1.A Case of Intestinal Tuberculosis Presenting Massive Hematochezia Controlled by Endoscopic Coagulation Therapy.
Joo Kyung PARK ; Sang Hyup LEE ; Sang Gyune KIM ; Hwi Young KIM ; Jeong Hoon LEE ; Joo Hyun SHIM ; Joo Sung KIM ; Hyun Chae JUNG ; In Sung SONG
The Korean Journal of Gastroenterology 2005;45(1):60-63
The clinical manifestations of intestinal tuberculosis are non-specific. But, abdominal pain, low grade fever, weight loss, anorexia, and diarrhea are major symptoms of intestinal tuberculosis. Massive bleeding has been reported as a rare manifestation of intestinal tuberculosis. Massive hematochezia from intestinal tuberculosis has rarely been reported in the medical literature. Also, most of them were treated with anti-tuberculosis medication only or with surgery. We treated a case of intestinal tuberculosis presenting massive hematochezia with colonoscopic coagulation therapy and anti-tuberculosis medication. Here, we report a Korean man who presented with massive hematochezia from ileal tuberculosis and treated by endoscopic coagulation therapy.
Adult
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English Abstract
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Gastrointestinal Hemorrhage/*etiology/therapy
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*Hemostasis, Endoscopic
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Humans
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Ileal Diseases/*complications/diagnosis
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Male
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Tuberculosis, Gastrointestinal/*complications/diagnosis
3.A Case of Brunner's Gland Hamartoma Presenting as Obscure Gastrointestinal Hemorrhage.
Chang Hwan PARK ; Soo Jung LEE ; Jeong Ho PARK ; Jae Hong PARK ; Wan Sik LEE ; Young Eun JOO ; Hyun Soo KIM ; Sung Kyu CHOI ; Jong Sun REW ; Seong Yeob RYU ; Min Cheul LEE ; Sei Jong KIM
The Korean Journal of Gastroenterology 2004;43(3):211-214
Brunner's gland hamartomas are rare tumors of duodenum, they are often discovered incidentally during esophagogastroduodenoscopy or upper gastrointestinal series. These tumors arise mainly in the duodenal bulb and can present with gastrointestinal hemorrhage and intestinal obstruction. Most of Brunner's gland hamartomas are located within the range of the standard esophagogastroduodenoscope. However, they are rarely located below the third portion of duodenum. As well known, the small intestine, including the 4th portion of duodenum, jejunum, and ileum, is relatively inaccessible with routine endoscopy. Thus, the diagnosis of Brunner's gland hamartoma in these area can be delayed up to several months after onset of symptoms. We report a case of Brunner's gland hamartoma which was located in the fourth portion of the duodenum and presented as obscure gastrointestinal hemorrhage. Radiologic, surgical, and pathologic appearances are presented.
Brunner Glands
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Duodenal Diseases/*complications/diagnosis
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Female
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Gastrointestinal Hemorrhage/*etiology
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Hamartoma/*complications/diagnosis
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Humans
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Middle Aged
4.A Case of Inflammatory Fibroid Polyp Presenting with Jejunal Bleeding.
Man Keun HWANG ; Jung Hun KIM ; Sang Won PARK ; Jae Bum PARK ; Chang Ik LEE ; Chang Gu LEE ; Jin Kwan LEE
The Korean Journal of Gastroenterology 2003;42(4):337-340
Inflammatory fibroid polyp occurs very rarely in the jejunum and gastrointestinal bleeding as an initial manifestation of inflammatory fibroid polyp has not been reported. We report a case of a jejunal inflammatory fibroid polyp presenting with melena for 10 days. Upper gastrointestinal endoscopic examination was negative for any active bleeding lesions and abdominal angiography failed to localize the bleeding site as well. In contrast, computed tomography of the abdomen demonstrated a segmental wall thickening of the jejunum with a tumor-like mass lesion associated with dense contrast enhancement. Consistent with this, technetium 99m red blood cells scintigraphy exhibited red cell pooling at the right upper quadrant. On exploratory laparotomy, there was an active bleeding from the site of the jejunal tumor and a segmental resection was performed. Histologically, the tumor lesion of the jejunum was consistent with inflammatory fibroid polyp. Thus, we conclude that the tumor lesion was a cause of the gastrointestinal bleeding.
Adult
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Gastrointestinal Hemorrhage/*etiology
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Humans
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Intestinal Polyps/diagnosis/*pathology
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Jejunal Diseases/diagnosis/*pathology
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Male
5.A Case of Secondary Amyloidosis Presenting as Massive Gastrointestinal Bleeding.
Hee KIM ; Sam Ryong JEE ; Sang Bong LEE ; Jae Ho LEE ; Sung Jae PARK ; Eun Taek PARK ; Yeon Jae LEE ; Sang Hyuk LEE ; Sang Young SEOL ; Jung Myung CHUNG
The Korean Journal of Gastroenterology 2006;47(5):397-401
Amyloidosis is a disorder characterized by extracellular deposition of amyloid in various tissues and organs. Gastrointestinal manifestations including gastroparesis, constipation, malabsorption, intestinal pseudo-obstruction, and bleeding are common. GI bleeding is a rare initial symptom which can be fatal in some cases. Absence of systemic symptoms and nonspecific endoscopic findings in amyloidosis may make diagnosis difficult. Therefore, amyloidosis-induced GI bleeding should be considered in patients with an obscure hemorrhage. Recently, we experienced a 65-year-old woman who presented with massive hematochezia as a manifestations of amyloidosis. Colonoscopy and SMA angiography showed massive bleeding in the small and large intestine. Colonoscopic biopsy established amyloidosis. We report this case with a review of the relevant literatures.
Aged
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Amyloidosis/*complications/diagnosis
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Female
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Gastrointestinal Hemorrhage/*etiology
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Humans
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Intestinal Diseases/*complications/diagnosis
6.What Are the Risk Factors for Delayed Post-polypectomy Bleeding?.
The Korean Journal of Gastroenterology 2012;59(6):393-394
No abstract available.
Colonic Diseases/*diagnosis
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Colonic Polyps/*surgery
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Female
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Gastrointestinal Hemorrhage/*etiology
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Humans
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Male
7.Gastrointestinal Complications Following Hematopoietic Stem Cell Transplantation in Children.
Ji Hye LEE ; Gye Yeon LIM ; Soo Ah IM ; Nak Gyun CHUNG ; Seung Tae HAHN
Korean Journal of Radiology 2008;9(5):449-457
Gastrointestinal system involvement is one of the principal complications seen in the recipients of hematopoietic stem cell transplantation (HSCT), and it is also a major cause of morbidity and death in these patients. The major gastrointestinal complications include typhlitis (neutropenic enterocolitis), pseudomembranous enterocolitis, viral enteritis, graft-versus-host disease, benign pneumatosis intestinalis, intestinal thrombotic microangiopathy, and post-transplantation lymphoproliferative disease. As these patients present with nonspecific abdominal symptoms, evaluation with using such imaging modalities as ultrasonography and CT is essential in order to assess the extent of gastrointestinal involvement and to diagnose these complications. We present here a pictorial review of the imaging features and other factors involved in the diagnosis of these gastrointestinal complications in pediatric HSCT recipients.
Child
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*Diagnostic Imaging
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Gastrointestinal Diseases/*diagnosis/*etiology
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Hematopoietic Stem Cell Transplantation/*adverse effects
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Humans
8.Rate and Predictive Factors of Rebleeding with Obscure-Overt Gastrointestinal Bleeding.
Jong Hyung KIM ; Young Ho KIM ; Sun Young LEE ; Hyun Wook JUNG ; Jun Haeng LEE ; Hee Jung SON ; Poong Lyul RHEE ; Jae J KIM ; Jong Chul RHEE
The Korean Journal of Gastroenterology 2004;44(1):19-24
BACKGROUND/AIMS: Little information is available on the rate and predictive factors of rebleeding of unknown cause, which is very important in deciding further investigations on obscure-overt gastrointestinal bleeding. The aim of this study was to evaluate the rebleeding rate and related factors in obscure-overt gastrointestinal bleeding patients who revealed normal gastroscopic and colonoscopic findings. METHODS: A total of 69 patients with negative first-line gastroscopy and colonoscopy were enrolled in this study as obscure-overt gastrointestinal bleeding cases. The relationships between rebleeding and clinical characteristics were analyzed retrospectively. RESULTS: The causes of obscure-overt gastrointestinal bleeding were confirmed in 30 cases among the 69 cases. Small bowel tumors (14 cases) were the most common cause, followed by vascular lesions (6 cases). The mean follow-up period was 28 months and rebleeding was noticed in 19 patients (27.5%). Among these rebleeding patients, 14 cases (73.7%) occurred within 6 months. The past experience of previous bleeding was significantly related with rebleeding (p=0.0009). CONCLUSIONS: Close observation and detailed investigations are needed for obscure-overt gastrointestinal bleeding patients with bleeding history, especially during 6 months follow-up.
Adult
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Aged
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Angiodysplasia/complications/diagnosis
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Female
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Gastrointestinal Hemorrhage/diagnosis/*etiology
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Gastrointestinal Neoplasms/complications/diagnosis
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Humans
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Intestinal Diseases/complications/diagnosis
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Male
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Middle Aged
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Recurrence
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Risk Factors
9.Sigmoid Colon Diverticular Bleeding in a 75-year-old Woman.
Jeoung Ho CHOI ; Young Sook PARK ; Chae Young LIM ; Jun Young JUNG ; Seong Hwan KIM ; Won Mi LEE ; Jun Kil HAN ; Yun Young JUNG
The Korean Journal of Gastroenterology 2009;53(2):111-115
Most common cause of brisk hematochezia is diverticular bleeding in Western countries. It occurs in 15% of patients with diverticulosis and one-third of them appear to be massive. Most of diverticulosis in Western countries occur in the left colon but the right colon is more common in Korea. Especially, the reports of diverticular bleeding on left colon are rare in Korea. We report a case presenting with multiple diverticuli complicated by recurrent massive bleeding restricted to the left colon. 75-year-old female was admitted due to hematochezia and dizziness. On past history, two years and two weeks ago respectively, she was treated of diverticular bleeding with and without diverticulitis. Hemoglobin level was 9.8 g/dL. On Colonoscopy, numerous diverticuli were seen at sigmoid colon upto splenic flexure which showed fresh blood clots in the lumen. We diagnosed her as recurrent massive diverticular bleeding on the sigmoid colon. She received elective laparoscopic left hemicolectomy.
Aged
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Colonoscopy
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Diagnosis, Differential
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Diverticulosis, Colonic/complications/*diagnosis/surgery
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Female
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Gastrointestinal Hemorrhage/*diagnosis/etiology/therapy
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Humans
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Recurrence
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Sigmoid Diseases/*diagnosis/etiology/therapy
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Tomography, X-Ray Computed