1.Gastropericardial Fistula as a Complication in a Refractory Gastric Ulcer after Esophagogastrostomy with Gastric Pull-Up.
Semi PARK ; Jie Hyun KIM ; Yong Chan LEE ; Jae Bock CHUNG
Yonsei Medical Journal 2010;51(2):270-272
A gastropericardial fistula, defined as penetration of a gastric lesion into the pericardium, is a rare occurrence. Such a fistula is usually associated with a huge ulcer in the gastric fundus, an ulcer within a hiatus hernia, a history of esophagogastric surgery, the concurrent use of non-steroidal anti-inflammatory drugs (NSAIDs), or Zollinger-Ellison syndrome. The patient in this case presented with shoulder pain and melena, caused by a gastropericardial fistula that had occurred as a late complication of postoperative esophagogastrostomy and a refractory gastric ulcer. Despite the severity of the condition, the patient showed great improvement after medical treatment and the fistula was cured at the end.
Esophagectomy/*methods
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Gastric Fistula/*diagnosis/*etiology
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Humans
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Male
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Middle Aged
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Pericardium/*pathology
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Stomach Ulcer/*complications/*surgery
2.Serial Episodes of Gastric and Cecal Perforation in a Patient with Behcet's Disease Involving the Whole Gastrointestinal Tract: A Case Report.
Dong Yeob SHIN ; Jae Hee CHEON ; Jae Jun PARK ; Hoguen KIM ; Tae Il KIM ; Yong Chan LEE ; Nam Kyu KIM ; Won Ho KIM
The Korean Journal of Gastroenterology 2009;53(2):106-110
Behcet's disease (BD) has been recognized as multi-systemic chronic vasculitic disorder of recurrent inflammation, characterized by the involvement of multiple organs and resulting in orogenital ulcers, uveitis, and skin lesions. Involvement of the central nervous system, vessels, and intestines in BD often leads to a poor prognosis. Digestive manifestations in BD have been reported in up to 1-60% of cases, although the rate varies in different countries. The most frequent extra-oral sites of gastrointestinal involvement are the ileocecal region and the colon. Gastric or esophageal involvement is reported to be very rare. Moreover, there have been no reports on the simultaneous involvement of the esophagus, stomach, ileum, and colon. Here, we present a 55-year-old Korean man with intestinal BD and multiple ileal and colonic ulcerations complicated by perforation, gastric ulcer with bleeding followed by perforation, and esophageal ulcers with bleeding.
Behcet Syndrome/complications/*diagnosis/pathology
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Cecal Diseases/complications/pathology
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Diagnosis, Differential
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Endoscopy, Digestive System
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Gastrointestinal Diseases/complications/*diagnosis
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Gastrointestinal Hemorrhage
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Humans
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Intestinal Perforation/*diagnosis/etiology/pathology
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Male
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Middle Aged
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Peptic Ulcer Perforation/pathology
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Stomach Ulcer/complications/pathology
3.Gastrectomy for the treatment of refractory gastric ulceration after radioembolization with 90Y microspheres.
Sun Young YIM ; Jin Dong KIM ; Jin Yong JUNG ; Chang Ha KIM ; Yeon Seok SEO ; Hyung Joon YIM ; Soon Ho UM ; Ho Sang RYU ; Yun Hwan KIM ; Chong Suk KIM ; Eun SHIN
Clinical and Molecular Hepatology 2014;20(3):300-305
Transcatheter arterial radioembolization (TARE) with Yttrium-90 (90Y)-labeled microspheres has an emerging role in treatment of patients with unresectable hepatocellular carcinoma. Although complication of TARE can be minimized by aggressive pre-evaluation angiography and preventive coiling of aberrant vessels, radioembolization-induced gastroduodenal ulcer can be irreversible and can be life-threatening. Treatment of radioembolization-induced gastric ulcer is challenging because there is a few reported cases and no consensus for management. We report a case of severe gastric ulceration with bleeding that eventually required surgery due to aberrant deposition of microspheres after TARE.
Aged
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Carcinoma, Hepatocellular/*diagnosis/radiotherapy
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Embolization, Therapeutic/*adverse effects
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Gastrectomy
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Gastrointestinal Hemorrhage/etiology
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Gastroscopy
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Humans
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Liver Neoplasms/*diagnosis/radiotherapy
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Magnetic Resonance Imaging
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Male
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*Microspheres
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Radiopharmaceuticals/therapeutic use
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Stomach/pathology
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Stomach Ulcer/*etiology/surgery
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Yttrium Radioisotopes/chemistry
4.Non-healing Iatrogenic Gastric Ulcers after Endoscopic Mucosal Resection for Gastric Epithelial Neoplasia: Report of Two Cases.
Soo Hyeon LEE ; Jae Hee CHEON ; Jie Hyun KIM ; Jong Pill PARK ; Sang Kil LEE ; Yong Chan LEE
The Korean Journal of Gastroenterology 2008;51(2):127-131
Endoscopic mucosal resection (EMR) is widely accepted as a standard treatment for early gastric cancer or gastric adenoma. However, EMR inevitably results in the formation of large iatrogenic ulcer at the resected area. Although the characteristics of EMR-induced ulceration are not fully understood, this type of ulcer is thought to heal faster and to recur less often than non-iatrogenic gastric ulcer. Current available evidences have suggested that EMR-induced ulcers heal within 2-3 months. Herein, we report two cases of non-healing persistent gastric ulcers after EMR. One is a case of gastric carcinoma which developed at the same site of previous EMR site for the low grade dysplasia. The other is a case in which persistent EMR-induced ulcer was healed in the long run after Helicobacter pylori eradication therapy.
Aged
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Endoscopy, Gastrointestinal
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Gastric Mucosa/pathology/*surgery
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Helicobacter Infections/complications/drug therapy
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Helicobacter pylori
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Humans
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Iatrogenic Disease
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Male
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Middle Aged
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Stomach Neoplasms/complications/diagnosis/*surgery
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Stomach Ulcer/diagnosis/*etiology/pathology