No abstract available.
Humans ; Hypertension* ; Perindopril*

Superior mesenteric artery (SMA) syndrome is a rare condition that must be differentiated from other gastrointestinal diseases manifesting as upper abdominal pain, nausea, or vomiting. The description of SMA syndrome is compression of the third portion of the duodenum by the SMA and the abdominal aorta. SMA syndrome is managed with nasoenteral nutrition or surgical strategies such as laparoscopic duodenojejunostomy. However, SMA syndrome treated using enteral nutrition by percutaneous radiologic gastrojejunostomy has not been reported. Here, we report our experience of successfully managing a case of SMA syndrome with percutaneous radiologic gastrojejunostomy.
Abdominal Pain ; Aorta, Abdominal ; Duodenal Obstruction ; Duodenum ; Enteral Nutrition ; Gastric Bypass* ; Gastrointestinal Diseases ; Mesenteric Artery, Superior* ; Nausea ; Superior Mesenteric Artery Syndrome* ; Vomiting

PURPOSE: This study was undertaken to evaluate the clinical features and complication such as esophageal stricture in children with corrosive esophagitis. METHODS: We retrospectively reviewed medical records of 31 children who accidentally ingested corrosive materials and visited to emergency room of Chonnam National University Hospital from Jan. 1992 to Dec. 1999. Twenty-one children were examined by upper gastrointestinal(UGI) endoscopy to evaluate location and severity of caustic injury. RESULTS: 1) Among 31 patients, there were 20 males and 11 females and the ratio of male to female was 2:1. Average age at diagnosis was 2.3 years (12months to 9.8 years). Twenty-seven(87.1%) patients were accidentally ingested vinegar. 2) Initial presenting symptoms were dysphagia(54.8%), vomiting(48.3%), chemical burn on lips and skin(45.2%), excessive salivation(45.2%), coughing and respiratory grunting(32.3%) and aspiration pneumonia(9.8%). 3) UGI endoscopic examination showed caustic injury in 17 children : grade I in 8, grade II in 7 and grade III in 2. The region of caustic injury was proximal esophagus in 5, distal esophagus in 3, entire esophagus in 9 and stomach in 6. 4) Corrosive esophageal strictures developed in 6 children(19.4%) and gastric outlet stricture in 1(3.2%). All of them showed grade II or III caustic injury on endoscopic examination. CONCLUSION: The development of esophageal stricture was related to the severity of the caustic injury. Early UGI endoscopic examination in caustic ingestion seems to be useful for prediction of development of caustic stricture.
Acetic Acid ; Burns, Chemical ; Child* ; Constriction, Pathologic ; Cough ; Diagnosis ; Eating ; Emergency Service, Hospital ; Endoscopy ; Esophageal Stenosis ; Esophagitis* ; Esophagus ; Female ; Humans ; Jeollanam-do ; Lip ; Male ; Medical Records ; Retrospective Studies ; Stomach

A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

A mucocele is a cystic dilatation of the vermiform appendix that contains mucous material. The symptoms associated with it are not specific and the diagnosis is seldom made prior to surgery. The reported prevalence in appendectomy specimens procured during surgery is 0.2-0.3%. Recently, we experienced a case of patient with appendiceal mucocele detected by colonoscopic examination. This case did not show typical colonoscopic features of a mucocele, demonstrating protrusion of mucin, in the absence of a smooth mound with normal overlying mucosa surrounding the appendiceal orifice. The case involved a 64-year-old woman who underwent a colonoscopy. An abdominopelvic computed tomography scan suggested a normal appendix. Subsequently, we performed an appendectomy. The pathologic finding was a low-grade appendiceal mucinous neoplasm.

The common bile duct normally enters the posteromedial aspect of the second part of the duodenum. However, anomalous drainage of the common bile duct into the stomach, pyloric channel, duodenal bulb and fourth portion of the duodenum has been reported in the literature. An anomalous pancreatic duct, with ectopic drainage of the common bile duct, is particularly rare. Herein, we report the case of a 69-year-old woman who showed pancreatic ductal variation and anomalous drainage of the common bile duct into the duodenal bulb. The patient required a cholecystectomy and choledochoenteric anastomosis to relieve the obstructive jaundice and abdominal pain.
Abdominal Pain ; Aged ; Cholecystectomy ; Common Bile Duct* ; Drainage* ; Duodenum ; Female ; Humans ; Jaundice, Obstructive ; Pancreatic Ducts* ; Stomach

A 42-year-old man without any signs or symptoms of illness underwent esophagogastroduodenoscopy (EGD) for a routine health check up. On esophagogastroduodenoscopy, multiple small and yellowish mucosal plaques were detected in the mid to distal esophagus. These plagues proved to be ectopic sebaceous glands of the esophagus according to the histologic examination. On the immunohistochemical staining with anti-Keratin 14, the basal cells and the heterotopic sebaceous glands were immunoreactive for keratin 14. The histogenesis of this extremely rare lesion is not completely clear. There have been some reports on ectopic esophagus sebaceous glands combined with esophageal cancer or gastric cancer. However, malignant transformation of the ectopic sebaceous gland itself has not yet been reported on. This case was regularly followed up for 12 months, and no interval change or malignant transformation was found both endoscopically and histologically.
Adult ; Endoscopy, Digestive System ; Esophageal Neoplasms ; Esophagus ; Humans ; Keratin-14 ; Sebaceous Glands ; Stomach Neoplasms

We experienced a case of primary sclerosing cholangitis(PSC) in a 40-year-old female who complained of jaundice and pruritus. Marked elevation of serum alkaline phophatase level, typical beaded appearance and pruned-tree appearance on endoscopic retrograde cholangiography, together with a finding of chronic obliterative fibrosing cholangitis on sono-guided gun biopsy specimen of the liver led to a confirmative diagnosis of PSC. The patient responded to ursodeoxycholic acid (UDCA), but was reluctant to treatment and died of hepatic failure 7 months later. PSC is a very rare disease in Korea. So far, only 5 cases including our present case have been reported in the Korean literature. Male-to-female ratio was 2:3 and the median age was 40(27-80 years old). Ulcerative colitis was associated in one case. Four cases involved both intra, and extrahepatic bile ducts and one case was reported to be confined in the intrahepatic bile ducts. Fatality was in 3 cases, 20 days, 36 days, and 7 months after the initial presentaion, respectively. The causes of death were acute cholangitis and sepsis in two, and hepatic failure in one. We herein report a case of PSC and clinical charateristics of the reported cases in Korea, and review the literature with an emphasis on UDCA treatment in PSC.
Adult ; Bile Ducts, Extrahepatic ; Bile Ducts, Intrahepatic ; Biopsy ; Cause of Death ; Cholangiography ; Cholangitis ; Cholangitis, Sclerosing* ; Colitis, Ulcerative ; Diagnosis ; Female ; Humans ; Jaundice ; Korea ; Liver ; Liver Failure ; Pruritus ; Rare Diseases ; Sepsis ; Ursodeoxycholic Acid

Duodenal gastrointestinal stromal tumors (GISTs) are relatively rare tumors that commonly present with gastrointestinal bleeding. Evaluation with endoscopic ultrasonography (EUS) is a useful technique for the differential diagnosis of GISTs from other submucosal tumors. A 58-year-old man presented with melena and anemia. An esophago-gastroduodenoscopy showed the presence of a submucosal tumor in the second portion of the duodenum with central ulceration and a flat spot. EUS showed the presence of a suspicious malignant GIST that originated from the proper muscle layer, which was successfully resected. We report a case of a duodenal GIST with a bleeding ulcer. Positive reactivity for CD117 and S-100 was demonstrated by immunohistochemical staining.
Anemia ; Diagnosis, Differential ; Duodenum ; Endosonography ; Gastrointestinal Stromal Tumors ; Hemorrhage ; Humans ; Melena ; Middle Aged ; Muscles ; Ulcer

Acute mesenteric ischemia can result from emboli, arterial and venous thrombi or vasoconstriction secondary to low-flow states. Isolated spontaneous dissection of the superior mesenteric artery is a rare cause of acute mesenteric ischemia. The mortality rates of acute mesenteric ischemia averages 71% with a range of 59-93%. Diagnosis before the occurrence of intestinal infarction is the most important factor in improving survival rate for patients with acute mesenteric ischemia. A 68-year-old female presented with postprandial epigastric pain, and a dissection of the superior mesenteric artery and a gallbladder polyp were shown in abdominal computed tomographic scan. After the percutaneous metalic stent placement and laparoscopic cholecystectomy, her symptoms improved. We report a case of spontaneous dissection of main trunk of the superior mesenteric artery which was successfully treated by percutaneous stent placement with a review of literature.
Acute Disease ; Aged ; Aneurysm, Dissecting/complications/*therapy ; *Angioplasty, Balloon ; Female ; Humans ; Ischemia/etiology ; *Mesenteric Artery, Superior ; Mesenteric Vascular Occlusion/etiology ; *Stents