Arteriovenous malformations occur predominantly in the cecum and ascending colon and is not associated with vascular lesions of the skin, central nerveous system. or lung Arteriovenous malformations involving gastrointastinal tract is often to be found to be cause of the recurrent painless bleeding without specific past history and family history and usually diagnosed by selective mesenteric arteriography or colonoscopy, But because of small size of the lesion and local occurence, diagnosis of the arteriovenous malformation is very difficult. Authors exprienced a case of arteriovenous maltormation in the colon. The patient had a history of repeated gastrointestinal bleeding, and were diagnosed by colonoscopy and were treated with colonoscopic resection.
Angiography ; Arteriovenous Malformations* ; Cecum ; Colon* ; Colon, Ascending ; Colonoscopy ; Diagnosis ; Hemorrhage ; Humans ; Lung ; Skin

Gastrointesinal polyp is a premalignant lesion, it is recommanded to be removed. Endoscopic polypectomy has long been considered as a safe and effective method for removal of polyps. One hundred forty eight endoscopic gastrointestinal polypectomy were done in 111 patients who visited Chungnam National University Hospital from January in l991 to August in l993, and clinical character including histopathology were evaluated. (continue...)
Chungcheongnam-do ; Humans ; Pathology ; Polyps

No abstract available.
Helicobacter pylori* ; Helicobacter* ; Peptic Ulcer* ; Prevalence* ; Stomach Neoplasms*

Esophageal carcinoma is a rare malignant neoplasm consisting of about 1.5% of the whole gastrointestinal tract neoplasm and has poor prognosis of which survival rate is below 5%. The squamous cell carcinoma of the esophagus could be multicentric in character and may have occured in 9.5-27% of incidence. The most common site is head and neck region. The metastasis of esophageal carcinoma occur through hematogenous, lymphatic spread, direct invasion and rarely intramural metastasis. Of theses, intramural metastasis has been occured in 7-14.3% of incidence and its presence has been regared to poor prognostic factor due to early regional or distant metastasis. Surgery, chemotherapy, radiotherapy alone or combination of these has been used as treatment modalities of esophageal cancer, but combination chemoradiotherapy with or without operation is prefered method than other at present. Authors report a case of esophageal carcinoma showing intramural metastasis to the gastric wall, which had the complete remission with preoperative chemoradiotherapy.
Carcinoma, Squamous Cell ; Chemoradiotherapy* ; Drug Therapy ; Esophageal Neoplasms* ; Esophagus ; Gastrointestinal Tract ; Head ; Incidence ; Neck ; Neoplasm Metastasis* ; Prognosis ; Radiotherapy ; Stomach* ; Survival Rate

Peptic ulcer bleeding is the most common cause of upper gastromtestinal bleeding. The efficacy of local injection of hypertonic saline-epinephrine(RS-E)solutiom around the base of the bleeding vessels under endoscopy was assessed, During the period between January 1991 and August 1994, 83 patients with active bleeding or stigmata of recent hemorrhage in peptic ulcers were included to this study. The major cause of bleeding in this study consisted of gastric ulcers(60) and duodenal ulcers(23). Twenty patients rebled and seven required emergency surgery and two patients were died. Definitive hemoatasis was achieved in 74(89.3%). Two patients rebled due to mucosal ischemia induced by HS-E injection, other significant complication was not found. We conclude that the endoscopic injection with hypertonic saline-epinephrine solution is one of the effective and safe therapeutic modality in peptic ulcer bleeding.
Christianity ; Emergencies ; Endoscopy ; Epinephrine* ; Hemorrhage* ; Humans ; Ischemia ; Peptic Ulcer ; Ulcer*

Heteratopic or ectopic pancreas is found in 0.5% to 13% autopsy series and also found one in approximately every 500 operations in abdominal surgery. The mast common sites are stomach (esp, greater curvature of the antrum), duodenum and proximal jejunum. Many ar most of these lesions do not cause clinical symptoms and the symptoms with heterotopie pancreas are nonspecific. When it produces complication(hemorrhage, pancreatitis, pyloric or CBD obstruction, pseudocyst, cancer etc.), the symytoms depend on the site of lesion, the size of mass, and the primary pathologic processes occurring within the heterotopic pancreatic tissue. Gaetrofiberoscopy revealed a small round, submucosal projection with a central niche or umblication, but this characteristic umbilication is not always present. The lesions are frequently confused with polyp, leiomyoma, intramural neoplasm, gastric ulcer and early gastric cancer, The tumors are predominantly intramural masses; 75 percent are submuicosal and the others are either intrsmuscular or subserosal. We have recently experienced a case of heterotopic pancreas on the antrum of greater curvature of stomach in 54-year-old man, who visited our hospital for melena. Gastrofiberoscopy revealed a 2 x 2 cm sized submucosal mass without bleeding focus and local excision was performed. Histologic finding showed a pancreatic acini within the gastric poper muscle layer.
Autopsy ; Duodenum ; Hemorrhage ; Humans ; Jejunum ; Leiomyoma ; Melena ; Middle Aged ; Pancreas* ; Pancreatitis ; Pathologic Processes ; Polyps ; Stomach ; Stomach Neoplasms ; Ulcer

BACKGROUND/AIMS: Balloon dilatation is a useful alternative to surgery in patients with benign pyloric stenosis. However, little data are available on the long-term outcome of the procedure. This report was attempted to determine the safety and efficacy of endoscopic balloon dilatation for 14 patients with gastric outlet obstruction caused by duodenal ulcer. METHODS: Review of medical records or telephone interview was performed retrospectively. RESULTS: Follow-up was conducted for median 18.5 months (3-48 months). Gastric outlet strictures had a median diameter 6 mm (range, 2-9 mm). Five (35.7%) patients had active ulcer. 12 mm to 18 mm balloons were inflated a median of 1 times (range, 1-4 times) for a median of 4 minutes (range, 1-11 minutes). Thirty-two procedure (1.5/patient) were performed; 9 patients (64.3%) had one treatment and 5 patients (35.7%) had multiple treatment. Immediate symptomatic relief was achieved in 13 patients (92.8%) and 7 patients (50%) achieved sustained symptomatic relief. Dilatation failed only in 2 patients (14.3%) ultimately and both recovered by palliative bypass surgery. No complication was noted during treatment. CONCLUSIONS: Endoscopic balloon dilatation is safe and effective for most patients with gastric outlet obstruction induced by duodenal ulcer. And due to limitation of retrospective aspect of this report, further prospective, randomized studies must be performed.
Constriction, Pathologic* ; Dilatation* ; Duodenal Ulcer ; Follow-Up Studies ; Gastric Outlet Obstruction ; Humans ; Interviews as Topic ; Medical Records ; Pyloric Stenosis ; Retrospective Studies ; Ulcer

BACKGROUND: The purpose of this study is to compare the difference of the symptom, sign and laboratory findings among chronic inflammatory bowel diseases such as ulcerative colitis, Crohn's disease and tuberculous colitis in Korea. METHODS: We studied in Chungnam National University Hospital from March, 1990 to December, 1998. Seventy-eight cases of ulcerative colitis, fifteen cases of Crohn's disease, and thirty-nine cases of tuberculous colitis were analyzed in terms of age, sex, symptomatology, laboratory findings, radiologic findings and consequence of treatment. RESULTS: The sex ratio of ulcerative colitis, Crohn's disease and tuberculous colitis were 1.17:1, 1.14:1, and 1.29:1, respectively, and the mean age were 39.3, 26.5 and 36.0 years, respectively. The most common symptoms of ulcerative colitis, Crohn's disease and tuberculous colitis were bloody stool, diarrhea, and abdominal pain, respectively. In terms of symptoms and signs, we found that significant differences were bloody stool, diarrhea, and weight loss. Patients with tuberculosis colitis revealed significantly high rate of tuberculous lesion on chest X-ray. Among them, 14(35.9%) of the cases showed active tuberculous lesions. In terms of anatomical distribution of the lesion, the most frequently involved sites of ulcerative colitis, Crohn's disease and tuberculous colitis were rectosigmoid colon. descending colon, and ileocecal valve, respectively. CONCLUSION: In differential diagnosis of ulcerative colitis, Crohn's disease and tuberculous colitis, we should consider clinical findings, laboratory findings, colonoscopic appearance, histologic assessment, anatomical distribution of the lesions, and treatment course.
Abdominal Pain ; Chungcheongnam-do ; Colitis ; Colitis, Ulcerative ; Colon ; Colon, Descending ; Crohn Disease ; Diagnosis, Differential ; Diarrhea ; Humans ; Ileocecal Valve ; Inflammatory Bowel Diseases* ; Korea ; Sex Ratio ; Thorax ; Tuberculosis ; Weight Loss

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasm of the gastrointestinal tract. They are preferentially located in the stomach and small intestine. However, the duodenum is an unusual location for GIST. Here we present a case of a 67-year-old woman with a GIST of the 3rd portion of duodenum mimicking vascular neoplasm as an obscure acute gastrointestinal bleeding. The upper gastrointestinal endoscopy and colonoscopy failed to find the lesion. Finally, a large protruded lesion with ulcer was found at the 3rd portion of duodenum using a colonoscope through the oral approach. A spurting bleeding was developed during hypertonic saline epinephrine injection for treatment of oozing bleeding at the margin of the ulcer. Abdominal 3D CT-angiography showed a round and hypervascular structure at the posterior wall of duodenum. A wedge resection of the third portion of the duodenum was performed. Microscopic findings revealed GIST.
Aged ; Colonoscopes ; Colonoscopy ; Duodenum ; Endoscopy, Gastrointestinal ; Epinephrine ; Female ; Gastrointestinal Stromal Tumors ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Intestine, Small ; Stomach ; Ulcer ; Vascular Neoplasms

Bleeding in patients with liver cirrhosis is primarily caused by gastroesophageal varix in association with extensive collateral circulation, portal hypertensive gastropathy, a Mallory-Weiss tear and peptic ulcer disease. The spontaneous rupture of an artery, as a result of coagulopathy, is extremely rare in patients with liver cirrhosis; however, we recently observed a case of a spontaneous rupture of the lateral thoracic artery in a 47 year-old male patient with alcoholic liver cirrhosis. The patient expired despite repeated transcatheter arterial embolization of the lateral thoracic artery and best supportive care. This is, to our knowledge, the first documented case of the spontaneous rupture of the lateral thoracic artery in a patient with liver cirrhosis.
Aneurysm, Dissecting/*etiology ; Fatal Outcome ; Humans ; Liver Cirrhosis/*complications ; Male ; Middle Aged ; Rupture, Spontaneous/*etiology ; Thoracic Arteries/*pathology ; Time Factors