• Title/Summary/Keyword: Upper gastrointestinal bleeding

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Heterotopic Pancreas Presented as Duodenal Tumor with Obstruction

  • Kim, Sung Heun;Nam, So Hyun
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.4
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    • pp.280-285
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    • 2015
  • Heterotopic pancreas (HP) is defined as pancreatic tissue lacking anatomic and vascular continuity with the main body of the pancreas. Most are asymptomatic, but can cause ulcer, bleeding, intussusception, and mechanical obstruction. Herein, we presented one case of HP presented as duodenal tumor causing duodenal obstruction. A 7-year-old girl visited the emergency room for abdominal pain with vomiting for 24 hours. Computed tomography and upper gastrointestinal series revealed a polypoid mass with short stalk in the 2nd portion of duodenum. We attempted an endoscopic removal. However, the lumen was nearly obstructed by the mass and the stalk was too broad and hard to excise. The mass was surgically removed via duodenotomy. It was confirmed as a HP with ductal and acini components (type 2 by Heinrich classification). Postoperatively, the patient has been well without any complication and recurrence.

Laparoscopic Surgery for Removal of the Multiple Large Gastric Bezoars

  • Hong, Tae-Ho;Kim, Jin-Jo;Park, Seung-Man
    • Journal of Gastric Cancer
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    • v.10 no.2
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    • pp.84-86
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    • 2010
  • Bezoars are retained concretions of undigested animal or vegetable material that can produce gastrointestinal obstruction, ulceration, and bleeding. Therapeutic options for gastric bezoars include enzyme therapy (papain, cellulase, or acetylcysteine), endoscopic disruption and removal, and surgical removal. Multiple large gastric bezoars generally require conventional surgical management through an upper abdominal incision. With the recent improvement of laparoscopy, a lot of portions of abdominal operations have been performed laparoscopically. We successfully removed multiple large gastric phytobezoars in a 52-year-old female completely through laparoscopy. This supported the feasibility of laparoscopic surgery for patients with gastric bezoars.

BRUNNER'S GLAND ADENOMA - Case report, and review of etiopathogenesis and clinical features - (Brunner 씨 선종 - 임상증례 및 임상상적 문헌고찰 -)

  • Lee, Kyung-Chul
    • Journal of Yeungnam Medical Science
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    • v.2 no.1
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    • pp.265-269
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    • 1985
  • Brunner's glands of the duodenum rarely develop proliferative lesions, occasionally in association with gastric hyperchlorhydria or chronic pancreatitis. The clinical presentation can vary from vague upper abdominal symptoms with dyspepsia and nausea to diarrhea, jaundice, obstruction and gastrointestinal bleeding. The diagnosis is usually made by radiological studies followed by upper endoscopy which can also provide definitive treatment. At times surgery is necessary for adequate removal of these lesions, as in the case herein described.

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Isolated Gastric Varix Bleeding Caused by Splenic Vein Obstruction: Two Case Reports (비장 정맥 폐쇄로 인한 단독 위정맥류 출혈: 두 건의 증례 보고)

  • Juyoung Pak;Sangjoon Lee;Hyoung Nam Lee;Dongho Hyun;Sung-Joon Park;Youngjong Cho
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.291-297
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    • 2023
  • Isolated left-sided portal hypertension is a rare clinical syndrome caused by splenic veno-occlusive disease. Splenic vein thrombosis and extrinsic compression causes proximal splenic vein hypertension, and the splenic blood flows into the superior mesenteric or portal vein through the upper stomach's collateral vessels, such as the short gastric, coronary, and gastroepiploic veins. Open splenectomy is recommended to treat gastrointestinal bleeding caused by isolated left-sided portal hypertension. Interventional management could be a clinically useful option for selected patients who want to avoid surgical corrections. The report presents two cases of left-sided portal hypertension with gastric variceal bleeding.

Stepwise Endoscopy Based on Sigmoidoscopy in Evaluating Pediatric Graft-versus-Host Disease

  • Lee, Kyung Jae;Choi, Shin Jie;Yang, Hye Ran;Chang, Ju Yuong;Kang, Hyoung Jin;Shin, Hee Young;Kang, Gyeong Hoon;Ko, Jae Sung;Moon, Jin Soo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.1
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    • pp.29-37
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    • 2016
  • Purpose: The aim of our study was to establish a safe and convenient diagnostic method for acute gastrointestinal (GI) graft-versus-host disease (GVHD) in children by determining the sensitivity and negative predictive values of upper and lower endoscopic biopsies for children suspected of GI GVHD. Methods: Patients suspected of GI GVHD who received endoscopic evaluation within 100 days after stem cell transplantation and endoscopies between January 2012 and March 2014 in Seoul National University Children's Hospital were included in our study. Results: Fifteen patients with a total of 20 endoscopic procedures were included in our study. Sensitivity at the esophagus, stomach, and duodenum were 22.2%, 30.0%, and 80.0%, respectively. Negative predictive values at the esophagus, stomach, and duodenum were 22.2%, 30.0%, and 60.0%, respectively. Overall sensitivity and negative predictive values of upper endoscopic biopsy for GVHD were 77.8% and 50.0%, respectively. Overall sensitivity and negative predictive values of lower endoscopic biopsy for GVHD were 88.9% and 66.7%, respectively. Conclusion: We recommend flexible sigmoidoscopy as a safe and accurate diagnostic tool for GVHD, similar to other studies reported previously. However, if there is no evidence of GVHD on sigmoidoscopy with high index of suspicion of GI bleeding, full colonoscopy and upper endoscopy should be considered.

2005~2006 Nationwide Gastric Submucosal Tumor Report in Korea (2005~2006년 전국 위점막하종양 설문조사 결과 보고)

  • The Information Committee of the Korean Gastric Cancer Association,
    • Journal of Gastric Cancer
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    • v.8 no.2
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    • pp.104-109
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    • 2008
  • Purpose: To investigate the clinicopathlogical characteristics and the surgical methods for gastric submucosal tumors in Korea, the Information Committee of the Korean Gastric Cancer Association performed a nationwide survey. Materials and Methods: Data on 878 patients who underwent resection from 2005 to 2006 were collected from medical records obtained from 47 institutes. Diagnosis, demographics, symptoms, tumor factors (location, size, degree of malignancy) and operative factors (surgicalmethod and approach, mortality) were analyzed. Results: Gastrointestinal stromal tumors (GISTs) were the most common cancers (n=586, 66.8%), followed by leiomyomas (n=97, 11.1%), schwannomas (n=70, 8.0%), ectopic pancreas (n=67, 7.8%) and carcinoids (n=16, 1.8%). The mean age of patients was 56.0 years and the male to female ratio was 1:1.18. Only 40.9% of the patients had symptoms at the time of diagnosis, such as abdominal pain, dyspepsia and bleeding. Gastric submucosal tumors were most frequently located in the upper third of the stomach and 55.4% of the GISTs (n=319) and 84.5% of the leiomyomas (n=84.5%) were located in the upper third of the stomach. Wedge resection (n=726, 82.8%) was the most common operative method, and laparoscopic surgery was performed in 388 patients (44.2%). Only one patient (0.1%) died within 30 days of surgery. A total of 115 patients withGISTs (21.1%, 115/544) had a high risk of malignancy and 41 patients (8.3%, 45/495) received adjuvant imatinib mesylate therapy. Conclusion: The survey showed that about two-thirds of the patients with a gastric submuscoal tumor (SMT) had a GIST, and about one-half of the patients underwent laparoscopic resection. These data presented in the nationwide survey could be used as a fundamental resource for gastric submucosal tumors in Korea.

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Imaging Findings of an Intraluminal Duodenal Diverticulum Associated with Adult Duodeno-Duodenal Intussusception and Recurrent Pancreatitis: A Case Report (성인 십이지장-십이지장 장중첩증 및 재발성 췌장염과 관련된 관강내 십이지장 게실의 영상 소견: 증례 보고)

  • Ga Young Yi;Jeong Kyong Lee;Huisong Lee;Sun Young Yi;SangHui Park
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.680-686
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    • 2022
  • Intraluminal duodenal diverticulum (IDD) is a rare congenital abnormality, consisting of a saclike mucosal lesion in the duodenum. Cases of IDD can present with gastrointestinal bleeding, duodenal obstruction, or pancreatitis. Here, we report a rare case of a 25-year-old female presenting with IDD complicated by duodeno-duodenal intussusception and recurrent pancreatitis. The diagnosis was based on findings from radiologic examinations (CT and MRI), upper gastrointestinal series (barium swallow), and gastroduodenofiberscopy. Laparoscopic excision of the presumed duodenal duplication was performed. The subsequent histopathologic evaluation of the excised sac revealed normal mucosa on both sides, but the absence of a proper muscle layer confirmed the diagnosis of IDD. Radiologic detection of a saccular structure in the second portion of the duodenum can indicate IDD with duodeno-duodenal intussusception as the lead point.

Cytologic Findings of Pancreatic Islet Cell Tumor with Lymph Node Metastasis (림프절 전이를 동반한 췌소도세포종 1예의 세침흡인 생검소견)

  • Kim, Yee-Jeong;Choi, Yoon-Jung;Kim, Kyu-Rae;Jung, Woo-Hee;Lee, Kwang-Gil
    • The Korean Journal of Cytopathology
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    • v.3 no.2
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    • pp.60-66
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    • 1992
  • Islet cell neoplasms (ICNs) of pancreas are uncommon, and the cytologic features of ICN are not well delineated. We report a case of islet cell tumor with lymph node metastasis, describing the cytologic, histologic, and immunohistochemical findings. A 40-year-old woman was admitted due to upper gastrointestinal bleeding of 2 days' duration. Computed tomography of the abdomen showed a diffusely infiltrating bulky mass in the body and tail of the pancreas. The fine needle aspirate showed moderate to high cellularity, monotonous cell population, single ceil predominance over small cell clusters, and eccentrically located nuclei. Although the definite diagnosis of ICN on the cytologic basis is difficult, the cytomorphologic features are sufficiently distinctive to suggest the diagnosis.

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Multiple Myeloma Combined with Stomach Cancer - A case report - (위암이 동반된 다발성 골수종 1례)

  • Yang, Chang-Heon;Hyun, Myung-Soo;Lee, Hyun-Woo
    • Journal of Yeungnam Medical Science
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    • v.6 no.1
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    • pp.197-204
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    • 1989
  • A case of multiple myeloma combined with stomach cancer and related literatures were reviewed. A 67 year-old male patient entered the hospital with dysphagia and weight loss for 3 months. Peripheral blood examination revealed anemia with rouleaux formation. Total protein of the serum was 9.9g/$d{\ell}$ with hyperglobulinemia(albumin 2.7g/$d{\ell}$, globulin 7.2g/$d{\ell}$, A/G ratio 0.375). On the electrophoresis and immunoelectrophoresis of the serum, the abnormal protein with the pattern of monoclonal gammopathy(IgG-K type) was shown. There were multiple variable sized osteolytic lesions on skull X-ray and abnormal hot uptakes of ribs on bone scan and result of rib biopsy was plasmacytoma. Gastrofiberscopy was performed to search for the cause of upper gastrointestinal bleeding, revealed stomach cancer, and the result of the gastric mucosal biopsy proved to be well-differentiated adenocarcinoma.

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Portal Hypertension of a Delayed Onset Following Liver Abscesses in a 12-Month-Old Infant: A Case Report and Review of the Literature

  • Al-Qurashi, Faisal Othman;Aladsani, Ahmed Abdullah;Qanea, Fatema Khalil Al;Faisal, Sarah Yousef
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.4
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    • pp.400-406
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    • 2019
  • We report a 12-month-old female infant who had a history of neonatal sepsis with liver micro-abscesses that resolved with intravenous antibiotics during neonatal period. During her neonatal admission period, no umbilical vein catheter was inserted. Also, she did not undergo any abdominal surgeries or had a postnatal history of necrotizing enterocolitis. However, the child developed upper gastrointestinal bleeding in form of hematemesis and melena secondary to esophageal varices at the age of 12 months with an extra-hepatic portal vein obstruction with cavernous transformation and portal hypertension subsequently. The child underwent a successful endoscopic injection sclerotherapy. She is now 20-month-old and has portal hypertension but otherwise asymptomatic. We are proposing the possibility of a delayed-onset portal hypertension as a complication of liver abscess and neonatal sepsis.