Clinical Endoscopy

Endoscopic Submucosal Dissection for Colitis-Associated Dysplasia: Dong-Hoon Yang, Imelda Rey; Clin Endosc 2019;52(2):120-128. Published online March 27, 2019; DOI: https://doi.org/10.5946/ce.2019.047

Dysplasia is a precancerous lesion of colorectal cancer in patients with long-standing inflammatory bowel diseases (IBDs), such as ulcerative colitis and Crohn’s disease. Recent guidelines suggest endoscopic resection as a key modality for the treatment of endoscopically resectable dysplasia in patients with colitis. Endoscopic submucosal dissection (ESD) has been suggested as one of the therapeutic options for dysplasia that is potentially resectable but not suitable for the conventional endoscopic mucosal resection technique. Several recent studies supported the feasibility of ESD for the treatment of colitis-associated dysplasia in terms of the en bloc and complete resection rates and the risk of procedure-related complications. However, these studies were performed exclusively in expert centers. Moreover, the local and metachronous recurrence rates were relatively high, and long-term outcome data are still lacking. Endoscopists should be highly skilled in colorectal ESD and have an intensive understanding of not only the lesions but also the conditions of patients with IBDs. Therefore, the decision to perform ESD for colitis-associated dysplasia should be made scrupulously after careful discussion with patients, in collaboration with a multidisciplinary IBD team including physicians, surgeons, and pathologists specialized in IBDs.

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Characteristics of flat‐type ulcerative colitis‐associated neoplasia on chromoendoscopic imaging with indigo carmine dye spraying
Kaoru Takabayashi, Shinya Sugimoto, Kosaku Nanki, Yusuke Yoshimatsu, Hiroki Kiyohara, Yohei Mikami, Tomohisa Sujino, Motohiko Kato, Naoki Hosoe, Masayuki Shimoda, Naohisa Yahagi, Haruhiko Ogata, Yasushi Iwao, Takanori Kanai
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Efficacy and Safety of Endoscopic Submucosal Dissection for Dysplasia in Ulcerative Colitis Patients: A Systematic Review and Meta-Analysis
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An endoscopic treatment strategy for superficial tumors in patients with ulcerative colitis
Masafumi Nishio, Kingo Hirasawa, Yuichiro Ozeki, Atsushi Sawada, Ryosuke Ikeda, Takehide Fukuchi, Ryosuke Kobayashi, Makomo Makazu, Chiko Sato, Reiko Kunisaki, Shin Maeda
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Digestive Diseases and Sciences.2020; 65(1): 78. CrossRef

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Colonoscopic Cancer Surveillance in Inflammatory Bowel Disease: What's New Beyond Random Biopsy?: James E. East; Clin Endosc 2012;45(3):274-277. Published online August 22, 2012; DOI: https://doi.org/10.5946/ce.2012.45.3.274

Abstract PDF PubReader ePub

Colonoscopy based colitis surveillance is widely accepted to try to prevent development of and ensure early detection of colitis-associated colorectal cancer. Traditionally this has been performed with quadrantic random biopsies throughout the colon. Chromoendoscopy "dye-spray" with targeted biopsies only has been shown to increase dysplasia detection 4 to 5 fold on a per lesion basis. It has therefore been suggested that random biopsies should be abandoned as they do not increase dysplasia detection nor change patient clinical course. Recent British guidelines for colitis surveillance have strongly endorsed chromoendoscopy. This short review summarizes current international guidelines and looks at how to optimize white light colonoscopy in colitis considering: bowel preparation, withdrawal time, high definition, and structure enhancement. Data for advanced imaging techniques are reviewed including positive evidence in favor of chromoendoscopy, and limited data suggesting autofluoresence imaging may be promising. Narrow band imaging does not increase dysplasia detection in colitis. Confocal endomicroscopy might potentially reduce biopsies beyond that of chromoendoscopy but does not offer a clear detection advantage. Pan-colonic chromoendoscopy with targeted biopsies increases dysplasia detection and is the standard of care in the United Kingdom. It is likely that the use of chromoendoscopy for colitis surveillance will become widely accepted internationally.

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Rosario Fornaro, Michela Caratto, Elisa Caratto, Giuseppe Caristo, Francesco Fornaro, Davide Giovinazzo, Camilla Sticchi, Marco Casaccia, Enzo Andorno
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Cytomegalovirus Colitis with Ulcerative Colitis in the Steroid Naïve Immunocompetent Patient: Hyo Keun Lee, M.D., Won Ki Bae, M.D., Woo Sun Rou, M.D., Tae Jun Song, M.D., Nam-Hoon Kim, M.D., Kyung-Ah Kim, M.D., June Sung Lee, M.D. and Mee Joo, M.D.*; Korean J Gastrointest Endosc 2010;41(6):385-389. Published online December 30, 2010

Abstract PDF: Ulcerative colitis is an idiopathic chronic inflammatory bowel disease that exclusively involves the colon. It is characterized by diffuse mucosal inflammation and a recurrent course of remission and relapse. Factors such as smoking, diet, genetic factors and miocrobial infection have all been suggested as causes of ulcerative colitis. One of the important issues in the treatment of ulcerative colitis is opportunistic infection associated with the usage of corticosteroid and immunosuppresant. In most cases, opportunistic cytomegalovirus infection after treatment with corticosteroid or immunosuppressant worsens the course of ulcerative colitis. However, cytomegalovirus infection is uncommon in immunocompetent patients and it is rare in immunocompetent patients with corticosteroid naive ulcerative colitis. We report here on a case in which an immunocompetent patient was newly diagnosed with ulcerative colitis and cytomegalovirus coinfection simultaneously. (Korean J Gastrointest Endosc 2010;41:385-389)

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Two Cases of Pyoderma Gangrenosum Associated with Recurrent Ulcerative Colitis: Yong Hwan Kwon, M.D., Jae Woo Kim, M.D., So Yeon Park, M.D., Moon Young Kim, M.D., Hyun Soo Kim, M.D., Soon Koo Baik, M.D., Jamshid Abdul-Ghafar, M.D.* and Mee Yon Cho, M.D.*; Korean J Gastrointest Endosc 2010;41(5):312-318. Published online November 30, 2010

Abstract PDF: Pyoderma gangrenosum (PG) begins with a painful, erythematous skin lesion followed by pustule formation and rapid ulceration in which an erythematous border surrounds a sterile, necrotic center. In most patients, symptoms of ulcerative colitis precede PG, and exacerbations of the bowel disease frequently correlate with worsening of the skin lesions. As PG is not commonly encountered by clinicians, the diagnosis of such lesions is not always straightforward. This case emphasizes the importance of detailed history taking and the consideration of PG as a differential diagnosis of such lesions in patients with a background of related systemic disease. The prognosis of PG is generally good. But, early aggressive therapy can minimize severe complications, and maintenance treatment may prevent some devastating consequences. We report two cases of PG that developed on the entire body and on an anterior chest wall abscess with ulcerative colitis, which improved with corticosteroid and cyclosporine. (Korean J Gastrointest Endosc 2010;41:312-318)

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A Case of Benign Colonic Stricture Treated by Therapeutic Balloon Dilatation in Ulcerative Colitis: Jun Young Lee, M.D., Suck-Ho Lee, M.D., Sang Pil Kim, M.D., Jin Woo Park, M.D., Chang Kyun Lee, M.D., Ji-Young Park, M.D., Il-Kwun Chung, M.D. and Sun-Joo Kim, M.D.; Korean J Gastrointest Endosc 2008;37(5):380-383. Published online November 30, 2008

Abstract PDF: Ulcerative colitis produces repeated improvements and relapses of chronic colonic inflammation. Complications of the disease can include bleeding, toxic megacolon, colon cancer, or colon stricture. While colonic strictures are common in Crohn's disease, this complication rarely appears in ulcerative colitis cases. Unlike in Crohn's disease, where strictures are commonly treated by endoscopic balloon dilatation, surgical management is the basis for treatment of strictures in ulcerative colitis because malignant strictures are common and because the stricture region is generally wide. We report the case of a patient who presented with decreased stool caliber while undergoing treatment for ulcerative colitis. We performed therapeutic balloon dilatation in this patient with a benign stricture caused by ulcerative colitis and experienced improvement of symptoms. (Korean J Gastrointest Endosc 2008;37: 380-383)

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Endoscopic Removal of a Pork Bone from the Sigmoid Colon in a Patient with Ulcerative Colitis: Si Hyung Lee, M.D., Byung Ik Jang, M.D. and Tae Nyeun Kim, M.D.; Korean J Gastrointest Endosc 2008;37(1):51-54. Published online July 30, 2008

Abstract PDF: Inflammatory bowel disease is a risk factor for low gastrointestinal foreign body impaction, but such cases are very rare. Impaction of a foreign body in the lower gastrointestinal tract can result in perforation, bleeding, abscess formation and fistula. A risk factor for perforation is inflammatory bowel disease, a sharp foreign body and a long-standing foreign body in the gastrointestinal tract. Thus, a foreign body in the lower gastrointestinal tract should be promptly removed by surgery or endoscopy. Most of these cases can currently be managed by endoscopy because of the development of endoscopic devices and the accumulation of experience. Here we report on a case of successful removal of a pork bone from the sigmoid colon in a patient with ulcerative colitis. (Korean J Gastrointest Endosc 2008;37:51-54)

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A Case of Small Cell Carcinoma of the Rectum Associated with Ulcerative Colitis: Yoon Jung Kim, M.D., Eun Uk Jung, M.D., Myoung Joo Kang, M.D., Sang Won Park, M.D., Paul Choi, M.D., Ji Hyun Kim, M.D., Sung Jae Park, M.D., Sam Ryong Jee, M.D., Eun Taek Park, M.D., Youn Jae Lee, M.D., Sang Hyuk Lee, M.D. and Sang Young Seol, M.D.; Korean J Gastrointest Endosc 2008;36(1):52-55. Published online January 30, 2008

Abstract PDF: Small cell carcinoma associated with ulcerative colitis is a rare malignancy of the colon, so we report here on a case of small cell carcinoma (SCC) of the large bowel. A 60-yr-old woman had been diagnosed with ulcerative colitis about 10 years previously, and she was then continuously treated with 5-ASA. Colonoscopy was being done every two years for cancer surveillance. The last colonoscopy was done 16 months previously. At that time, colonoscopic finding was mild left side colitis. She was hospitalized because of severe abdominal pain and acute constipation that developed 2 weeks previously. During the colonoscopic examination, an obstructive mass was noted on the rectum. Pathology revealed small cell carcinoma. NSE (neuron specific enolase) and Synaptohpysin were strongly positive. Chromogranin and Cytokeratin were focally positive to a weak degree. So, the patients received a Hartmann's operation (T-colostomy). The mass had grossly invaded the adjacent peritoneum and serosa. Therefore, only the mass was removed. She then received chemotherapy with cisplatin and irinotecan for 2 cycles. She achieved a stable state 2 months after the operation. Only a few cases of colorectal SCC associated with ulcerative colitis have been reported, and its etiology remains unknown. Thus, we report here on a small cell carcinoma arising from ulcerative colitis. (Korean J Gastrointest Endosc 2008;36:52-56)

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A Case of Polyp with High Grade Dysplasia in Ulcerative Colitis: Han-Hyo Lee, M.D., Sung-Ae Jung, M.D., Seong-Eun Kim, M.D., Yoon-Joo Na, M.D., Hee-Sun Kim, M.D., Jun-Sik Nam, M.D., Moon-Sun Yeoum, M.D., Ki-Nam Shim, M.D., Kwon Yoo, M.D. and Il Hwan Moon, M.D.; Korean J Gastrointest Endosc 2004;29(1):46-49. Published online July 30, 2004

Abstract PDF: Patients with ulcerative colitis (UC) have the increased risk of colorectal cancer. The risk of colorectal cancer development in UC is associated with the extent of colitis and duration of disease. It is generally agreed that there is little or no increased risk associated with proctitis or proctosigmoiditis. A dysplasia-associated lesion or mass (DALM) is difficult to distinguish from sporadic adenoma. The DALM indicate a high association with colon cancer. The presence of DALM as a premalignant lesion has been considered as an indication for colectomy because of the high risk of progression to malignancy within a short period. We report a case of polyp with high grade dysplasia in a 27-year-old man of ulcerative colitis confined to rectum and sigmoid colon. (Korean J Gastrointest Endosc 2004;29: 46⁣49)

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A Case of Chronic Ulcerative Colitis Complicated by Budd-Chiari Syndrome and Colon Cancer: Rok Son Choung, M.D., Yoon Tae Jeen, M.D., Yong Sik Kim, M.D., Young Sun Kim, M.D., Hong Sik Lee, M.D., Hoon Jai Chun, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D., Ho Sang Ryu, M.D. and Jin Hai Hyun, M.D.; Korean J Gastrointest Endosc 2004;28(6):326-331. Published online June 30, 2004

Abstract PDF: Ulcerative colitis is a chronic inflammatory bowel disease and may have many intestinal and extraintestinal complications. Compared with general population, patients with longstanding ulcerative colitis have an increased risk of colorectal cancer. Patients with ulcerative colitis have an increased frequency of thromboembolism too. However, hepatic vein thrombosis is a very rare extraintestinal complication. This is the first reported case of a young patient with ulcerative colitis who developed synchronous colonic neoplasm and chronic Budd-Chiari syndrome manifested as esophageal variceal bleeding. We report a case of ulcerative colitis complicated by Budd-Chiari syndrome and colon cancer in a 28-year-old female. (Korean J Gastrointest Endosc 2004;28:326⁣331)

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43세 여자, 궤양성 대장염 진단 중 발견된 충수 점액류: Korean J Gastrointest Endosc 2003;26(5):371-371. Published online May 30, 2003

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Pyoderma Gangrenosum on the Sternal Area in Ulcerative Colitis: Chul Hee Park, M.D., Hoon Jai Chun, M.D., Yoon Tae Jeen, M.D., Rok Sun Jeong, M.D.,Kyung Oh Kim, M.D., Yong Sik Kim, M.D., Young Sun Kim, M.D., Hong Sik Lee, M.D.,Soon Ho Um, M.D., Sang Woo Lee, M.D., Jai Hyun Choi, M.D., Chang Duck Kim, M.D.,Ho Sang Ryu,; Korean J Gastrointest Endosc 2002;25(6):470-474. Published online December 30, 2002

Abstract PDF: Pyoderma gangrenosum is a painful, chronic, ulcerative skin disease of unknown cause. It commences as an erythematous papulopustule and rapidly evolves to form an area of frank ulceration with undermined, violaceous edges and a bright outer halo of erythema. An underlying systemic illness is present in more than 75 per cent of patients. Inflammatory bowel disease, either ulcerative colitis or Crohn's disease, is the most frequent. Pyoderma gangrenosum generally appears during the course of active bowel disease and frequently concur with exacerbations of colitis. However, they also occur in inactive colitis. Nor is there general agreement regarding the relationship between the duration, activity, and extent of bowel disease and the incidence and severity of the skin lesions. We experienced a case of pyoderma gangrenosum developed on the sternum with inactive ulcerative colitis and improved with corticosteroid, antimicrobial agents and topical dressing but recurred another site with active colitis. (Korean J Gastrointest Endosc 2002;25:470⁣474)

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구연 / 포스터 : Ulcerative Colitis with Skin Lesion: Korean J Gastrointest Endosc 2001;22(5):370-370. Published online November 30, 2000

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구연 / 포스터 : Sigmoid Endometriosis: Korean J Gastrointest Endosc 2001;22(5):368-368. Published online November 30, 2000

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구연 / 하부 : 28 세 여자 , 궤양성 대장염: Korean J Gastrointest Endosc 2001;22(5):313-314. Published online November 30, 2000

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궤양성 대장염에서 발생산 비호치킨 림프종 1 예 ( A Case of Malignant Lymphoma in Patient with Ulcerative Colitis ): Korean J Gastrointest Endosc 2001;23(3):188-191. Published online November 30, 2000

Abstract PDF: Ulcerative colitis has been recognized as a premalignant condition because a considerable proportion of patients with colitis eventually develop colorectal carcinoma at the site of the inflammatory disease. Malignant lymphoma occurring in cases of long-standing ulcerative colitis is rare. Cancer risk is positively correlated with duration and anatomic extent of colitis, but do not appear to be increased by early age at onset of disease. Patients with chronic ulcerative colitis should have periodic rectal and colonoscopic biopsies, and those with moderate to marked dysplasia require colectomy because of the increased risk of colon carcinoma. We report a case of malignant lymphoma in patient with ulcerative colitis. (Korean J Gastrointest Endosc 2001;23:188-191)

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궤양성 대장염에서 확대색소내시경술 (Magnifying Chromoscopy)의 유용성 ( Usefulness of Magnifying Chromoscopy in Ulcerative Colitis ): Korean J Gastrointest Endosc 2001;22(1):21-26. Published online November 30, 2000

Abstract PDF: Background
/Aims: Ulcerative colitis is an inflammatory bowel disease with unknown etiology, which has waxed and waned course. It is diagnosed by colon study, pathology, and especially colonoscopy. It is difficult to differentiate between ulcerative colitis and other infectious colitis, especially amebic colitis, and to confirm of remnant lesion by endoscopic findings. Methods: Magnifying colonoscopy has 100 time magnifying power compared to 30 time of conventional colonoscopy, By spraying 0,2% indigo carmine dye, we evaluated the magnifying and microscopic findings of 31 colonic mucosa of 23 patients with ulcerative colitis. Results: Initial and magnifying chromoscopic findings in ulcerative colitis were loss of cryptal opening 72% (13/18), loss of submucosal vessel 89% (16/18), mucosal denudation (or microscopic erosion) 83% (15/1S), and mucosal unevenness 94% (17/18). Recovery rate of magnifying chromoscopic findings after treatment in ulcerative colitis were in crytal opening S0% (+8/10), submucosal vascularity 60% (6/10), mucosal denudation (microscopic erosion) 30% (3/10), and in mucosal unevenness 40% (4/10). Conclusions: It is suggested that magnifying chromoscopic findings in ulcerative colitis may be useful in initial diagnosis and confirmation of remnant lesion, but, not in prediction of clinical severity. (Korean J Gastrointest Endosc 2001;22:21 - 26)

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궤양성 대장염 환자에서 Mesalazine 투여 후 발생한 미세 변화 신증후군: Korean J Gastrointest Endosc 2000;20(5):408-408. Published online November 30, 1999

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궤양성 대장염에 동반된 강직성 척추염: Korean J Gastrointest Endosc 2000;20(5):404-404. Published online November 30, 1999

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궤양성 대장염에 병발한 비전형적 유암종 1예 ( A Case of an Atypical Carcinoid Tumor Arising in Ulcerative Colitis ): Korean J Gastrointest Endosc 2000;20(3):213-217. Published online November 30, 1999

Abstract PDF: Ulcerative colitis is a chronic inflammatory bowel disease manifested by diffuse continuous mucosal and submucosal inflammation. Adenocarcinoma of the colon may be complicated in the long-standing, extensive ulcerative colitis. But the case of an atypical carcinoid tumor arising in the chronic ulcerative colitis has been very rarely reported. A case was experienced involving a 54-year-old woman with chronic ulcerative pancolitis that was complicated by an atypical carcinoid tumor of the sigmoid colon. A small, flat, elevated lesion was found at the sigmoid colon, 8 years after the initial diagnosis of ulcerative colitis had been made. The microscopic finding of the lesion showed the nest of moderately differentiated, medium sized cells with large nuclei. The immunohistochemical stains for cytokeratin, NSE, chromogranin A, and synaptophysin were positive.The patient was treated with a total colectomy accompanied with an ileostomy, and is now in a very favor able state of recovery.

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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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궤양성 대장염에 동반된 괴저성 농피증 1 예 (Pyoderma Gangrenosum in Ulcerative Colitis): Korean J Gastrointest Endosc 1999;19(2):300-305. Published online November 30, 1998

Abstract PDF: Ulcerative colitis is an inflammatory disorder that affects the rectum and extends proximally to affect a variable extent of the colon. The major symptoms of ulcerative colitis include diarrhea, rectal bleeding, the passage of mucus, and abdominal pain. Ulcer-ative colitis also may be complicated by many local and systemic disorders as extrain-testinal manifestations. Pyoderma gangrenosum is the most severe dermatologic com-plication associated with ulcerative colitis. It is a painful , chronic, ulcerating skin disease of unknown cause. Diagnosis is clinical, there being no accepted histological diagnostic criteria. Conventional therapy is empirical, usually with high dose corticosteroids, but var-ious other agents have been tried with occasional success including topical antibiotics, cyclosporine, disodium cromoglycate, and dapsone. This patient was treated with high dose corticosteroid (prednisolone 1 mg/kg/day) and discharged with clinical improvement. So we report this case with a literature review. (Korean J Gastrointest Endosc 19: 300 ∼305, 1999)

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증례 : 식도 위장관 ; 비활동성 궤양성 대장염과 관련된 괴저성 농피증 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Pyoderma Gangrenosum Associated with Inactive Ulcerative Colitis ): Korean J Gastrointest Endosc 1998;18(4):597-603. Published online November 30, 1997

Abstract PDF: Ulcerative colitis is assoicated with various extraintestinal manifestations. Skin lesions are occurring in 9-19% of patients with ulcerative colitis. Among these lesions erythema nodosum is the most common and pyoderma gangrenosum is the most severe. While pyoderma gangrenosum occurs more frequently in patients with ulcerative colitis, erythema nodosum occurs more frequently in patients with Crohn's disease. The overall incidence of pyoderma gangrenosum is approximately 1-5% of patients with inflammatory bowel disease (IBD). Painful lesions usually appear on the pretibial area, and develop in patients with long-standing IBD, but occasionally precede the diagnosis of IBD and may occur after colectomy. Lesions are discrete ulcers with a necrotic base and begin as small painful pustules, which coalesce into a fluctuant sterile abscess within days. Usually pyoderma gangrenosum is present for weeks to months, occasionally persisting for more than 1 year. The recurrence rate is reported in about 33% of all cases. Lesions usually appear in patients with pancolitis and respond to treatment of systemic corticosteroids, antimicrobial agents, and occasionally are treated with cyclosporine or surgery. We experienced a case of pyoderma gangrenosum developed on the left pretibial area in a patient with inactive ulcerative colitis, and completely healed with oral prednisolone, antimicrobial agents and external dressing. Subsequently, we report this case with a review of corresponding literature. (Korean J Gastrointest Endnsc 18: 597-601, 1998)

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증례 : 식도위장관 ; 염증성 장질환에 병발한 괴저성 농피증 2예 ( Case Reports : Esophagus , Stomach & Intestine ; Two Cases of Pyoderma Gangrenosum Associated with Inflammatory Bowel Diseases ): Korean J Gastrointest Endosc 1997;17(6):847-853. Published online November 30, 1996

Abstract PDF: Pyoderma gangrenosum is a painful, chronic, ulcerating skin disease of unknown cause. It commences as an erythematous papulopustule and rapidly evolves to form an area of frank ulceration with undermined, violaceous edges and a bright outer halo of erythema. Diagnosis is clinical, there being no accepted histological diagnostic criteria. An underlying systemic illness is present in more than 50 percent of patients. Pyoderma gangrenosum develops in 0.8-5.0 percent of patients with inflammatory bowel disease, which is the most frequent underlying disease of pyoderma gangrenosum. There is no report of pyoderma gangrenosum associated with Crohn's disease in Korea. We recently experienced two cases of pyoderma gangrenosum, a 52-year old man with Crohn's disease and a 30-year old man with ulcerative colitis. The cases are presented with the review of literature. (Korean J Gastrointest Endosc 17: 847-852, 1997)

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증례 : 위장관 ; 간세포암과 병발한 임상적으로 진단된 궤양성 대장염 1예 ( Case Reports : Stomach & Intestine ; A Case of Clinical Ulcerative Colitis with Concurrent Hepatocellular Carcinoma ): Korean J Gastrointest Endosc 1997;17(5):696-701. Published online November 30, 1996

Abstract PDF: Ulcerative colitis is a diffuse inflammatory disease which is characterized by the vascular congestion and superficial ulcerations in the mucosal and the submucosal layers of the rectum and colon. Extraintestinal manifestations such as arthritis, skin lesion, hepatobiliary and ocular diseases occur in a large number of patients with ulcerative colitis, though gastrointestinal symptoms of mucous and bloody stool, diarrhea and abdominal pain are frequently presented. The association of ulcerative colitis and hepatobiliary disease has been frequently reported in the western countries since the first description by Thomas C.H. in 1874. Fatty degeneration, chronic active hepatitis, cirrhosis, primary sclerosing cholangitis and hepatobiliary carcinoma are included in this list of complications. In the case of hepatobiliary carcinoma, however, the histological diagnosis has almost invariably been cholangiocarcinoma. We report a case of clinical ulcerative colitis with coneurrent hepatocellular carcinoma confirmed by the histologic examination of biopsy specimen in a 49 year old man with the relevant literatures. (Korean J Gastrointest Endosc 17: 696-701, 1997)

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증례 : 식도 위장관 ; 궤양성 대장염 치료 중 합병된 거대세포바이러스 대장염 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Cytomegalvirus Colitis Developed during the Treatment of Ulcerative Colitis ): Korean J Gastrointest Endosc 1997;17(4):557-560. Published online November 30, 1996

Abstract PDF: Cytomegalovirus colitis has been reported infrequently in patients with underlying inflammatory bowel disease, and usually in those who are taking corticosteroid drugs. It has been implicated as a possible exacerbating factor of ulcerative colitis. We experienced a case of cytomegalovirus colitis developed in patient with ulcerative colitis during corticosteroid therapy. So we report the case with a brief review of literatures. (Korean J Gastrointest Endosc 17: 557-560, 1997)

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증례 : 식도 위장관 ; 원발성경화성담관염 (原發性硬化性膽管炎) 을 동반한 궤양성대장염 (潰梁性大腸炎) 환자 1예 ( Case Reports : Esophagus , Stomach & Intestine ; A Case of Primary Sclerosing Cholangitis with Ulcerative Colitis ): Korean J Gastrointest Endosc 1996;16(6):1001-1007. Published online November 30, 1995

Abstract PDF: Sclerosing cholangitis is cholestatic disease, characterized by progressive fibrotic inflammation and obliteration af intrahepatic bile ducts and extrahepatic bile ducts and sometimes associated with ulcerative colitis. The pathogenesis of this disease is not understood well. In this disease, however, have been proposed infectious agent, endotoxin of bacteria and immunological event. In Europe and U.S.A., the incidence of sclerosing cholangitis associated with ulcerative colitis was between 2,4 and 4.0 percent. The association is strongest in patients with pancolitis, with a prevalenee of 5.5 percent, compared with patients with disease confined to the distal colon, with a prevalence of 0.5 percent. But, in Korea, it has not been reported sclerosing cholangitis associated with ulcerative colitis. A 30-year old man was diagnosed as an ulcerative colitis 9 years ago and has been followed up, intermittently. Recently, he has experienced hematochezia and dizziness. Colonoscopy showed active ulcerative colitis(pancolitis), blood chemistry elevated alkaline phosphatase and y-GTP. ERCP and liver biopsy specimen revealed sclerosing cholangitis. we concluded that this case was a sclerosing cholangitis as a complication of ulcerative colitis and the first case report of primary sclerosing cholangitis with ulcerative colitis in Korea, Hence, we reported a case of primary sclerosing cholangitis with ulcerative colitis with a review of literatures. (Korean J Gastrointest Endosc 16: 1001-1o07, 1996)

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증례 : 궤양성 대장염의 경과중 발생된 비허혈성 망막중심정맥폐쇄증 1예 ( Case Reports : A Case of Nonischemic Central Retinal Vein Occlusion Developed in the course of Ulcerative Colits ): Korean J Gastrointest Endosc 1994;14(2):202-206. Published online November 30, 1993

Abstract PDF: Ulcerative colitis is a chronic, inflammatory disease of colon which is rare in Korea. In the course of ulcerative colitis numerous extraintestinal complication may develop on the joints, skin, liver, kidney, vessel, oral cavity and eyes. The most common ocular lesions complicated in patients with ulcerative colitis are episcleritis and iritis. And the cases of retinal vascular disease in associated with ulcerative colitis are extremely rare. We experienced nonischemic central retinal vein occlusion complicated in a patient with ulcerative colitis, who is 32-year-old male and complained decreased visual acuity and metamorphosis.

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