E.S.T. is performed not only for the treatment but also for the diagnosis of biliary tract diseases. E.S.T. serves as a diagnostic aid for some of biliary tract diseases which require such procedures as a peroral cholangioscopy or biopsy of the biliary duct for precise diagnosis and further differential diagnosis. The diseases of our patients were diagnosed by clinical findings and such diagnostic maneuvers as abdominal ultrasonography, intravenous cholangiography, percutaneous transhepatic chorangiography(P.T.C.), endoscopic retrograde chorangiopancreatography(E.R.C.P.), In all the two cases, abdominal ultrasonography revealed dilated extrahepatic duct, but biliary trees were not visualized at E.R.C.P. In one of the two cases, P.T.C. revealed a filling defect with dilated common bile ducts(CBD) but we could not make a differential diagnosis of CBD stone from CBD cancer. In another of the two cases, on which intravenous cholangiography was done, we could not see CBD. For the purpuse of precise diagnosis and further differential diagnosis, we performed EST and then ERCP thraugh widened papillae. With those procedures, CBD stones were shown.
Bile ; Biliary Tract Diseases ; Biopsy ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis ; Diagnosis, Differential ; Humans ; Ultrasonography

Heterotopic panereas is pancreactie tissue occuring outside its normal anatomical location and without any connection and normal pancreas and it is a developmental anormaly. The most commen site is stomach(esp. greater curvature of the antrum), duodenum and jejunum, In majority of cases heterotopic pancreas does not produce symptoms. When it produces complications, the symptoms depend on the site of lesion and the size of mass. Pathologically, the heterotopic pancreatic tissue is subject to all the lesions found in the normally placed pancreas. Tbe smooth broad base intramural defect with central niche ie typical radiologic fiadings of heterotoPic pancreas. Gastrofiberscopy revealed a small round, submucosal projection with a central umblication. The lesions are frequently confused with polys, lymphoma, in.tramural neoplasm and gastric uleer. Accurate diagnosis may prevent needless surgical procedures. Three cases of heterotopic pancreas of stomach were reported and the pertinent literature were reviewed briefly.
Diagnosis ; Duodenum ; Jejunum ; Lymphoma ; Pancreas* ; Stomach*

A patient with amebic colitis in which the rare complication of ameboma developed accompanying liver abscess is presented. The diagnosis was made by colonic mucosal biopsy and microscopic stool examination which revealed hematophagous trophzoites of Entamoeba histolytica. All rnanifestations of this patient's illness, including liver abscess, completley reverted to normal after appropriate therapy.
Amebiasis* ; Biopsy ; Colon ; Diagnosis ; Dysentery, Amebic* ; Entamoeba histolytica ; Humans ; Liver Abscess* ; Liver*

Acute appendicitis is the most common operative disease in general surgery, but it is not also rate disease to see in other clinical department such as Internal Medicine and Obstetric and Gynecology, because it reqnires to differenciate from many other diseases which have similar symptoms. Expecially, because the clipical aymptoms of acute appendicitis are not typieal in children, elderly, and women, it is hard to be diagnosed as acute appendicitis and it is often misdiagnosed as other disease. We performed colonoscopy due to be interpretated aa one of the colon diseases rather than acute appendicitis. But in colonoscopic findings, there were hyperemie and edematous change on the appendiceal orifice of cecum(cherry or acorn shape). So we report 5 cases of acute appendicitis diagnosed br colonoscopy.
Aged ; Appendicitis* ; Child ; Colon ; Colonoscopy* ; Female ; Gynecology ; Humans ; Internal Medicine

Familial polyposis is inherited as an autosomal dominant trait. It is characterized by the progressive development of hundreds to thousands of adenomsteus polyps in the large intestine. A patient who inherited the gene for familial polyposis is asually asymptomatic until after puberty, at which time polyps begin to appear. The disease at first non-malignant but after an interval of a few months or years, the development of colon cancer is inevitable. In Korea, several cases were reported, but almost all of the cases had incomplete familial histories. We experienced one case of familial polypasis in 33-year old Korean male who had no malignant changes in the adenomatous polyps. Among his family, his father and his brother have adenomatous polps in the colon and the rectum confirmed through total colonoscopy with biopsy. We report a case of familial polyposis of colon with a brief review of literatures.
Adenomatous Polyposis Coli* ; Adenomatous Polyps ; Adolescent ; Adult ; Biopsy ; Colon* ; Colonic Neoplasms ; Colonoscopy ; Fathers ; Humans ; Intestine, Large ; Korea ; Male ; Polyps ; Puberty ; Rectum ; Siblings

56-year-old Korean male had complained of abdominal pain and bloody diarrhea who showed a wide area of isehemic colitis above obstructing colon cance due to distention. Ischemic lesions of the distended colon are clinically important because it so often remain unrecognized and can result in anastomotic leakage, fecal fistula and peritonitis after operation. Involvement of the colon by ischemic damage is usually segmental or localized. We experienced unusual case of iachemic colitis proximal to obstructive colon cancer in which the entire colon except ileocecal region was affected. We reported a case with literature review.
Abdominal Pain ; Anastomotic Leak ; Colitis ; Colitis, Ischemic* ; Colon ; Colonic Neoplasms* ; Diarrhea ; Fistula ; Humans ; Male ; Middle Aged ; Peritonitis

Crohn's disease is an acute or chronic inflammatory disorder, characteristically non- specific granuloxaatous neerotiziag, cicatrical low grade inflammation, occuring in various portions of the entire oro-gastraintestinal tract. The etiology is not clearly defined and rather uncertain. The disease is a heterogenous & dubious entity with multiple systemic manifestations. The incidence of the disease is geographically unequal in world wide distrihution. And male and female are equally involve. In June, 1985, a case of 17-year-old female patient, who was diagnosed by clinico-micro- scopic examination at Han Yang Univ. hospital. And then, we report with a review of world literatare.
Adolescent ; Crohn Disease* ; Female ; Humans ; Incidence ; Inflammation ; Male

So-called Brunners gland adenoma is characterized by a nodular proliferation of histologically normal Brunners gland, accompanied hy duots and scattered stromal elements. This benign tumor of the duodenum is rare and is not eaey to discover because of non-specific symptoms. The clinical presentation can vary from vague upper abdominal symptoms with dyspepsia and nausea to diarrhea, jaundice, obetruction and gastrointestinal bleeding. The diagnosis is usually made by radiologic studies and gastroduodenal endoscopy which can also provide definitive treatment. The management of Brunners gland adenoma is complete removal of the lesion and pathologic examination, always necessary to define the nature of the lesion and exclude malignacy. We experienced two cases of Brunner's gland adenoma in the duodenal bulb. The patients complained of epigastric discomfort and bloating respectively. The endoscopic examination revealed round semipedunculated polypoid mass covered with normal muosa at duodenal bulb. One case with a small adenoma (size: 0.7 x 0.7 cn) had been removed by endoscopic polypectomy and the other case with a relatively large polyp (aize: 2.0x2.0cm) had been treaed by transduodenal exploration and excision of the polyp.
Adenoma* ; Diagnosis ; Diarrhea ; Duodenum ; Dyspepsia ; Endoscopy ; Hemorrhage ; Humans ; Jaundice ; Nausea ; Polyps

Heterotopic pancreas is an aberrant pancreatic tissue that lacks anatomic and vascular continuity with the main pancreas. Although heterotopic pancreas is a relatively rare entity and usually noted as an incidentel findings at autopsy and during surgery for other causes, it is capable of producing symptoms depending on the site and size of lesions as well as various pathological changes occuring in the pancreas itself. We have recently experienced a case of heterotopic pancreas on the mid-body of posterior wall along the lesser curvatrue of stomach in a 30-year-old man, who visited our hospital for the evaluation of postprandial epigastric discomfort and indigestion for two months. Gastrofiberoscopy revealed a 3x4 cm sized submucosal mass, and subtotal gastrectomy gastrojejunostomy was performed and he was discharged without any postoative complication.
Adult ; Autopsy ; Dyspepsia ; Gastrectomy ; Gastric Bypass ; Humans ; Pancreas* ; Stomach

Gastritis cystica polyposa (GCP) is a lesion characterized by all the histological features described for hyperplastic polyps, And there is s marked proliferation of muscular elements and entrapment of numerous epithelial cysts. These lesions have been described at gastroenterostomy stomas, at peptic ulcer edges, and in association with carcinoma. It is rare that GCP presenting as a submucosal tumar-like lesion develops in the absence of above mentioned associated conditions. We had experienced a 69 year-old man with GCP. Barium X-ray and endoacopic findings showed submucosal tumor in antrum, and endoscopic ultrasonograpic findings showed markedly thickened mucosal layer with scattered hypoechoeic areas and the submucosal layer well preserved. GCP was confirmed by histological examination of resected stomach.
Aged ; Barium ; Gastritis* ; Gastroenterostomy ; Humans ; Peptic Ulcer ; Polyps ; Stomach