Congenital pancreatic cysts are rare in newborn babies, and this makes prenatal diagnosis difficult. Diagnosis can be delayed for a few months after birth until the infant presents with an abdominal mass, abdominal distension, or vomiting due to gastric outlet obstruction. Excision of the cyst is the treatment of choice. A congenital pancreatic cyst should be considered if the fetus has an abdominal cyst without a definite origin. A prompt diagnosis is crucial to prevent fatal complications such as cholangitis, pancreatitis, cyst rupture, and peritonitis. We report a case of neonate with multiple congenital pancreatic cysts suspected prenatally to be stomach diverticulum or duplication cysts of the intestine.
Cholangitis ; Diagnosis ; Diverticulum, Stomach ; Fetus ; Gastric Outlet Obstruction ; Humans ; Infant ; Infant, Newborn ; Intestines ; Pancreatic Cyst ; Pancreatic Pseudocyst ; Pancreatitis ; Parturition ; Peritonitis ; Prenatal Diagnosis ; Rupture ; Vomiting

Endoscopic submucosal dissection (ESD) is a standard treatment for early gastric cancer (EGC) that does not have any risk of lymph node or distant metastases. Here, we report a case of EGC resembling a diverticulum. Diverticular formation makes it difficult for endoscopists to determine the depth of invasion and to subsequently perform ESD. Because the false diverticulum does not have a muscular layer, this lesion can be treated with ESD. Our case was successfully treated with ESD. After ESD, the EGC was confined to the submucosal layer without vertical and lateral margin involvement. This is the first case in which ESD was successfully performed for a case of EGC that coexisted with a false gastric diverticulum. An additional, larger study is needed to determine the efficacy of ESD in various types of EGC, such as a false gastric diverticulum.
Diverticulum ; Diverticulum, Stomach* ; Endoscopy, Digestive System ; Lymph Nodes ; Neoplasm Metastasis ; Stomach Neoplasms

Jejunal and ileal diverticula are rare in adults. Duodenal diverticula are five times more prevalent than jejunoileal diverticula. Most patients are asymptomatic. However, chronic symptoms including intermittent abdominal pain, flatulence, diarrhea and constipation are seen in 10%-30% of patients. Gastric cancer is the second most common cancer in South Korea and here we report a case of early gastric cancer with multiple duodenal and jejunal diverticula. A 67-year-old woman was admitted to Konkuk University Medical Center with chronic diarrhea and weight loss of 19 kg over 2 months. Following gastroduodenoscopy, we identified adenocarcinoma of the lower body of the stomach. On abdominopelvic computed tomography, diverticula of duodenum and jejunum were found. Patient underwent distal gastrectomy and gastroduodenostomy with lymphadenectomy. She was discharged on the tenth postoperative day without complications.
Abdominal Pain ; Academic Medical Centers ; Adenocarcinoma ; Adult ; Aged ; Constipation ; Diarrhea ; Diverticulum* ; Duodenum ; Female ; Flatulence ; Gastrectomy ; Humans ; Jejunum ; Korea ; Lymph Node Excision ; Malabsorption Syndromes ; Stomach ; Stomach Neoplasms* ; Weight Loss

Actinomycosis is a chronic suppurative and granulomatous disease caused by a Gram-negative anaerobic bacterium, Actinomyces israelii, which is among the normal flora of the oral cavity and gastrointestinal tract of humans and animals. It is characterized by sulfur granule formation and can involve the cervicofacial area, chest, abdomen, and pelvis. The most common predisposing factors are the presence of an intrauterine contraceptive device, previous trauma, appendectomy, colon diverticulum, and gastrointestinal perforation. Primary gastric actinomycosis is an extremely rare disease. Three cases of gastric actinomycosis have been reported in people who had a subtotal gastrectomy for stomach cancer in Korea. We report a case of primary gastric actinomycosis in a 59-year-old man with untreatable hepatocelluar carcinoma. His actinomycosis was cured with penicillin therapy.
Abdomen ; Actinomyces ; Actinomycosis ; Animals ; Appendectomy ; Carcinoma, Hepatocellular ; Diverticulum, Colon ; Gastrectomy ; Gastrointestinal Tract ; Humans ; Intrauterine Devices ; Korea ; Middle Aged ; Mouth ; Pelvis ; Penicillins ; Rare Diseases ; Stomach Neoplasms ; Stomach Ulcer ; Sulfur ; Thorax

Gastric diverticulum is an uncommon form of diverticular disease that can occur at all ages but is generally encountered between the ages of 20 to 60 years. Only 4% of gastric diverticula occur in patients younger than 20 years old. Apart from Meckel's diverticulum, gastrointestinal tract diverticula are extremely rare, particularly during infancy and childhood with the stomach being the least common site of occurrence. We report a case of gastric diverticulum in a 40-day-old infant who presented with frequent vomiting and a failure to thrive. An upper gastrointestinal contrast study revealed a diverticulum on the posterior wall of the stomach located approximately 2 cm below the esophagogastric junction. The same lesion was also identified by esophagogastroduodenoscopy. Congenital gastric divertilulum should be considered in a differential diagnosis of vomiting and/or a failure to thrive in infancy.
Diagnosis, Differential ; Diverticulum ; Diverticulum, Stomach* ; Endoscopy, Digestive System ; Esophagogastric Junction ; Failure to Thrive ; Gastrointestinal Tract ; Humans ; Infant* ; Meckel Diverticulum ; Stomach ; Vomiting ; Young Adult

A 69-year old man presented with severe epigastric pain for 1 day. He had early gastric cancer at the antrum and underwent a distal subtotal gastrectomy and Billorth II gastrojejunostomy one month later without any post-operative complications. Radiologic examination revealed a large amount of retroperitoneal free air formation. Because of unremitting pain and unstable vital sign, exploratory laparotomy was followed. During the operation, a perforated duodenal diverticulum at the posterior wall of the 2nd portion of the duodenum was identified. He underwent diverticulectomy and primary closure. He was discharged on the 18th post operative day and has been followed up without any evidence of comlpication for several months.
Aged ; Diverticulum* ; Duodenum ; Gastrectomy* ; Gastric Bypass* ; Humans ; Laparotomy ; Stomach Neoplasms ; Vital Signs

Adolescent ; Diagnosis, Differential ; Diverticulum, Stomach ; complications ; diagnosis ; pathology ; Gastrointestinal Hemorrhage ; diagnosis ; etiology ; pathology ; Gastroscopy ; Humans ; Male

PURPOSE: We wanted to evaluate the safety and effectiveness of superselective transarterial embolization for the management of gastrointestinal bleeding. MATERIALS AND METHODS: We evaluated 97 of 115 patients who had undergone diagnostic angiography and transarterial embolization for gastrointestinal bleeding from February 2001 to July 2004, and they subsequently underwent superselective transarterial embolization. Their ages ranged from 17 to 88 years (mean age: 58.5 years), and 73 were men and 24 were women. The etiologies were a postoperative condition (n=31), ulcer (n=23), Mallory-Weiss syndrome (n=3), trauma (n=3), pseudoaneurysm from pancreatitis (n=3), diverticula (n=2), inflammatory bowel disease (n=2), tumor (n=2), Behcet's disease (n=2), hemobilia (n=1), and unknown origin (n=25). The regions of bleeding were the esophagus (n=3), stomach and duodenum (n=41), small bowel (n=38) and colon (n=15). All the patients underwent superselective transarterial embolization using microcoils, gelfoam or a combination of microcoils and gelfoam. Technical success was defined as devascularization of targeted vascular lesion or the disappearance of extravasation of the contrast media, as noted on the angiography after embolization. Clinical success was defined as the disappearance of clinical symptoms and the reestablishment of normal cardiovascular hemodynamics after transarterial embolization without any operation or endoscopic management. RESULTS: The technical success rate was 100%. The primary clinical success rate was 67% (65 of 97 patients). Of the 32 primary failures, fourteen patients underwent repeat embolization; of these, clinical success was achieved in all the patients and so the secondary clinical success rate was 81% (79 of 97 patients). Of the 18 patients with primary failures, five patients underwent operation, one patient underwent endoscopic management and the others died during the observation period due to disseminated coagulopathy or complications of their underlying diseases. During the follow up period, six patients of the 79 clinically successful patients died due to disseminated coagulopathy or complications of their underlying diseases, and so the total mortality rate was 19% (18 of 97 patients). Postembolization complications such as bowel ischemia or infarction did not occur during the observation period. CONCLUSION: Superselective transarterial embolization is an effective therapy for treating acute gastrointestinal hemorrhage, and it has a high technical rate and clinical success rate, and a low complication rate.
Aneurysm, False ; Angiography ; Colon ; Contrast Media ; Diverticulum ; Duodenum ; Esophagus ; Female ; Follow-Up Studies ; Gastrointestinal Hemorrhage ; Gelatin Sponge, Absorbable ; Hemobilia ; Hemodynamics ; Hemorrhage* ; Humans ; Infarction ; Inflammatory Bowel Diseases ; Ischemia ; Male ; Mallory-Weiss Syndrome ; Mortality ; Pancreatitis ; Stomach ; Ulcer

Diverticulosis of the small intestine is a rare entity, compared with that of duodenum or colon, and is found in only 1% of autopsied patients. The main complications are diverticulitis with or without a perforation, obstruction and hemorrhage, which are associated with a high mortality. Intussusception is primarily a disease of childhood; with only 5 to 10% of cases occurring in adults. In contrast to childhood intussusception, 90% of adult intussusception cases are had an associated pathologic processes. An inflammatory fibroid polyp is an uncommonly localized non-neoplastic lesion of the gastrointestinal tract. It occurs most often in the stomach and secondly in the ileum. It rarely occurs in other organs such as the colon, jejunum, duodenum and esophagus. We report a case of jejunal diverticulitis with a perforation combined with intussusception caused by an inflammatory fibroid polyp. A 78-year-old female presented with abdominal pain, fever and chill. Contrast CT scan showed intussusception of the ileum. The patient was treated with a small bowel segmental resection. After surgery, the specimen showed jejunal diverticulitis with perforation.
Abdominal Pain ; Adult ; Aged ; Colon ; Diverticulitis* ; Diverticulum ; Duodenum ; Esophagus ; Female ; Fever ; Gastrointestinal Tract ; Hemorrhage ; Humans ; Ileum ; Intestine, Small ; Intussusception* ; Jejunum ; Leiomyoma* ; Mortality ; Pathologic Processes ; Polyps* ; Stomach ; Tomography, X-Ray Computed

An ectopic pancreas, also known as a heterotopic or aberrant pancreas, is defined as pancreas tissue lying outside its normal location and lacking anatomic or vascular connections with the pancreas. Most occurrences of an ectopic pancreas are located in the stomach, duodenum, or jejunum. However, an ectopic pancreas can sometimes be found in unusual sites such as the Meckel's diverticulum, gallbladder, umbilicus, mediastinum and fallopian tubes. An ectopic pancreas rarely produces clinical symptoms, but occasionally can result in varying symptoms according to its location, size and involvement of the overlying mucosa. Herein, a case of 41-year-old male with an ectopic pancreas in the duodenum, presenting as a duodenal obstructing mass, is reported.
Adult ; Deception ; Duodenum ; Fallopian Tubes ; Female ; Gallbladder ; Humans ; Jejunum ; Male ; Meckel Diverticulum ; Mediastinum ; Mucous Membrane ; Pancreas* ; Stomach ; Umbilicus