1.A Case of Choledochocele Associated with Papillary Adenocarcinoma.
Dong Hun LEE ; Jae Seon KIM ; Ji Hoon KIM ; Eun Sun KIM ; Young Jin KIM ; Nark Soon PARK ; Sun Jae LEE ; Beom Jae LEE ; Young Tae BAK
Korean Journal of Gastrointestinal Endoscopy 2007;35(5):364-368
Choledochocele is a rare abnormality that's defined as cystic or diverticular dilatation of the common bile duct, and this protrudes into the duodenal lumen. It may cause abdominal pain, recurrent pancreatitis, obstructive jaundice etc. Although its anatomic form does not meet the criteria of pancreaticobiliary malunion, malignant changes of the choledochocele in relation to pancreaticobiliary reflux may occur. It still is regarded as having a lower malignant potential than any other type of choledochal cyst. Only one case has been currently been reported in Korea. We experienced a case of a 71 year-old woman with upper abdominal pain that was caused by a choledochocele with duodenal ampullary adenocarcinoma. She was successfully treated by surgical excison without severe complications. We report here on this case along with a review of the literature.
Abdominal Pain
;
Adenocarcinoma
;
Adenocarcinoma, Papillary*
;
Aged
;
Choledochal Cyst*
;
Common Bile Duct
;
Dilatation
;
Female
;
Humans
;
Jaundice, Obstructive
;
Korea
;
Pancreatitis
2.Risk Factors for Severe Diverticulitis in Computed Tomography-Confirmed Acute Diverticulitis in Korea.
Nark Soon PARK ; Yoon Tae JEEN ; Hyuk Soon CHOI ; Eun Sun KIM ; Young Jin KIM ; Bora KEUM ; Yeon Seok SEO ; Hoon Jai CHUN ; Hong Sik LEE ; Soon Ho UM ; Chang Duck KIM ; Ho Sang RYU
Gut and Liver 2013;7(4):443-449
BACKGROUND/AIMS: Acute complicated diverticulitis can be subdivided into moderate diverticulitis and severe diverticulitis. Although there have been numerous studies on the risk factors for complicated diverticulitis, little research has focused on severe diverticulitis. This study was designed to identify the risk factors for severe diverticulitis in an acute diverticulitis attack using the modified Hinchey classification. METHODS: Patients were included if they had any evidence of acute diverticulitis detected by computed tomography. The patients were subdivided into severe diverticulitis (Hinchey class > or =Ib; abscesses or peritonitis) and moderate diverticulitis (Hinchey class Ia; pericolic inflammation) groups. RESULTS: Of the 128 patients, 25 exhibited severe diverticulitis, and 103 exhibited moderate diverticulitis. In a multivariate analysis, age >50 years (odds ratio [OR], 5.27; p=0.017), smoking (OR, 3.61; p=0.044), comorbidity (OR, 4.98; p=0.045), leukocytosis (OR, 7.70; p=0.003), recurrence (OR, 4.95; p=0.032), and left-sided diverticulitis (OR, 6.92; p=0.006) were significantly associated with severe diverticulitis. CONCLUSIONS: This study suggests that the risk factors for severe diverticulitis are age >50 years, smoking, comorbidity, leukocytosis, recurrent episodes, and left-sided diverticulitis.
Abscess
;
Comorbidity
;
Diverticulitis
;
Humans
;
Korea
;
Leukocytosis
;
Multivariate Analysis
;
Recurrence
;
Risk Factors
;
Smoke
;
Smoking
3.Intestinal Tuberculosis with a Duodenal Fistula.
Eun Bum PARK ; Yoon Tae JEEN ; Jae Hong AHN ; Sang jun SUH ; Sun Jae LEE ; Nark Soon PARK ; Bora KEUM ; Yeon Seok SEO ; Yong Sik KIM ; Hoon Jai CHUN ; Hong Sik LEE ; Soon Ho UM ; Sang Woo LEE ; Jai Hyun CHOI ; Chang Duck KIM ; Ho Sang RYU
Korean Journal of Gastrointestinal Endoscopy 2007;35(5):346-350
Intestinal tuberculosis is a common disease of extrapulmonary tuberculosis. A diagnosis of intestinal tuberculosis is difficult as the symptoms and laboratory findings are not specific for the disease. Intestinal tuberculosis may cause various complications, such as intestinal obstruction, intestinal perforation, intraabdominal abscess, intestinal hemorrhage and fistula formation. A duodenal fistula caused by tuberculosis is an especially rare condition. We experienced a case of intestinal tuberculosis with a duodenal fistula as a complication. The patient was a 25-year-old man that presented with weight loss and diarrhea. Esophagogastroduodenoscopy showed a deep ulcerative lesion on the third portion of the duodenum with a fistula opening. A histological finding revealed granulomatous inflammation with multinucleated giant cells. In addition, the result of a Tb PCR assay was positive. After two months of treatment with the appropriate medication, the symptoms improved and the fistula has closed completely. We report the case with a review of the literature.
Abscess
;
Adult
;
Diagnosis
;
Diarrhea
;
Duodenum
;
Endoscopy, Digestive System
;
Fistula*
;
Giant Cells
;
Hemorrhage
;
Humans
;
Inflammation
;
Intestinal Obstruction
;
Intestinal Perforation
;
Polymerase Chain Reaction
;
Tuberculosis*
;
Ulcer
;
Weight Loss
4.A Case of a Double Gallbladder with Common Bile Duct Stones.
Nark Soon PARK ; Hong Sik LEE ; Ji Hoon KIM ; Dong Hun LEE ; Eun Sun KIM ; Young Jin KIM ; Eun Bum PARK ; Jin Nam KIM ; Ja Seol KOO ; Sang Woo LEE ; Jae Hyun CHOI ; Chang Duck KIM ; Ho Sang RYU
Korean Journal of Gastrointestinal Endoscopy 2007;35(5):369-372
A double or bilobed gallbladder is a rare congenital anomaly, occurring at a rate of 1/4,000~5,000. We encountered a case of a double gallbladder that was diagnosed by an endoscopic retrograde cholangiogram. In view of the paucity of this anomaly, we report the case of a patient with a double gallbladder (Y duplication) accompanied by a common bile duct (CBD) stone. We also discuss the characteristics, classification, embryology and treatment of the double gallbladder.
Cholangiopancreatography, Endoscopic Retrograde
;
Classification
;
Common Bile Duct*
;
Embryology
;
Gallbladder*
;
Humans
5.Pneumoretroperitoneum, Pneumomediastinum, Peumopericardium, and Subcutaneous Emphysema after Colonoscopic Examination.
Nark Soon PARK ; Jae Hyun CHOI ; Dong Hun LEE ; Young Jin KIM ; Eun Sun KIM ; Sung Woo JUNG ; Ja Seol KOO ; Hong Sik LEE ; Sang Woo LEE
Gut and Liver 2007;1(1):79-81
Colonoscopy is regarded as a relatively safe procedure and is widely performed. However, complications such as bleeding, perforation, and coagulation syndromes can occur during colonoscopy. Although bowel perforation is as rare as 0.4-1.9% of cases, it is the most serious and awful adverse event which can lead to a death. Colon perforation may occur as either intraperitoneal or extraperitoneal, or in combination. Right subdiaphragmatic free air suggests intraperitoneal perforation while pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema suggest extraperitoneal perforation. Combined intraperitoneal and extraperitoneal perforation is very rare. Herein, we present a case of combined intraperitoneal and extraperitoneal colon perforation which manifested as pneumoretroperitoneum, pneumomediastinum, pneumopericardium, and subcutaneous emphysema. The lesion was closed with endoscopic clipping.
Colon
;
Colonoscopy
;
Hemorrhage
;
Intestinal Perforation
;
Mediastinal Emphysema*
;
Pneumopericardium
;
Retropneumoperitoneum*
;
Subcutaneous Emphysema*
6.A Case of a Pedunculated Exoluminal Gastrointestinal Stromal Tumor in the Stomach.
Young Jin KIM ; Jai Hyun CHOI ; Eun Sun KIM ; Dong Hun LEE ; Nark Soon PARK ; Ja Seol KOO ; Sung Woo JUNG ; Hyung Joon YIM ; Hong Sik LEE ; Sang Woo LEE ; Ho Sang RYU
Korean Journal of Gastrointestinal Endoscopy 2007;35(5):332-336
A 49-year-old man visited our hospital with a complaint of a left lower quadrant abdominal mass. Abdominal computed tomography (CT) showed an exophytic tumor attached to the stomach; the marginal region was intensely enhanced as seen on contrast imaging in the delayed phase. The gastric tumor was excised using a laparoscopic procedure. The gastric tumor was removed along with the gastric wall where the tumor was attached to by a pedicle. The external surface of the tumor showed a well-encapsulated appearance and several engorged vessels. Histologically, the tumor cells had a clear or eosinophilic cytoplasm and round nuclei. Four mitotic figures were seen per 50 cells on a high power field. Immunohistochemical staining demonstrated positive expression of c-kit, CD34, and vimentin and negative expression of smooth muscle actin (SMA) and S-100. The final diagnosis was a pedunculated exoluminal gastrointestinal stromal tumor (GIST).
Actins
;
Cytoplasm
;
Diagnosis
;
Eosinophils
;
Gastrointestinal Stromal Tumors*
;
Humans
;
Middle Aged
;
Muscle, Smooth
;
Stomach*
;
Vimentin