Endoscopic retrograde cholangiopancreatography (ERCP) is a safe procedure with life-threatening complications rarely occurring after the procedure. There are several reports of complications with ERCP, including bleeding, perforation, pancreatitis, cholangitis and cholecystitis. In our case, an umbilical hernia was strangulated after therapeutic ERCP had been performed in a patient with acute pancreatitis by a biliary stone, which required a surgical resection. To the best of our knowledge, this is the first report of such a case in Korea. This case highlights the need for close and careful observations for the early detection of possible complications after ERCP.
Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Cholecystitis ; Hemorrhage ; Hernia, Umbilical* ; Humans ; Korea ; Pancreatitis*

BACKGROUND/AIMS: Indications for submucosal saline-epinephrine injection (SSEI) for prevention of postpolypectomy bleeding, in the colon, is variable among endoscopists. The aim of this study was to determine the proper indication for SSEI. METHODS: Clinical data of 1,745 polypectomies was evaluated. Postpolypectomy bleeding after snare polypectomy were evaluated in 1,039 polypectomies. Subgroup analysis was performed in 4 subgroups by size (< or = 8 mm or >8 mm) and gross morphology (pedunculated or sessile), also. RESULTS: Submucosal saline-epinephrine injection was used in 679 snare polypectomies. The size of polyps was 9.5+/-4.3 mm. Distribution of polyps showed left side shift in the colon. Sessile polyps (79.4%) and benign adenoma (75.3%) were predominant. Twenty seven episodes (2.6%) of bleeding occurred after snare polypectomy. Rectal polyp, malignant polyp and procedure without SSEI increased bleeding after snare polypectomy with odds ratio 4.71, 10.48 and 3.44, respectively. However, SSEI significantly reduced the bleeding only in patients who had >8 mm sized sessile polyps with odds ratio 16.41 regardless of location and histopathology. CONCLUSIONS: SSEI should be performed in colonoscopic snare polypectomy for >8 mm sized sessile polyps, and might be performed in others for prevention of bleeding at the discretion of the clinician.
Adenoma

No abstract available.

BACKGROUND/AIMS: Detection of asymptomatic benign colon polyp is increasing because colonoscopy is widely used as a screening and diagnostic method. Fecal occult blood test is usually performed for the selection of patients requiring colonoscopy as well as mass screening for colon cancer. The aim of this study was to investigate the usefulness of fecal occult blood test performed prior to colonoscopy as a screening method of benign colon polyps. METHODS: Clinical characteristics of patients with polyps were evaluated according to the fecal occult blood test results in patients who underwent one-day fecal occult blood test and colonoscopic polypectomies from May 2003 to October 2004, retrospectively. RESULTS: A total of 942 colonoscopic polypectomies in 288 patients were evaluated. Fecal occult blood tests were positive only in 32 patients (11.1%). In univariate analysis, there was a significant difference in polyp size (p=0.02) and location (p=0.03) according to the presence of positive fecal occult blood tests. In addition, age of the patient (p=0.046), polyp size (mean, p=0.04; largest, p<0.01) and the number of polyps (p=0.045) were significantly different. However, in multivariate analysis, only polyp size larger than 20 mm was significantly related with positive fecal occult blood test with estimated odds ratio of 4.71. CONCLUSIONS: Fecal occult blood test has limitations as a screening test in asymptomatic patients with colon polyps, except for colon polyps larger than 20 mm in size.
Colonic Neoplasms/diagnosis ; Colonic Polyps/*diagnosis ; Colonoscopy ; Female ; Humans ; Male ; Mass Screening ; *Occult Blood ; Sensitivity and Specificity