Clinical Endoscopy.2014;47(6):584-585. doi:10.5946/ce.2014.47.6.584
Clinical Endoscopy
to Present ISSN: 2234-2400
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Acute Pancreatitis Due to a Duodenal Ulcer.
Clinical Endoscopy.2014;47(6):579-583. doi:10.5946/ce.2014.47.6.579
Duodenal ulcers and acute pancreatitis are two of the most commonly encountered gastrointestinal diseases among the general population. However, duodenal ulcer-induced pancreatitis is very rarely reported worldwide. This report elaborates on a distinct medical treatment that contributes to partial or complete treatment of acute pancreatitis induced by a duodenal ulcer scar.
Cicatrix ; Duodenal Ulcer* ; Duodenum ; Gastrointestinal Diseases ; Pancreatitis* ; Stents ; Ulcer
Cicatrix ; Duodenal Ulcer* ; Duodenum ; Gastrointestinal Diseases ; Pancreatitis* ; Stents ; Ulcer
Polypoid Arteriovenous Malformation Presenting with Jejunojejunal Intussusceptions in an Adult.
Clinical Endoscopy.2014;47(6):575-578. doi:10.5946/ce.2014.47.6.575
Jejunal polypoid arteriovenous malformations (AVMs) and jejunojejunal intussusceptions are both rare. Here, we present the case of a 61-year-old woman who suffered intermittent episodes of abdominal pain over the course of 13 years. A computed tomography scan of her abdomen and pelvis revealed a distal jejunojejunal intussusception. A suspected low density mass was observed at the tip of the intussusception. Treatment comprised laparoscopic small bowel resection with end-to-end jejunostomy. The final diagnosis was a polypoid AVM measuring 5x3.5x3 cm. We suggest that polypoid AVM should be considered as a differential diagnosis in patients presenting with small intestinal neoplasms.
Abdomen ; Abdominal Pain ; Adult* ; Arteriovenous Malformations* ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Intestinal Neoplasms ; Intussusception* ; Jejunostomy ; Jejunum ; Middle Aged ; Pelvis
Abdomen ; Abdominal Pain ; Adult* ; Arteriovenous Malformations* ; Diagnosis ; Diagnosis, Differential ; Female ; Humans ; Intestinal Neoplasms ; Intussusception* ; Jejunostomy ; Jejunum ; Middle Aged ; Pelvis
Gastric Squamous Papilloma in a 52-Year-Old Female Patient.
Clinical Endoscopy.2014;47(6):571-574. doi:10.5946/ce.2014.47.6.571
A papilloma is a benign epithelial lesion characterized by finger-like projections of tissue lined by an overgrowth of squamous cells and a core of connective tissue. We report a case of squamous papilloma on the cardia in a 52-year-old asymptomatic female. Endoscopy showed a 1-cm sized is polyp with hyperemic change originating from the cardia adjacent to the esophagogastric junction, the biopsy of which suggested a diagnosis of squamous papilloma. Endoscopic mucosal resection was performed to obtain a definite diagnosis and the polyp was completely removed. The histological result was compatible with squamous papilloma, and its surrounding tissues showed foveolar epithelium, which suggested a stomach origin. This is the first report of endoscopic resection of a gastric squamous papilloma. Squamous papilloma should be considered in the differential diagnosis of a gastric polyp, especially one in the cardia. As the prognostic value of a squamous papilloma is not well known, we recommend endoscopic resection to treat a gastric squamous papilloma, when possible.
Biopsy ; Cardia ; Connective Tissue ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Epithelium ; Esophagogastric Junction ; Female ; Humans ; Middle Aged* ; Papilloma* ; Polyps ; Stomach
Biopsy ; Cardia ; Connective Tissue ; Diagnosis ; Diagnosis, Differential ; Endoscopy ; Epithelium ; Esophagogastric Junction ; Female ; Humans ; Middle Aged* ; Papilloma* ; Polyps ; Stomach
Endoscopic Diagnosis of Duodenal Stenosis in a 5-Month-Old Male Infant.
Clinical Endoscopy.2014;47(6):568-570. doi:10.5946/ce.2014.47.6.568
Duodenal stenosis and duodenal atresia are well-known gastrointestinal anomalies in patients with Down syndrome. Although duodenal atresia presents early and classically with vomiting in the immediate neonatal period, the presentation of duodenal stenosis can be significantly more subtle and the diagnosis delayed. Here, we describe the case of a 5-month-old male infant with Down syndrome and delayed presentation of high-grade duodenal stenosis diagnosed endoscopically. Pediatric gastroenterologists should include duodenal stenosis in the differential diagnosis of older infants and children with vomiting and should be familiar with the endoscopic appearance of this lesion.
Child ; Constriction, Pathologic* ; Diagnosis* ; Diagnosis, Differential ; Down Syndrome ; Duodenal Obstruction ; Hematemesis ; Humans ; Infant* ; Male ; Vomiting
Child ; Constriction, Pathologic* ; Diagnosis* ; Diagnosis, Differential ; Down Syndrome ; Duodenal Obstruction ; Hematemesis ; Humans ; Infant* ; Male ; Vomiting
Clinical Endoscopy.2014;47(6):564-567. doi:10.5946/ce.2014.47.6.564
We report a rare case of a gastric plasmacytoma treated with endoscopic resection and oral thalidomide therapy. A 70-year-old man was admitted to our hospital with indigestion. He had no specific medical history and unremarkable laboratory results. Gastroendoscopic findings revealed a focal, erythematous, flat elevated lesion in the anterior wall of the stomach antrum. A biopsy revealed atypical lymphocytes. Endoscopic submucosal dissection (ESD) with an insulation-tipped knife was performed 45 days after diagnosis. Radiological and hematological evaluations, including a bone marrow biopsy, were performed and showed no involvement of other organs. The patient was diagnosed with extramedullary gastric plasmacytoma. Follow-up gastroendoscopy was performed three times during a 2-year period and showed nonspecific ESD scarring. The patient's condition was found to be stable.
Aged ; Biopsy ; Bone Marrow ; Cicatrix ; Diagnosis ; Dyspepsia ; Follow-Up Studies ; Humans ; Lymphocytes ; Plasmacytoma* ; Stomach ; Thalidomide*
Aged ; Biopsy ; Bone Marrow ; Cicatrix ; Diagnosis ; Dyspepsia ; Follow-Up Studies ; Humans ; Lymphocytes ; Plasmacytoma* ; Stomach ; Thalidomide*
Clinical Endoscopy.2014;47(6):560-563. doi:10.5946/ce.2014.47.6.560
Transoral incisionless fundoplication (TIF) has been used for endoscopic treatment of gastroesophageal reflux disease (GERD). TIF using the EsophyX device system (EndoGastric Solutions) was designed to create a full-thickness valve at the gastroesophageal junction through the insertion of multiple fasteners; it improves GERD, reduces proton pump inhibitor use, and improves quality of life. Although TIF is effective in select patients, a significant subset of patients undergoing TIF develop persistent or recurrent GERD symptoms and may need antireflux surgery to control the GERD symptoms. We now report a 48-year-old man with chronic GERD unresponsive to medical management. He underwent TIF complicated by esophageal perforation and developed mediastinitis, left pneumothorax, bilateral pleural effusions, and acute respiratory failure. He required chest tube placement and bilateral decortication for treatment of nonresolving empyemas. Additional postmarketing studies are required to assess the safety, efficacy, and clinical outcomes of this novel procedure, and patients undergoing this procedure need close postprocedural follow-up.
Chest Tubes ; Empyema* ; Esophageal Perforation ; Esophagogastric Junction ; Fundoplication* ; Gastroesophageal Reflux ; Humans ; Mediastinitis ; Middle Aged ; Pleural Effusion ; Pneumothorax ; Proton Pumps ; Quality of Life ; Respiratory Insufficiency
Chest Tubes ; Empyema* ; Esophageal Perforation ; Esophagogastric Junction ; Fundoplication* ; Gastroesophageal Reflux ; Humans ; Mediastinitis ; Middle Aged ; Pleural Effusion ; Pneumothorax ; Proton Pumps ; Quality of Life ; Respiratory Insufficiency
Clinical Endoscopy.2014;47(6):555-559. doi:10.5946/ce.2014.47.6.555
BACKGROUND/AIMS: Immunoglobulin G4 (IgG4)-associated cholangiopathy (IAC) is an inflammatory disease and may mimic primary sclerosing cholangitis (PSC), cholangiocarcinoma (CCA), or pancreatic cancer on cholangiography. We investigated whether IgG4 levels in bile aspirated during endoscopic retrograde cholangiopancreatography (ERCP) can distinguish IAC from PSC, CCA, and pancreatic cancer. METHODS: Bile was aspirated directly from the common bile duct during ERCP in patients with IAC prior to steroid therapy. For control purposes, bile was obtained from patients with PSC, CCA, pancreatic cancer, and benign biliary conditions (sphincter of oddi dysfunction/choledocholithiasis). RESULTS: Biliary IgG4 levels were measured in 54 patients. The median bile IgG4 levels were markedly elevated in patients with IAC (5.5 mg/dL; interquartile range [IQR], 5.1 to 15.6) as compared to patients with benign biliary conditions (0 mg/dL; IQR, 0 to 0.1; p=0.003). The median biliary IgG4 levels in PSC, CCA, and pancreatic cancer were 1.2 (IQR, 0.2 to 3.8), 0.9 (IQR, 0.2 to 3.4), and 0.2 mg/dL (IQR, 0.1 to 0.8), respectively. A cutoff value of 3.8 mg/dL distinguished IAC from PSC and CCA patients with 100% and 76.9% sensitivity and specificity, respectively. CONCLUSIONS: The results of this pilot study suggest that measurement of biliary IgG4 levels may have clinical value in distinguishing patients with IAC from biliary disorders that can mimic IAC.
Bile* ; Cholangiocarcinoma ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing ; Common Bile Duct ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Pancreatic Neoplasms ; Pilot Projects* ; Sensitivity and Specificity
Bile* ; Cholangiocarcinoma ; Cholangiography ; Cholangiopancreatography, Endoscopic Retrograde ; Cholangitis, Sclerosing ; Common Bile Duct ; Humans ; Immunoglobulin G* ; Immunoglobulins ; Pancreatic Neoplasms ; Pilot Projects* ; Sensitivity and Specificity
Clinical Endoscopy.2014;47(6):544-554. doi:10.5946/ce.2014.47.6.544
BACKGROUND/AIMS: In order to reduce the procedure time and the number of accessory changes during endoscopic submucosal dissection (ESD), we developed a novel versatile knife, which has the combined advantages of several conventional knives. The aim of this study was to compare the efficacy, safety, and histological quality of ESD performed using this novel versatile knife and a combination of several conventional knives. METHODS: This was an in vivo animal study comparing two different modalities of ESD in mini-pigs. Completion time of each resection was documented, and the resected specimens were retrieved and evaluated for completeness. To assess the quality control of the procedures and adverse events, detailed histopathological examinations were performed. RESULTS: A total of 18 specimens were dissected by ESD safely and easily (nine specimens using the new versatile knife; nine specimens by mixing conventional knives). All resections were completed as en bloc resections. There was no significant difference in procedure time between the 2 modalities (456 seconds vs. 355 seconds, p=0.258) and cutting speed (1.983 mm2/sec vs. 1.57 mm2/sec, p=1.000). The rate of adverse events and histological quality did not statistically differ between the modalities. CONCLUSIONS: ESD with a versatile knife appeared to be an easy, safe, and technically efficient method.
Animals ; Equipment and Supplies ; Feasibility Studies* ; Models, Animal ; Quality Control
Animals ; Equipment and Supplies ; Feasibility Studies* ; Models, Animal ; Quality Control
Gastric Endoscopic Submucosal Dissection Is Safe for Day Patients.
Clinical Endoscopy.2014;47(6):538-543. doi:10.5946/ce.2014.47.6.538
BACKGROUND/AIMS: Although the advantages of endoscopic submucosal dissection (ESD) are well established, there are important limitations that relate to its higher cost and higher rate of complications compared with endoscopic mucosal resection. This study assessed the therapeutic safety and efficacy of ESD in the treatment of small gastric dysplasia and early gastric cancer (EGC) located within the antrum in an outpatient setting, and it compared the results with those from patients admitted to hospital for ESD treatment. METHODS: This study was a retrospective analysis of a prospectively maintained database. We reviewed consecutive patients with EGC or gastric dysplasia who underwent ESD between October 2007 and May 2008. The lesions were smaller than 2 cm and were located in the antrum. We analyzed 105 lesions in 105 patients. The patients were assigned to two groups according to each patient's preference. RESULTS: The overall rates of complete resection were 98.1% in the inpatients group and 94.3% in the outpatients group. Immediate bleeding occurred in four inpatients, which included one patient in the outpatient group. Delayed bleeding occurred in one inpatient within 24 hours of the procedure. Macroperforations did not occur in either group. A microperforation was found in one outpatient. CONCLUSIONS: The safety and efficacy of ESD used to treat small gastric tumors in the antrum in an outpatient setting appeared to be similar to the safety and efficacy of ESD used to treat patients who were admitted to the hospital.
Hemorrhage ; Humans ; Inpatients ; Outpatients ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms
Hemorrhage ; Humans ; Inpatients ; Outpatients ; Prospective Studies ; Retrospective Studies ; Stomach Neoplasms
Country
Republic of Korea
Publisher
Korean Society of Gastrointestinal Endoscopy
ElectronicLinks
http://e-ce.org/Editor-in-chief
William Y. Chey
ksge@gie.or.kr
Abbreviation
Clin Endosc
Vernacular Journal Title
ISSN
2234-2400
EISSN
2234-2443
Year Approved
2007
Current Indexing Status
Currently Indexed
Start Year
Description
Aims and Scope > About > Aims and Scope Clinical Endoscopy is an open-access and peer-reviewed journal, helping researchers, technicians, and practicing physicians stay updated on global advances in experimental, diagnostic, and therapeutic endoscopic techniques used in the treatment of disorders of the gastrointestinal and pancreatico-biliary tract. CE publishes well-structure original articles, state-of-the-art review articles, instructive case reports, brief reports, and letters to the editor on all subjects in the field of experimental, diagnostic, and therapeutic endoscopy as well as newer technologies.
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