Malignant melanomas have the potential to metastasize to any site in the body. They commonly invade the gastrointestinal tract. The small bowel is most commonly involved, followed by the stomach, large bowel, and esophagus. The vast majority of gastrointestinal melanomas are metastatic from a cutaneous lesion. An abdominal CT scan revealed multiple and variable sized low density lesions throughout the whole liver. Endoscopy revealed multiple black pigmentations at the distal esophagus, stomach, duodenum and rectum. The brain CT showed multiple hemorrhagic metastases in the brain. This 72-year-old man had malignant melanoma in his right thumb one year ago. It had metastasized to the liver, lung, gastrointestinal tract and brain. Here we report this case of whole body metastatic malignant melanoma and review the literature.
Aged ; Brain ; Duodenum ; Endoscopy ; Esophagus ; Gastrointestinal Tract ; Humans ; Liver ; Lung ; Melanoma ; Neoplasm Metastasis ; Pigmentation ; Rectum ; Stomach ; Thumb

Duodenal abscess is a form of phlegmonous enterocolitis and is a rarely reported disease throughout the entire world. Duodenal abscess mostly develops from complications of duodenal ulcer perforation, and may result in a clinically fatal course because it is difficult to differentiate from some diseases such as gastric ulcer, gastric cancer, hepatobiliary disorders etc.. The therapeutic gold standard is surgical intervention including abscess removal and drainage. We experienced a case of duodenal abscess that expressed non-specific symptoms, weight loss and epigastric pain, and diagnosed by gastrointestinal endoscopy, abdominal computed tomography. We successfully treated it through surgical intervention with intravenous antibiotics.
Abscess ; Anti-Bacterial Agents ; Cellulitis ; Drainage ; Duodenal Ulcer ; Endoscopy, Gastrointestinal ; Enterocolitis ; Foreign Bodies ; Stomach Neoplasms ; Stomach Ulcer ; Weight Loss

A gastric duplication cyst is a rare congenital anomaly. Among gastrointestinal duplication cysts, gastric duplication cyst account for only 3.8%. They tend to be symptomatic in early childhood, but asymptomatic during adulthood. So its diagnosis is incidental. Abdominal pain is the most common complaint in adults, and most cases are discovered incidentally by radiological examination or endoscopic gastroduodenoscopy. Preoperative diagnosis of gastric duplication cyst is difficult, and definitive diagnosis requires pathological examination of the lesion. So far, about 8 cases of gastric duplication cyst have been reported in adults in the Korean literature. We report here a case of multiple gastric duplication cysts presenting with melena in a 14-year-old man, which were detected by endoscopic gastroduodenoscopy, abdominal computed tomography and endoscopic ultrasonography. They were treated by complete excision of the multiple gastric duplication cysts by laparoscopic wedge resection.
Abdominal Pain ; Adolescent ; Adult ; Endosonography ; Humans ; Melena

An ectopic pancreas in the gastrointestinal tract is mostly found incidentally and its malignant transformation is extremely rare. We report herein a rare case of malignant transformation of ectopic pancreas in the stomach, associated with gastric outlet obstruction. A 69-year-old woman was admitted to our hospital, complaining of vomiting. Esophagogastroduodenoscopy revealed an encircling submucosal tumor-like lesion on the prepyloric antrum showing outlet obstruction. Abdominal CT showed an enhancing mass on the antrum and PET CT showed hypermetabolic wall thickening. So we performed a subtotal gastrectomy. Surgical specimens showed a moderately differentiated ductal adenocarcinoma, and the tumor cells were strongly positive for cytokeratin 7. The tumor was located close to the ectopic pancreas tissue. The tumor showed subserosal and omental invasion. There was one lymph node metastasis and no distant metastasis. The patient is being followed up in the outpatient department.
Adenocarcinoma ; Aged ; Carcinoma, Pancreatic Ductal ; Endoscopy, Digestive System ; Female ; Gastrectomy ; Gastric Outlet Obstruction ; Gastrointestinal Tract ; Humans ; Keratin-7 ; Lymph Nodes ; Neoplasm Metastasis ; Outpatients ; Pancreas ; Stomach ; Stomach Neoplasms ; Vomiting

Esophageal foreign bodies should be retrieved as soon as possible, as they may cause complications such as bleeding, perforation, and respiratory distress. Flexible endoscopy is the preferred method, because it is effective and safe, but rigid esophagoscopy or a surgical procedure should be considered if flexible endoscopy fails. Extraction with a Foley balloon is an effective method for removing blunt foreign bodies from the esophagus. The general technique used is to insert the catheter into the esophagus through the nose or mouth, place it in the distal part of the foreign body, balloon the catheter, and remove the foreign body by pulling the catheter out. This procedure is generally performed under fluoroscopy, but a few reports have used Foley balloon extraction during endoscopy. We report a case of an elderly woman with a blunt foreign body in the upper esophagus. After failing to remove the object by endoscopy, we removed it with a Foley balloon under endoscopy.
Aged ; Catheters ; Endoscopy ; Esophagoscopy ; Esophagus ; Female ; Fluoroscopy ; Foreign Bodies ; Hemorrhage ; Humans ; Hypogonadism ; Mitochondrial Diseases ; Mouth ; Nose ; Ophthalmoplegia

We experienced a case of an 18-year-old woman who ingested salt-fermented northern sand lance and developed corrosive gastritis. The patient underwent a esophagogastroscopy and had developed a deep ulceration in the antrum. This cases shows that salt-fermented northern sand lance, which is very acidic and includes various biogenic amines, has the possibility of inducing a corrosive injury to the stomach.
Adolescent ; Biogenic Amines ; Female ; Gastritis ; Humans ; Silicon Dioxide ; Stomach ; Ulcer

Eosinophilic gastroenteritis is an unusual disease that is associated with various clinical gastrointestinal manifestations. Its severity depends on the area involved as well as the wall layer involved. Eosinophilic gastroenteritis often causes abdominal pain, nausea, vomiting and diarrhea. To date, there has been an extremely rare case of eosinophilic gastroenteritis with systemic symptoms, such as fever or lymphadenopathy (LAP). We experienced a case of a 68-year-old-woman with fever and abdominal pain. Abdominal computed tomography revealed diffuse wall thickening of the gastric antrum as linitis plastica. Multiple hot uptakes of lymph nodes were visualized on fludeoxyglucose-positron emission tomography. The gastric biopsy pathological report demonstrated eosinophilic infiltration without malignant cells. We could not exclude malignancy and performed an exploratory laparoscopy. A lymph node specimen showed reactive hyperplasia, and her illness was finally diagnosed as eosinophilic gastroenteritis. Herein, we report the case with a brief review.
Abdominal Pain ; Biopsy ; Diarrhea ; Enteritis ; Eosinophilia ; Eosinophils ; Fever ; Gastritis ; Gastroenteritis ; Hyperplasia ; Laparoscopy ; Linitis Plastica ; Lymph Nodes ; Lymphatic Diseases ; Nausea ; Pyloric Antrum ; Vomiting

BACKGROUND/AIMS: Attempts to increase colonoscopy withdrawal time have been the topic of several recent publications. We assessed whether the real-time measurement of withdrawal time affected the withdrawal time and polyp detection rate. METHODS: Real-time colonoscopy withdrawal time was measured in 197 subjects in a study group and 184 subjects comprised a control group without real-time measurements. Colonoscopies were performed by four endoscopy specialists and three fellows during their first year of training. Withdrawal time, clinical features, bowel preparation, and polyp detection rates were comparatively analyzed. RESULTS: No significant differences in age, gender, bowel preparation, or polyp history were found in the two groups. Withdrawal time was significantly higher in the study group than that in the control group when a fellow performed the withdrawal. However, polyp detection rate did not significantly increase in the study group, regardless of physician. CONCLUSIONS: Real-time measurement of colonoscopy withdrawal time did not increase polyp detection rate, but the withdrawal time was significantly higher when a fellow performed the withdrawal phase than when a specialist performed withdrawal. Therefore, the real-time measurement of colonoscopy withdrawal time seems to be a useful tool for fellow training.
Colonoscopy ; Endoscopy ; Polyps ; Quality Control ; Specialization

BACKGROUND/AIMS: Ecabet sodium is known for its bactericidal effect against H. pylori. It was reported that a supplement of ecabet sodium to conventional triple therapy showed good results in Asia. The Aim of this study was to ascertain the efficacy of additional ecabet sodium on conventional triple therapy for eradication of H. pylori. METHODS: We reviewed the cases of 111 patients (Group A) with H. pylori infection who received ecabet sodium with triple therapy (20 mg of rabeprazole, 1 g of amoxicillin, 500 mg of clarithromycin and 1 g of ecabet sodium, twice daily for 7 days). Another 186 patients (Group B) received PPI-based triple therapy (same as the above, except without the ecabet sodium). Eradication was evaluated 4 weeks later after completion of treatment by 13C-UBT. RESULTS: Eradication rates were 74.8% (83/111) in group A and 70.4% (131/186) in group B by intention-to-treat analysis (p=0.420), and 75.2% (82/109) in group A and 70.7% (128/181) in group B by per protocol analysis (p=0.405). CONCLUSIONS: The addition of ecabet sodium to conventional triple therapy did not increase the eradication rate of H. pylori in this study. These findings imply that ecabet sodium as an additional agent cannot overcome antibiotic resistance, which is the most important cause of failure of triple therapy.
2-Pyridinylmethylsulfinylbenzimidazoles ; Amoxicillin ; Asia ; Clarithromycin ; Diterpenes, Abietane ; Drug Resistance, Microbial ; Helicobacter ; Helicobacter pylori ; Humans ; Korea ; Sodium

Treatment of primary esophageal motility disorders, particularly achalasia, has developed enormously. The proven treatments for these patients include mostly endoscopic methods. Currently, pneumatic dilatation and laparoscopic myotomy with partial fundoplication are both useful for treating achalasia. A young man with high lower esophageal sphincter pressure might be best indicated for a laparoscopic myotomy with fundoplication, whereas an older patient with a high risk for surgery or vigorous achalasia may for a candidate for an endoscopic botulinum toxin injection. Pneumatic balloon dilatation is the choice of treatment for other cases of achalasia. The best treatment option for a nonachalasia spastic motor disorder of the esophagus may be endoscopic injection of botulinum toxin. In the future, endoscopic injection of neuronal stem cells could be the best treatment option for achalasia.
Botulinum Toxins ; Dilatation ; Esophageal Achalasia ; Esophageal Motility Disorders ; Esophageal Sphincter, Lower ; Esophagus ; Fundoplication ; Humans ; Muscle Spasticity ; Neurons ; Stem Cells