Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.
Adult ; Cholecystitis, Acute* ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Fever ; Humans ; Korea ; Male ; Mass Screening ; Polyps ; SNARE Proteins

Acute cholecystitis after a colonoscopy is a rare event, and only eight documented cases are reported in the literature. A 35-year-old male underwent a screening colonoscopy. There was a 5-mm sessile polyp in the sigmoid colon, which was removed by using a hot snare polypectomy. Forty-eight hours after the colonoscopy, the patient visited our emergency department with epigastric pain and fever. Based on the clinical findings, laboratory data and radiologic imaging, our diagnosis was acute cholecystitis. Because no previous cases of this type have been reported to date in Korea, we publish the details of our patients who presented with a postcolonoscopy complication diagnosed as acute cholecystitis.
Adult ; Cholecystitis, Acute* ; Colon, Sigmoid ; Colonoscopy* ; Emergencies ; Fever ; Humans ; Korea ; Male ; Mass Screening ; Polyps ; SNARE Proteins

Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.
Adult ; Bile Duct Neoplasms/*diagnosis/etiology/pathology ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/etiology/pathology ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangiopancreatography, Magnetic Resonance ; Choledochal Cyst/complications/*diagnosis ; Female ; Humans ; Positron-Emission Tomography and Computed Tomography ; Tomography, X-Ray Computed

Amyloidosis is a disorder resulting from extracellular deposition of insoluble fibrils and causes dysfunction in many organs. Secondary amyloidosis, caused by chronic infectious and inflammatory disease, may involve the kidneys, liver, bone marrow and gastrointestinal tract. Involvement of the gastrointestinal tract is common and presents various symptoms according to location. Amyloidosis as a complication of Crohn's disease is a rare but serious complication that may worsen the prognosis. We report a case of gastrointestinal amyloidosis in a 59-year-old male patient with Crohn's disease that was diagnosed with an endoscopic forceps biopsy of the stomach, terminal ileum and colon.
Amyloidosis ; Biopsy ; Bone Marrow ; Colon ; Crohn Disease ; Gastrointestinal Tract ; Humans ; Ileum ; Kidney ; Liver ; Male ; Middle Aged ; Prognosis ; Stomach ; Surgical Instruments

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

Biliary strictures can be caused by various diseases. Intrahepatic duct (IHD) strictures are usually related to IHD stones and cholangitis. However, focal IHD strictures without IHD stones often create diagnostic problems. Parasitic diseases such as clonorchiasis can be a rare cause of an IHD stricture. Human clonorchiasis (Clonorchis sinensis infection) is an endemic parasitic disease in Eastern Asia, including Korea, and patients acquire the infestation by eating raw fish. On radiological examinations, clonorchiasis shows typically diffuse, minimal, or mild dilatation of the small IHD, particularly in the periphery, without dilatation of the extrahepatic duct. However, diagnosis of clonorchiasis can sometimes be difficult when radiological changes are atypical. We report a case of focal left IHD dilatation caused by clonorchiasis that was confused with a malignancy.
Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; Cholangitis ; Clonorchiasis ; Constriction, Pathologic ; Dilatation ; Eating ; Far East ; Humans ; Korea ; Liver Neoplasms ; Parasitic Diseases ; Cholangiocarcinoma

A volvulus of the colon is a twisting of a redundant segment of the colon at its narrow mesentery. A sigmoid volvulus is the most common type. This disorder may spontaneously reduce and recur as a chronic problem. However, it more frequently becomes acute as a result of an obstruction, which can lead to strangulation and gangrene with a high mortality if not treated promptly. Colonoscopic reduction and decompression is the preferred initial treatment for patients with a sigmoid volvulus who show no signs of bowel strangulation, which may be the cause of the high mortality associated with emergency surgery. We experienced 2 cases of a sigmoid volvulus in a 44-year-old female and a 51-year-old male. The sigmoid volvulus was diagnosed by simple abdominal film and treated successfully by an emergency colonoscopic reduction. We report our experience on the use of colonoscopy to treat sigmoid volvulus with a reviews of the relevant literlature.
Female ; Humans ; Mortality

OBJECTIVES: To evaluate the effect of ALAD polymorphism on the relationship of blood and bone lead with hematologic biomarkers in lead exposed workers, 450 lead exposed workers and 85 non-lead exposed workers were selected. METHODS: Blood lead and tibia bone lead were selected as parameters of lead exposure and blood ZPP, urinary ALA (ALAU), hemoglobin (Hb) and hematocrit (Hct) were chosen as parameters of hematologic effect of lead exposure. Genotype of each subject was assayed and expressed as ALAD1 and ALAD2. Demographic information such as sex, age and personal habit of smoking and drinking were collected. Job duration of lead exposed workers was also obtained. RESULTS: The overall prevalence of the variant allele, ALAD2 in lead exposed workers was 9.6 %(43 out of 450 lead workers) which was not differed from control workers (9.4 % : 8 out of 85). The means of tibial lead and blood ZPP in lead workers with ALAD2 were lower than those of lead workers with ALAD1, but the differences were not statistically significant. After adjusting for possible confounders (sex, job duration, BMI, drinking and smoking status) only blood lead and bone lead contributed negatively to the level of hemoglobin with statistical significance without any contribution of ALAD genotype. On the other hand, no significant effect of blood lead, bone lead and ALAD genotype were observed on the level of hematocrit after controlling possible confounder. ALAD genotype in the multiple regression analysis of blood lead and bone lead with log transformed urinary ALA (LogALAU) after adjusting for possible confounders showed significant main and interaction effect on LogALAU simultaneously, which resulted lower LogALAU in lead exposed workers of ALAD2 than ALAD1. It was also observed only main effect of ALAD gene type on blood ZPP after adjusting possible confounder resulting lower ZPP in lead workers of ALAD2 than ALAD1. CONCLUSIONS: With above results, it was found that ALAD polymorphism did not affect on the level of hemoglobin and hematocrit, but ALAD polymorphism made significant effect on the association of blood and bone lead with urinary ALA and blood ZPP. The lower urinary ALA and blood ZPP in ALAD2 lead workers suggested that ALAD2 genotype may be supportive for the protective effect of lead.
Alleles ; Biological Markers* ; Drinking ; Genotype ; Hand ; Hematocrit ; Humans ; Prevalence ; Smoke ; Smoking ; Tibia

The incidence of intussusception in adults is quite low. A preoperative diagnosis was quite difficult due to the atypical clinical features, but the success rate of preoperative diagnosis of intussusception has improved with the advances in abdominal US and CT. However, the value of colonoscopy in making a preoperative diagnosis is unclear. The incidence of multiple primary cancer of the colon and rectum can vary widely. We report a case of intussusception in a patient who had synchronous cecal and sigmoid colonic cancer. A 71-year-old man was visited our hospital for diarrhea and general weakness. The abdominal US and CT revealed a mass lesion in the cecal area. Preoperative colonoscopy confirmed the lesion to be cecal cancer with a synchronous sigmoid colon cancer. In conclusion, the rarity of these synchronous cancers may result in a misdiagnosis. Therefore, a preoperative colonoscopy or postoperative colonoscopy might be useful.
Adult ; Aged ; Cecal Neoplasms ; Colon* ; Colon, Sigmoid* ; Colonic Neoplasms* ; Colonoscopy ; Diagnosis ; Diagnostic Errors ; Diarrhea ; Humans ; Incidence ; Intussusception* ; Rectum ; Sigmoid Neoplasms*

Gastritis cystica profunda (GCP) is a rare disease in which mature glandular epithelium extends into the muscularis mucosae or below. GCP lesions mainly develop at the gastroenterostomy stomas. These lesions show malignant histologic features such as metaplastic and even dysplastic alteration, however they usually exhibit benign behavior. We report a case of a patient with GCP who had not previously undergone gastric surgery. A 63-year-old woman visited our hospital for anorexia and epigastric discomfort. The esophagogastroduodenoscopy revealed two polyps on the anterior wall of the greater curvature, antrum. The polyps were removed by snare polypectomy and the histology findings showed the character of a tubular adenoma and a hyperplastic polyp with an associated GCP.
Adenoma* ; Anorexia ; Endoscopy, Digestive System ; Epithelium ; Female ; Gastritis* ; Gastroenterostomy ; Humans ; Middle Aged ; Mucous Membrane ; Polyps ; Rare Diseases ; SNARE Proteins