Journal Detail Information

1

Cite

Share

A Case of Ampullary Perforation Treated with a Temporally Covered Metal Stent.

Woo Young PARK ; Kwang Bum CHO ; Eun Soo KIM ; Kyung Sik PARK

Clinical Endoscopy.2012;45(2):177-180. doi:10.5946/ce.2012.45.2.177

Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation is classified into three or four types based on anatomical location and the mechanism of injury. Although ampullary injury, among them, may be managed nonsurgically, surgical management is required in cases of perforation with retroperitoneal fluid collection and severe condition. Here, a patient with ERCP-related severe ampullary perforation with retroperitoneal fluid collection that was treated nonsurgically with a covered stent is presented.
Cholangiopancreatography, Endoscopic Retrograde ; Humans ; Stents

2

Cite

Share

Cecal Fecaloma Due to Intestinal Tuberculosis: Endoscopic Treatment.

Sun Moon KIM ; Ki Hyun RYU ; Young Suk KIM ; Tae Hee LEE ; Euyi Hyeog IM ; Kyu Chan HUH ; Young Woo CHOI ; Young Woo KANG

Clinical Endoscopy.2012;45(2):174-176. doi:10.5946/ce.2012.45.2.174

Colorectal fecaloma is a mass of accumulated feces that is much harder in consistency than a fecal impactation. The rectosigmoid area is the common site for fecalomas and the cecum is the most unusual site. Diagnosis is usually made by distinctive radiographic findings of a mobile intraluminal mass with a smooth outline and no mucosal attachment. Most of the fecalomas are successfully treated by conservative methods such as laxatives, enemas and rectal evacuation. When conservative treatments have failed, endoscopic procedures or a surgical intervention may be needed. We report here that a cecal fecaloma caused by intestinal tuberculosis scar was successfully removed by endoscopic procedures.
Cecum ; Cicatrix ; Enema ; Feces ; Laxatives ; Tuberculosis

3

Cite

Share

Successful Treatment of Early Gastric Cancer Adjacent to a Fundal Varix by Endoscopic Submucosal Dissection and Endoscopic Cyanoacrylate Therapy.

Yeon Soo KIM ; Won Young CHO ; Joo Young CHO ; So Young JIN

Clinical Endoscopy.2012;45(2):169-173. doi:10.5946/ce.2012.45.2.169

Endoscopic submucosal dissection (ESD) was developed for the en bloc resection of large early gastrointestinal neoplasms. A disadvantage of ESD is its technical difficulty, which requires advanced skills and is associated with a higher rate of complications. Endoscopic variceal obturation (EVO) using cyanoacrylate has emerged as the initial treatment of choice for acute gastric variceal bleeding. This procedure achieves hemostasis in 90% of cases. A 52-year-old patient with Child A alcoholic liver cirrhosis presented with early gastric cancer in the cardia and type 1 isolated gastric varices in the fundus. The two lesions were so close together that treatment was not easy. The lesions were managed successfully with a combination of ESD and EVO using cyanoacrylate.
Cardia ; Child ; Cyanoacrylates ; Esophageal and Gastric Varices ; Gastrointestinal Neoplasms ; Hemorrhage ; Hemostasis ; Humans ; Liver Cirrhosis, Alcoholic ; Middle Aged ; Stomach Neoplasms ; Varicose Veins

4

Cite

Share

A Case of Giant Lipoma Causing Chronic Recurrent Intussusception of the Colon.

Chang Seob LEE ; Mi Jin LEE ; Kyoung Lee KIM ; Yeon Soo KIM ; Gwang Ho BAIK ; Jin Bong KIM ; Dong Joon KIM ; Sang Hak HAN

Clinical Endoscopy.2012;45(2):165-168. doi:10.5946/ce.2012.45.2.165

Colonic lipomas, which often occur in elderly women, usually have small size and occur mainly in the cecum and ascending colon. Most colonic lipomas are asymptomatic and identified incidentally at the time of endoscopy or surgery. However, they may cause symptoms such as bleeding, obstruction or intussusception as their size increases. Intermittent episodes of intussusception are uncommon but may be caused by large pedunculated lipoma. In a 68-year-old woman suffering intermittent abdominal pain, 5.5x4.5x3.8-cm huge mass was found by colonoscopy at proximal ascending colon, which was intussuscepted to proximal transverse colon on abdominal computed tomography. Segmental right colonic resection was conducted. We report a case of symptomatic giant pedunculated colonic lipoma causing intussusception requiring surgical intervention, with a successful recovery after surgery.
Abdominal Pain ; Aged ; Cecum ; Colon ; Colon, Ascending ; Colon, Transverse ; Colonoscopy ; Endoscopy ; Female ; Hemorrhage ; Humans ; Intussusception ; Lipoma ; Stress, Psychological

5

Cite

Share

Effectiveness of Premedication with Pronase for Visualization of the Mucosa during Endoscopy: A Randomized, Controlled Trial.

Gyu Jin LEE ; Seun Ja PARK ; Sun Jung KIM ; Hyung Hun KIM ; Moo In PARK ; Won MOON

Clinical Endoscopy.2012;45(2):161-164. doi:10.5946/ce.2012.45.2.161

BACKGROUND/AIMS: Gastric mucus should be removed before endoscopic examination to increase visibility. In this study, the effectiveness of premedication with pronase for improving visibility during endoscopy was investigated. METHODS: From April 2010 to February 2011, 400 outpatients were randomly assigned to receive endoscopy with one of four premedications as follows: dimethylpolysiloxane (DMPS), pronase and sodium bicarbonate with 10 minutes premedication time (group A, n=100), DMPS and sodium bicarbonate with 10 minutes premedication time (group B, n=100), DMPS, pronase and sodium bicarbonate with 20 minutes premedication time (group C, n=100), and DMPS and sodium bicarbonate with 20 minute premedication time (group D, n=100). One endoscopist, who was unaware of the premedication types, calculated the visibility scores (range, 1 to 3) of the antrum, lower gastric body, upper gastric body and fundus. The sum of the scores from the four locations was defined as the total visibility score. RESULTS: Group C showed significantly lower scores than other groups (p=0.002). Group C also had the lowest frequency of flushing, which was significantly lower than that of group D. Groups C and D had significantly shorter durations of examination than groups A and B. CONCLUSIONS: Using pronase 20 minutes before endoscopy significantly improved endoscopic visualization and decreased the frequency of water flushing.
Dimethylpolysiloxanes ; Endoscopy ; Flushing ; Humans ; Mucous Membrane ; Mucus ; Outpatients ; Premedication ; Pronase ; Sodium Bicarbonate ; Unithiol

6

Cite

Share

Extended Spectrum-beta-Lactamase or Carbapenemase Producing Bacteria Isolated from Patients with Acute Cholangitis.

Ja Chung GOO ; Mun Hyuk SEONG ; Young Kwang SHIM ; Hee Seung LEE ; Jung Ho HAN ; Kyeong Seob SHIN ; Jae Woon CHOI ; Sei Jin YOUN ; Seon Mee PARK

Clinical Endoscopy.2012;45(2):155-160. doi:10.5946/ce.2012.45.2.155

BACKGROUND/AIMS: This study assessed the antibiotic resistance organisms isolated from the blood and bile of acute cholangitis and evaluated risk factors associated with them and their impact on clinical outcomes. METHODS: The identities and antibiotic resistance profiles of bacteria isolated from 433 cases of acute cholangitis from 346 patients were analyzed. Risk factors and the outcomes of patients infected with them were assessed. RESULTS: Microorganisms were isolated from 266 of 419 blood cultures and 256 of 260 bile cultures. Isolates from bile and blood were identical in 71% of the cases. A total of 20 extended spectrum-beta-lactamase (ESBL)-producers and 4 carbapenemase-producing organisms were isolated from blood, and 34 ESBL-producers and 13 carbapenemase-producers were isolated from bile. Sixty-four (14.8%) cases were infected with any one of these bacteria isolated from blood or bile. Risk factors associated with them in blood were nosocomial infection and prior biliary intervention. In bile, indwelling biliary device was a risk factor associated with them. Antibiotic-resistant bacteria were associated with mortality, independent of other prognostic factors. CONCLUSIONS: ESBL or carbapenemase-producing bacteria were frequently isolated in acute cholangitis patients especially with prior biliary intervention and nosocomial infection. Isolation of antibiotic-resistant bacteria was an independent risk factor of mortality.
Bacteria ; Bacterial Proteins ; beta-Lactamases ; Bile ; Cholangitis ; Cross Infection ; Drug Resistance, Microbial ; Humans ; Risk Factors

7

Cite

Share

Expression of MUC5AC and Trefoil Peptide 1 (TFF1) in the Subtypes of Intestinal Metaplasia.

Joo Yong SONG ; Byung Wook KIM ; Ah Won LEE ; Kyo Young LEE ; In Sik CHUNG ; Bo In LEE ; Hwang CHOI ; Jeong Seon JI ; Hiun Suk CHAE ; Kyu Yong CHOI

Clinical Endoscopy.2012;45(2):151-154. doi:10.5946/ce.2012.45.2.151

BACKGROUND/AIMS: Alterations of the expression pattern of mucins and trefoil peptides have been described in gastric adenocarcinomas and in their precursor lesions. The aim of this study was to determine the progression patterns of intestinal metaplasia (IM) subtypes by analyzing the expression patterns of TFF1 and MUC5AC in different subtypes of IM of the stomach. METHODS: Endoscopic gastric biopsies of the antrum and body were obtained from patients with dyspepsia and endoscopic IM. Alcian blue/periodic acid-Schiff staining and the high iron diamine technique were used to classify the subtypes of IM. Immunoreactivity for MUC5AC and TFF1 was estimated in different types of IM. RESULTS: IM was detected in 128 samples from 80 patients; type I was found in 48 samples, type II was found in 37 samples, and type III was found in 43 samples. There was a gradual decrease in MUC5AC and TFF1 expression during the progression of IM from type I to type III via the type II intermediate. CONCLUSIONS: This downregulation of MUC5AC and TFF1 expression may challenge the sequential progression of IM from type I to type III via the type II intermediate, and it might be associated with gastric carcinogenesis.
Adenocarcinoma ; Biopsy ; Down-Regulation ; Dyspepsia ; Humans ; Iron ; Lotus ; Metaplasia ; Mucins ; Peptides

8

Cite

Share

The Clinical Meaning of Benign Colon Uptake in 18F-FDG PET: Comparison with Colonoscopic Findings.

Sun Hee ROH ; Sung Ae JUNG ; Seong Eun KIM ; Hye In KIM ; Min Jin LEE ; Chung Hyun TAE ; Ju Young CHOI ; Ki Nam SHIM ; Hye Kyung JUNG ; Tae Hun KIM ; Kwon YOO ; Il Hwan MOON ; Bom Sahn KIM

Clinical Endoscopy.2012;45(2):145-150. doi:10.5946/ce.2012.45.2.145

BACKGROUND/AIMS: Benign colon 18F-fluorodeoxyglucose (FDG) uptake is frequently observed in asymptomatic individuals. Aims of this study were to investigate the benign colon uptake by whole body FDG-positron emission tomography (PET) in asymptomatic adults and to correlate those results with colonoscopic and histologic findings. METHODS: Among 3,540 subjects who had undergone FDG-PET, 43 subjects who were diagnosed to have benign colon uptake in FDG-PET and underwent colonoscopy were retrospectively reviewed. Subjects were classified as diffuse or focal groups based on their FDG uptake patterns. PET results were analyzed together with colonoscopic and histologic findings. RESULTS: Forty-three subjects showed benign colon uptake in FDG-PET; 28 of them were shown as the diffuse group, while other 15 subjects were classified as the focal group. Five subjects among those showed diffuse uptake were diagnosed as adenoma. Seven among 15 subjects who showed focal uptake were diagnosed as adenocarcinoma (n=2), adenoma (n=3), or non-neoplastic polyp (n=2). Positive predictive values were 25% in the diffuse group and 47% in the focal group. CONCLUSIONS: We recommend that patients showing benign FDG uptake in the colon should be further evaluated by colonoscopy, especially for patients with focal FDG uptake.
Adenocarcinoma ; Adenoma ; Adult ; Colon ; Colonoscopy ; Fluorodeoxyglucose F18 ; Humans ; Polyps ; Retrospective Studies

9

Cite

Share

Non-Steroidal Anti-Inflammatory Drug-Induced Enteropathy.

Yun Jeong LIM ; Chang Hun YANG

Clinical Endoscopy.2012;45(2):138-144. doi:10.5946/ce.2012.45.2.138

Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the most commonly prescribed drugs in the world. NSAID-induced lower gastrointestinal (GI) complications are increasing while upper GI complications are decreasing. Lower GI events accounted for 40% of all serious GI events in patients on NSAIDs. Capsule endoscopy and device assisted enteroscopy are available for detection of small intestinal lesions. Capsule endoscopy studies have demonstrated that NSAIDs use in healthy volunteers raised the incidence (55% to 75%) of intestinal damage. It appears that selective cyclooxygenase-2 inhibitors (coxibs) improved upper and lower GI safety based on results of clinical trials. Selective coxibs are still capable of triggering GI adverse events and cardiovascular toxicity issues were the main focus of concerns. Unfortunately, definite strategies are not available to prevent or heal NSAID-induced intestinal injuries. Thus, there is still a strong clinical need for effective drugs with improved safety profiles than the existing NSAIDs.
Anti-Inflammatory Agents, Non-Steroidal ; Capsule Endoscopy ; Cyclooxygenase 2 Inhibitors ; Humans ; Incidence ; Lower Gastrointestinal Tract

10

Cite

Share

How Can We Get the Best Results with Endoscopic Ultrasound-Guided Fine Needle Aspiration?.

Jayapal RAMESH ; Shyam VARADARAJULU

Clinical Endoscopy.2012;45(2):132-137. doi:10.5946/ce.2012.45.2.132

Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) has evolved to become an indispensable tool for tissue acquisition. While the overall diagnostic accuracy of EUS-FNA is greater than 90% for lung cancer staging, it is lower for pancreatic mass lesions. Several factors such as location of the tumor, disease characteristics and procedural techniques determine the outcomes of EUS-FNA. In this review we evaluate the various technical factors that are keys to attaining optimal procedural outcomes.
Endoscopic Ultrasound-Guided Fine Needle Aspiration ; Lung Neoplasms ; Needles

DISPLAY OPTIONS

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share

Cite

Share