Henoch-Schonlein purpura is the most common form of systemic vasculitis in children but occurs rarely in adults. Henoch-Schonlein purpura has characteristic features of a purpuric skin rash, abdominal pain, arthralgia, and abnormal urinary findings. Gastrointestinal tract involvement is characterized by abdominal pain and gastrointestinal bleeding. Recently, we experienced a case of Henoch-Schonlein purpura with gastrointestinal involvement mimicking colon cancer in a 41-year-old female who complained of erythematous macules, arthralgia, and abdominal pain. The initial colonoscopic findings and computed tomographs failed to rule out colon cancer, but serial endoscopic examinations and clinical manifestations revealed colonic involvement of Henoch-Schonlein purpura.
Abdominal Pain ; Adult ; Arthralgia ; Child ; Colon ; Colonic Neoplasms ; Colonoscopy ; Exanthema ; Female ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Purpura ; Purpura, Schoenlein-Henoch ; Systemic Vasculitis

The greatest advantage of endoscopic submucosal dissection (ESD) in the stomach is that it can be used to perform en bloc resection of a large gastric neoplasm. However, ESD is more technically difficult and more commonly associated with prolonged procedure time and complications than conventional endoscopic mucosal resection. Until now, only a few reports have considered aspiration pneumonia after ESD, which is rare, but can be fatal. We experienced two cases of aspiration pneumonia after ESD with a gastric neoplasm. One was treated by intensive care with mechanical ventilation, and the other by antibiotics only. Prevention is thought to be important for aspiration pneumonia after ESD; therefore, patients at high risk for aspiration pneumonia are urged to take precautions. We considered various factors contributing to aspiration under endoscopy, such as local pharyngeal anesthesia, procedural time, and bleeding.
Anesthesia ; Anti-Bacterial Agents ; Endoscopy ; Hemorrhage ; Humans ; Imidazoles ; Critical Care ; Nitro Compounds ; Pneumonia, Aspiration ; Respiration, Artificial ; Stomach ; Stomach Neoplasms

Double pylorus is a rare disease. It is described by a double communication between the gastric antrum and the duodenal bulb. The cause of double pylorus is either a congenital abnormality or an acquired condition. It is believed to be mostly a complication of peptic ulcer disease. Most reports revealed conditions only for the gastric antrum. However, case reports describing the involvement of the gastric body are extremely rare. Herein, we report a case of a double pylorus that developed on the gastric body and we present a review of the literature.
Congenital Abnormalities ; Peptic Ulcer ; Pyloric Antrum ; Pylorus ; Rare Diseases

Foreign bodies in the upper esophagus should be removed as soon as possible to avoid serious complications. These foreign bodies can penetrate the bowel wall and cause severe complications. The peristalsis of the esophagus is not strong enough to prevent it from retaining swallowed objects. Hence, perforation from a foreign body is more likely to occur in the esophagus than in the rest of the gastrointestinal tract. A razor blade is a rare foreign body of the esophagus. Its sharpness and large size make it difficult to remove. A razor blade was very firmly impacted in the esophageal wall in our case, and the razor blade had not moved from the upper esophagus. A standard overtube has limitations to remove a razor blade inside the overtube's lumen. We report here on a case of using a wedge resected overtube made it possible to successfully extract a razor blade and no serious complications occurred after extraction of the razor blade.
Esophagus ; Foreign Bodies ; Gastrointestinal Tract ; Peristalsis

BACKGROUND/AIMS: Colonoscopy is a useful method for detecting colorectal disease, but complications are on the rise due to the increasing number of colonoscopies. The aim of this study was to analyze colon perforations following diagnostic colonoscopies. METHODS: We performed retrospective reviews of all patients with colonoscopic perforations between January 2000 and June 2010. RESULTS: Of 25,883 diagnostic colonoscopies performed, seven cases of colon perforations were reported. Among those, five cases had an abdominal operation history; the site of perforation was the sigmoid colon in three cases and the rectum in four cases. The manipulation type was forward viewing in three cases and retroflexion in four cases. The time to diagnosis was immediate in six cases and delayed in one case, and treatment was conservative management in three cases and surgical management in four cases. CONCLUSIONS: Special attention is required for patients with a previous abdominal operation and retroflexion. Even after perforations occur, favorable outcomes can be obtained by conservative treatment if the patient's condition is stable, the bowel preparation is proper, and there are no signs of peritonitis.
Colon ; Colon, Sigmoid ; Colonoscopy ; Humans ; Peritonitis ; Rectum ; Retrospective Studies

BACKGROUND/AIMS: A number of studies have reported wide variability in the colonoscope insertion time among patients who had prior abdominal surgery. The aim of this study was to investigate the effect of abdominal surgery on colonoscope insertion time. METHODS: The subjects were 192 patients with prior abdominal surgery, among 3,600 patients who underwent a colonoscopy at Samsung Changwon Hospital from May 2008 to May 2010. We collected the following data: insertion time, age, gender, height, weight, BMI, waist circumference, method of abdominal surgery, and the degree of bowel cleanliness. Previous abdominal operations were divided into colectomy, non-colectomy abdominal surgery, pelvic surgery, and laparoscopic surgery groups. RESULTS: The average colonoscope insertion time in patients with prior abdominal surgery (7.73+/-5.95 min) was longer than that of the non-surgery group (6.4+/-3.88 min). Patients in the colectomy groups were older and had a shorter insertion time (5.11+/-3.32 min) than patients in the other groups. CONCLUSIONS: Insertion of a colonoscope in patients with previous abdominal surgery was more difficult than that in the control group, except the colectomy group.
Colectomy ; Colonoscopes ; Colonoscopy ; Humans ; Laparoscopy ; Waist Circumference

Obese patients have been increasing with the development of a social economy. Obesity is a disease with high mortality rates due to associated cardiovascular disease and diabetes. Diet or exercise therapy, medications, bariatric surgery are used for treating obesity. However, although bariatric surgery is safe and effective, it is expensive, and reoperation is a burden if patients fail to lose weight. Operative complications are also a problem. The recent development of endoluminal techniques may permit obesity treatment and many endoscopic procedures have been attempted. The role of endoscopy for treating obesity is treating the postoperative complications of bariatric surgery, for example, a stricture or widening of the anastomosis, fistula, or leaks. Second, endoscopic applications could be used for weight reduction to temporarily bridge surgery for high-risk patients with obesity, and for reducing weight in patients unable to undergo surgery. This article provides a brief overview of bariatric surgery and its complications and introduces several endoscopic applications to treat obesity.
Bariatric Surgery ; Cardiovascular Diseases ; Constriction, Pathologic ; Diet ; Endoscopy ; Exercise Therapy ; Fistula ; Humans ; Obesity ; Postoperative Complications ; Reoperation ; Weight Loss

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

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