• Title/Summary/Keyword: 관 내시경

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Usefulness of Computed Tomography Gastrography in the Surgical Management of a Gastric GIST (위에 발생한 위장관간질종양의 수술적 치료에서 Computed Tomogrophy Gastrography의 유용성)

  • Han, Dong-Seok;Lee, Hyuk-Joon;Lee, Min-Woo;Kim, Se-Hyung;Lee, Kuhn-Uk;Yang, Han-Kwang
    • Journal of Gastric Cancer
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    • v.6 no.4
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    • pp.207-213
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    • 2006
  • Purpose: This study was performed to evaluate the usefulness of computed tomography (CT) gastrography in the surgical management of a gastric gastrointestinal stromal tumor (GIST). Materials and Methods: We retrospectively analyzed the clinicopathologic data of 38 patients who had undergone CT gastrography from among patients who had gastric GISTS surgically resected at the Department of Surgery, Seoul National University Hospital, between January 2001 and February 2006. We compared CT gastrography data, including tumor size and location and distance from the gastroesophageal junction or pylorus with endoscopic, surgical and pathologic findings. Results: The longitudinal tumor locations on CT gastrography and endoscopy were identical to the surgical findings. For tumor sizes on CT gastrography of less than 5 cm, we performed 11 (42.3%) laparoscopic wedge resections from among 26 cases. In the 12 cases with tumor sizes of 5 cm or over, only 1 (8.3%) laparoscopic wedge resection was performed. When the tumor was located in the middle third of the stomach, a laparoscopic wedge resection was performed in 88.9% (8/9) of the cases, but when it was located in the upper or lower third, a laparoscopic wedge resection was performed in only 13.8% (4/29) of the cases. Conclusion: Three-dimensional information from CT gastrography allows the surgeon to perform preoperative planning, including accurate localization.

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ESOPHAGEAL FOREIGN BODY REMOVAL WITH FIBEROPTIC ESOPHAGOSCOPY (식도이물의 굴곡형 내시경을 이용한 치료)

  • 박수헌
    • Korean Journal of Bronchoesophagology
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    • v.2 no.2
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    • pp.182-193
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    • 1996
  • 식도내 이물은 종종 어린이나 식도질환을 가진 환자, 죄수들, 정신박약자 및 정신질환자등의 위험성이 높은 성인에서 흔히 발생한다. 그러나 대부분의 이물은 저절로 위장관을 통과하나 날카롭고 뾰족하며 긴 이물은 위장관의 천공이나 혈관과 누공형성 및 다른 합병증을 초래할 수도 있다. 이물의 섭취는 대개 환자나 다른 목격자에 의하여 복용한 병력으로 진단할 수 있다. 그러나 어린이나 정신박약자는 병력을 얻을 수 없기 때문에 우선 의심하는 것이 중요한 진단방법이 될 수밖에 없다. 연하곤란과 연하통은 식도이물의 통상적인 증상이다. 주변기도의 압박으로 인한 호흡기 증상은 어린이에 흔하며 종종 성인에서도 관찰된다. 식도내 이물을 제거하는데 많이 사용되는 방법은 굴곡형내시경을 사용하여 제거하는 것이다. 이방법은 성인이나 어린이에서 전신마취없이 기존의 진정제 투여방법으로 시술할 수 있다. 이물제거에 사용되는 파지겸자와 올가미는 내시경이물제거술을 가능하게 하였고 굴곡형내시경에 사용되는 overtube는 기존의 강직 형내시경의 장점을 얻을 수 있어 뽀족하거나 날카로운 이물을 제거하는데 사용하게 되었다. 이런 내시경적이물제거 원칙을 잘 지키고 적절한 준비가 된다면 합병증이 거의 없이 98% 정도의 이물을 제거할 수 있다. 내시경을 사용하지 않는 여러 가지 방법은 천공의 위험성이 높고 흡인성폐렴을 유발할 수 있기 때문에 사용하지 않는 것이 낫다. 수술적인 처치는 천공이 되었거나 다른 이물로 인한 합병증이 있는 경우에만 드물게 적용된다.

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Vision transformers for endoscopic pathological findings classification (내시경 병리소견 분류를 위한 비전 트랜스포머)

  • Ayana, Gelan;Choe, Se-woon
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2022.05a
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    • pp.396-398
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    • 2022
  • The endoscopic pathological findings of gastrointestinal tract (GIT) are important in the early diagnosis of colorectal cancer. Deep learning based on convolutional nueral network (CNN) has been implemented to solve the subjective analysis problem and to increase the performance of early detection of pathological findings. However, the desired performance is yet to be achieved and CNNs are computationally complex. To solve these problems, in this paper, we propose a vision transformer based endoscopic pathological findings classification for the early detection of colorectal cancer. Publicly available endoscopic images with three pathological findings, including esophagitis, polyps, and ulcerative colitis, each with 1000 images were used. Using our approach, we have achieved a test accuracy of 98% in classifying the three pathological findings.

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Role of Endoscopic Ultrasonography in the Diagnosis of Gastrointestinal Stromal Tumors in the Stomach (위의 위장관 간질성 종양에 대한 내시경 초음파의 진단적 역할)

  • Yoon, Ji-Hoon;Kim, Hyun-Chul;Choi, Chang-Soo;Oh, Sang-Hoon;Choi, Young-Kil
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.120-126
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    • 2005
  • Purpose: Endoscopic ultrasonography (EUS) is a useful imaging procedure for the diagnosis of submucosal tumors in the stomach. The present study investigated the EUS features of benign and malignant gastrointestinal stromal tumors(GISTs) and assessed differences between the two groups. Materials and Methods: Thirty patients with a GIST in the stomach were included in the study (23 benign and 7 malignant GISTs). We compared characteristic EUS findings (tumor size, location of tumor, regularity of the outer margin, echoheterogeneity, presence of cystic spaces, echogenic foci and mucosal ulceration) between benign and malignant GISTs. Results: Tumor sizes over 40 mm were observed in $85.7\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.000). Intralesional cystic spaces were noted in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.003). The outer margin was irregular in $71.4\%$ of the malignant and $8.7\%$ of the benign tumors (P=0.014). $85.7\%$ of the malignant and $13.0\%$ of the benign tumors had an echo-heterogeneity in the tumor (P=0.001). The locations of tumor and the presence of echogenic foci or mucosal ulcerations were not different between the two groups. Conclusion: Tumor sizes over 40 mm, intralesional cystic spaces, irregular outer margins, and echo-heterogeneity in the tumor were significantly more frequent in malignant GISTs. EUS can provide informations in differentiating benign from malignant GISTs.

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Henoch-Scholein Purpura Presenting with Acute Abdominal Pain Preceding Skin Rash : Review of 23 Cases (급성 복통이 피부 발진에 선행한 Henoch-Schonlein Purpura 23례에 대한 고찰)

  • Chang, Ju Young;Kim, Yong Joo;Kim, Kyo Sun;Kim, Hee-Ju;Seo, Jeong Kee
    • Clinical and Experimental Pediatrics
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    • v.46 no.6
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    • pp.576-584
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    • 2003
  • Purpose : For the early diagnosis of Henoch-Schonlein purpura(HSP) presenting with acute abdominal pain preceding skin rash. Methods : The clinical, endoscopic and radiological records of 23 cases of HSP, presenting with gastrointestinal symptoms preceding skin rash were reviewed. Results : The intervals from the onset of abdominal pain to the development of the skin rash were one day to 30 days(median five days), most of them were within two weeks. The presenting abdominal symptoms were abdominal pain(23 cases), vomiting(16 cases), hematochezia or melena(eight cases) and hematemesis(three cases). The abnormal endoscopic findings include coalescing erythematous lesions, areas of submucosal hemorrhage and superficial erosions and ulcers. The upper gastrointestinal endoscopy showed the abnormalities in 21 of 23 cases, which were observed in the duodenum( 21 cases), the stomach(12 cases) and the esophagus(one case). Duodenitis with hemorrhage and/or erosions in the descending duodenum was the sole endoscopic abnormality in two cases and was the most marked finding in three cases. Sigmoidoscopy showed the abnormalities in six of eight cases. The abdominal ultrasonogram showed abnormalities in 12 of 17 cases, which included small bowel wall thickening(eight cases) and intramural hemorrhage(three cases). Recurrences after three months of symptom free intervals developed in four cases; three of them had persistent nephritis beyond one year. Conclusion : The erosive hemorrhagic duodenitis in the descending duodenum in the upper endoscopy and the small bowel wall thickening in the abdominal ultrasonogram can be useful findings in the diagnosis of HSP presenting with acute abdomen.

Endoscopic Retrieval of a Large and Circular Foreign Body Lodged in Gastric Pylorus in a Dog (내시경을 이용한 유문폐색을 유발한 개의 이물제거)

  • Lee, Seung-Gon;Choi, Ran;Moon, Hyeong-Sun;Hyun, Chang-Baig
    • Journal of Veterinary Clinics
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    • v.24 no.2
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    • pp.229-232
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    • 2007
  • A 7-year-old Shih Tzu cross dog was presented for severe abdominal pain, persistent vomiting and anorexia. Laboratory tests revealed mild anemia and hypoproteinemia. Abdominal survey radiography revealed marked gastric distension and large circular foreign body in the gastric pylorus. The foreign body was removed using a videoendoscope, fishing line and retrieval forceps. The dog's clinical signs resolved following foreign body removal.

Parasitic Leiomyoma with Lymphatic Dilatation in Trocar Port-Site of Abdominal Wall: A Case Report (트로카 삽입 부위에 생긴 림프관 확장을 동반한 기생 평활근종: 증례 보고)

  • Gayoung Jeon;Seo Young Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.280-285
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    • 2023
  • Uterine leiomyoma is the most common benign pelvic tumor in female and being symptomatic is an indication for surgical removal. As laparoscopic surgery has been developed, some cases related to parasitic leiomyomas in the port site have been reported. A 40-year-old female who a history of previous laparoscopic surgery to remove uterine myoma 2 years ago visited in outpatient clinic of general surgery with palpable mass in left lower abdomen. Contrast enhanced abdomen CT and pelvis MRI were done to evaluate the mass. It was diagnosed parasitic leiomyoma in pathologic study after surgical removal and parasitic leiomyoma should be considered when patient visited presenting abdominal mass with the history of laparoscopic myomectomy.

Upper Gastrointestinal Bleeding in Full-Term Infants (만삭아에서 발생한 상부위장관 출혈에 대한 임상적 고찰)

  • Choi, Hyon Ju;Kim, Jae Seon;Yoon, Hye Sun;Bae, Sun Hwan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.164-171
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    • 2005
  • Purpose: The aim of this study was to evaluate the clinical characteristics, endoscopic findings and risk factors related to the upper gastrointestinal bleeding (UGIB) seen in full-term infants. Methods: A clinical analysis for 9 cases with UGIB confirmed by endoscopy was carried out retrospectively. Patients were admitted to the Department of Pediatrics, Eulji Hospital, from January to December 2003. Results: UGIB from gastric or duodenal mucosal lesions has been seen in 0.13% in newborns infants. All patients were full-term AGA neonates without asphyxic findings at birth. Hematemesis, melena or recurrent vomiting developed within $4.4{\pm}3.8days$ after birth. Vital sign and laboratory test was normal on admission. Endoscopic findings showed hemorrhagic gastritis in 6 cases and peptic ulcers in 3 cases. All patients were successfully managed by medical treatment for $18.6{\pm}5.0days$. On treatment, clinical symptoms improved within $0.9{\pm}0.3days$. Follow-up endoscopy was not performed because there was no recurrence of symptoms in all patients. Case mothers had no history of gastritis, ulcer or anti-ulcer medications before and during pregnancy. Conclusion: If the healthy full-term infants express UGIB within a few days after birth, it is necessary to take careful history of family, mother and delivery process and to practice endoscopy for mucosal lesions of the patients. A follow-up endoscopy dose not seem to be necessary if the infant is clinically well.

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A Study of Clinical Manifestations of Gastrointestinal Symptoms in Children with Henoch-Schönlein Purpura (소아 Henoch-Schönlein Purpura 환아에서 위장관 증상 유무에 따른 임상 소견에 대한 연구)

  • Oh, Se-Whung;Choe, Jae-Hyung;Kim, Yong-Joo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.9 no.2
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    • pp.183-192
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    • 2006
  • Purpose: This study was undertaken to evaluate the factors correlated with the clinical course and outcome in patients of Henoch-Sch${\ddot{o}}$nlein Purpura. Methods: The medical records of 104 children diagnosed with Henoch-Sch${\ddot{o}}$nlein Purpura (HSP) from January 1996 to April 2006 were reviewed retrospectively. The patients were divided into two groups: patients with Gastrointestinal (GI) symptoms and those without GI symptoms. When there were joint, scrotum, and renal symptoms except for skin lesion in whole HSP, those patients were excluded. The history of acute infection, duration of admission, treatment requirement, recurrence of HSP, CBC, stool occult blood test, abdominal ultrasonographic findings and GI endoscopic findings were reviewed. Results: Among 104 patients, patients with GI symptoms included 66 cases (63.5%), those without GI symptoms accounted for 38 cases (36.5%). GI symptoms included: abdominal pain in 57 cases (54.8%), vomiting 21 cases (20.2%), GI bleeding 5 cases (4.8%), nausea 3 cases (2.9%) and diarrhea 3 case (2.9%). Positive GI symptoms and GI mucosal lesions on GI endoscopy had a statistically significant correlation with increased admission duration, treatment requirement, recurrence of HSP, and positive stool occult blood. Six cases with small intestinal wall thickening were noted on abdominal ultrasonography. Six cases of hemorrhagic gastritis and hemorrhagic duodenitis, 3 cases of duodenal ulcer, 3 cases of hemorrhagic gastritis and duodenal ulcer, 2 cases of hemorrhagic duodenitis and colitis, and 1 case of colitis were noted on GI endoscopy. Conclusion: These results suggest that GI endoscopic examination may be helpful for the diagnosis and treatment of children with HSP.

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