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A Case of Nonischemic Central Retinal Vein Occlusion Developed in the course of Ulcerative Colits.

Jin Hai HYUN ; Dong Hoon KANG ; Myung Kyu PARK ; Hoon Jai CHUN

Korean Journal of Gastrointestinal Endoscopy.1994;14(2):202-206.

Ulcerative colitis is a chronic, inflammatory disease of colon which is rare in Korea. In the course of ulcerative colitis numerous extraintestinal complication may develop on the joints, skin, liver, kidney, vessel, oral cavity and eyes. The most common ocular lesions complicated in patients with ulcerative colitis are episcleritis and iritis. And the cases of retinal vascular disease in associated with ulcerative colitis are extremely rare. We experienced nonischemic central retinal vein occlusion complicated in a patient with ulcerative colitis, who is 32-year-old male and complained decreased visual acuity and metamorphosis.
Adult ; Colitis, Ulcerative ; Colon ; Humans ; Iritis ; Joints ; Kidney ; Korea ; Liver ; Male ; Mouth ; Retinal Vein* ; Retinaldehyde ; Scleritis ; Skin ; Ulcer* ; Vascular Diseases ; Visual Acuity

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Adenosquamous Carcinoma Arising in Choledochal Cyst.

Jin Hai HYUN ; Hong Sik LEE ; Sang Woo LEE ; Chi Wook SONG ; Ho Sang RYU ; Dong Hoon KANG ; Chang Duck KIM ; Jong Woong KIM ; Jae Hyun CHOI ; Hun Jai JEON

Korean Journal of Gastrointestinal Endoscopy.1994;14(2):196-201.

Cystic dilatation of the biliary tree, so called choledochal cyst, is an uncommon disease and is not uncommonly associated with carcinoma. The most symptoms on. presentation are abdominal pain, weight loss, jaundice, and palpable mass. The prognosis of these lesions is dismal. Recently we experienced a case of carcinoma arising in a choledochal cyst in 27-year-old male complaining jaundice and fever. ERCP revealed marked dilated the CBD and obstruction of the proximal portion of the CHD. A computerized tomographic scan and percutaneous cholangiogram showed cystic dilatation of both intrahepatic ducts and solid mass in the left hepatic duct. The patient was treated with surgical resection. Pathologic studies disclosed an adenosquamous carcinoma.
Abdominal Pain ; Adult ; Biliary Tract ; Carcinoma, Adenosquamous* ; Cholangiopancreatography, Endoscopic Retrograde ; Choledochal Cyst* ; Dilatation ; Fever ; Hepatic Duct, Common ; Humans ; Jaundice ; Male ; Prognosis ; Weight Loss

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128 Cases of Endoscopic Sphincterotomy (EST).

Duck Yeii CHOI ; Ho Soon CHOI ; Byung Seok CHO ; Woo Seok CHOI ; Jin Hyung AHN ; Byung Su PARK ; Jeong Hee KO

Korean Journal of Gastrointestinal Endoscopy.1994;14(2):190-195.

Endoscopic sphincterotomy(EST) is now an established therapeutic procedure for various disorder of the pailla of Vater, the biliary tract, and the pancreas. From November 1992 to September l993, 123 cases of E.S.T were performed in our hospital. The success rate of EST was 97.8%, and choledocholithiasis was the indication for EST in 63. 4% of cases. Among 78 cases of choledocholithiasis, 47 cases were presence of gall bladder with stone (16 cases) or without stone (31 cases), especially 46 cases were assisted with needle type papillotome and 23 cases were assisted with guidewire. EST hae relatively low complications and is the therapy of choice for choledocholithiasis and various diisease of biliary tract. Guidewire assisted stanard papillotome probable reduce the use of needle type papillotome in the difficult cases that EST with pull type papillotome was impossible.
Biliary Tract ; Choledocholithiasis ; Needles ; Pancreas ; Sphincterotomy, Endoscopic* ; Urinary Bladder

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Collection and Analysis of Pure Pancreatic Juice via Duodenoscopie Cannulation.

Young Il MIN ; Sung Koo LEE ; Myung Hwan KIM ; Ho Soon CHOI ; Jung Won KIM ; Il Ran WHANG ; Won Ki MIN

Korean Journal of Gastrointestinal Endoscopy.1994;14(2):182-189.

The recent development of endoscopic retrograde cholangiopancreatography (ERCP) now permits the collection of pure human pancreatic secretions via duodenoscopic cannulation. Study objectives are evaluation of exocrine pancreatic function and analysis of pure pancreatic juice collected by use of ERCP technique in subjects without pancreatic disease. From March to July 1993, we performed ERCP and collection of pure pancreatic juice in 10 patients without evidence of pancreatic disease. (continue...)
Catheterization* ; Cholangiopancreatography, Endoscopic Retrograde ; Duodenoscopy ; Humans ; Pancreatic Diseases ; Pancreatic Juice*

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Diagnostic Value of ERCP in Pancreatic Cystic Lesions.

Young Myung MOON ; Jin Kyung KANG ; In Suh PARK ; Jae Bock CHUNG ; Si Young SONG ; Joon Pyo CHUNG ; Hee Yong MOON

Korean Journal of Gastrointestinal Endoscopy.1994;14(2):175-181.

The majority of cystic lesions of the pancreas are psudocysts and a small fraction neoplastic. Failure to recognize the true nature of neoplastic cyst will lead to an incorrct treatment strategy. Ultrasonography, computerized tomography and angiography were used to distingish these lesions, but diagnostic value of ERCP is in controversy. To evaluate the diagnostic value of ERCP in cystic lesions of the pancreas, we analysed 33 cases of pancreatic cystic lesions (pseudocyst 18 cases, retention cyst 3 cases and cystic, neoplasm l2 cases) between Apr. 1985 and June 1993. In 18 cases of pseudocysts, ERP findings were communication with cyst in 8 cases (44.4%), chronic pancreatitis in 8 cases (44.4%), obstruction in 4 cases (22.2%) and displscement of pancreatic duct in 2 cases (11.1%), and ERC findings, which were perfomed in 8 cases, showed cholangitis in 3 cases (37.5%), CBD stone in 2 cases (25%), mass effect in 1 case (12.5%) and normal in 2 cases (25%). There was no communication with the cyst and pancreatic duct, except two mucinous ductal ectasia, in 12 cases of cystic neoplasms, and the other findings were displacement of pancreatic duct in 4 cases (33.3%), obstruction in 2 cases (16.7%) and normal in 4 cases (33.3%). ERC findings of cystic neoplasm were almost normal (85.7%) except 1 case of cholangitis. In conclusion, ERCP findings of pseudocysts were communication with pancreatic duct, chronic pancreatitis and biliary tract abnormality. In contrast, ERCP findings of cystic neoplasms were displacement or obstruction of pancreatic duct without communication and chronic pancreatitis, and biliary tract abnormality were rare.
Angiography ; Biliary Tract ; Cholangiopancreatography, Endoscopic Retrograde* ; Cholangitis ; Dilatation, Pathologic ; Mucins ; Pancreas ; Pancreatic Cyst* ; Pancreatic Ducts ; Pancreatitis, Chronic ; Ultrasonography

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Strangulation of Umbilical Hernia after Therapeutic Endoscopic Retrograde Cholangiopancreatography of Acute Biliary Pancreatitis.

Dae Hee CHOI ; Sang Huyb LEE ; Joo Kyoung PARK ; Ji Won YOO ; Sang Myung WOO ; Ji Kon RYU ; Yong Tae KIM ; Yong Bum YOON ; Kyu Joo PARK

Korean Journal of Gastrointestinal Endoscopy.2007;34(6):351-355.

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*

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A Case of Intramural Duodenal Hematoma Complicated with Obstructive Jaundice and Pancreatitis following Endoscopic Hemostasis.

Hyung Chul LEE ; Kook Hyun KIM ; Youn Sun PARK ; Hee Jung MOON ; Tae Nyeun KIM ; Byung Ik JANG

Korean Journal of Gastrointestinal Endoscopy.2007;34(6):346-350.

An intramural duodenal hematoma is rarely observed in adults and may occur as an iatrogenic complication after endoscopic treatment for duodenal ulcer bleeding, particularly in patients with bleeding disorders or undergoing anticoagulant therapy. Upper gastrointestinal endoscopy, abdominal CT scan and hypotonic duodenography are used to establish a diagnosis. We report a case of an intramural duodenal hematoma complicated with obstructive jaundice and pancreatitis after endoscopic hemostasis in a patient with a cerebral infarction. A 64-year-old male had duodenal ulcer bleeding, which was treated by a local injection of epinephrine followed by hemoclipping. One to three days after the endoscopic treatment, he complained of abdominal pain and jaundice. The abdominal CT scan revealed acute, edematous pancreatitis and a huge hematoma in the 2nd to 4th portion of the duodenum. The follow-up endoscopy revealed severe stenosis of the duodenal lumen caused by an intramural hematoma. He was treated with conservative management for 18 days. There was gradual improvement in the hematoma that had been complicated by jaundice and pancreatitis.
Abdominal Pain ; Adult ; Cerebral Infarction ; Constriction, Pathologic ; Diagnosis ; Duodenal Ulcer ; Duodenum ; Endoscopy ; Endoscopy, Gastrointestinal ; Epinephrine ; Follow-Up Studies ; Hematoma* ; Hemorrhage ; Hemostasis, Endoscopic* ; Humans ; Jaundice ; Jaundice, Obstructive* ; Male ; Middle Aged ; Pancreatitis* ; Tomography, X-Ray Computed

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Sigmoidoscopic Removal of Migrated Plastic Biliary Stents.

Chang Nyol PAIK ; Jong Young CHOI ; Jae Myung PARK ; Yu Kyung CHO ; In Seok LEE ; Sang Woo KIM ; Myung Gyu CHOI ; In Sik CHUNG

Korean Journal of Gastrointestinal Endoscopy.2007;34(6):343-345.

Endoscopic retrograde biliary drainage is a well-established, minimally invasive procedure for treating biliary obstructions caused by malignant or benign diseases. Although there is a low rate of complications with biliary stenting, late complications of stent migration can occur, occasionally resulting in bowel inflammation, obstruction or perforation. We report a case of a migrated biliary stent that induced an obstruction of the colon following ERBD in the stricture of hepatic ducts after a liver transplant, and was removed endoscopically
Colon ; Constriction, Pathologic ; Drainage ; Hepatic Duct, Common ; Inflammation ; Liver ; Plastics* ; Stents*

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Tuberculous Meningitis in a Patient with Crohn's Disease, Which was Treated with Infliximab.

Youn Ho KIM ; Beom Jae LEE ; Jong Jae PARK ; Won Woo LEE ; Woo Sik HAN ; Sung Nam OH ; Do Won CHOI ; Jae Seon KIM ; Young Tae BAK ; Hee Jin CHEONG

Korean Journal of Gastrointestinal Endoscopy.2007;34(6):339-342.

Clinical trials of tumor necrosis factor (TNF) inhibitor have demonstrated significant efficacy in those patients with Crohn's disease that is not responsive to other anti-inflammatory drug. Infliximab is a human-murine chimeric monoclonal antibody with a high binding affinity and specificity for TNF-alpha. Yet therapy with infliximab is associated with an increased risk of opportunistic infection, and especially tuberculosis. Here we reported on a case of tuberculous meningitis in 26-year-old man, and he was treated with infliximab for uncontrolled and fistulous Crohn's disease. We also include a review of the literature.
Adult ; Crohn Disease* ; Humans ; Opportunistic Infections ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Meningeal* ; Tumor Necrosis Factor-alpha ; Infliximab

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A Case of Gastrointestinal Stromal Tumor of the Jejunum with Obscure Gastrointestinal Hemorrhage Diagnosed by Exploratory Laparotomy.

Hae Bin JUNG ; Sun Young KIM ; Shin Ae PARK ; Sang Mi PARK ; Kon Ho SHIM ; Eui Hyung KIM ; Eun Jung JEON ; Jung Hwan OH ; Jeong Jo JEONG ; Sang Wook CHOI

Korean Journal of Gastrointestinal Endoscopy.2007;34(6):334-338.

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract, and they represent about 2% of all neoplasms of the gastrointestinal tract. GISTs primarily affect the stomach (50~60%), but they can also affect the small intestine (20~30%), large intestine (7%) and esophagus (1%). The clinical manifestations of GISTs vary according to the location and size of the mass. GISTs are generally KIT (CD117)-positive and are diagnosed by immunohistochemistry. Tumor size and mitotic activity are the best predictive prognostic features. The treatment of choice for primary GIST is complete surgical resection with a negative margin. A 78-year-old man who presented with melena and diffuse abdominal pain was admitted to our hospital. Esophagogastroduodenoscopy, colonoscopy, angiography and an RBC scan were performed but we were unable to locate the focus of the hemorrhage. A gastrointestinal stromal tumor (GIST) of the jejunum was diagnosed after laparotomy.
Abdominal Pain ; Aged ; Angiography ; Colonoscopy ; Endoscopy, Digestive System ; Esophagus ; Gastrointestinal Hemorrhage* ; Gastrointestinal Stromal Tumors* ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Immunohistochemistry ; Intestine, Large ; Intestine, Small ; Jejunum* ; Laparotomy* ; Melena ; Stomach

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