• Title/Summary/Keyword: 관 내시경

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Gastrointestinal Foreign Bodies in Children -Experiences of 60 Cases in Kangwon, Korea- (소아 위장관 이물 -강원지역 소아 60례-)

  • Lee, Young-Sub;Kang, Kae-Wool;Choi, Won-Kyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.4 no.2
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    • pp.148-154
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    • 2001
  • Purpose: Ingested foreign bodies present a common clinical problem. It is well known that most of them pass uninterrupted through the gastrointestinal tract. We evaluated the role of endoscopy and Foley catheter for removal of foreign bodies in the gastrointestinal tract. Methods: We investigated retrospectively 60 cases with foreign bodies in the gastrointestinal tract. They had been treated at Wonju Christian Hospital, Yonsei University of Korea, from January, 1996 through December, 1999. Results: The age of the patients ranged from 7 months to 13 years. Patients under 5 years were 57 cases (97%) and there was no significant difference in sex (M : F=1.07 : 1). 45 cases of the patients had no symptom. The most common foreign bodies were coins (43 cases). The most common location was esophagus (31 cases). The number of foreign body removal using flexible endoscopy and Foley catheter was 22 (36.7%) and 18 (30.0%) cases, respectively. In 18 cases (30.0%), foreign bodies passed spontaneously. Only 1 case (1.7%), curtain pin impaction at ileocecal region, required surgery. Conclusion: Early foreign body removal from esophagus and stomach is recommended to lessen the morbidity and complication. Fluoroscopic foley catheter technique and flexible endoscopy for removal of esophageal foreign bodies in children is safe and effective.

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Wireless capsule endoscopy Locomotion

  • Wang, Zhao;Lim, Eng Gee;Leach, Mark;Xia, Tianqi;Lee, Sanghyuk
    • Journal of Convergence Society for SMB
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    • v.4 no.1
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    • pp.55-62
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    • 2014
  • Wireless capsule endoscopy (WCE) was one of the most influential bio-medical electronic technologies to be developed at the beginning of the century. In comparison to traditional endoscopic diagnosis, this application is characterized as non-invasive and low-risk, thereby providing surgeons with a new alternative for inspecting the entire gastrointestinal (GI) track in a much more user friendly way. Apart from regular hardware upgrades, the frontier of WCE research basically lies in the miniaturization of the capsule and in active locomotion. In order to overcome the intrinsic drawback of current commercialized WCE products, which is that locomotion is generally a function of natural peristalsis, active locomotion is proposed as a series of strategies used to effectively navigate the device into different organs and conduct therapeutic functions within targeted human tissues. Reviews of several novel designs with respect to this aspect of research will be discussed in this article.

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The Usefulness of Capsule Endoscopy in Diagnosis of Small Bowel Diseases (소장질환의 진단에 캡슐내시경 검사의 유용성)

  • Eun, Jong-Ryul;Jang, Byung-Ik
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.45-51
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    • 2006
  • Background: This study was conducted to evaluate the usefulness of capsule endoscopy (CE) for the diagnosis of small bowel diseases. Materials and Methods: We reviewed the medical records of 66 patients (mean age: 52.1 years, male/female: 39/27), who underwent CE at Yeungnam University Hospital from August 2003 to March 2006. Results: Suspicious gastrointestinal (GI) bleeding presenting as anemia or history of gross bleeding was the most common reason to perform CE (71.2%). Other indications included GI symptoms (21.2%) such as abdominal pain/discomfort, nausea, diarrhea, and others (7.6%). In studies performed for GI bleeding (n=47), ulcer/erosion was the most common finding (n=22, 46.8%) followed by tumor (n=5, 10.6%), angiodysplasia (n=3, 6.4%), polyp (n=3, 6.4%), active bleeding (n=1, 2.1 %), ulcer with stenosis (n=1, 2.1%), and normal findings (n=12, 25.5%). Of these, a bleeding focus was detected in 32 cases (68.1%) undergoing CE studies. Among 14 patients with GI symptoms, only two patients had typical findings related with symptoms. Surgical resection was performed in five cases with tumor. Of these, four were diagnosed as gastrointestinal stromal tumor and the other one was a lymphangioma. There were no complications associated with the CE procedure. Conclusion: Capsule endoscopy is a safe, noninvasive diagnostic tool for small bowel diseases and may be useful for the diagnosis of small bowel hemorrhage including obscure bleeding. However, further studies are needed to confirm its utility for abdominal symptoms other than hemorrhage because of the low diagnostic yield.

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Clinical Features of Henoch-Schönlein Purpura Gastroenteropathy without Purpura before Diagnosis (진단 전에 자반이 동반되지 않았던 Henoch-Schönlein 자반 위장병증의 임상적 고찰)

  • Oh, Jae Min;Park, Jae Hong
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.54-60
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    • 2004
  • Purpose: Henoch-$Sch{\ddot{o}}nlein$ purpura (HSP) is a small-vessel vasculitic disease that most often affects the skin. Abdominal symptoms precede the typical purpuric rash of HSP in 14~36%. It is a challenge to diagnose HSP in the absence of a rash, because there are no biologic tests that can identify HSP with certainty, so we tried to find out the characteristic features of HSP gastroenteropathy without purpura before diagnosis. Methods: This study included 82 children with HSP who had been admitted or visited outward of the Department of Pediatrics, Pusan National University Hospital from 1995 to 2000. The cases that the onset of purpura preceded or coincided that of abdominal pain were defined as purpura-positive group. The cases that the onset of abdominal pain preceded purpura more than 1 week and purpura was not presented till diagnosed as HSP gastroenteropathy were defined as purpura-negative group. We compared and analyzed the clinical features of the two groups by reviewing the medical records retrospectively. To ensure the diagnosis of HSP gastroenteropathy, we conducted upper GI series, abdominal ultrasonogram, abdominal CT, endoscopy and/or skin biopsy. Results: The number of cases of purpura-positive group and purpura-negative group were 72 and 10, respectively. There is no difference between two groups in the incidence of clinical symptoms and laboratory findings. Children with HSP gastroenteropathy had characteristic erosive or ulcerative lesions in the stomach or duodenum on esophagogastroduodenoscopy, or mural thickening of the small bowel on abdominal ultrasonogram, CT or upper GI series. Skin biopsy revealed leukocytoclastic vasculitis in 3 of them, although biopsy specimen was taken from any areas of normal- appearing skin. In purpura-negative group, 9 patients improved by steroid therapy. Conclusion: In purpura-negative group, there is no diagnostic feature on the laboratory findings and clinical features. Therefore, to diagnose HSP gastroenteropathy in patients with abdominal pain in the absence of the characteristic rash, careful observation of clinical features and laboratory data, and prompt application of available diagnostic tools such as gastrointestinal endoscopy, radiologic study and skin biopsy are recommended. Early use of corticosteroid may reduce the suffering in these patients.

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The Clinical and Histopathologic Findings of Lymphonodular Hyperplasia of the Colon in Infancy and Childhood (소아에서 대장 림프결절증식의 임상적 및 병리조직학적 소견)

  • Nam, Yoo-Nee;Lee, Seung-Hyeon;Chung, Dong-Hae;Sim, So-Yeon;Eun, Byung-Wook;Choi, Deok-Young;Sun, Yong-Han;Cho, Kang-Ho;Ryoo, Eell;Son, Dong-Woo;Jeon, In-Sang;Tchah, Hann
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.1
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    • pp.1-9
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    • 2009
  • Purpose: Lymphonodular hyperplasia of the colon (LNHC) is a rare finding in children and its significance as a pathologic finding is unclear. The aim of this study was to investigate the clinical significance of LNHC by analyzing clinical and histopathologic findings in children with LNHC. Methods: We analyzed data from 38 patients who were confirmed to have LNHC by colonoscopy. We checked age, birth history, past history, family history, and clinical symptoms. A hematologic exam, stool exam, and image studies were performed and biopsy specimens were examined by a pathologist. All patients were asked to have short- and long-term follow-up. Results: The mean age of the patients was 12.5${\pm}$14.4 months. All patients presented with complaints of bloody stool. They appeared healthy and the hematologic findings were within a normal range, with the exception of one case. There was no other identified source of bleeding. On histologic exam, 36 patients (94.7%) had lymphoid follicles and 34 patients (84.5%) fulfilled the criteria of allergic colitis. Regardless of diet modification and presence of residual symptom, there was no recurrence of bloody stool through long-term follow-up in all patients. Conclusion: LNHC is more common in infants who are affected by allergic colitis, but it can appear even after infancy. LNHC should be regarded as the etiology when there are any other causes of rectal bleeding, especially in healthy children. We suggest that LNHC has a benign course regardless of diet modification and it might not require excessive concerns.

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The Role of Bronchoscopy for the Staging in Patient with Peripheral Lung Cancer (말초형 폐암 환자에 있어서 병기판정을 위한 기관지 내시경검사의 필요성)

  • Baek, Seung-Min;Sea, Hyang-Eun;Kim, Se-Hwan;Kim, Seong-Kyu;Kim, Yean-Jae;Lee, Byung-Ki;Kim, Won-Ho;Park, Jae-Yang;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
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    • v.51 no.2
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    • pp.147-154
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    • 2001
  • Background : Bronchoscopy has been widely used for a histologic diagnosis through a transbronchial lung biopsy or for staging of patients with peripheral lung cancer. However a transthoracic needle aspiration (TTNA) has been used more widely for a histologic diagnosis in patient with a small size nodule or a nodule located in the outer portion of the lung because of the low diagnostic yield of bronchoscopy in these cases. The role of bronchoscopy for staging is not well established in patients with peripheral lung cancer diagnosed by a TTNA or patients who are undergoing surgery without a histologic diagnosis. Method: To evaluate the role of bronchoscopy for the staging in patients with peripheral lung cancer, who were diagnosed by TTNA, the medical records of 86 patients with peripheral lung cancer who underwent bronchoscopyat Kyungpook National University Hospital between January 1995 and May 1997 were reviewed. Results : While 53 cases had normal bronchoscopic findings, 33 cases had abnormal bronchoscopic findings comprising 9 cases of tumor, 10 cases of infiltration and 14 cases of compression of which there were 25 cases of T1 and 8 T2 endoscopically. The bronchoscopic staging did not influence the changes of the clinical stage of lung cancer. The frequencies of bronchial involvement tended to increase as the sizes of the nodule increased. Among the 42 patients who underwent surgery, 9 patients staged higher after operation because of lymph node involvement in 8 patients and the involvement of the pulmonary artery in 1 patient. No case staged above after operation due to a bronchial invasion. Conclusion : These findings suggests that bronchoscopy is not useful for staging in patients with peripheral lung cancer diagnosed by a TTNA.

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Endoscopic Management with Ethanol Injection in a Child with Gastric Dieulafoy Lesion (Dieulafoy 병변 소아의 내시경적 치료 1례)

  • Kim, Hyun-Jin;Shin, Jee-Seon;Seo, Jeong-Wan
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.187-191
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    • 2003
  • The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

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Excision of Malignant Gastrointestinal Stromal Tumor of Distal Esophagus and Stomach using Thoracoabdominal Incision (흉복부 절개를 이용한 식도와 위에 발생한 거대 악성 위장관 간질 종양의 절제)

  • Hwang Jin Wook;Son Ho Sung;Jo Jong Ho;Park Sung Min;Lee Song Am;Sun Kyung;Kim Kwang Taik
    • Journal of Chest Surgery
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    • v.38 no.7 s.252
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    • pp.514-517
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    • 2005
  • Gastrointestinal stromal tumor is documented on every part of the gastrointestinal tract. It develops in the stomach and the small intestine most commonly, and also in the esophagus. A 44 year-old male patient was admitted due to dysphagia and weight loss. Chest CT showed about $15\times11\times11cm$ sized, well-defined, and lobulated soft tissue mass with central necrosis was noted in the posterior wall of lower esophagus throughout the lesser curvature of upper stomach. We performed the distal esophagectomy and total gastrectomy using thoracoabdominal incision. The tumor was positive at CD117 (c-kit) and CD 34, and was diagnosed as malignant GIST of the distal esophagus and upper stomach. The patient is on routine follow up at the out patient department for nineteen months up to now.

A Study on Adequacy of Pipe Deterioration Evaluation Methods using the Endoscope of Water Distribution Pipe (배수관 내시경 조사를 통한 간접적인 관 노후도 평가방법의 적정성 연구)

  • Choi, Tae Ho;Kang, Sin Jae;Choi, Jae Ho;Koo, Ja Yong
    • Journal of Korean Society of Water and Wastewater
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    • v.26 no.5
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    • pp.669-683
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    • 2012
  • The water supply pipes are buried across wide range of areas, so it is hard to spot them using excavation and takes a large amount of expense. Thus, there is a high risk for direct research and application, accompanying many difficulties in implementation of them. Therefore, it is more economical and convenient to use indirect evaluation variables than direct evaluation of the buried pipes in assessing the degree of pipe deterioration. To assess the degree of pipe deterioration using the indirect evaluation variables, it should be done first to identify how and to what extent they affect the degree of deterioration. This study measured the evaluation variables for pipe deterioration using the pipe endoscope and analyzed the measurement results and the degree of impact on the pipes. In addition, this study attempted to evaluate the adequateness of the pipe deterioration evaluation using the indirect variables based on the analysis results. The evaluation variables measured through the pipe endoscope were the thickness of sediments, size of scale, degree of desquamation and condition of connections. For the indirect evaluation variables, the data such as the property data from GIS pipe network map as well as the material, diameter, age and pipe lining material of the pipe, road type, leakage frequency, average water velocity and water pressure using the leakage repair records was collected. Using the collected data, this study comparatively analyzed the indirect evaluation variables for the degree of pipe deterioration and the results from the pipe endoscope to choose appropriate variables for pipe deterioration evaluation and calculated the weights of the indirect variables on the degree of deterioration. The results showed that the order of the impact of indirect variables on deterioration was pipe age > pipe lining material > road type > leakage frequency > average water velocity with their weights of 0.45, 0.20, 0.15, 0.10, and 0.10, respectively. Conclusively, the results suggest that the measures of sediment thickness, scale size, degree of desquamation and condition of connections are appropriate for the evaluation of pipe deterioration and sufficient for the analysis of the impact of the indirect variables on deterioration.

Identifying Small Bowel Gastrointestinal Stromal Tumor as the Culprit Lesion in Obscure Gastrointestinal Bleeding: Emphasis on Angiographic Findings (원인불명의 위장관 출혈을 보인 소장 위장관 기질종양 식별: 혈관조영술 소견의 강조)

  • Hyung In Choi;Min Jeong Choi;Bong Man Kim;Hwan Namgung;Seung Kyu Choi
    • Journal of the Korean Society of Radiology
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    • v.83 no.2
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    • pp.400-405
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    • 2022
  • Gastrointestinal stromal tumors (GISTs) are not uncommon and often cause gastrointestinal bleeding. GISTs occurring in the small intestine are occasionally difficult to identify by endoscopy and CT. In this case, the patient underwent CT three times before surgery, and the lesion was found to be located in a different area of the abdominal cavity on each CT scan. Moreover, the lesion was missed in the first two CT images because it was difficult to distinguish it from the nearby collapsed small intestine. The lesion was eventually detected through angiography; however, the correct diagnosis and treatment were delayed for 3 years because it was mistaken for a vascular malformation, which is the most common cause of obscure GI bleeding in elderly patients. This report emphasizes the need for interventional radiologists to be updated and vigilant of the angiographic features of GISTs to make an accurate diagnosis and establish a management strategy.