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Mutational Analysis of MITOSTATIN, a Candidate Tumor-Suppressor Gene, at a Mononucleotide Repeat in Gastric and Colorectal Carcinoma.

Yoo Ri KIM ; Sung Soo KIM ; Nam Jin YOO ; Sug Hyung LEE

Gut and Liver.2010;4(1):149-150.

No abstract available.
Colorectal Neoplasms

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Inflammatory Myoglandular Polyps Causing Hematochezia.

Sook Hee CHUNG ; Byoung Kwan SON ; Young Sook PARK ; Yun Ju JO ; Seong Hwan KIM ; Dae Won JUN ; Eun Sun CHEONG ; Won Mi LEE ; Jong Eun JU

Gut and Liver.2010;4(1):146-148.

We report herein three cases of inflammatory myoglandular polyp (IMGP) presenting as hematochezia. The polyps had pedunculated, red, and smooth features, and were 12, 12, and 15 mm in diameter and located in the sigmoid colon, transverse colon, and rectum, respectively. Endoscopic polypectomies were performed. Histologic examination of the recovered specimens revealed inflammatory granulation in the lamina propria mucosa, proliferation of smooth muscle, and hyperplastic glands with cystic dilatation. The three colon polyps were finally diagnosed both clinically and histologically as IMGP. Endoscopists should bear in mind that a polyp featuring endoscopic findings of pedunculation or semipedunculation; a red, smooth, spherical, and hyperemic surface; and patchy mucosa exudation and erosion is likely to be an IMGP.
Colon ; Colon, Sigmoid ; Colon, Transverse ; Dilatation ; Gastrointestinal Hemorrhage ; Mucous Membrane ; Muscle, Smooth ; Polyps ; Rectum ; Ursidae

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EUS-Guided Multitransgastric Endoscopic Necrosectomy for Infected Pancreatic Necrosis with Noncontagious Retroperitoneal and Peritoneal Extension.

Ja Eun KOO ; Do Hyun PARK ; Joo OH ; Young Hee LEE ; Sung Hoon MOON ; Sang Soo LEE ; Dong Wan SEO ; Sung Koo LEE ; Myung Hwan KIM

Gut and Liver.2010;4(1):140-145.

Endoscopic necrosectomy was introduced as a safe and effective treatment modality for infected pancreatic necrosis. Although there have been many reports of endoscopic drainage of retroperitoneal pancreatic necrosis, the optimal endoscopic management of pancreatic necrosis extending to the noncontagious retroperitoneal and peritoneal spaces has yet to be established. We report herein a patient with infected pancreatic necrosis with noncontagious retroperitoneal and peritoneal extension who was treated successfully by endoscopic ultrasound (EUS)-guided multiple cystogastrostomy and endoscopic necrosectomy. EUS-guided multitransgastric necrosectomy may be technically feasible and effective for the management of infected pancreatic necrosis with noncontagious retroperitoneal and peritoneal extension that demonstrates suitable anatomy. Further studies to assess the efficacy and safety of this technique are needed before its routine clinical use can be recommended.
Drainage ; Humans ; Necrosis ; Pancreatitis

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A Case of Recurrent Acute Pancreatitis due to Pancreatic Arteriovenous Malformation.

Jong Kyoung CHOI ; Sang Hyub LEE ; Min Sun KWAK ; Jai Hwan KIM ; Eun Sun JANG ; Sung Wook HWANG ; Jin Hyeok HWANG ; Li Jin JOO ; Yoo Seok YOON ; Hae Ryoung KIM

Gut and Liver.2010;4(1):135-139.

Pancreatic arteriovenous malformation (AVM) is an extremely rare condition with various clinical manifestations. We report herein a case of recurrent acute pancreatitis due to pancreatic AVM in a 49-year-old man. This patient presented with epigastric pain that had developed after consuming alcohol 2 days prior to admission. Serum amylase and lipase levels were elevated and computed tomography revealed focal low-attenuation lesions with peripancreatic infiltrations in the pancreatic tail and multiple collateral vessels around the low-attenuation lesions. He was diagnosed with acute pancreatitis and pancreatic AVM. Although he had stopped drinking after the first attack of acute pancreatitis, his pancreatitis recurred twice within 3 months. He underwent a distal pancreatectomy after the third attack of acute pancreatitis. He was free of symptoms for 2 years after the pancreatectomy.
Amylases ; Arteriovenous Malformations ; Drinking ; Humans ; Lipase ; Middle Aged ; Pancreatectomy ; Pancreatitis

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Development of Spontaneous Bacterial Peritonitis after Extended Hepatic Resection in a Patient without Evidence of Liver Cirrhosis.

Min Sun KWAK ; Jeong Hoon LEE ; Yoon Jun KIM ; Jung Hwan YOON ; Hyo Suk LEE

Gut and Liver.2010;4(1):129-134.

Hilar cholangiocarcinomas are often treated with liver resections. Hepatic dysfunction and infection are common postoperative complications. Although secondary bacterial peritonitis due to abdominal abscess or perforation is common, we report herein the first case of spontaneous bacterial peritonitis after hepatic resection. A 61-year-old male patient without underlying liver disease was diagnosed as having a Klatskin tumor, and a right trisectionectomy with caudate lobectomy was performed. From postoperative days 18-28, the patient gained 4.1 kg as ascites developed, and showed evidence of hepatic insufficiency with prolonged prothrombin time and jaundice. Computed tomography, performed at postoperative day 28 when fever had developed, showed only ascites without bowel perforation or abscess. When paracentesis was performed, the serum-ascites albumin gradient was 2.3 g/dL, indicating portal hypertension, and the ascites' polymorphonuclear cell count was 1,156/mm3. Since the clinical, laboratory, and image findings were compatible with spontaneous bacterial peritonitis, we started empirical antibiotics without additional intervention. Follow-up analysis of the ascites after 48 hours revealed that the polymorphonuclear cell count had decreased markedly to 108/mm3; the fever and leukocytosis had also improved. After 2 weeks of antibiotic treatment, the patient recovered well, and was discharged without any problem.
Abdominal Abscess ; Abscess ; Anti-Bacterial Agents ; Ascites ; Cell Count ; Cholangiocarcinoma ; Fever ; Follow-Up Studies ; Hepatic Insufficiency ; Humans ; Hypertension, Portal ; Jaundice ; Klatskin's Tumor ; Leukocytosis ; Liver ; Liver Cirrhosis ; Liver Diseases ; Male ; Middle Aged ; Paracentesis ; Peritonitis ; Postoperative Complications ; Prothrombin Time

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Appendiceal Orifice Inflammation in an 8-Year-Old Girl with Ulcerative Colitis Complicating Wilson's Disease.

Hee Jin JANG ; Joo Young JANG ; Kyung Mo KIM

Gut and Liver.2010;4(1):126-128.

Appendiceal orifice inflammation (AOI) may occur as a skipped lesion in ulcerative colitis (UC). Cases of ulcerative colitis complicated by Wilson's disease have also been reported. We report herein a case of AOI that occurred as a missed lesion in an 8-year-old girl with UC complicating Wilson's disease, which is rare in children.
Child ; Colitis, Ulcerative ; Hepatolenticular Degeneration ; Humans ; Inflammation ; Inflammatory Bowel Diseases ; Ulcer

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Synchronous Large-Cell Neuroendocrine Carcinoma and Adenocarcinoma of the Colon.

Jin Seok PARK ; Lucia KIM ; Chul Hyun KIM ; Byoung Wook BANG ; Don Haeng LEE ; Seok JEONG ; Yong Woon SHIN ; Hyung Gil KIM

Gut and Liver.2010;4(1):122-125.

Large-cell neuroendocrine carcinoma of the colon is a rare entity with a prognosis that is usually poor due to the high likelihood of early metastasis. A 61-year-old man had surgery for colon cancer of the transverse colon and cecum. Microscopic examination of the tumor showed that the location was the proximal transverse colon, with small nests containing rosettes and palisading patterns of large tumor cells with faintly granular cytoplasm. The immunohistochemistry was positive for synaptophysin and chromogranins. The tumors were diagnosed as a large-cell neuroendocrine carcinoma of the colon. In addition, the tumor of the cecum showed microscopic findings consistent with a well-differentiated adenocarcinoma. The immunohistochemical panel showed that the tumor was negative for neuroendocrine markers. There were no clinical findings suggestive of hormone hypersecretion. Cancer metastasis was found in the peritoneum section of the small bowel. Postoperative chemotherapy was applied. The patient was alive with good performance after, and there was no sign of tumor progression. This is the first case of a synchronous large-cell neuroendocrine carcinoma and adenocarcinoma of the colon. The patient was treated successfully with debulking surgery and systemic chemotherapy.
Adenocarcinoma ; Carcinoma, Neuroendocrine ; Cecum ; Chromogranins ; Colon ; Colon, Transverse ; Colonic Neoplasms ; Cytoplasm ; Humans ; Immunohistochemistry ; Middle Aged ; Neoplasm Metastasis ; Neoplasms, Multiple Primary ; Peritoneum ; Prognosis ; Synaptophysin

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Ileal Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma with a Large-Cell Component That Regressed Spontaneously.

Yohsuke MAKINO ; Hidekazu SUZUKI ; Toshihiro NISHIZAWA ; Kaori KAMEYAMA ; Tadakazu HISAMATSU ; Hiroyuki IMAEDA ; Makio MUKAI ; Toshifumi HIBI

Gut and Liver.2010;4(1):117-121.

Reported herein is a case of mucosa-associated lymphoid tissue (MALT) lymphoma of the terminal ileum with a large-cell component, which regressed spontaneously. To the best of our knowledge, only five cases of spontaneously regressing MALT lymphoma have been reported in the English-language literature, and all of these cases were low-grade lymphomas. Spontaneous regression of a MALT lymphoma with a high-grade component is very rare. The present case suggests that MALT lymphoma cells have a reversible nature, even in the presence of a high-grade component.
Ileum ; Lymphoid Tissue ; Lymphoma ; Lymphoma, B-Cell, Marginal Zone ; Lymphoma, Non-Hodgkin

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A Case of Asymptomatic Aspiration of a Capsule Endoscope with a Successful Resolution.

Hyun Sook CHOI ; Jin Oh KIM ; Hyun Gun KIM ; Tae Hee LEE ; Wan Jung KIM ; Won Young CHO ; Joo Young CHO ; Joon Seong LEE

Gut and Liver.2010;4(1):114-116.

Aspiration is a very rare complication of capsule endoscopy, but it is potentially life-threatening and should be considered an emergency requiring immediate intervention since it can evolve into major airway compromise and obstructive pneumonitis. We experienced a case of asymptomatic aspiration of a capsule in a 75-year-old man. The aspirated capsule was diagnosed on routine chest and abdomen X-rays to confirm its position after ingestion. The capsule was removed via bronchoscopy using a net, without sequelae, after inducing the patient to cough. To prevent this complication, a thorough history of swallowing disorders is needed before capsule ingestion, and patients with swallowing difficulties should have the capsule placed in the duodenum endoscopically. Moreover, on capsule aspiration, cough induction is the most effective method of capsule removal.
Abdomen ; Aged ; Bronchoscopy ; Capsule Endoscopes ; Capsule Endoscopy ; Cough ; Deglutition ; Deglutition Disorders ; Duodenum ; Eating ; Emergencies ; Humans ; Pneumonia ; Thorax

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Endoscopic Removal of a Bile-Duct Stone Using Sphincterotomy and a Large-Balloon Dilator in a Patient with Situs Inversus Totalis.

Jin Ho LEE ; Dae Hwan KANG ; Jong Hwan PARK ; Min Dae KIM ; Ki Tae YOON ; Cheol Woong CHOI ; Hyung Wook KIM ; Mong CHO

Gut and Liver.2010;4(1):110-113.

A 45-year-old female with known situs inversus totalis presented with colicky pain in the left upper abdominal quadrant. The laboratory parameters showed elevated neutrophils and a bilirubin level of 2 mg/dL. CT confirmed situs inversus totalis and dilatation of the intra- and extrahepatic ducts with a 10-mm common bile duct (CBD) stone and a 10-mm gallstone. She underwent papillary dilatation using a radial expansion balloon after sphincterotomy, after which the CBD stone was removed with a basket and balloon. There were no complications, such as bleeding, pancreatitis, or perforation. It might be reasonable to attempt a "partial" biliary endoscopic sphincterotomy followed by a large-balloon dilator in patients with concomitant distal bile duct, papillary stenosis, or altered anatomy (e.g., periampullary diverticulum, Billroth II anatomy). However, when performing an "adequate" biliary endoscopic sphincterotomy this is technically difficult, or in some cases even impossible, and is associated with a higher risk of complications. This paper further expands on the application of these techniques and shows that a papillary balloon dilatation after endoscopic sphincterotomy is a safe, easy, and effective technique for removing bile-duct stones in a patient with situs inversus totalis.
Bile Ducts ; Bilirubin ; Common Bile Duct ; Constriction, Pathologic ; Dilatation ; Diverticulum ; Female ; Gallstones ; Gastroenterostomy ; Hemorrhage ; Humans ; Middle Aged ; Neutrophils ; Pancreatitis ; Situs Inversus ; Sphincterotomy, Endoscopic ; Abdominal Pain

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