Chul Rhee, M.D.; Korean J Gastrointest Endosc 2003;27(4):239-243. Published online October 31, 2003

Abstract PDF: Neuroendocrine carcinoma of the colon is a very rare entity. However, this type of tumor is known to have aggressive progression and poor prognosis. A case of a 72-year-old male is presented in this report. A 3 cm sized tumor was found on the rectum with multiple liver metastases. The pathological findings including a positive immunohistochemical staining for synaptophysin and cytokeratin done with colonoscopic biopsy and liver biopsy confirmed the tumor as a neuroendocrine carcinoma. The nomenclature and definition of this disease still remains somewhat unclear, and not a small population of this disease may thus have been misdiagnosed and treated as other less aggressive entities, such as carcinoid tumor. The necessity to make an accurate differential diagnosis in such cases is thus emphasized because of different treatments and clinical courses. For its rarity and clinical significance, we report this case with a review of the literatures. (Korean J Gastrointest Endosc 2003;27:239-243)

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A Case of Granular Cell Tumor in the Rectum: Dong Hee Kim, M.D., Young-Ho Kim, M.D., Nam Hee Kwon, M.D., Bong Geun Song, M.D., Jae Hong Jung, M.D., Min Hyung Kim, M.D., Poong-Lyul Rhee, M.D., Jae J. Kim, M.D. and Jong Chul Rhee, M.D.; Korean J Gastrointest Endosc 2003;27(2):88-91. Published online August 30, 2003

Abstract PDF: Granular cell tumor (GCT), first described by Abrikossoff in 1926, is relatively uncommon, usually benign and solitary neoplasm. The most frequently involved organs include the tongue, skin, breast, and digestive tract. Until now, less than 200 cases of GCTs of the digestive tract have been reported in the esophagus, and less than 50 cases in the large intestine, stomach, biliary tract in the world. Only less than 20 cases of GCT of the rectum have been reported in the world. It is believed that there have been no reported cases of GCT of the rectum in Korea. Recently, the incidence of granular cell tumor has been slowly rising since endoscopy has been used more commonly as a diagnostic tool. We report a case of granular cell tumor in the rectum in a 49-year-old male patient, which was confirmed by microscopic examination after colonoscopic polypectomy. (Korean J Gastrointest Endosc 2003;27:88⁣91)

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직장 Dieulafoy양 병변 출혈의 내시경적 치료 1예 ( A Case of Bleeding from Rectal Dieulafoy-like Lesion Treated by Endoscopy ): Korean J Gastrointest Endosc 2000;21(1):577-580. Published online November 30, 1999

Abstract PDF: Dieulafoy-like lesion is a relatively uncommon disease which is a potential source of life-threatening gastrointestinal bleeding. The lesion comprises mainly of an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is frequently found at distal portion of gastroesophageal junction but may occur anywhere in gastrointestinal tract including small bowel, colon and rectum. Moreover bleeding from dieulafoy-like lesion of rectum is very reae. It has been reported that rectal Dieulafoy-like lesion is very rare source of lower gastrointestinal bleeding and its pathogenesis may be associated with constipation. Recently, endoscopy has an important role in the diagnosis and treatment (including injection and coagulation therapy) of bleeding from Dieulafoy-like lesion. We herein report a case of a patient who presented wih massive hemorrhage from a small rectal ulcer with adherent blood clots. Bleeding was controlled with endoscopic treatment by utilizing bipolar electrocoagulation without complication and recurrence.(Korean J Gastrointest Endosc 2000;21:577-580)

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직장 악성 흑색종: Korean J Gastrointest Endosc 2000;20(5):418-418. Published online November 30, 1999

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조기 직장암에서 진행성 직장암으로의 이행을 보인 고유근층 직장암: Korean J Gastrointest Endosc 2000;20(5):401-401. Published online November 30, 1999

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거대세포바이러스 직장염: Korean J Gastrointest Endosc 2000;20(5):400-400. Published online November 30, 1999

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위장과 대장에 발생한 과형성 용종증 1예 ( A Case of Multiple Hyperplastic Polyps in the Stomach and Colorectum ): Korean J Gastrointest Endosc 2000;20(1):63-67. Published online November 30, 1999

Abstract PDF: Hyperplastic polyps are a benign epithelial proliferation and a common type of colorectal and gastric polyps. Malignant change of hyperplatic polyps is rare. Patients with multiple lesions however, tend to have a high frequency of malignancy. Colorectal polyposis syndromes with gastric polyps include familial adenomatous polyposis, Gardners syndrome, Peutz-Jeghers syndrome, juvenile polyposis and others. But the case of colorectal hyperplastic polyposis with multiple gastric hyperplastic polyps has not been reported until now. A case was recently experienced involving a 32 year old women with both colorectal and gastric hyperplastic polyposis. Multiple hyperplastic polyps were found in the lower part of the body and the antrum of the stomach, rectosigmoid, transverse and ascending colon. (Korean J Gastrointest Endosc 2000;20:63~67)

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직장 유암종 1 예 ( A Case of Carcinoid Tumor of the Rectum ): Korean J Gastrointest Endosc 2000;21(4):807-810. Published online November 30, 1999

Abstract PDF: Carcinoid tumor primarily affects the intestinal tract, which arise from the Kulchitsky cells found at the base of the crypts of Lieberkuhn. Rectal carcinoids are relatively uncommon lesions, representing only 1.3 percent of all rectal tumors. Rectal carcinoids have benign course and are usually asymptomatic. While their prognosis is generally favorable, it is known that about 15% of these tumors metastasize. Rectal carcinoid tumors should be treated appropriately and aggressively when indicated. Present-day treatment programs call for radical cancer resection only for lesions larger than 2 cm in diameter and local resection for all others. We have experienced a case of carcinoid tumor of the rectum treated by endoscopic polypectomy.

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간 전이를 일으킨 작은 직장 유암종 1 예 ( A Small Rectal Carcinoid Tumor with Liver Metastasis ): Korean J Gastrointest Endosc 2000;21(4):802-806. Published online November 30, 1999

Abstract PDF: Carcinoid tumors are originated from the enterochromaffin cells in the gastrointestinal mucosa, The incidence of rectal carcinoid tumors is more than 10 percent of gastrointestinal tract carcinoid. The tumor has naturally the benign character that does not develop symptoms and it is found incidentally. The tumor may infrequently have a malignant behavior such as invasion to muscle wall, obstruction of bowel lumen and metastasis to distant organ (especially, liver) almost when its size is larger than 2 cm. We have experienced a case of rectal carcinoid tumor smaller than 1 cm in its size with huge metastatic mass of liver.

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충수병변이 선행된 비전형적 궤양성 대장염 1예 ( A Case of Atypical Ulcerative Colitis Initially Presented as the Appendiceal Lesion ): Korean J Gastrointest Endosc 1999;19(6):971-974. Published online November 30, 1998

Abstract PDF: Ulcerative colitis (UC) is an inflammatory disease primarily involving the colonic mucosa. The extension of classic UC is uniform and continuous with no intervening areas of normal mucosa. The rectum is usually involved and the inflammation extends proximally in a continuous fashion for a variable distance. However, as more patients get colonoscoped, it had been reported that there is a wide spectrum to what is called UC. There appear to be a few patients with otherwise typical UC but with rectal sparing. And also there are patients with classic distal UC who have an isolated area of cecal disease and segmental UC with skipped area. We have experienced a case of atypical UC initially presented as a isolated lesion around the appendiceal orifice with the segmental distribution of inflammatory change without an active inflammatory lesion in the rectum. It was considered that understanding of the significance of an isolated lesion in the appendix would contribute to the elucidation of the pathogenesis of UC. (Korean J Gastrointest Endosc 19: 971∼974, 1999)

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과산화수소에 의해 유발된 대장염 1예 ( A Case of Hydrogen Peroxide Induced Colitis ): Korean J Gastrointest Endosc 1999;19(4):659-667. Published online November 30, 1998

Abstract PDF: Endometriosis is the abnormal growth of endometrial tissue outside the uterine cavity. Involvement of the gastrointestinal tract is seen in 3∼34% of patients affected by this condition. Although the commonest sites involved are the sigmoid colon and rectum, only 4 cases have been reported in Korea. The most frequent symptoms are lower abdominal and pelvic pain typically worsening at the time of menstruation. Bleeding per rectum is uncommon since the mucosa is rarely involved. Endoscopy has not been thought to be helpful in the evaluation of patients with suspected colonic endometriosis. However, endoscopy is often used as the first test in patients with rectal bleeding, excluding malignancy or other sources of bleeding. There are few reports of endoscopic documentation of colorectal endometriosis. A 26 year-old woman having a history of endometriosis with cyclic hematochezia and lower abdominal pain is herein reported. A flexible sigmoidoscopy revealed a protrusion of hyperemic mucosa with a surrounding fold formation on the rectum 8 cm above the anal verge. The subsequent biopsy of the lesion gave rise to a diagnosis of endometriosis. (Korean J Gastrointest Endosc 19: 667∼670, 1999)

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대량 하부 위장관 출혈의 원인으로서 직장 내 Dieulafoy 양 병변 ( A Dieulafoy-like Lesion of the Rectum as a Cause of Massive Lower G-I Bleeding ): Korean J Gastrointest Endosc 1999;19(3):454-459. Published online November 30, 1998

Abstract PDF: Dieulafoy's lesion is an exposed submucosal artery associated with a minute mucosal defect in the stomach, and it is a rare cause of profuse, but intermittent gastrointestinal bleeding. Less commonly, similar lesions have been identified in the duodenum, jejunum, colon, and in rare cases, the rectum. Only four cases of rectal Dieulafoy's lesion have been reported in English Medical literature: one case involved a child, two in otherwise healthy young men, and one in on elderly man. In this report, two elderly men are described, who suffered an massive hematochezia from a small rectal mucosal defect with a visible vessel. Control of the bleeding was successfully achieved with on endoscopic sclerotherapy or hemoclipping. The fact that rectal Dieulafoy disease is one of the causes of massive hematochezia should serve as a reminder in future cases, especially involving alcoholics and elderly men. (Korean J Gastrointest Endosc 19: 454∼459, 1999)

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직장 유암종 1 예 (A Case of Rectal Carcinoid Tumor ): Korean J Gastrointest Endosc 1999;19(1):130-138. Published online November 30, 1998

Abstract PDF: Carcinoid is a tumor that primarily affects the intestinal tract, which arises from entero-chromaffin cells. Rectal carcinoid tumor is a relatively rare neoplasm originated in Kul-chitszky cell and clinicians have the difficulties in predicting their malignant potential and in proper treatment. These cells are found to increase in the distal small intestine, are common in the appendix, and then decrease within the mucosa of the colon from cecum to rectum. In the cumulative world literature, the incidence of carcinoids of rectum is slightly higher than 10 percent. All of these tumors are within reach of the rigid procto-sigmoidoscope, most being located between 4 and 13 cm from the anal verge. Eighty five percent are found on the anterior and lateral walls. The tumors are usually submucosal and light yellowish or reddish color. The vast majority of rectal carcinoid tumors are be-nign, which can be treated by local excision safely. Lesions larger than 2 cm and invading the muscular wall of the rectum should be considered malignant, which are treated by more radical surgery such as abdominoperitoneal resection. We experienced a case of rectal carcinoid tumor, which was excised by endoscopic polypectomy, so we present this case with a review of relevant literatures. (Korean J Gastrointest Endosc 19: 130 ∼136, 1999)

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증례 : 위장관 ; 혈변을 동반한 직장 국소성 림프양 증식증 1예 ( Case Reports : Stomach & Intestine ; A Case of Focal Lymphoid Hyperplasia of the Rectum Presented with Hematochezia ): Korean J Gastrointest Endosc 1997;17(5):702-709. Published online November 30, 1996

Abstract PDF: Pseudolymphoma or benign lymphoid hyperplasia is an unusual pathologic entity representing lymphoid hyperplasia, which is sometimes not easily classified as reactive or neoplasic. It occurs in a wide variety of sites, including the orbit, salivary glands, skin, thyroid, gastrointestinal tract and lung. Within the gastrointestinal tract, stomach, small intestine and large intestine, particulary rectum, can be involved, but intestine including rectum has been rarely reported in Korea to the best of our knowlege. We experienced a case of focal lymphoid hyperplasia of the rectum presented with hematochezia in a 33-year old male. It was diagnosed by histopathology with sigmoidoscopic biopsy and molecular genetic study. Rectal lesion as well as hematochezia was improved by prednisolone and mesalamine enema therapy. Hence, we report this case with a brief review of literatures. (Korean J Gastrointest Endosc 17: 702-707, 1997)

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증례 : 식도 위장관 ; 직장의 림프용종 ( Case Reports : Esophagus , Stomach & Intestine ; Lymphoid Polyp in the Rectum ): Korean J Gastrointest Endosc 1996;16(6):1017-1021. Published online November 30, 1995

Abstract PDF: Lymphoid polyp is a rare disease in the colorectal area. It occurs commonly in the rectum. It is a nonepithelial benign tumor. Because of the benignancy of its nature, it has other names as well, such as benign lymphoma or rectal tonsil. A lymphoid polyp can be differentiated from a malignant lymphoma by the proliferation of normal lymphoid tissue which has a prominent follicular pattern and a clearly defined germinal center. A lymphoid polyp can regress spontaneousely without any treatment. There is no recurrence or malignant transformation. Recently, the authors experienced a case of lymphoid polyp in the rectum. We report a case of lymphoid polyp in the rectum diagnosed by piecemeal polypectomy. (Korean J Gastrointest Endosc 16: 1017-1020, 1996)

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증례 : 식도 위장관 ; 직장의 연반증 ( Case Reports : Esophagus , Stomach & Intestine ; Malakoplakia ): Korean J Gastrointest Endosc 1996;16(2):254-259. Published online November 30, 1995

Abstract PDF: Malakoplakia is an uncommon granulomatous disease most frequently found in the bladder or ureter. Howevcr, it has been reyorted in almost every ather organ and structure, the colon is the most common site of malakoplakia outside the urogenital tract and colonic carcinoma is the most commonly associated disease. A case of malakoplakia of the colon in a 54-year-old female is reported. Sigmoidoscopy revealed multiple whiteyellowish nodules simulating polypoid lesion at 10cm from the anal verge. The biopsy showed characteristically comprised submucosal proliferations of histiocyte and chronic inflammatory cells with typical cytoplasmic inclusions known as Michaelis-Gutmann bodies. Intravenous pyelogram showed no evidence of involvement of the urinary system. These nodules were removed by endoscopic polypectomy, So far, this is the first case of isolated colonic malakoplakia in Korea. (Korean J Gastrointest Endosc 16: 254~257, 1996)

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직장으로 전이된 악성 흑색종 1예 ( A Case of Metastatic Melanoma of the Rectum ): Korean J Gastrointest Endosc 1993;13(2):411-413. Published online November 30, 1992

Abstract PDF: A 42-year-old woman preseated with intermittent rectal bleeding of a week's duration. A large polypoid mass with pigmented, ulcerated, nodular surface was seen in the rectum at 3cm from the anal verge during flexible sigmoidoscopy. A histologic diagnosis of metastatic melanoma wae made on light microscopic examination of biopsies obtained at sigmoidoscopy. The presence of metastatic melanoma at sites other than the rectum was found at the skin, pleura and lung. We report a case of metastatic malignant melanoma of the rectum with the review of the literature.

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