No abstract available.
Biliary Tract Surgical Procedures ; Catheterization ; Duodenoscopy ; Constriction, Pathologic ; Dilatation ; Common Bile Duct ; Bile Ducts ; Duodenum ; Liver ; Cholangiography ; Mucous Membrane

BACKGROUND/AIMS: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. METHODS: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. RESULTS: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). CONCLUSIONS: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.
Adenoma, Villous ; Anemia, Iron-Deficiency* ; Case-Control Studies ; Colonoscopy ; Colorectal Neoplasms ; Duodenoscopy ; Endoscopy* ; Endoscopy, Digestive System ; Humans ; Inflammatory Bowel Diseases ; Iron* ; Male ; Prevalence ; Stomach Ulcer

A Morgagni hernia was first described in 1761 by Giovanni Morgagni. In adults, it is accompanied by gastrointestinal- or respiratory-type symptoms. Herein, we report an 84-year-old woman presented to our hospital with nausea and vomiting. After hospitalization, an X-ray revealed a right diaphragmatic hernia. Based on the results of abdominal computed tomography, duodenoscopy, and upper gastrointestinography (gastrografin), we concluded that her symptoms were caused by Morgagni hernia. Our patient underwent laparoscopic surgery, and shortly thereafter, her symptoms resolved.
Adult ; Aged* ; Aged, 80 and over ; Duodenoscopy ; Dyspepsia* ; Female ; Hernia* ; Hernia, Diaphragmatic ; Hospitalization ; Humans ; Incidental Findings* ; Laparoscopy ; Nausea ; Vomiting

BACKGROUND/AIMS: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI. METHODS: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission. RESULTS: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics. CONCLUSIONS: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea.
Anti-Bacterial Agents ; Clostridium difficile* ; Clostridium* ; Colonoscopy ; Disease Transmission, Infectious ; Duodenoscopy ; Fecal Microbiota Transplantation* ; Follow-Up Studies ; Gastrointestinal Microbiome ; Humans ; Korea ; Pneumonia, Aspiration ; Recurrence ; Tissue Donors

No abstract available.
Adult ; Biopsy ; *Brunner Glands/pathology/surgery ; Duodenal Diseases/*complications/diagnosis/surgery ; Duodenal Obstruction/diagnosis/*etiology/surgery ; Duodenoscopy ; Gastric Outlet Obstruction/diagnosis/*etiology/surgery ; Hamartoma/*complications/diagnosis/surgery ; Humans ; Male ; Tomography, X-Ray Computed ; Treatment Outcome

A Killian-Jamieson diverticulum (KJD) is an unfamillar and unusual cervical esophageal diverticulum. This diverticulum originates on the anterolateral aspect of the esophagus through the Killian-Jamieson's area that is formed between cricopharyngeal muscle and the lateral to longitudinal esophageal muscle. Recently, we experienced a patient who was found outpouching lesion on lateral side of left esophagus on the duodenoscopy. Then, a barium esophagography performed and in left lateral position demonstrated a left-sided diverticulum with a frontal projection, highly suggestive of a KJD. There are two ways of surgical approach to manage the KJD. First is external approach, another one is endoscopic approach. In common, external approach has been recommended for the treatment of KJD because of concern of nerve injury. We present a case of KJD that underwent external approach and sternocleidomastoid muscle flap in the management of KJD.
Barium ; Diverticulum* ; Diverticulum, Esophageal ; Duodenoscopy ; Esophagus* ; Humans

BACKGROUND/AIMS: Sporadic non-ampullary duodenal neoplasms are rare and optimal treatment for these lesions remains undefined. Endoscopic resection of duodenal neoplasms is widely used recently and it is an alternative treatment strategy to surgical excision. This study aimed to evaluate the safety and efficacy of endoscopic resection of duodenal neoplasms and to determine its outcomes. METHODS: Patients who underwent endoscopic resection for non-ampullary duodenal neoplasms between January 2005 and December 2014 were analyzed retrospectively. Data including size, morphology, histology, location and endoscopic procedural technique were reviewed. The main outcome measurements were success rate, complication, recurrence and follow-up assessments. RESULTS: The study included 33 patients with duodenal neoplasms. The mean size of resected lesion was 8.58 mm. The results of histologic examination were as follows: 23 (69.7%) adenomas, 2 (6.1%) adenocarcinoma, 3 (9.1%) Brunner's gland tumor and 3 (9.1%) neuroendocrine tumor. Tubular adenoma wase the most common type (63.6%) of non-ampullary duodenal neoplasms. Eighteen (54.5%) lesions were found in the second portion of the duodenum, and 10 (30.3%) lesions on bulb and 3 (9.1%) lesions on superior duodenal angle. Of the 33 cases, 32 (97.0%) were managed by endoscopic mucosal resection technique during a single session and one case was managed by endoscopic submucosal dissection (ESD). One episode of perforation occurred after ESD. During a median follow-up period of 5.76 months, recurrence was observed in only one case of in a patient with tubular adenoma. CONCLUSIONS: Endoscopic resection of duodenal neoplasm is a safe and effective treatment modality that can replace surgical resection in many cases. Careful endoscopic follow-up is essential to manage recurrence or residual lesions.
Adenocarcinoma/pathology ; Adenoma/pathology ; Adult ; Aged ; Aged, 80 and over ; Brunner Glands/pathology ; Duodenal Neoplasms/pathology/*surgery ; Duodenoscopy ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neuroendocrine Tumors/pathology ; Retrospective Studies

Choristoma ; complications ; diagnosis ; diagnostic imaging ; Duodenal Diseases ; complications ; diagnosis ; diagnostic imaging ; Duodenoscopy ; Fatal Outcome ; Female ; Humans ; Middle Aged ; Pancreas ; Shock, Septic ; etiology ; Tomography, X-Ray Computed ; Ultrasonography

PURPOSE: This study presents findings on the clinical usefulness of an overlap method that is another modification for the currently well-known intracorporeal gastroduodenostomy in totally laparoscopic distal gastrectomy (TLDG). METHODS: We studied 42 patients diagnosed with gastric cancer who underwent TLDG between December 2011 and March 2013. Endoscopic linear staplers were used for intracorporeal anastomosis and patients were observed with endoscopic tracking six months after surgery. We retrospectively reviewed the outcome of the operation, the clinical pathological results, and the endoscopy results. RESULTS: The mean duration of the operation for 42 patients was 228.3 +/- 42.5 minutes and the mean time to complete the anastomosis was 12.18 +/- 2.3 minutes. There were no mortalities and no cases of open conversion. Following the operation, 37 patients had stage IA, 5 in stage IB, and 3 in stage II gastric cancer. Abscesses were seen in 3 patients and 5 cases of stasis during the postoperative period. Duodenoscopy 6 months after the operation showed 11 cases of gastric stasis, 28 cases of bile reflux, and 1 new case of erosive gastritis. We did not observe contraction in any of the patients. CONCLUSION: The overlap method for intracorporeal gastroduodenostomy, using an endoscopic linear stapler, can be considered a feasible and safe technique for the treatment of stomach cancer. However, a long-term comparative study is required to sufficiently evaluate our findings.
Abscess ; Bile Reflux ; Duodenoscopy ; Endoscopy ; Gastrectomy* ; Gastritis ; Gastroparesis ; Humans ; Laparoscopy ; Mortality ; Postoperative Period ; Retrospective Studies ; Stomach Neoplasms*

Cholangitis and cholecystitis are intra-abdominal infections that show poor prognosis upon progression to sepsis and multiorgan failure. Administration of antibiotics with high antimicrobial susceptibility and removal of infected bile at the initial treatment are important. After undergoing ERCP for diagnostic purposes, a 58-year-old man developed acute cholangitis and cholecystitis accompanied by rhabdomyolysis, multi-organ failure, and severe sepsis. Broad-spectrum antibiotics with bedside endoscopic nasobiliary drainage were administered, but clinical symptoms did not improve. Therefore, bedside EUS-guided transgastric gallbladder aspiration and lavage was performed, resulting in successful treatment of the patient. We report the above described case along with a discussion of relevant literature.
Cholangiopancreatography, Endoscopic Retrograde ; Cholecystitis, Acute/complications/*diagnosis/diagnostic imaging ; Drainage ; Duodenoscopy ; Endosonography ; Escherichia coli/isolation & purification ; Humans ; Male ; Middle Aged ; Multiple Organ Failure/pathology ; Rhabdomyolysis/complications/diagnosis ; Sepsis/diagnosis/etiology/microbiology ; Therapeutic Irrigation ; Tomography, X-Ray Computed