3.Visualization of Jejunal Bleeding by Capsule Endoscopy in a Case of Eosinophilic Enteritis.
Nayoung KIM ; Jin Wook KIM ; Jin Hyeok HWANG ; Dong Ho LEE ; Hye Seung LEE ; Kyoung Ho LEE ; Sung Won KIM
The Korean Journal of Internal Medicine 2005;20(1):63-67
Eosinophilic enteritis is a rare disease characterized by tissue eosinophilia, which can affect different layers of bowel wall. Normally, the disease presents as colicky abdominal pain, and rarely as an acute intestinal obstruction or perforation. In this paper, we report a case of eosinophilic enteritis, hitherto unreported, presenting as an ileal obstruction, and followed by jejunal bleeding, which was visualized by capsule endoscopy. A 62-year-old man received a 15 cm single segmental ileal resection at a point 50 cm from the IC valve due to symptoms of obstruction, which were diagnosed as eosinophilic enteritis. Seventeen days after operation, intermittent abdominal pain occurred again, and subsided upon 30 mg per day treatment with prednisolone. Fourteen days after this pain attack, the patient exhibited hematochezia, in spite of continuous prednisolone treatment. Capsule endoscopy showed fresh blood spurting from the mid-to-distal jejunum, in the absence of any mass or ulcer. This hematochezia rapidly disappeared following a high-dose steroid injection, suggesting it was a manifestation of jejunal eosinophilic enteritis.
Endoscopy, Gastrointestinal/*methods
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Enteritis/*complications
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Eosinophilia/*complications
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Gastrointestinal Hemorrhage/*diagnosis
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Humans
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Jejunal Diseases/*diagnosis
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Male
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Middle Aged
4.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
5.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
6.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
7.Bleeding and hyperpyrexia in an adult with gastric inflammatory fibroid polyp.
Hong-yong HE ; Zhen-bin SHEN ; Yong FANG ; Yi-hong SUN ; Xin-yu QIN
Chinese Medical Journal 2013;126(13):2594-2594
Adult
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Fever
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etiology
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Gastrointestinal Hemorrhage
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etiology
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Humans
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Male
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Polyps
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complications
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Stomach Diseases
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complications
8.Gastroduodenal Intussusception Due to Pedunculated Polypoid Gastrointestinal Stromal Tumor.
Hyo Sun SEOK ; Chong Il SHON ; Hyun Il SEO ; Young Ghil CHOI ; Won Gil CHUNG ; Hyun Sun WON
The Korean Journal of Gastroenterology 2012;59(5):372-376
The gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the digestive tract showing differentiation along the line of interstitial cell of Cajal. The most GISTs in the stomach generally show the appearance of submucosal tumors. It is rare for GISTs to appear as a pedunculated polypoid lesion on endoscopy. We experienced a case of a 51-year-old man who had a pedunculated polypoid GIST. He was admitted to our hospital for nausea, vomiting, melena and severe anemia (hemoglobin 3.4 g/dL, hematocrit 10.8%). An upper endoscopy showed gastroduodenal intussusception due to a pedunculated polypoid mass. This report presents a rare case of endoscopically proven gastroduodenal intussusceptions due to pedunculated polypoid GIST in the stomach.
Duodenal Diseases/etiology/*pathology
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Gastrointestinal Hemorrhage
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Gastrointestinal Neoplasms/complications/*pathology
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Gastrointestinal Stromal Tumors/complications/*pathology
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Gastroscopy
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Humans
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Intussusception/etiology/*pathology
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Male
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Middle Aged
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Tomography, X-Ray Computed
9.Lower gastrointestinal bleeding due to cytomegalovirus ileal ulcers in an immunocompetent man.
Sung Woo CHOI ; Jun Pyo CHUNG ; Young Koo SONG ; Young Nyun PARK ; Juck Kum CHU ; Dong Joo KIM ; Jae Han JUNG ; Chang Hoon LEE ; Se Joon LEE ; Hyo Jin PARK ; Kwan Sik LEE ; Sang In LEE ; In Suh PARK ; Seung Kook SOHN
Yonsei Medical Journal 2001;42(1):147-151
Cytomegalovirus (CMV) infections are commonly reported in severely immunocompromised hosts and ulcers of the alimentary tract are frequently observed in systemic CMV infections. However, invasive and ulcerative disease of the gastrointestinal (GI) tract caused by CMV has also been reported in healthy adults. Many reports show that a CMV infection can produce localized ulcerations in the esophagus, stomach, small intestine, and colon in nonimmunocompromised individuals. The most common site of involvement by CMV infection in the GI tract is the colon followed by the upper GI tract and the least common site is the small intestine. Although GI bleeding is one of the major presenting symptoms of patients with CMV infections of the GI tract, lower GI bleeding due to CMV ileal ulcers in immunocompetent patients, to our knowledge, has not been reported in the English literature. Recently, we experienced a case of lower GI bleeding due to CMV ileal ulcers in a 57-year-old man who had no evidence of immunocompromise. This case suggests that small intestinal ulcers due to CMV infection should be included in the differential diagnosis of lower GI bleeding even in immunocompetent hosts.
Case Report
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Cytomegalovirus Infections/complications*
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Gastrointestinal Hemorrhage/etiology*
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Human
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Ileal Diseases/complications*
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Male
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Middle Age
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Ulcer/complications*
10.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