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Amyloidosis uncommonly presents with intestinal pseudo-obstruction. According to previous reports, patients with primary AL amyloidosis presented with a chronic process with symtom duration of more than 1 year, but patients with secondary AA amyloidosis presented as an acute illness, usually less than 10 weeks. Localized gastrointestinal amyloidosis limited to the jejunum, without involvement of stomach, duodenum, colon, or rectum, is very rare. Imaging studies in small intestinal amyloidosis generally show a symmetrical uniform appearance. AA amyloidosis with acute-phase reactant serum amyloid A protein is associated with inflammatory, infectious or neoplastic disorders. To our knowledge, no case of amyloidosis associated with latent syphilis has been reported to date. We present a case of a 56-year-old man who presented with clinical and radiographic features of a small bowel obstruction and obscure gastrointestinal bleeding. Investigations including laparoscopy and other laboratory dataled to a diagnosis of pseudo-obstruction of the jejunum due to AA amyloidosis associated with latent syphilis. After appropriate treatment for latent syphilis, abdominal symptoms had been disappeared, but jejunal dilatation was still present two years later.
Amyloidosis ; Colon ; Dilatation ; Duodenum ; Hemorrhage ; Humans ; Intestinal Pseudo-Obstruction ; Jejunum ; Laparoscopy ; Middle Aged ; Rectum ; Serum Amyloid A Protein ; Stomach ; Syphilis ; Syphilis, Latent

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A Case of Granular Cell Tumor of Cecum Misdiagnosed as Carcinoid Tumor.

Kyu Hyun CHO ; Jin Tae JUNG ; Jimin HAN ; Joong Goo KWON ; Eun Young KIM ; Chang Ho CHO

Intestinal Research.2010;8(2):191-194. doi:10.5217/ir.2010.8.2.191

Granular cell tumors (GCTs) are relatively rare submucosal tumors with an incidence of 10% in the gastrointestinal tract. In the gastrointestinal tract, the esophagus is the most common site for GCTs, while the colorectum is an uncommon site. GCTs are often found incidentally as small, submucosal tumors on esophagogastroduodenoscopy. On endoscopic ultrasonography (EUS), GCTs usually have a homogeneous hypoechoic pattern. EUS cannot adequately distinguish GCTs from carcinoid tumors. We report a case of a cecal GCT that was misdiagnosed as a carcinoid tumor by EUS and was treated by endoscopic mucosal resection, along with a review of the literature.
Carcinoid Tumor ; Cecum ; Endoscopy, Digestive System ; Endosonography ; Esophagus ; Gastrointestinal Tract ; Granular Cell Tumor ; Incidence

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Colitis Cystica Profunda Masquerading as a Pneumatosis Cystoides Intestinalis: A Case Report.

Eun Suk JUNG ; Jae Hee CHEON ; Kyong Joo LEE ; Hyun Jung LEE ; Hui Won JANG ; Young Eun CHON ; Kyu Sik JUNG ; Seonjung CHANG ; Sung Pil HONG ; Tae Il KIM ; Won Ho KIM

Intestinal Research.2010;8(2):187-190. doi:10.5217/ir.2010.8.2.187

Colitis Cystica Profunda (CCP) is an uncommon and benign disease entity characterized by mucoid cysts located in the submucosal layer of the colon. It can mimic cystic submucosal tumors or mucinous adenocarcinoma and is usually located in the rectum. CCP is found in the ascending colon less frequently. CCP manifesting as multiple cystic tumors, similar to pneumatosis cystoides intestinalis, has not yet been reported. Recently, a case of CCP mimicking pneumatosis cystoides intestinalis in the ascending colon was treated. Here this case is reported and the literature reviewed.
Adenocarcinoma, Mucinous ; Colitis ; Colon ; Colon, Ascending ; Hydrazines ; Pneumatosis Cystoides Intestinalis ; Rectum

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A Case of Peutz-Jeghers Syndrome Diagnosed by Wireless Capsule Endoscopy.

Seung Uk JEONG ; Hyun Joo SONG ; Eun Kwang CHOI ; Yoo Kyung CHO ; Heung Up KIM ; Byung Cheol SONG ; Weon Young CHANG ; Young Hee MAENG

Intestinal Research.2010;8(2):181-186. doi:10.5217/ir.2010.8.2.181

Peutz-Jeghers syndrome (PJS), is a rare autosomal dominant hereditary disorder. Intestinal hamartomatous polyps in association with melanocytic pigmentation of the skin and mucous membranes characterize PJS. Patients with PJS often have complications associated with the polyps, such as intestinal obstruction, intussusception, acute or chronic gastrointestinal bleeding, and the development of various types of cancer. Enteroclysis, small bowel follow-through, and push enteroscopy are generally used to identify the presence and location of small bowel polyps. Wireless capsule endoscopy (CE) has been confirmed as a feasible, safe, and sensitive test for the surveillance of small bowel polyps in patients with PJS and could replace radiographic small bowel surveillance. Here, a case of PJS newly diagnosed by CE is reported. The patient, a 30-year-old man who had developed rectal polyps associated with anal extrusion 7 years previously, had six episodes of hematochezia.
Adult ; Capsule Endoscopy ; Gastrointestinal Hemorrhage ; Hemorrhage ; Humans ; Intestinal Obstruction ; Intussusception ; Mucous Membrane ; Peutz-Jeghers Syndrome ; Pigmentation ; Polyps ; Skin

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A Pityrosporum Fungal Infection Following Infliximab Therapy in a Crohn's Disease Patient.

Keun Young SHIN ; Jun HEO ; Min Kyu JUNG ; Seong Woo JEON ; Sung Kook KIM

Intestinal Research.2010;8(2):177-180. doi:10.5217/ir.2010.8.2.177

Crohn's disease (CD) is a chronic immune-mediated inflammatory disorder. Treatment strategies for CD are targeted toward various components of the proinflammatory mediators and subsequent immune response. Recently, the anti-tumor necrosis factor (TNF) monoclonal antibody, infliximab has been used in patients with CD. However, uncommon and unusual infections have been reported during anti-TNF-alpha therapy and immunomodulator. Here, we report a case of pityriasis versicolor occurring in a patient with CD receiving infliximab treatment. The patient was successfully treated with topical ketoconazole.
Antibodies, Monoclonal ; Crohn Disease ; Humans ; Infliximab ; Ketoconazole ; Malassezia ; Necrosis ; Tinea Versicolor

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Squamous Cell Carcinoma of the Rectum: Report of Two Cases.

Na Rae KIM ; Dong Hae CHUNG ; Jeong Heum BAEK ; Yeon Ho PARK ; Hee Eun KYUNG ; Mi Sook ROH ; Seung Yeon HA

Intestinal Research.2010;8(2):172-176. doi:10.5217/ir.2010.8.2.172

Squamous cell carcinoma of the rectum is extremely rare. Herein we report two cases of rectal squamous cell carcinoma. Case 1 was a 44-year-old Korean female presenting with abdominal pain and rectal bleeding for 3 months before her hospital visit. A colonoscopic examination revealed an ulcerated rectal mass 8 cm proximal to the anal verge. Chemoradiotherapy was administered following Hartmann's procedure in case 1. The patient remained alive during 19 months of follow up. Case 2 was a 43-year-old Korean female who had severe constipation for 2 months. A barium enema and computed tomography of the pelvis showed a rectal mass adherent to the sacrum. Based on the results of a colonoscopic biopsy, a diverting colostomy was performed in case 2, with no further treatment. The pathologic findings showed that both tumors were composed of oval-shaped cells with abundant eosinophilic cytoplasm and intercellular bridges with keratin pearls, and thus were diagnosed as well-differentiated squamous cell carcinoma. Neither of the cases showed evidence of HPV infection. The pathogenesis of rectal squamous cell carcinoma has not been clarified. Herein we report two cases of rectal squamous cell carcinoma and briefly discuss the possible histogenesis.
Abdominal Pain ; Adult ; Barium ; Biopsy ; Carcinoma, Squamous Cell ; Chemoradiotherapy ; Colostomy ; Constipation ; Cytoplasm ; Enema ; Eosinophils ; Female ; Follow-Up Studies ; Hemorrhage ; Humans ; Keratins ; Pelvis ; Rectum ; Sacrum ; Ulcer

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The Effect of Autonomic Nerve System on Neurotensin Induced Motility in Isolated, Vascularly Perfused Rat Colon.

Jeong Hoon JI ; Sung Moo KIM ; Euikeun SEO ; Young Shim CHO ; Suk Hee YOO ; Joung Ho HAN ; Hee Bok CHAE ; Seon Mee PARK ; Sei Jin YOUN

Intestinal Research.2010;8(2):162-171. doi:10.5217/ir.2010.8.2.162

BACKGROUND/AIMS: Although neurotensin (NT) stimulates colon motility and the passage of intestinal contents, the associated mechanism of action remains unclear. The objective of this study was to investigate the effects of NT on colon motility using isolated rat colon. METHODS: Intraluminal pressure was measured at both the proximal and distal portions of the isolated colon. An isolated rat colon was perfused with Krebs solution via the superior mesenteric artery. After stabilization, NT was administered in concentrations of 14, 28, 138 and 276 pM. After pretreatment with phentolamine, propranolol, hexamethonium, atropine or tetrodotoxin, NT was administered at a concentration of 276 pM, and then the intraluminal pressure was monitored. RESULTS: NT significantly increased colon motility at concentrations of 14, 28, 138, and 276 in the proximal colon (25.1+/-6.5%, 175.4+/-117.0%, 240.8+/-115.1% and 252.3+/-110.6%, respectively) and in the distal colon (35.6+/-11.8%, 97.5+/-35.1%, 132.7+/-36.7% and 212.1+/-75.2%, respectively). The stimulant effect of NT was more potent in the proximal colon, in a concentration-dependent manner (P<0.05). The stimulant effect of NT was significantly inhibited by atropine at both the proximal and distal colon and by tetrodotoxin at the proximal colon, but not by tetrodotoxin at the distal colon and not by propranolol, phentolamine, or hexamethonium at both the proximal and distal colon. CONCLUSIONS: NT increased colon motility at both the proximal and distal portions of the rat colon. The effects were more prominent at the proximal portion. The results of this study suggest that the stimulant action of NT may be mediated by local cholinergic muscarinic receptors.
Animals ; Atropine ; Autonomic Pathways ; Colon ; Gastrointestinal Contents ; Hexamethonium ; Isotonic Solutions ; Mesenteric Artery, Superior ; Neurotensin ; Phentolamine ; Propranolol ; Rats ; Receptors, Muscarinic ; Tetrodotoxin

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