Gastrointestinal foreign bodies are a common problem. It can be managed by observation, endoscopic removal, and/or surgical intervention. Bowel perforation, obstruction, bleeding, fistularization and abscess formation are common significant complications associated with foreign bodies.A 38-year-old woman with a toothbrush in the duodenum was referred to our hospital due to abdominal pain. Three years ago, she ingested a tooth brush. Esophagogastroduodenoscopy showed a tooth brush placed in the second portion of the duodenum. We removed a tooth brush by a snare and found a fistula at the junction of the second and third portion of the duodenum. Upper gastrointestinal series revealed a fistula between the duodenum and cecum. We report a case of duodeno-cecal fistula developed due to a toothbrush ingested 3 years before.
Abdominal Pain ; Abscess ; Adult ; Cecum ; Duodenum ; Endoscopy, Digestive System ; Female ; Fistula* ; Foreign Bodies* ; Hemorrhage ; Humans ; SNARE Proteins ; Tooth

BACKGROUND/AIMS: The correct histological diagnosis of gastric adenoma is important, because it has been reported to be precancerous lesion and associated with focal gastric carcinoma. However, there is some discrepancy between the histology of the forceps biopsy and that of the endoscopic resection. In this study, we compared the histologic findings of gastric mucosal elevated lesion between the specimens of forceps biopsy and endoscopic resection. METHODS: We reviewed retrospectively 137 cases of gastric mucosal elevated lesion which had been removed by the resection such as polypectomy or endoscopic mucosal resection. All patients had undergone forceps biopsy before endoscopic resection. We compared the histologic findings of the specimens by forceps biopsy with those by resection. RESULTS: The histologic fidings were accordant at 101 of the 137 cases (73.7%), and different at 30 cases (21.9%). Among the 86 cases with adenoma in the biopsied specimens, 10 cases (11.6%) were finally diagnosed as gastric cancer in the resected specimens. CONCLUSIONS: Because biopsy specimens may not be presentative of the entire lesion, endoscopic resection of gastric mucosal elevated lesion is needed for accurate histologic diagnosis and treatment if adenoma is suspected.
Adenoma ; Biopsy* ; Diagnosis ; Humans ; Retrospective Studies ; Stomach Neoplasms ; Surgical Instruments*

Groove pancreatitis is a special form of chronic pancreatitis in which scarring is found mainly in the groove between the pancreatic head, duodenum, and common bile duct. Preoperative differentiation between groove pancreatitis and pancreatic cancer is difficult. Here we report one case of segmental groove pancreatitis diagnosed by clinical and radiological features. The patient was a 46-year old man with severe abdominal pain, weight loss, and a long history of alcohol abuse. Computed tomography revealed swelling of the pancreatic head and a heterogeneously enhanced low-density lesion in the groove. MR images revealed a mass in the groove that had a low signal on T1-weighted images and a low signal relative to the pancreatic head on T2-weighted images. T1-weighted images on dynamic study showed the medial wall thickening of descending duodenum, several small cysts in the groove and thickened duodenal wall. The patient has been under conservative treatment for 2 months and his severe abdominal pain has improved.
Chronic Disease ; Human ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pancreatitis/*diagnosis ; Tomography, Emission-Computed ; Ultrasonography

Gastrointestinal cytomegalovirus (CMV) disease causes substantial morbidity and mortality in immunocompromised patients, especially in transplant recipients and those who infected with HIV. Although acute infection is generally asymptomatic or produces only non-specific symptoms in the immunocompetent host, acute CMV infection accompanies gastrointestinal ulceration in a small number of patients. The colon is the most common site of the infection, although it may occur in other gastrointestinal tract. CMV infection associated with simultaneous esophageal and colonic ulcers has not been reported in Korea. We report a patient with subarchnoid hemorrhage who had suffered from simultaneous esophageal and colonic ulcers associated with CMV infection which showed characteristic histologic findings of CMV infection.
Colon* ; Cytomegalovirus ; Gastrointestinal Tract ; Hemorrhage ; HIV ; Humans ; Immunocompromised Host ; Korea ; Mortality ; Transplantation ; Ulcer*

Breast carcinoma is common malignancy in women and frequently metastasize to multiple organ such as lung, bone, lymph node and liver. But metastasis to gastrointestinal tract is rare and only two cases have been reported in Korea. We experienced a case of upper gastrointestinal bleeding caused by gastric metastasis from ductal carcinoma of breast and report this case with review of several literatures.
Breast Neoplasms* ; Breast* ; Carcinoma, Ductal ; Female ; Gastrointestinal Tract ; Hemorrhage* ; Humans ; Korea ; Liver ; Lung ; Lymph Nodes ; Neoplasm Metastasis*

BACKGROUND/AIMS: Tuberculous peritonitis is still a very important cause of exudative ascites in Korea. We analized the clinical features and laparoscopic findings in patients with tuberculous peritonitis diagnosed by laparoscopy. METHODS: We studied 51 patients who had tuberculous peritonitis confirmed by laparoscopic biopsy from 1980 to 2000, in retrospective method. RESULTS: The ratio of male to female was 1:2. The peak incidence was between 21 and 40 years of age. The mean duration of symptoms is 60 days. The most frequent chief complaints and physical findings was abdominal fullness (88.2%) and shifting dullness (94.1 %). Involvement of other organs included pulmonary tuberculosis (27.4%), cervical tuberculous lymphadenitis (3.9%). The mean ascitic fluid protein concentration was 4.9 gm/dL, mean WBC count 1,240/mm3 and lymphocyte dominant exudate 88.2%. AFB smear was positive only one patient (2.0%). Tuberculous nodules on laparoscopy were noted in all of the patients. Histolologic findings were caseating granuloma (72.6%), non-caseating granuloma (19.6%) and nonspecific inflammation (7.8%). Tissue AFB stain was positive 10 patients (19.6%). CONCLUSIONS: Tuberculous peritonitis shows nonspecific clinical features. Therefore, laparoscopic examination with biopsy is the most useful method to make differential diagnosis of patients who are suspected tuberculous peritonitis.
Ascites ; Ascitic Fluid ; Biopsy ; Diagnosis, Differential ; Exudates and Transudates ; Female ; Granuloma ; Humans ; Incidence ; Inflammation ; Korea ; Laparoscopy* ; Lymphocytes ; Male ; Peritonitis, Tuberculous* ; Retrospective Studies ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

Percutaneous liver biopsy is valued in the diagnosis of diffuse or localized liver disease. Serious complications after ultrasonography-guided liver biopsy are rare. We report a case of a 69-year-old man who underwent a percutaneous liver biopsy for the evaluation of his underlying liver disease with subsequent late complication of intraluminal gallbladder hematoma.
Aged ; Biopsy, Needle/*adverse effects ; English Abstract ; Gallbladder Diseases/*etiology ; Hematoma/*etiology ; Human ; Liver/*pathology/ultrasonography ; Male ; Ultrasonography, Interventional

Fascioliasis is a zoonotic helminthiasis caused by Fasciola hepatica, the sheep liver fluke. Humans are accidental hosts in the life cycle of the parasite. They are infected by the ingestion of water or raw aquatic vegetables contaminated with the metacercaria. The diagnosis of fascioliasis is based on clinical symptoms, absolute eosinophilia, serologic test (ELISA), radiologic finding, and presence of eggs in the feces or duodenal fluid. Recently, some radiologists have been reporting specific findings of fascioliasis by MRI. We report a case of liver abscess associated with fascioliasis diagnosed by MRI.
Diagnosis ; Eating ; Eggs ; Eosinophilia ; Fasciola hepatica ; Fascioliasis* ; Feces ; Helminthiasis ; Humans ; Life Cycle Stages ; Liver Abscess* ; Liver* ; Magnetic Resonance Imaging* ; Ovum ; Parasites ; Serologic Tests ; Sheep ; Vegetables ; Water

Primary extrapulmonary small cell carcinoma have been described in the esophagus, stomach, pancreas, salivary gland, paranasal sinus, small bowel, uterus, urinary bladder and skin. Primary small cell carcinoma of the esophagus has rarely been reported since McKeown had reported the first 2 cases of small cell carcinoma of the esophagus in 1952. Primary small cell cancer of esophagus is extremely aggressive tumor with grave prognosis. Because of the highly malignant potency, multimodality treatment including chemotherapy for the primary therapy is accepted generally. We experienced 2 cases of small cell carcinoma of the esophagus. One patient was a 57 year-old male without metastasis and we treated him with a multi-drug regimen (cisplatin and VP-16) being used in small cell carcinoma of the lung at our hospotal. But the other patient was a 67 year-old male with bone metastasis, and he refused all management.
Aged ; Carcinoma, Small Cell* ; Drug Therapy ; Esophageal Neoplasms ; Esophagus ; Humans ; Lung ; Male ; Middle Aged ; Neoplasm Metastasis ; Pancreas ; Prognosis ; Salivary Glands ; Skin ; Stomach ; Urinary Bladder ; Uterus

BACKGROUND/AIMS: Reflux esophagitis is pertained to gastroesophageal reflux disease. On recent studies, western GERD patients shows reflux esophagitis over than 50% on gastroscopy. We expect lower incidence of reflux esophagitis in Korea, but few epidemiological data are available for korean patients. We intended to investigate the alteration of incidence of reflux esophagitis by gastroscopy result for patients who visited general health screening center and department of gastroenterology with chief complaint of gastrointestinal symptoms. METHODS: The 13,439 people of general health screening center visitors, 28,037 patients who visited department of gastroenterology due to gastrointestinal symptoms from March, 1996 to August, 1999 were underwent gastroscopy. And 24,952 patients who showed gastrointestinal symptoms and general health screening center visitors from March, 1993 to Feburary, 1996 were also underwent gastroscopy. The grading of esophagitis was based on the Savary-Miller classification and prevalence alteration of reflux esophagitis was investigated by retrospective manner. RESULTS: 1) Overall prevalence of general health screening people group and patients with gastrointestinal symptoms from March, 1993 to Feburary, 1996 was 2.08%. 2) Overall prevalence of general health sceening group from March, 1996 to August, 1999 was 2.37%. During the same period, Overall prevalence of patients with gastrointestinal symptoms was 3.69%. Overall prevalence was 2.96% and it was higher than that of 3 years ago (2.02%). CONCLUSIONS: On recent gastrofiberscopy studies, prevalence of reflux esophagitis is increasing. So further investigation is needed on the prevalence of reflux esophagitis over the whole country by prospective manner.
Classification ; Cross-Sectional Studies ; Esophagitis ; Esophagitis, Peptic* ; Gastroenterology ; Gastroesophageal Reflux ; Gastroscopy ; Humans ; Incidence ; Korea ; Mass Screening ; Prevalence* ; Retrospective Studies