The most common cause of acute pancreatitis is gallstones. However, idiopathic causes comprise about 10 to 15% of all cases of acute pancreatitis. Biliary sludge is thought to be a cause of idiopathic acute pancreatitis and mainly via obstruction of the common bile duct. Cholesterol polyps of the gallbladder, cholesterolosis and hemobilia can be associated with biliary pain. Fragments of the gallbladder polyps and blood clots can lead to acute pancreatitis in a way similar to that of biliary sludge. Yet it has never been reported that the necrotic tissue of gallbladder cancer can lead to acute pancreatitis. Herein, we report on the case of a 52-year-old man with acute pancreatitis that was caused by the necrotic tissue of gallbladder cancer. The necrotic tissue in the bile duct was revealed on endoscopic retrograde cholangiopancreatography (ERCP). The patient was successfully treated by laparoscopic cholecystectomy along with liver segmentectomy.
Bile ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy, Laparoscopic ; Cholesterol ; Common Bile Duct ; Gallbladder ; Gallbladder Neoplasms ; Gallstones ; Hemobilia ; Humans ; Liver ; Mastectomy, Segmental ; Middle Aged ; Pancreatitis ; Polyps

Most tumors affecting Vater's ampulla are adenocarcinomas, but a neuroendocrine carcinoma in the ampulla of Vater is extremely rare. The coexistence of these two tumors has been reported in only a few cases. Here, we report a rare case of a collision tumor of the ampulla of Vater with an adenocarcinoma and a large cell neuroendocrine carcinoma.
Adenocarcinoma ; Ampulla of Vater ; Carcinoma, Neuroendocrine

Pneumatosis cystoides intestinalis (PCI) is an uncommon condition in which submucosal or subserosal gas cysts are present within the bowel wall. We report a case of a 37-year-old man with no medical history. He underwent a colonoscopy for screening purposes, which revealed multiple and variably sized submucosal tumors in the ascending colon. Endoscopic ultrasonographic (EUS) finding showed multiple hyperechogenic regions with distal acoustic shadowing within the submucosa of the ascending colon. A computed tomography scan showed multiple air-filled cystic masses in the ascending colon. EUS appears to be effective for the diagnosis of PCI.
Acoustics ; Adult ; Colon, Ascending ; Colonoscopy ; Endosonography ; Humans ; Mass Screening ; Pneumatosis Cystoides Intestinalis ; Shadowing (Histology)

BACKGROUND/AIMS: Photodynamic therapy (PDT) has a promising effect on nonresectable cholangiocarcinoma (CC) but its long term data is not yet available. This study examined the long term outcome and factors associated with increased survival after performing PDT for hilar cholangiocarcinoma. METHODS: A list of 393 patients with a diagnosis of hilar CC was retrieved from the database of Soonchunhyang University Hospital (Seoul, Korea) and these patients were seen from January 1, 2001, to April 1, 2010. We retrospectively reviewed the records of 74 patients who underwent PDT in addition to biliary stenting with/without chemoradiation. RESULTS: The median overall survival from the date of diagnosis to death or to the last follow-up was 11.7 months (range: 2.2~78.4). After performing PDT, a complete remission was observed in 1.3% (1/74) of the patients who had a superficial depth of tumor without lymph node involvement. On multivariate analysis using the Cox regression model, increasing the time to treatment after the diagnosis was a statistically significant predictor of shorter survival after PDT [Odds ratio: 3.25, 95% confidence interval (CI): 1.90~4.71, p=0.034]. CONCLUSIONS: Although PDT does not prevent progression of CC, it appears to control the cholestasis. The early treatment of PDT after the diagnosis showed a survival benefit for patients with advanced hilar CC.
Cholangiocarcinoma ; Cholestasis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Multivariate Analysis ; Photochemotherapy ; Retrospective Studies ; Stents ; Time-to-Treatment ; Triazenes

The Korean Society of Gastrointestinal Endoscopy was established in 1976 for academic exchanges between endoscopic specialists. It joined the Korean Academy of Medical Science in 1988 and founded The Gastrointestinal Endoscopy Research Foundation of Korea in 2009 for academics, education, and research on gastrointestinal endoscopy. The Korean Academy of Medical Science rated this academic society 250 out of 275 points, which is equivalent to 91 points when converted to a 100 point scale. Globalization is the recommendation of the Korean Academy of Medical Science. To pursue globalization, this academic society will publish and register English journals on Index Medicus and encourage the use of English during symposiums. Such efforts will allow this academic society to better cooperate and exchange knowledge with academic societies of other countries. Moreover, this academic society must contribute socially by enlightening the public about endoscopy.
Endoscopy ; Endoscopy, Gastrointestinal ; Internationality ; Korea ; MEDLINE ; Specialization

Eosinophilic gastroenteritis is an uncommon disease characterized by eosinophilic infiltration in the bowel wall and presents various symptoms depending on the affected site and bowel layer. Pseudomembranous colitis is an antibiotic-associated infection caused by abnormal overgrowth of the toxin-producing Clostridium difficile in the large bowel. A 16-year-old boy was admitted with abdominal pain for 6 days. On admission, we performed an endoscopy and diagnosed gastroduodenitis. Then, we prescribed gastritis medication but he still presented with diffuse abdominal pain and fever above 38.0degrees C after admission. We considered infectious enterocolitis, so we prescribed an antibiotic. The next day, he presented with bloody diarrhea. A diagnosis of pseudomembranous colitis was confirmed by a colonoscopic examination with a biopsy. We also obtained a diagnosis of eosinophilic gastroenteritis through a histological diagnosis. This is the first case of the simultaneous occurrence of eosinophilic gastroenteritis and pseudomembranous colitis in the Korean medical literature. We report this case with a brief review of the literature.
Abdominal Pain ; Adolescent ; Biopsy ; Clostridium ; Clostridium difficile ; Diarrhea ; Endoscopy ; Enteritis ; Enterocolitis ; Enterocolitis, Pseudomembranous ; Eosinophilia ; Eosinophils ; Fever ; Gastritis ; Gastroenteritis ; Humans

Acute lymphoblastic leukemia is a cancer of blood cells. It is known as lymphoblastic lymphoma when it involves lymph nodes rather than the blood and bone marrow. The gastrointestinal tract is a predominant site for extra-nodal lymphomas. But, B-lymphoblastic leukemia/lymphoma more frequently presents in the leukemic form than in the lymphomatous form. We herein report a case of B-lymphoblastic leukemia/lymphoma detected as a laterally spreading tumor in the colon. A 54-year-old man was referred to our hospital for removal of multiple colonic polyps. A colonoscopy revealed multiple colonic polyps and several colonic laterally spreading tumors. An esophagogastroduodenoscopy revealed several raised erosive lesions on the fundus and several variable sized sessile polypoid lesions on the duodenum. We diagnosed B-lymphoblastic leukemia/lymphoma following biopsies of the lesions.
Biopsy ; Blood Cells ; Bone Marrow ; Colon ; Colonic Polyps ; Colonoscopy ; Duodenum ; Endoscopy, Digestive System ; Gastrointestinal Tract ; Humans ; Lymph Nodes ; Lymphoma ; Middle Aged ; Precursor Cell Lymphoblastic Leukemia-Lymphoma

Typhoid fever, the most serious human salmonellosis, is a systemic infectious disease caused by Salmonella enterica serovar Typhi and is characterized by prolonged fever, bacteremia, and multiplication of the organism within mononuclear phagocytic cells of the liver, spleen, lymph nodes, and Peyer's patches. The characteristic lesion of typhoid fever is an ulceration of the small intestinal lymphoid tissue, particularly the Peyer's patches. The usual histological findings of typhoid ulcer are necrosis and histiocytic proliferation that phagocytizes erythrocytes and degenerated lymphocytes. A granuloma is an unusual histopathological presentation of a typhoid lesion. Even if granulomas have been reported in the bone marrow, liver, and spleen in cases of typhoid fever, granulomas in primary ulcers of the ileum and transverse colon have been reported very rarely. We experienced a case of typhoid fever in which ill-defined granulomas were seen in ulcers of the terminal ileum and transverse colon.
Bacteremia ; Bone Marrow ; Colon, Transverse ; Communicable Diseases ; Erythrocytes ; Fever ; Granuloma ; Humans ; Ileum ; Liver ; Lymph Nodes ; Lymphocytes ; Lymphoid Tissue ; Necrosis ; Peyer's Patches ; Phagocytes ; Salmonella Infections ; Salmonella typhi ; Spleen ; Typhoid Fever ; Ulcer

Even though percutaneous transhepatic gallbladder drainage (PTGBD) is performed prior to ERCP or following ERCP because of the patients' medical condition or failed bile duct cannulation, there are no definite endoscopic landmarks that are useful for successful bile duct cannulation in some cases. We report here on 4 patients in whom selective bile duct cannulation, as guided by the endoscopic landmarks, was successful following indigocarmine injection via PTGBD.
Bile ; Bile Ducts ; Catheterization ; Cholangiopancreatography, Endoscopic Retrograde ; Drainage ; Gallbladder ; Humans

Endoscopic retrograde cholangiopancreatography has become a standard procedure for the diagnosis and treatment of pancreatobiliary disease. Like any invasive procedure, it carries a small, but significant rate of serious complications such as duodenal perforation. Primary surgical closure is the treatment of choice for the cases of duodenal perforation. However, there have been some case reports in which endoscopic metal clip closure of an iatrogenic duodenal perforation was successful. We experienced three cases of successful treatment of the iatrogenic duodenal perforation using endoscopic clipping and fibrin glue injections during a duodenoscope insertion.
Cholangiopancreatography, Endoscopic Retrograde ; Duodenoscopes ; Fibrin Tissue Adhesive