• Title/Summary/Keyword: Submucosal

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Totally Laparoscopic Resection for a Large Gastrointestinal Stromal Tumor of Stomach

  • Lee, Jeong-Sun;Kim, Jin-Jo;Park, Seung-Man
    • Journal of Gastric Cancer
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    • v.11 no.4
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    • pp.239-242
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    • 2011
  • A debate is currently ongoing about whether a large gastrointestinal stromal tumor (GIST) should be treated by the laparoscopic approach because of the increased risk of tumor rupture during manipulation of the tumor with laparoscopic instruments and the resultant peritoneal tumor dissemination. Herein, we report a case of a large GIST of the stomach which was successfully treated by the laparoscopic approach. A 57 year old female patient visited our institution complaining of postprandial epigastric discomfort. An esophagogastroduodenoscopy and an abdominal computed tomography scan revealed a $10{\times}8$ cm sized submucosal tumor at the greater curvature side of the gastric antrum. The patient underwent laparoscopic distal gastrectomy with intracorporeal Billroth-II reconstruction without any breakage of the tumor. Her postoperative course was uneventful and she was discharged on the 7th postoperative day. Even a large GIST of the stomach can safely be treated by the laparoscopic approach when it is performed with proper techniques by an experienced surgeon.

Plexiform Angiomyxoid Myofibroblastic Tumor of the Stomach: a Rare Case

  • Kim, Su Mi;An, Ji Yeong;Choi, Min-Gew;Lee, Jun Ho;Sohn, Tae Sung;Kim, Kyung-Mee;Kim, Sung;Bae, Jae Moon
    • Journal of Gastric Cancer
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    • v.17 no.3
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    • pp.277-281
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    • 2017
  • Plexiform angiomyxoid myofibroblastic tumor (PAMT) of the stomach is a very rare mesenchymal tumor of the gastrointestinal tract. We report a case of asymptomatic gastric PAMT that was pathologically confirmed after surgical resection. The tumor had a multinodular plexiform growth pattern, bland-looking spindle cells, and an Alcian bluepositive myxoid stromal matrix rich in small blood vessels. Immunohistochemistry analysis revealed that the tumor cells of the PAMT were positive for smooth muscle actin (SMA) and negative for c-kit, CD34, S-100 protein, epithelial membrane antigen (EMA), and desmin. PAMT should be differentiated from other submucosal tumors of the stomach by immunohistochemical findings. Considering the benign features of this tumor, observation without resection may be an option for the treatment of PAMT if the tumor is asymptomatic.

A Case of Tracheopathia Osteoplastica (기관 골형성증 1예)

  • Kim, Chang-Ho;Kang, Tae-Kyung;Park, Ki-Soo;Park, Jae-Yong;Jung, Tae-Hoon;Bae, Kyung-Soo;Kang, Duk-Sik;Lee, Sang-Han;Kwak, Jyung-Sik
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.2
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    • pp.257-261
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    • 1996
  • Tracheopathia osteoplastica is a rare disease characterized by submucosal cartilaginous or bony projections into tracheobroncheal lumen with sparing of the posterior membranous portion of tracheobroncheal tree. The cause of this disorder is unknown. In the past, a majority of the cases were discovered incidentally at autopsy. But recently, antemortem diagnosis is increasingly reported after the introduction of computed tomography and bronchoscopy. We report a case of extensive tracheopathia osteoplastica diagnosed antemortem by computed tomography, bronchoscopic examination and biopsy.

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Two Cases of Advanced Gastric Carcinoma Mimicking a Malignant Gastrointestinal Stromal Tumor

  • Shin, Ha Song;Oh, Sung Jin;Suh, Byoung Jo
    • Journal of Gastric Cancer
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    • v.15 no.1
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    • pp.68-73
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    • 2015
  • Gastric cancer that mimics a submucosal tumor is rare. This rarity and the normal mucosa covering the protuberant tumor make it difficult to diagnosis with endoscopy. We report two cases of advanced gastric cancer that mimicked malignant gastrointestinal stromal tumors preoperatively. In both cases, the possibility of cancer was not completely ruled out. In the first case, a large tumor was suspected to be cancerous during surgery. Therefore, total gastrectomy with lymph node dissection was performed. In the second case, the first gross endoscopic finding was of a Borrmann type II advanced gastric cancer-like protruding mass with two ulcerous lesions invading the anterior wall of the body. Therefore, subtotal gastrectomy with lymph node dissection was performed. Consequently, delayed treatment of cancer was avoided in both cases. If differential diagnosis between malignant gastrointestinal stromal tumor and cancer is uncertain, a surgical approach should be carefully considered due to the possible risk of adenocarcinoma.

Sedative Effect of Sublingual Midazolam after Oral Chloral Hydrate or Hydroxyzine in Children (소아 진정시 Chloral Hydrate, Hydroxyzine복용 후 Midazolam의 점막하 투여 용량에 따른 진정효과에 관한 연구)

  • Lee, Hyun-Jung;Baek, Kwang-Woo;Jung, Sang-Hyuk
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.8 no.1
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    • pp.16-21
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    • 2008
  • Recently combining regimen of minimal doses of chloral hydrate, hydroxyzine and midazolam is good in sedation of children. Midazoalm, water soluble benzdiazepine, has rapid onset and relatively short duration of action. And midazolam has prospective amnesic effect. With these advantages midazolam is popular in conscious sedation for children. This study was to reveal the dose-dependency of behavior and physiologic effects of sublingual midazolam. Sedation records were surveyed retrospectively, of which the patients admitted from April, 2005 to July, 2007. we assigned three groups according the dose of midazolam, 0.1 mg/kg, 0.2 mg/kg and 0.3 mg/kg, respectively and the behavioral evaluation was analyzed with Houpt scale statistically. Combined sublingual midazolam increased the success rate in sedation and the vital signs were stable during sedation.

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Surgical treatment of esophageal submucosal tumor (식도의 양성 점막하 종양의 수술적 치료)

  • Noh, Dong-Sub;Park, Chang-Kwon;Keum, Dong-Yoon;Kim, Jae-Bum
    • Korean Journal of Bronchoesophagology
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    • v.15 no.1
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    • pp.24-27
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    • 2009
  • Background: Benign tumors of the esophagus are rare. They include leiomyomas, gastrointestinal stromal tumors, neurofibromas and lipomas. In this study we present our experience with enucleation of these 13 tumors for 10 years. Material and Method: A retrospective review of patients who underwent enucleation of benign esophageal tumors between 1995 and 2005 was conducted. Symptom, tumor location and size, operative approach and outcomes after surgery were recorded. Result Thirteen patients were identified(leiomyoma: n=12; GIST n=l). Eight patients were men, five patients were women. Most of them were 4rd and 5th decade. The tumors arose in the lower(7 patients) and middle(6 patients) thirds of the esophagus. Eleven patients underwent a thoracotomy; the remainder were resected using VATS. All of patients underwent simple enucleation. There were no complications and recurrences after surgery. Conclusion: We present our experience with enucleation of these 12 leiomyomas and one GIST for 10 years.

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A Case of Duodenal Ganglioneuroma Manifesting as a Subepithelial Tumor (상피하 종양으로 발견된 십이지장 신경절신경종 1예)

  • Joo, Dong Chan;Kim, Gwang Ha;Chae, Chul Byung;Lee, So Jeong;Park, Do Youn
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.4
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    • pp.271-274
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    • 2018
  • Ganglioneuroma of the gastrointestinal tract is a rare tumor that consists of ganglion cells, nerve fibers, and supporting cells of the enteric nervous system. Ganglioneuromas are usually associated with genetic disorders such as the multiple endocrine neoplasia syndrome or neurofibromatosis. Ganglioneuromas of the gastrointestinal tract predominantly involve the colon and rectum, and reports about duodenal ganglioneuromas are few. Herein, we report a case of duodenal ganglioneuroma treated with endoscopic resection. A 56-year-old female patient visited our hospital because of a subepithelial tumor in the second portion of the duodenum. She had no remarkable medical or family history and revealed no history of genetic disorders. Endoscopic ultrasonography and abdominal computed tomography revealed a tumor located mainly in the submucosal layer, without any regional lymph node involvement. Endoscopic resection of the lesion was performed, and the pathological examination confirmed a duodenal ganglioneuroma.

Endoscopic Resection of Xanthogranulomatous Gastritis Presenting as a Subepithelial Tumor: A Case Report

  • Kim, Tae Wan;Kim, Tae Ho;Kim, Chang Whan;Chang, Jae Hyuck;Han, Sok Won;Kim, Jae Kwang
    • The Korean journal of helicobacter and upper gastrointestinal research
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    • v.18 no.3
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    • pp.198-203
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    • 2018
  • Xanthogranulomatous gastritis (XGG) presenting as a subepithelial tumor (SET) is a very rare entity. We report a case of SET-like XGG diagnosed and treated with endoscopic resection. A 55-year-old female patient was initially referred with a 1.5-cm SET located at the anterior wall of the middle antrum. Endoscopic ultrasound examination revealed submucosal invasion without any perigastric lymph node enlargement. Endoscopic resection was performed for an accurate diagnosis and treatment, and the lesion was diagnosed histopathologically as XGG. At the 18-month follow-up after endoscopic resection, there was no evidence of XGG recurrence. SET-like XGG is very rare and the diagnosis is a preoperative challenge. However, inflammatory tumors should be considered in the differential diagnosis of SET.

Anti-oxidant Effects of Portulaca oleracea L. on HCl-ethanol Induced Gastritis in Rats (염산-에탄올에 의해 유발된 흰쥐 위염에 대한 마치현의 항산화 작용)

  • Kim, Chae-Hyun
    • The Korea Journal of Herbology
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    • v.24 no.1
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    • pp.35-40
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    • 2009
  • Objectives : The purpose of this study is to evaluate whether or not a pretreatment with Portulaca oleracea has an antioxidant effect in HCl-ethanol induced gastric mucosal damage. Methods : We elucidated the level of reactive oxygen species (ROS), lipid peroxidation, and two important constituents of antioxidant defense such as superoxide dismutase (SOD), glutathione (GSH) in these effects. Results : The oral administration of crude extract from P. oleracea attenuated the gastritic lesion area, submucosal edema and hemorrhage, and mucosal necrosis induced by HCl-ethanol. The MDA levels of control group were higher than those in the rats given the P. oleracea pretreatment. While the GSH levels of control were decreased, the GSH activity on the gastric mucosal layer maintain normal level in rats given the Portulaca oleracea pretreatment before HCl-ethanol induced gastritis significantly increased. However, the SOD activites were not altered by P. oleracea. Conclusions : The administration of Portulaca oleracea have a protective antioxidant effect against the gastric lesion induced by HCl-ethanol and may therefore be a promising drug for gastritis and gastric ulcer.

Role of endoscopy in gastroesophageal reflux disease

  • Daniel Martin Simadibrata;Elvira Lesmana;Ronnie Fass
    • Clinical Endoscopy
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    • v.56 no.6
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    • pp.681-692
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    • 2023
  • In general, gastroesophageal reflux disease (GERD) is diagnosed clinically based on typical symptoms and/or response to proton pump inhibitor treatment. Upper gastrointestinal endoscopy is reserved for patients presenting with alarm symptoms, such as dysphagia, odynophagia, significant weight loss, gastrointestinal bleeding, or anorexia; those who meet the criteria for Barrett's esophagus screening; those who report a lack or partial response to proton pump inhibitor treatment; and those with prior endoscopic or surgical anti-reflux interventions. Newer endoscopic techniques are primarily used to increase diagnostic yield and provide an alternative to medical or surgical treatment for GERD. The available endoscopic modalities for the diagnosis of GERD include conventional endoscopy with white-light imaging, high-resolution and high-magnification endoscopy, chromoendoscopy, image-enhanced endoscopy (narrow-band imaging, I- SCAN, flexible spectral imaging color enhancement, blue laser imaging, and linked color imaging), and confocal laser endomicroscopy. Endoscopic techniques for treating GERD include esophageal radiofrequency energy delivery/Stretta procedure, transoral incisionless fundoplication, and endoscopic full-thickness plication. Other novel techniques include anti-reflux mucosectomy, peroral endoscopic cardiac constriction, endoscopic submucosal dissection, and endoscopic band ligation. Currently, many of the new endoscopic techniques are not widely available, and their use is limited to centers of excellence.