An intraluminal duodenal diverticulum (IDD) is a rare congenital anomaly consisted of a sac-like mucosal projection within the second portion of the duodenum. Even though most of cases are asymptomatic, patients may develop recurrent abdominal pain, pancreatitis, and gastrointestinal bleeding. We report a case of symptomatic IDD which presented as acute pancreatitis and obscure gastrointestinal bleeding. Diagnosis was made by typical findings of upper GI series and coronal reformatted CT images. Although surgical resection is the treatment of choice, endoscopic incision and ligation with detachable snare was performed which led to a good result.
Acute Disease ; Adult ; Diverticulum/radiography/*surgery ; Duodenal Diseases/radiography/*surgery ; *Endoscopes, Gastrointestinal ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Hemorrhage/diagnosis ; Humans ; Pancreatitis/diagnosis

Hepatocellular carcinoma (HCC) rarely invades the gastrointestinal (GI) tract. It occurs in 0.7% to 2% of clinical HCC cases. Moreover, gastric invasion with GI hemorrhage via peritoneal seeding is very rare. We report the case of 67-year-old woman who had a history of HCC rupture and was admitted due to left upper quadrant abdominal pain. The patient was diagnosed with three omental metastatic masses and underwent hepatic segmentectomy and omental tumorectomy. Two months later, the patient had massive melena, and an esophagogastroduodenoscopy showed very large ulcerated friable mass on the gastric body. The histology was consistent with the diagnosis of metastatic HCC. The patient died from persistent GI hemorrhage 93 days after the admission. This case illustrates the very rare event of peritoneal seeding of a ruptured HCC causing direct invasion of the stomach, followed by GI hemorrhage.
Aged ; Carcinoma, Hepatocellular/*diagnosis/radiography/secondary ; Female ; Gastrointestinal Hemorrhage/*diagnosis/etiology/radiography ; Gastroscopy ; Humans ; Liver Neoplasms/*diagnosis/pathology/radiography ; *Neoplasm Seeding ; Peritoneal Neoplasms/*diagnosis/radiography/secondary ; Stomach Neoplasms/*diagnosis/radiography/secondary ; Tomography, X-Ray Computed

A jejunal ectopic pancreas, where pancreatic tissue is found outside of the usual anatomical location, is a rare submucosal tumor that may cause obscure gastrointestinal (GI) bleeding. After initial negative endoscopic evaluation of the obscure GI bleeding, including colonoscopy and/or upper endoscopy, it is reasonable to proceed with further evaluation of the small bowel. Diagnostic options for the evaluation of the small bowel may include capsule endoscopy, push enteroscopy, or barium contrast small bowel studies. Here, we report a case of obscure GI bleeding caused by a jejunal ectopic pancreas, diagnosed through capsule endoscopy and barium contrast small bowel studies, which was treated successfully with single incision access laparoscopy.
Aged ; Capsule Endoscopy ; Diagnosis, Differential ; Female ; Gastrointestinal Hemorrhage/*diagnosis/surgery ; Humans ; Intestine, Small/radiography ; Jejunum/pathology ; Pancreas/pathology

Phlebosclerotic colitis is a rare disease of intestinal ischemia caused by calcified peripheral mesenteric veins and a thickened colonic wall, differentiating it from the typical ischemic colitis. A 68-year-old man who was undergoing hemodialysis presented with hematochezia and abdominal pain. Colonoscopic findings showed typical dark purple-colored edematous mucosa. Linear calcifications in the colon were noted on both a plain abdominal radiolography and abdominal computer tomography. These findings suggested that the patient suffered from phlebosclerotic colitis. Following bowel rest and fluid therapy, there was full recovery. We herein report a rare case of phlebosclerotic colitis in a hemodialysis patient and include a review of the relevant literature.
Abdominal Pain ; Aged ; Calcinosis ; Colitis/*diagnosis/radiography ; Colonoscopy ; Gastrointestinal Hemorrhage ; Humans ; Male ; Mesenteric Veins ; Renal Dialysis ; Tomography, X-Ray Computed

Duodenal variceal bleeding in patients with portal hypertension due to cirrhosis or other causes is uncommon. We report on a case of a 55-year-old male with an ectopic variceal rupture at the distal fourth part of the duodenum who presented with massive hematochezia and shock. Shortly after achievement of hemodynamic stability, due to the limitation of an endoscopic procedure, we initially attempted to find the bleeding focus by abdominal computed tomography, which showed tortuous duodenal varices that drained into the left gonadal vein. He was treated with first-line balloon-occluded retrograde transvenous obliteration (BRTO), resulting in a favorable long-term outcome without rebleeding three years later. This case suggests that BRTO may be a first-line therapeutic option for control of ruptured duodenal varices, especially at a distal location.
Balloon Occlusion ; Duodenal Diseases/*diagnosis/radiography/therapy ; Embolization, Therapeutic ; Gastrointestinal Hemorrhage/therapy ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

Arterio-enteric fistula is a very rare cause of massive lower gastrointestinal hemorrhage. We report here on a case of massive hematochezia caused by iliac arterio-colic fistula in a 60-year-old woman who had a recent history of spinal surgery for herniated nucleus pulposus. Abdomen computed tomography showed the extravasation of radiocontrast media from right iliac artery encased by an intraabdominal abscess into the adjacent dilatated colon. Also, diagnostic angiography revealed the active extravasation of radiocontrast media via a fistula between right iliac artery and colon. Although successful endovascular exclusion of the fistula with stent graft and coils was performed, disseminated intravascular coagulation and multi-organ failure were developed.
Colonic Diseases/complications/*diagnosis ; Female ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Iliac Artery/*radiography ; Intestinal Fistula/complications/*diagnosis ; Middle Aged ; Stents ; Tomography, X-Ray Computed ; Vascular Fistula/complications/*diagnosis

The Dieulafoy lesion is a rare cause of severe gastrointestinal hemorrhage. Although it may occur anywhere in the gastrointestinal tract, the lesion is most commonly located in the stomach, and the small bowel is an extremely uncommon site. Since Dieulafoy lesion in the small bowel is difficult to access by endoscopy, it seems impossible to diagnose and treat by initial endoscopy unlike the lesions in stomach. We experienced a case of Dieulafoy lesion of jejunum with massive hemorrhage in 54-year-old male. Active jejunal bleeding was shown by computed tomography scan and mesenteric angiography. Partial resection of the jejunum was performed. Final pathologic finding revealed Dieulafoy lesion of the jejunum.
Angiography ; Gastrointestinal Hemorrhage/complications/*diagnosis ; Humans ; Jejunal Diseases/complications/*diagnosis/surgery ; Male ; Mesenteric Arteries/radiography ; Middle Aged ; Tomography, X-Ray Computed

No abstract available.
Amyloidosis/complications/*diagnosis/pathology ; Colitis, Ulcerative/diagnosis ; Colonoscopy ; Gastrointestinal Hemorrhage/*etiology ; Heart Ventricles/radiography ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged

Henoch-Schonlein purpura (HSP) is a vasculitis involving small vessels of skin, joints, gastrointestinal (GI) tract, and kidneys. The patients typically show palpable purpura with one or more characteristic manifestations including abdominal pain, hematuria or arthritis. HSP shows gastrointestinal symptoms in 50~85% of patients, and in 14~40% of patients GI symptoms precede purpuric rash which makes the diagnosis of HSP difficult. We present a case of Henoch-Schonlein purpura with GI bleeding, septic shock by ileal microperforation, small bowel obstruction as a result of ileal stricture and psoas muscle abscess.
Abdominal Pain ; Anti-Inflammatory Agents/therapeutic use ; Colonoscopy ; Gastrointestinal Diseases/*diagnosis/etiology/pathology ; Gastrointestinal Hemorrhage/diagnosis ; Humans ; Male ; Middle Aged ; Prednisolone/therapeutic use ; Psoas Abscess/etiology/*radiography ; Purpura, Schoenlein-Henoch/*complications/*diagnosis/pathology ; Tomography, X-Ray Computed

Follicular dendritic cell sarcoma is a rare neoplasm that originates from follicular dendritic cells in lymphoid follicles. This disease usually involves the lymph nodes, and especially the head and neck area. Rarely, extranodal sites may be affected, including tonsil, the oral cavity, liver, spleen and the gastrointestinal tract. We report here on the imaging findings of follicular dendritic cell sarcoma of the abdomen that involved the retroperitoneal lymph nodes and colon. It shows as a well-defined, enhancing homogenous mass with internal necrosis and regional lymphadenopathy.
Abdomen/ultrasonography ; Abdominal Neoplasms/complications/*radiography/*ultrasonography ; Abdominal Pain/etiology ; Aged ; Colon/radiography/ultrasonography ; Colonic Neoplasms/complications/*radiography/*ultrasonography ; Dendritic Cell Sarcoma, Follicular/complications/*radiography/*ultrasonography ; Dendritic Cells, Follicular/radiography/ultrasonography ; Diagnosis, Differential ; Dyspepsia/etiology ; Female ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lymph Nodes ; Male ; Middle Aged ; Radiography, Abdominal/methods ; Retroperitoneal Space/radiography/ultrasonography ; Tomography, X-Ray Computed/methods