A solid pseudopapillary tumor is a rare pancreatic tumor with a low malignant potential that occurs commonly in young females. We report a case of 12-year-old girl with a solid pseudopapillary tumor of the pancreas associated with symptoms of anemia. She was suspected to have a 7x4.5 cm mass growing from the head of the pancreas based on an esophagogastroduodenoscopy, a radiological imaging study, and an immunohistochemical stain examination. She was finally diagnosed with a solid pseudopapillary tumor after a pancreaticoduodenectomy as the definitive treatment.
Anemia ; Child ; Endoscopy, Digestive System ; Female ; Head ; Hemorrhage ; Humans ; Pancreas ; Pancreaticoduodenectomy

Infestation with Ascaris lumbricoides is one of the most common helminthic diseases in humans. The highly motile mature worm can cause intestinal obstructions, pancreaticobiliary diseases, appendicitis, and peritonitis. However, biliary ascariasis associated with duodenal stenosis is extremely rare. We report a case of biliary ascariasis with duodenal stenosis in a 70-year-old man. The patient was admitted to our hospital with a 2 month history of epigastric pain and vomiting. An esophagogastroduodenoscopy showed stenosis of the second portion of the duodenum and an impacted living round worm in the ampulla of Vater. The round worm was extracted with a snare without any complications, and the patient received albendazole treatment. A pathological examination of the stenotic portion of the biopsy specimen revealed chronic inflammation with eosinophilic infiltration throughout the mucosa. The patient remained asymptomatic at a follow-up examination. Duodenal stenosis should be considered in the complications of ascariasis, particularly in areas where this parasitic infestation is endemic.
Aged ; Albendazole ; Ampulla of Vater ; Appendicitis ; Ascariasis ; Ascaris lumbricoides ; Biopsy ; Constriction, Pathologic ; Duodenal Obstruction ; Duodenum ; Endoscopy, Digestive System ; Eosinophils ; Follow-Up Studies ; Helminths ; Humans ; Inflammation ; Intestinal Obstruction ; Mucous Membrane ; Peritonitis ; SNARE Proteins ; Vomiting

Duodenal perforations caused by biliary prostheses are uncommon, but they are potentially life threatening and require immediate treatment. Here we describe an unusual case of duodenal perforation induced by a plastic biliary stent. It masqueraded as a case of cholecystitis and combined systemic upset with a localized peritonitis and fever. Primary endoscopic closure by hemoclips was difficult due to the position of the lateral wall and the complexity of aligning the perforation with the endoscope. To approximate the perforated hole and adherent hemoclips, glue injection and sprayings were successfully performed under cap-fitted endoscopy. The patient recovered without additional complications.
Adhesives ; Cholecystitis ; Endoscopes ; Endoscopy ; Fever ; Fibrin ; Fibrin Tissue Adhesive ; Humans ; Intestinal Perforation ; Peritonitis ; Plastics ; Prostheses and Implants ; Stents

Adenosquamous carcinoma of the pancreas is a rare tumor, which is difficult to diagnose. A 65-year-old man was admitted complaining of abdominal pain. Abdominal computed tomography (CT) demonstrated a cystic mass in the pancreatic body. Endoscopic ultrasound (EUS) showed an approximate 1.0 cm-sized hypoechoic cystic mass with a solid portion in the pancreatic body and narrowing of the main pancreatic duct. Under the impression of acute pancreatitis with a pseudocyst diagnosis, medical therapy including pancreatic stent insertion was administered to the patient for 4 weeks. A distal pancreatectomy was performed with the suspicion of pancreatic cancer due to the remaining mass on a follow-up CT scan, and the tumor was histopathologically diagnosed as stage I (TNM classification) adenosquamous carcinoma of the pancreatic body. The patient was discharged without any problems and has been on follow-up without recurrence. We report a case of adenosquamous carcinoma of the pancreas that was diagnosed relatively early with the help of EUS.
Abdominal Pain ; Aged ; Carcinoma, Adenosquamous ; Follow-Up Studies ; Humans ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Pancreatic Neoplasms ; Pancreatitis ; Recurrence ; Stents

Hemobilia is a rare upper gastrointestinal (GI) bleeding phenomenon usually caused by trauma but may occur due to various liver and pancreatobiliary diseases. Causes related to gallbladder disease include vascular disorders, malignancy, polyps, heterotopic GI mucosa, acalculous inflammation, and most commonly gallstones. Most cases are treated with a cholecystectomy. If hemobilia is detected, efforts must be made to exclude malignancy because hemobilia develops from both benign and malignant disease. Particularly in gallbladder disease with hemobilia, the possibility of gallbladder carcinoma should be considered. We report two cases of hemoblia by endoscopic retrograde cholangiopancreatography and duodenoscopy, with a review of the literature. The first case was xanthoglanulomatous cholesystitis and the second case was gallbladder cancer disclosed by cholecystectomy.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystectomy ; Cholecystitis ; Duodenoscopy ; Gallbladder ; Gallbladder Diseases ; Gallbladder Neoplasms ; Gallstones ; Granuloma ; Hemobilia ; Hemorrhage ; Inflammation ; Liver ; Mucous Membrane ; Polyps ; Xanthomatosis

Neuroendocrine carcinomas mostly occur in the gastrointestinal tract, lung and pancreas. The gallbladder is an uncommon organ for a neuroendocrine carcinoma and it is difficult to diagnose before gallbladder surgery. Owing to its rare occurrence its natural course and treatment are not definitely established. A 71-year-old woman was hospitalized with intermittent abdominal pain and nausea. Abdominal computed tomography showed multiple masses of the gallbladder obstructing the biliary tract. From endoscopic ultrasonography we suspected carcinoma of the gallbladder that was infiltrating a common bile duct. A biopsy was taken using endoscopic retrograde cholangiopancreatography (ERCP) and the mass was diagnosed as a neuroendocrine carcinoma of the gallbladder. Here we report a case of a neuroendocrine carcinoma of the gallbladder confirmed by endoscopic biopsy, and provide a review of the literature.
Abdominal Pain ; Aged ; Biliary Tract ; Biopsy ; Carcinoma, Neuroendocrine ; Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct ; Endoscopy ; Endosonography ; Female ; Gallbladder ; Gastrointestinal Tract ; Humans ; Lung ; Nausea ; Pancreas

Biliary casts are uncommon but are typically seen in post-liver transplant patients, whereas very few cases have been reported in non-liver transplant patients. A 65-year-old man, who had not undergone a liver transplantation or other hepatobiliary surgery, presented with jaundice and fever. Radiological imaging studies showed diffuse thickening and enhancement of the intrahepatic duct with mild ductal dilatation and multiple linear filling defects. A percutaneous transhepatic cholangioscopy revealed severe bile duct inflammation and multiple biliary casts, which were removed with multiple percutaneous choledocoscopic procedures. The pathogenesis of the biliary casts in this patient was uncertain. However, we presumed that biliary tract infection with subsequent extensive cholangitis was an important predisposing factor in the cast formation. We report a case of biliary cast syndrome with no preexisting morbidity that was managed favorably with endoscopic removal.
Aged ; Bile Ducts ; Biliary Tract ; Cholangitis ; Dilatation ; Fever ; Humans ; Inflammation ; Jaundice ; Liver Transplantation ; Superior Mesenteric Artery Syndrome ; Transplants

Primary adenosquamous carcinoma arising from the papilla of Vater is an extremely rare tumor. Here we report a case of adenosquamous carcinoma of the duodenal major papilla. The patient was a 56-year-old man presenting with abdominal discomfort and anorexia. A computed tomography (CT) scan showed dilatation of the common bile duct (CBD) and both intrahepatic ducts with a suspicious mass in the distal CBD. Duodenoscopy revealed a mass with an irregular surface at the papilla. The patient underwent Whipple's operation. He was diagnosed as having adenosquamous carcinoma of the papilla of Vater. Eighteen months after pancreaticoduodenectomy, metastatic lymph nodes were noted in a follow-up CT scan.
Ampulla of Vater ; Anorexia ; Carcinoma, Adenosquamous ; Common Bile Duct ; Dilatation ; Duodenoscopy ; Follow-Up Studies ; Humans ; Lymph Nodes ; Middle Aged ; Pancreaticoduodenectomy

Clostridium difficile is the most common nosocomial pathogen of the gastrointestinal tract. Pseudomembranous colitis occurs as a result of a severe inflammatory response to Clostridium difficile toxins. Pseudomembranous colitis is an increasingly frequent cause of morbidity and mortality among elderly hospitalized patients. Diarrhea is the most common manifestation. According to the literature, stools are almost never grossly bloody, and range from soft and unformed to watery or mucoid in consistency. We now report the cases of three patients with pseudomembranous colitis whose main clinical manifestation was hematochezia.
Aged ; Clostridium difficile ; Diarrhea ; Enterocolitis, Pseudomembranous ; Gastrointestinal Hemorrhage ; Gastrointestinal Tract ; Humans

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 28x7 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.
Abdominal Pain ; Adult ; Anesthesia, Spinal ; Colon, Sigmoid ; Colostomy ; Daucus carota ; Emergencies ; Endoscopy, Gastrointestinal ; Foreign Bodies ; Humans ; Intestinal Perforation ; Male ; Pneumoperitoneum ; Rectum ; Republic of Korea ; Sigmoidoscopy