1.A Case of a Colon Perforation Due to a Soft Rectal Foreign Body.
Jeong Hwa LEE ; Sang Bum KANG ; Dong Cheon HA ; Ki Huyn KWON ; Seung Woo LEE ; Yeon Soo KIM ; Dong Soo LEE ; Soon Woo NAM
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):52-55
Numerous foreign bodies in the rectum have been reported in the literature. Their removal can be challenging depending on the size and shape of the objects and their anatomical location in the rectum. A 64-year-old man presented to the emergency department after inserting a sausage into his rectum. He had some rectal discomfort and lower abdominal pain. There were no signs of bowel perforation. We attempted to extract the sausage impacted in the recto-sigmoid junction by colonoscopy using a snare and grasping forceps but failed to extract the foreign body. Unfortunately, a colon perforation had occurred, and the sausage was eventually extracted by performing a colostomy at the recto-sigmoid junction with primary repair. We report this case of a soft rectal foreign body impacted in the recto-sigmoid colon complicated by a colon perforation with a literature review.
Abdominal Pain
;
Colon
;
Colonoscopy
;
Colostomy
;
Emergencies
;
Foreign Bodies
;
Hand Strength
;
Humans
;
Middle Aged
;
Rectum
;
SNARE Proteins
;
Surgical Instruments
2.A Case of Churg-Strauss Syndrome Manifesting as Colonic Aphthous Ulcers with Granuloma.
Jun Sup PARK ; Nam Hoon KIM ; Joo Hyun PARK ; Won Ki BAE ; Jae Won JEONG ; June Sung LEE ; Young Soo MOON ; Mee JOO
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):47-51
Churg-Strauss syndrome is characterized by asthma, peripheral and tissue eosinophilia, extravascular granuloma formation, and vasculitis of multiple organ systems. The gastrointestinal tract may be involved in 20% to 50% of patients, mainly with abdominal pain, diarrhea and GI bleeding. Ulcers in the small and large bowel are an uncommon manifestation, usually detected during laparotomy performed in the setting of bowel perforation. Endoscopically proven segmental colonic aphthous ulcers with typical pathologic findings such as extravascular granuloma formation, eosinophilic infiltration, or vasculitis are a rarer manifestation. We present a patient with Churg-Strauss syndrome and two aphthous ulcers in the sigmoid colon that healed after treatment with high dose steroids and cyclophosphamide.
Abdominal Pain
;
Asthma
;
Churg-Strauss Syndrome
;
Colon
;
Colon, Sigmoid
;
Cyclophosphamide
;
Diarrhea
;
Eosinophilia
;
Eosinophils
;
Gastrointestinal Tract
;
Granuloma
;
Hemorrhage
;
Humans
;
Laparotomy
;
Steroids
;
Stomatitis, Aphthous
;
Ulcer
;
Vasculitis
3.A Case of Steroid Treated Amebic Colitis Misdiagnosed as Eosinophilic Colitis.
Eun Sun CHEONG ; Yun Ju JO ; Sang Bong AN ; Seong Hwan KIM ; Young Sook PARK ; Won Mi LEE ; Young Ok HONG
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):42-46
Some cases have reported that amebic colitis leads to serious complications that are caused by a misdiagnosis of an inflammatory bowel disease and consequential ill-managed steroid therapy. Therefore, it should be stressed that the differential diagnosis on such a case is very important. Eosinophilic colitis may reveal its presence as diarrhea, abdominal pain, ascites, and eosinophilic deposits in tissues. Therefore, it is highly necessary to make a differential diagnosis to distinguish eosinophilic colitis from other infectious or inflammatory bowel diseases. We report a case of amebic colitis, which was mistakenly diagnosed as eosinophilic colitis and a liver eosinophilic abscess in a young male who complained of bloody diarrhea and right upper quadrant pain. However, the misdiagnosed steroid therapy did not aggravate the progress of the amebic infection.
Abdominal Pain
;
Abscess
;
Amoeba
;
Ascites
;
Colitis
;
Diagnosis, Differential
;
Diagnostic Errors
;
Diarrhea
;
Dysentery, Amebic
;
Eosinophils
;
Humans
;
Inflammatory Bowel Diseases
;
Liver
;
Liver Abscess
;
Male
;
Steroids
4.A Case of Barium Appendicitis after a Small Bowel Series.
Ki Ho YUN ; Hyeon Woong YANG ; Se Young PARK ; Young Wook YOO ; Seung Yeon NA ; Young Woo LEE ; Sang Woo CHA
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):38-41
Barium appendicitis is a rare complication that occurs due to barium retention in the appendix after a barium study. It is believed that retained barium in the appendix forms a barium-coated fecalith and causes barium appendicitis. A 19-year-old man visited the hospital due to melena. He underwent an endoscopy and a colonoscopy but no bleeding focus was discovered. Next, a small bowel series was performed to confirm the absence of small bowel bleeding. Two weeks later, he felt right lower quadrant pain in his abdomen and developed a fever. A blood test revealed an elevated white blood cell count. A plain abdominal radiograph indicated retained barium in the appendix. A computed tomography scan revealed a dilated barium filled appendix. Thus, the pain was thought to caused by barium retention in the appendix that precipitated acute appendicitis. He underwent an appendectomy and healed well without complications.
Abdomen
;
Appendectomy
;
Appendicitis
;
Appendix
;
Barium
;
Colonoscopy
;
Endoscopy
;
Fecal Impaction
;
Fever
;
Hematologic Tests
;
Hemorrhage
;
Humans
;
Leukocyte Count
;
Melena
;
Retention (Psychology)
;
Young Adult
5.Huge Gastric Schwannoma Characterized by a Gastric Ulcer During Endoscopy.
Chang Jung LEE ; Suk Joon PARK ; Seong Yong WOO ; Hyun Jong OH ; Mi Kyung SUNG ; Byeong Ho LEE ; Sung Bae AN ; Hyun Ju YOO
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):33-37
Gastric schwannomas are very rare mesenchymal tumors that can occur throughout the gastrointestinal tract, but are most commonly found in the stomach. The majority of patients have no symptoms, while others may complain of epigastric pain or upper gastrointestinal ulcer bleeding. Endoscopic examination of a gastric schwannoma commonly reveals a protrusive mass, but, as in this case, many types of ulceration can be observed with central necrosis. We report on a 62-year-old woman with endoscopic findings of 1 cm sized necrotizing ulceration and an 11 cm sized submucosal mass on radiological examinations. The patient underwent a wedge-shaped resection of the stomach and segmental resection of the transverse colon. Both histological and immunohistochemical staining revealed a gastric schwannoma.
Colon, Transverse
;
Endoscopy
;
Female
;
Gastrointestinal Tract
;
Hemorrhage
;
Humans
;
Middle Aged
;
Necrosis
;
Neurilemmoma
;
Stomach
;
Stomach Ulcer
;
Ulcer
6.A Case of Corrosive Esophagogastritis after Copper Sulfate Ingestion.
Hee Rin JOO ; Jongha PARK ; Tae Gyoon KIM ; Eun Hee SEO ; Seung Ha PARK ; Tae Oh KIM ; Sung Yeon YANG ; Young Soo MOON
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):30-32
Copper sulfate ingestion is a rare cause of corrosive gastrointestinal injury in the Republic of Korea. In developing countries, copper sulfate is chiefly used for agricultural purposes as a pesticide and in the leather industry. It is also used in school science classes in the form of bright blue crystals. Copper sulfate is a powerful oxidizing agent that is corrosive to mucous membranes. Concentrated solutions are acidic, with a pH of 4. We report a case of corrosive gastritis and esophagitis due to accidental copper sulfate ingestion in a 12-year-old boy.
Burns
;
Child
;
Copper
;
Copper Sulfate
;
Developing Countries
;
Eating
;
Esophagitis
;
Gastritis
;
Humans
;
Hydrogen-Ion Concentration
;
Mucous Membrane
;
Republic of Korea
7.A Case of Gastric Low-grade MALT Lymphoma Induced by a Helicobacter heilmannii-like Organism.
Dong Hoon OH ; Nam Hoon KIM ; Yu Jung CHO ; Tae Jun SONG ; Won Ki BAE ; Kyung Ah KIM ; June Sung LEE ; Mee JOO
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):25-29
Helicobacter heilmannii is a Gram negative, long spiral-shaped organism associated with zoonotic infections acquired from primates including cats and dogs. Infection with H. heilmannii leads to gastritis, peptic ulcer disease, gastric adenocarcinoma, and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. We experienced a 54-year-old man with dyspepsia who was diagnosed with primary gastric MALT lymphoma (stage IE1) associated with a H. heilmannii-like organism. Upper gastrointestinal endoscopy revealed only microvascular dilatation and mucosal granularity without elevated or ulcerative lesions at the stomach angle. He was probably infected by a pet dog. The man was treated with eradication therapy for 2 weeks including lansoprazole, amoxicillin, and clarithromycin. Four weeks after eradication of the H. heilmannii-like organism, follow-up endoscopy and pathological biopsy findings showed complete remission of the gastric MALT lymphoma.
2-Pyridinylmethylsulfinylbenzimidazoles
;
Adenocarcinoma
;
Amoxicillin
;
Animals
;
Biopsy
;
Cats
;
Clarithromycin
;
Dilatation
;
Dogs
;
Dyspepsia
;
Endoscopy
;
Endoscopy, Gastrointestinal
;
Follow-Up Studies
;
Gastritis
;
Helicobacter
;
Helicobacter heilmannii
;
Helicobacter pylori
;
Humans
;
Lymphoid Tissue
;
Lymphoma
;
Lymphoma, B-Cell, Marginal Zone
;
Middle Aged
;
Peptic Ulcer
;
Primates
;
Stomach
;
Stomach Diseases
;
Ulcer
8.CMV Gastric Ulcers Healed by Supportive Therapy.
Hyoung Don LEE ; Nam Hoon KIM ; Ki Jun LEE ; Hyuk LEE ; Jin Ho JUN ; Won Ki BAE ; Kyung Ah KIM ; June Sung LEE
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):21-24
Cytomegalovirus (CMV) is a potentially important pathogen in an immunocompromised host. CMV infection usually occurs in patients with severe immune deficiency, such as acquired immunodeficiency syndrome, organ transplantation, malignant disease, or immunosuppressive therapy. CMV can cause ulcerations anywhere in the GI tract ranging from the esophagus to the rectum, but the colon is the most susceptible organ in the GI tract. CMV infection rarely occurs but generally causes an asymptomatic or mildly symptomatic acute illness in immunocompetent patients. Some patients with gastrointestinal CMV disease do not require antiviral treatment such as ganciclovir and frequently recover with supportive therapy. Although in immunocompetent patients, antiviral therapy may be needed based on age, chronic illness, or treatment response. We experienced a case of CMV-induced multiple gastric ulcers with severe epigastric pain in an immunocompetent patient who fully recovered with supportive therapy including a proton pump inhibitor.
Acquired Immunodeficiency Syndrome
;
Chronic Disease
;
Colon
;
Cytomegalovirus
;
Esophagus
;
Ganciclovir
;
Gastrointestinal Tract
;
Humans
;
Immunocompromised Host
;
Organ Transplantation
;
Proton Pumps
;
Rectum
;
Stomach Ulcer
;
Transplants
;
Ulcer
9.A Case of Peripheral T-cell Lymphoma of the Duodenum and Jejunum.
Hsueh Chen YUEH ; Chi Sung HWANG ; Jae Won CHOI ; Seung Keun PARK ; Hee Ug PARK ; Hye Sook KIM
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):17-20
Primary T-cell lymphoma of the duodenum is uncommon, and peripheral T-cell lymphoma of the duodenum is extremely rare. Approximately 90% of primary gastrointestinal lymphomas originate from B-cells and fewer than 10% originate from T-cells. A peripheral T-cell lymphoma involved in the small intestine is usually detected by complications such as gastrointestinal bleeding, perforation, or obstruction. A 57-year-old man complained of postprandial discomfort and weight loss of 5 kg for 1 month. An esophagogastroduodenoscopy showed a deep ulcer with blood clots and whitish exudates. We conducted a Whipple's operation because of the high risk of ulcer perforation and difficulty in distinguishing the ulcer from malignancy. The resected tissue was confirmed as a peripheral T-cell lymphoma. We reported a case of peripheral T-cell lymphoma of the duodenum and jejunum that extended to the pancreatic head where a diffuse lesion was found without any complications or specific symptoms.
B-Lymphocytes
;
Duodenum
;
Endoscopy, Digestive System
;
Exudates and Transudates
;
Head
;
Hemorrhage
;
Humans
;
Intestine, Small
;
Jejunum
;
Lymphoma
;
Lymphoma, T-Cell
;
Lymphoma, T-Cell, Peripheral
;
Middle Aged
;
T-Lymphocytes
;
Ulcer
;
Weight Loss
10.A Case of Gastric Intramural Hematoma after an Epinephrine Injection for Gastric Ulcer Bleeding in a Patient Medicated with Aspirin.
Hyung Min NOH ; Young Ho SEO ; Nam Hun LEE ; Bong Kyu LEE ; Sang Hyun PARK ; Yeon Hwa KIM ; Chur Hoan LIM ; Sung Hwan SONG
Korean Journal of Gastrointestinal Endoscopy 2011;43(1):13-16
An intramural hematoma of the stomach usually results from trauma. Gastric intramural hematomas may also occur in patients with bleeding disorders who are receiving anticoagulation therapy or after an endoscopic procedure. Here, we describe a case of a gastric intramural hematoma after endoscopic hemostasis for gastric ulcer bleeding in a patient medicated with aspirin.
Aspirin
;
Epinephrine
;
Hematoma
;
Hemorrhage
;
Hemostasis, Endoscopic
;
Humans
;
Stomach
;
Stomach Ulcer