• 제목/요약/키워드: Endoscopy, gastrointestinal

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

  • 은종렬;장병익
    • Journal of Yeungnam Medical Science
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    • 제23권1호
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    • pp.45-51
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    • 2006
  • 소장질환을 진단하는데 있어서 캡슐내시경의 유용성을 평가하고자 본 연구를 시행하였다. 2003년 8월부터 2006년 3월까지 영남대학병원에서 캡슐내시경을 시행한 66명(평균나이: 52.1세, 남/녀: 39/27)의 의무기록과 내시경 기록을 검토하였다. 상부 및 하부 위장관 내시경에서 이상이 발견되지 않아 소장질환을 확인하기 위한 목적으로 시행되었으며, 특히 소장출혈의 확인을 위해 시행한 경우가 47명(71.3%)으로 가장 많았다. 이 가운데 궤양 또는 미란이 22예(46.8%), 종양 5예(10.6%), 혈관이형성증 3예(6.4%), 용종 3예(6.4%), 협착이 동반된 궤양 1예(2.1%), 활동성 출혈 1예(2.1%), 정상 소견 12예(25.5%) 등이었다. 이들 가운데 출혈과 관련이 있을 것으로 생각되는 병소는 32예(68.1%)였다. 종양이 발견된 5명에서 수술을 하였는데 위장관간질종양이 4예, 림프관종 1예가 진단되었다. 비특이적 복부 증상으로 시행한 경우의 병변발견율은 42.9%(6/14)였는데, 증상과 관련있는 경우는 1예에 불과하였다. 캡슐내시경 검사로 인한 합병증은 발생하지 않았다. 결론적으로, 캡슐내시경은 소장질환에 대해 안전하고 비침습적인 검사법이며, 소장출혈에 대해 우수한 결과를 보였다. 그러나, 출혈 이외의 복부증상에 대해서는 더 연구가 필요하다.

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A Rare Case of Primary Duodenal Follicular Lymphoma

  • Hyun-Jung Kim;Jeongmin Choi
    • Journal of Digestive Cancer Research
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    • 제10권1호
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    • pp.39-42
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    • 2022
  • Primary duodenal follicular lymphoma is rare and presents as multiple, small polyp-like lesions on endoscopy. If this lesion is suspected, an endoscopic biopsy is crucial for diagnosis. A watchful wait would be appropriate management as it has a fairly indolent clinical course. Herein, we present a rare case of primary duodenal follicular lymphoma.

$^{99m}Tc$-MDP 골스캔에서 위출혈에 의한 위장관의 일과성 방사능 집적 (Abnormal Gastrointestinal Accumulation of Radiotracer by Gastric Bleeding During $^{99m}Tc$-MDP Bone Scintigraphy)

  • 천경아;이상우;이재태;이규보
    • 대한핵의학회지
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    • 제32권2호
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    • pp.168-171
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    • 1998
  • We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during $^{99m}Tc$-methylene diphosphonate(MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of $^{99m}Tc$-MDP in this patient is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleeding site, so we can see the intestinal activity.

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Factors Associated with Gastric and Duodenal Neuroendocrine Tumor Development

  • Kwangwoo Nam;Su Youn Nam
    • Journal of Digestive Cancer Research
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    • 제12권1호
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    • pp.1-5
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    • 2024
  • The incidence and prevalence of upper gastrointestinal neuroendocrine tumors (NETs), including gastric NETs (GNETs) and duodenal NETs (DNETs), have been gradually increasing. These trends may be associated with the increased use of health checkups, which includes upper endoscopy, in conjunction with better disease recognition. However, the clinical factors associated with GNETs and DNETs remain unknown; previous studies revealed discrepancies. Recently, metabolic disorders have been indicated as potential factors that are associated with GNETs and DNETs. This review summarizes the results of previous studies and briefly introduces the results of a recent Korean multicenter study on the factors associated with GNETs and DNETs.

Comparison of Endoscopic and Histological Findings between Typical and Atypical Celiac Disease in Children

  • Semwal, Pooja;Gupta, Raj Kumar;Sharma, Rahul;Garg, Kapil
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제21권2호
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    • pp.86-92
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    • 2018
  • Purpose: Celiac disease is a common non-communicable disease with varied presentations. Purpose of this study was to find the duodeno-endoscopic features in celiac disease and to compare duodeno-endoscopic and histological findings between typical and atypical celiac disease in children. Methods: Hospital based observational study was conducted at Sir Padampat Mother and Child Health Institute, Jaipur from June 2015 to May 2016. Patients were selected and divided in two groups- typical and atypical celiac disease based upon the presenting symptoms. Upper gastrointestinal endoscopy and duodenal biopsy was performed for serology positive patients. Results were analysed using appropriate statistical test of significance. Results: Out of 101 enrolled patients, 47.5% were male. Age ranged from 1 to 18 years. Study showed that 54.5% were typical and 45.5% were atypical. Patients presenting with atypical symptoms were predominantly of older age group. On endoscopy, scalloping, mosaic pattern, reduced fold height and absent fold height; and in histology, advanced Marsh stage were significantly higher in the typical group. Conclusion: Awareness of atypical presentations as well as duodeno-endoscopic features may have considerable practical importance for the diagnosis of celiac disease in children. Scalloping, mosaic pattern, reduced fold height and nodularity are main endoscopic markers of celiac disease in children. Endoscopic markers of duodenal mucosa may be important in early diagnosis of celiac disease, in children subjected to endoscopy for atypical presentations or indication other than suspected celiac disease.

Risk of Gastric Cancer in Children with Helicobacter pylori Infection

  • Cam, Sebahat
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권22호
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    • pp.9905-9908
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    • 2014
  • Background: Helicobacter pylori (H. pylori) is the most common chronic infectious agent in the stomach. Most importantly, it may lead to atrophy, metaplasia and cancer. The aim of this study was to investigate the incidence of H. pylori infection and to detect early mucosal changes that may lead to malignant degeneration in children. Materials and Methods: Children who underwent upper gastrointestinal endoscopy were included. Familial history of gastric cancer was noted. Endoscopic examinations were performed by a single pediatric gastroenterologist. A minimum of three biopsy samples were collected during endoscopy. The patients were accepted as H. pylori infected if results of biopsies and rapid urease test were both positive. Biopsies were evaluated for the presence and degree of chronic inflammation, the activity and severity of gastritis, glandular atrophy and intestinal metaplasia. Results: A total of 750 children (388 boys, 362 girls) were evaluated in our study, with a mean age of 10.1 years. A total of 390 patients (52%) were found to be infected with H. pylori. Among the H. pylori infected patients, 289 (74%) were diagnosed to have chronic superficial gastritis, 24 (6.2%) had gastric atrophy. Most strikingly, intestinal metaplasia was observed in 11 children, all were in the H. pylori positive group. There was no difference in the mean of age, gender and socioeconomic class between H. pylori infected and non-infected groups. The frequency of gastric cancer in family members (4 in number) was higher in patients with H. pylori infection. No gastric cancer case was reported from the parents of non-infected children. The worst biopsy parameters (atropy and metaplasia) were improved after H. pylori eradication on control endoscopy. Conclusions: The current study shows a higher prevalence of familial history of gastric cancer in H. pylori infected children. Intestinal metaplasia was also higher in the infected children. Eradication of H. pylori infection for this risk group may prevent subsequent development of gastric cancer.

IgG4-related Disease in the Stomach which Was Confused with Gastrointestinal Stromal Tumor (GIST): Two Case Reports and Review of the Literature

  • Seo, Ho Seok;Jung, Yoon Ju;Park, Cho Hyun;Song, Kyo Young;Jung, Eun Sun
    • Journal of Gastric Cancer
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    • 제18권1호
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    • pp.99-107
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    • 2018
  • Immunoglobulin G4-related disease (IgG4-RD) is an immune-mediated fibro-inflammatory disorder characterized by specific pathological findings and elevated serum IgG4 level. IgG4-RD in the stomach is rare, and occasionally diagnosed as gastric subepithelial tumor (SET) by endoscopy or computed tomography scan. Two female patients in the age group of 40-50 years were diagnosed with 4 cm sized gastric SET. One underwent laparoscopic gastric wedge resection. Another one had a history of subtotal gastrectomy for early gastric cancer and idiopathic thrombocytopenic purpura with oral steroids administration. She underwent a completion total gastrectomy with splenectomy for the gastric SET and ITP. The pathology showed storiform fibrosis, and IgG4 was positive in immunohistochemistry (IHC) stain. IgG4-RD is known as a medical disease that could be treated with oral steroids. The difficulty in preoperative diagnosis of the disease occasionally causes unnecessary gastric resection. Thus, preoperative diagnostic methods for IgG4-RD such as deep biopsy with IHC stain or magnetic resonance imaging are needed.

Gardner syndrome associated with multiple osteomas, intestinal polyposis, and epidermoid cysts

  • Koh, Kwang-Joon;Park, Ha-Na;Kim, Kyoung-A
    • Imaging Science in Dentistry
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    • 제46권4호
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    • pp.267-272
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    • 2016
  • Gardner syndrome is known as a variant of familial adenomatous polyposis. This syndrome is characterized by multiple intestinal polyposes, osteomas, and epidermoid cysts. In addition, dental abnormalities include an increased frequency of multiple odontomas, as well as supernumerary and impacted teeth. The authors report the case of a 7-year-old male patient with Gardner syndrome. Radiographic findings revealed multiple osteomas in both sides of the maxilla, multiple diffuse enostoses in both jaws, and a complex odontoma in the left mandibular body. Two years later, multiple epidermoid cysts on the scalp were found. Since this patient was suspected to have Gardner syndrome, the authors recommended gastrointestinal endoscopy to check for intestinal polyposis. Gastrointestinal endoscopic examination revealed multiple polyposes in the upper gastrointestinal tract and fundus of the stomach. As a result, the final diagnosis was Gardner syndrome.

Quantitative Analysis of Distribution of the Gastrointestinal Tract Eosinophils in Childhood Functional Abdominal Pain Disorders

  • Lee, Eun Hye;Yang, Hye Ran;Lee, Hye Seung
    • Journal of Neurogastroenterology and Motility
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    • 제24권4호
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    • pp.614-627
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    • 2018
  • Background/Aims Although functional abdominal pain disorders (FAPDs) are common in children, the accurate pathogenesis of FAPDs is not known yet. Micro-inflammation, particularly tissue eosinophilia of gastrointestinal (GI) tract, has been suggested as the pathophysiology observed in several GI disorders. We aimed to evaluate eosinophilic infiltration throughout the entire GI tract in children with FAPDs, compared to those with inflammatory bowel diseases (IBD) and to normal reference values. Methods We included 56 children with FAPDs, 52 children with Crohn's disease, and 23 children with ulcerative colitis. All subjects underwent esophagogastroduodenoscopic and colonoscopic examination with biopsies. Tissue eosinophil counts were assessed in 10 regions throughout the GI tract. Results Eosinophil counts of the gastric antrum, duodenum, terminal ileum, cecum, and ascending colon were significantly higher in children with FAPDs compared to normal reference values. Eosinophil counts of the stomach and the entire colon were observed to be significantly higher in children with IBD than in those with FAPDs. Even after selecting macroscopically uninvolved GI segments on endoscopy in children with IBD, eosinophil counts of the gastric body, cecum, descending colon, sigmoid colon, and the rectum were also significantly higher in children with IBD than those with FAPDs. Conclusions Significantly high eosinophil counts of the stomach and colon were observed in the order of IBD, followed by FAPDs, and normal controls, regardless of endoscopically detected macroscopic IBD lesions in children. This suggests some contribution of GI tract eosinophils in the intrinsic pathogenesis of FAPDs in children.