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Low Prevalence of Polyps in Chronic Inflammatory Status of the Colon.

Sook Hee CHUNG

The Korean Journal of Gastroenterology.2015;66(5):300-302. doi:10.4166/kjg.2015.66.5.300

No abstract available.

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Pancreatitis with Pseudocyst Arising from Ectopic Pancreas in a Chronic Alcoholism.

Ki Hyun RYU ; Yong Seok KIM ; Yong Woo CHOI

The Korean Journal of Gastroenterology.2015;66(5):297-299. doi:10.4166/kjg.2015.66.5.297

No abstract available.
Alcoholism/complications/*diagnosis ; Endoscopy, Digestive System ; Humans ; Male ; Middle Aged ; Pancreatic Pseudocyst/*diagnosis/diagnostic imaging ; Pancreatitis/*diagnosis/diagnostic imaging/etiology ; Tomography, X-Ray Computed

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Primary Adenocarcinoma with Focal Choriocarcinomatous Differentiation in the Sigmoid Colon.

Sook Kyoung OH ; Hyung Wook KIM ; Dae Hwan KANG ; Cheol Woong CHOI ; Yu Yi CHOI ; Hong Kyu LIM ; Ja Jun GOO ; Sung Yeol CHOI

The Korean Journal of Gastroenterology.2015;66(5):291-296. doi:10.4166/kjg.2015.66.5.291

Primary colorectal choriocarcinoma is a rare neoplasm. Only 19 cases have been reported worldwide, most of which involved adenocarcinomas. The prognosis is usually poor, and the standard therapy for this tumor has not been established. A 61-year-old woman presented with constipation and lower abdominal discomfort. She was diagnosed with primary adenocarcinoma with focal choriocarcinomatous differentiation in the sigmoid colon and liver metastasis. Because the serum beta-human chorionic gonadotropin level was not significantly elevated, and because only focal choriocarcinomatous differentiation was diagnosed, we selected the chemotherapy regimen that is used for the treatment of metastatic colorectal adenocarcinoma. The patient survived for 13 months after the initial diagnosis. This is the first case in Korea to assess the suppressive effects of the standard chemotherapy for colorectal adenocarcinoma against coexisting colorectal choriocarcinoma and adenocarcinoma.
Adenocarcinoma/*diagnosis/drug therapy/pathology ; Antineoplastic Agents/administration & dosage ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; CA-19-9 Antigen/analysis ; Chorionic Gonadotropin, beta Subunit, Human/blood ; Colon, Sigmoid/pathology ; Colonic Neoplasms/*diagnosis/drug therapy/pathology ; Colonoscopy ; Constipation/etiology ; Female ; Fluorouracil/therapeutic use ; Humans ; Leucovorin/therapeutic use ; Liver Neoplasms/secondary ; Middle Aged ; Organoplatinum Compounds/therapeutic use ; Prognosis ; Tomography, X-Ray Computed

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Successful Treatment of Bleeding Duodenal Varix by Percutaneous Transsplenic Embolization.

Dong Hun KANG ; Ji Won PARK ; Eui Yong JEON ; Sung Eun KIM ; Jong Hyeok KIM ; Young Seok KWON ; Seung Ah PARK ; Choong Kee PARK

The Korean Journal of Gastroenterology.2015;66(5):286-290. doi:10.4166/kjg.2015.66.5.286

Variceal bleeding occurs primarily in the esophagus or stomach in patients with liver cirrhosis, but can also occur rarely in the duodenum. Duodenal variceal bleeding has a high mortality and poor prognosis due to heavy blood flow originating from the portal vein (PV) and the technical difficulty of hemostatic procedures. Treatments including endoscopic sclerotherapy, endoscopic ligations, endoscopic clipping and transjugular intrahepatic portosystemic shunt have been tried, with only moderate and variable success. A percutaneous transsplenic approach offers another way of accessing the PV. Here we report a case of successfully treated duodenal variceal bleeding by percutaneous transsplenic embolization.
Aged ; Duodenum ; Embolization, Therapeutic ; Endoscopy, Gastrointestinal ; Esophageal and Gastric Varices/complications/*diagnosis ; Gastrointestinal Hemorrhage/*therapy ; Humans ; Liver Cirrhosis/complications/*diagnosis ; Male ; Portal Vein/diagnostic imaging ; *Portasystemic Shunt, Transjugular Intrahepatic ; Recurrence ; Tomography, X-Ray Computed

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A Case of Aerophagia Diagnosed by Multichannel Intraluminal Impedance Monitoring.

Ki Chang SOHN ; Young Hoon JEONG ; Dong Ho JO ; Won Gak HEO ; Dong Han YEOM ; Suck Chei CHOI ; Han Seung RYU

The Korean Journal of Gastroenterology.2015;66(5):282-285. doi:10.4166/kjg.2015.66.5.282

Aerophagia is a disorder caused by abnormal accumulation of air in the gastrointestinal tract as a result of repetitive and frequent inflow of air through the mouth. For the diagnosis of this condition, it is difficult to objectively measure the air swallowing. However, multichannel intraluminal impedance monitoring facilitates the differential diagnosis between normal air swallowing and pathologic aerophagia, and can aid in the determination of the frequency and amount of air swallowed. In this report, in addition to a literature review, we describe a case of 36-year-old man with abdominal distension who was diagnosed with aerophagia using esophageal impedance monitoring and was treated with clonazepam.
Adult ; Aerophagy/*diagnosis/diagnostic imaging/drug therapy ; Anticonvulsants/therapeutic use ; Clonazepam/therapeutic use ; Diagnosis, Differential ; Electric Impedance ; Humans ; Male ; Mental Disorders/complications ; Tomography, X-Ray Computed

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Massive Gastrointestinal Bleeding due to Aneurysmal Rupture of Ileo-colic Artery in a Patient with Behcet's Disease.

Seung Up KIM ; Jae Hee CHEON ; Joon Seok LIM ; Seung Hyuk PAIK ; Sang Kyum KIM ; Sang Kil LEE ; Yong Chan LEE ; Won Ho KIM

The Korean Journal of Gastroenterology.2007;49(6):400-404.

Behcet's disease has been recognized as a systemic vasculitis characterized by the involvement of multiple organs such as orogenital ulcers, eye lesions including uveitis and optic neuritis, and skin lesions including folliculitis and erythema nodosum. Vascular involvement occurs occasionally and is classified into thrombosis and aneurysm. However, massive gastrointestinal bleeding from arterial aneurysm is a rare manifestation of intestinal Behcet's disease. Recently, we experienced a case of intestinal Behcet's disease presenting with massive gastrointestinal bleeding due to aneurysmal rupture of ileo-colic artery. A 30-year-old male with Behcet's disease was admitted because of massive gastrointestinal bleeding. A large ileo-cecal ulcer was revealed as a bleeding focus on colonoscopic examination. Celiac angiography showed aneurysm and stenosis of ileo-colic artery. After the failure of hemostasis with arterial embolization, ileocecectomy was performed. After the resection hematochezia was completely stopped.
Adult ; Aneurysm, Ruptured/complications/*diagnosis ; Behcet Syndrome/complications/*diagnosis ; Cecum/*blood supply/pathology/surgery ; Celiac Artery/radiography ; Colonoscopy ; Gastrointestinal Hemorrhage/*diagnosis/etiology ; Humans ; Ileum/*blood supply/pathology/surgery ; Male ; Tomography, X-Ray Computed

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Three Cases of Hereditary Pancreatitis in Two Households in the Same Family Associated with R122H Mutation in Cationic Trypsinogen Gene.

Tae Yoon LEE ; Hyoung Chul OH ; Myung Hwan KIM ; Seunghyun KWON ; Sang Soo LEE ; Dong Wan SEO ; Sung Koo LEE

The Korean Journal of Gastroenterology.2007;49(6):395-399.

Hereditary pancreatitis is a rare, autosomal dominant, inherited disease characterized by recurrent attacks of acute pancreatitis with the development of chronic pancreatitis and an increased risk of pancreatic cancer. R122H or N29I mutation in cationic trypsinogen (protease serine 1, PRSS1) gene causes hereditary pancreatitis. R122H mutation is the most common mutation that causes pancreatitis by preventing deactivation of trypsin within the pancreas and prolonging its action. Three members of the family, the patient, her elder son, and her niece experienced recurrent attacks of pancreatitis. We analyzed five exons of the PRSS1 gene in DNA samples of five family members including her husband and younger son who were asymptomatic. We found out that four members of the family, the patient, her two sons, and her niece, had R122H mutation in the exon 3 of PRSS1 gene. Finally, we diagnosed hereditary pancreatitis in two households in the same family.
Adolescent ; Adult ; Amino Acid Substitution ; Cholangiopancreatography, Endoscopic Retrograde ; Female ; Humans ; *Mutation ; Pancreatitis, Chronic/*diagnosis/*genetics ; Pedigree ; Sequence Analysis, DNA ; Tomography, X-Ray Computed ; Trypsinogen/*genetics

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Celiac Artery Thrombosis and Splenic Infarction in a Patient with Protein S Deficiency.

Chan Woong KIM ; Jeong Wook KIM

The Korean Journal of Gastroenterology.2007;49(6):390-394.

Protein S deficiency is a rare blood disorder associated with an increased risk of thrombosis. Only a few cases of arterial thrombosis of digestive tract have been noted. We report a case of celiac arterial thrombosis and splenic infarction in 46-year-old male with protein S deficiency. Abdominal computed tomography and angiography revealed thrombotic obstruction of the proximal celiac and common hepatic artery with splenic infarction. His total and free antigen of protein S were normal, however, the activity of protein S was low. Percutaneous transluminal angioplasty was performed to revascularise celiac and common hepatic artery.
*Celiac Artery/radiography ; Humans ; Male ; Middle Aged ; Protein S Deficiency/*complications/genetics ; Splenic Infarction/etiology/*radiography ; Thrombosis/etiology/*radiography ; Tomography, Spiral Computed

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SPINK1 N34S Mutation as a Possible Cause of Chronic Pancreatitis in a Patient with Familial Background.

Hyoung Chul OH ; Tae Yoon LEE ; Seunghyun KWON ; Sang Soo LEE ; Dong Wan SEO ; Sung Koo LEE ; Myung Hwan KIM

The Korean Journal of Gastroenterology.2007;49(6):384-389.

New insight in the field of chronic pancreatitis was provided by the discovery of protease serine 1 (PRSS1) mutation, inherited by autosomal dominant trait in hereditary pancreatitis. Serine protease inhibior, Kazal type 1 (SPINK1) is a potent protease inhibitor which prevents premature intrapancreatic activation of trypsin and pancreatic autodigestion. Strong associations of SPINK1 mutation and different forms of pancreatitis were suggested. However, it is unlikely that SPINK1 mutation alone can cause chronic pancreatitis. This mutation acts as a disease-modifier or plays a role within polygenic or multifactorial models. A 23 year-old young woman with chronic pancreatitis was recently discovered to have SPINK1 N34S heterozygous mutation cosegregated with two intronic mutations, IVS1-37T>C and IVS3-69insTTTT, during the evaluation for potential cause of chronic idiopathic pancreatitis. The same mutation was identified in her mother. This is the first report in Korea suggesting that SPINK1 mutation would be a possible cause of chronic pancreatitis in a patient with familial background.
Adult ; Amino Acid Substitution ; Carrier Proteins/*genetics ; Cholangiopancreatography, Endoscopic Retrograde ; Family ; Female ; Heterozygote ; Humans ; *Mutation ; Pancreatitis, Chronic/*diagnosis/*genetics ; Sequence Analysis, DNA ; Tomography, X-Ray Computed

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Non-endoscopic Predictors of Large Esophageal Varices in Patients with Liver Cirrhosis.

Myung Hee CHANG ; Joo Hyun SOHN ; Tae Yeob KIM ; Byoung Kwan SON ; Jong Pyo KIM ; Yong Cheol JEON ; Dong Soo HAN

The Korean Journal of Gastroenterology.2007;49(6):376-383.

BACKGROUND/AIMS: The aim of this study was to identify non-endoscopic predictors for the presence of large esophageal varices in Korean patients with liver cirrhosis. METHODS: Among 736 patients with liver cirrhosis newly diagnosed between the year 2001 and 2005, 245 patients (171 men and 74 women, mean age of 51.9 years) fulfilled the inclusion criteria and underwent EGD as screening tests for esophageal varices. Fifteen variables were analysed to identify the presence of large esophageal varices. RESULTS: Esophageal varices were noted in 186 patients (75.9%) and large varices in 55 patients (22.4%), while 59 patients (24.1%) had no varices at the time of initial diagnosis of cirrhosis. The causes of liver cirrhosis were viral hepatitis (41.2%), chronic alcoholism (42.4%), viral hepatitis/alcoholism (9.8%), and others (6.6%). Fifty-one percent, 35.1% and 13.9% of the patients belonged to Child-Pugh class A, B, and C, respectively. Variables associated with the presence of large esophageal varices on univariate analysis were the presence of ascites, splenomegaly (long-axis > or =12 cm by ultrasound measure), alcoholism, Child-Pugh class, platelet count, prothrombin time, and albumin. On multivariate analysis, alcohol, splenomegaly, and ascites were significantly associated with the presence of large esophageal varices. If the patients have two of them, sensitivity and negative predictive value were 80% and 91.7%, respectively. Patients without all three factors had no large esophageal varices. CONCLUSIONS: These results suggest that patients who have at least two among ascites, splenomegaly, and alcoholism would have an increased risk of having large esophageal varices.
Adult ; Aged ; Ascites/diagnosis ; Esophageal and Gastric Varices/diagnosis/epidemiology/*etiology ; Female ; Humans ; Liver Cirrhosis/*complications/epidemiology ; Liver Cirrhosis, Alcoholic/*complications/epidemiology ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; Prevalence ; ROC Curve ; Risk Factors ; Sensitivity and Specificity ; Severity of Illness Index ; Splenomegaly/complications

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