• Title/Summary/Keyword: endoscopy

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Intramural esophageal dissection after endoscopy: A case report in a hypopharyngeal cancer patient treated with concurrent chemoradiotherapy

  • Park, Jae Hwi;Jeong, Sun Young;Song, Hyun Joo;Kim, Miok;Ko, Su Yeon
    • Journal of Medicine and Life Science
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    • v.17 no.1
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    • pp.21-24
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    • 2020
  • Intramural esophageal dissection is a rare disorder characterized by a separation of the mucosa and/or submucosa from deeper muscular layers of the esophagus, with or without perforation. Iatrogenic instrumentation such as endoscopy is one of the major causes of IED. We report a case of IED after endoscopy in a patient with hypopharyngeal cancer treated with concurrent chemoradiotherapy, and suggest that a history of chemoradiotherapy can be a risk factor of IED on endoscopy. In this case, chest computed tomography scans show not only typical esophageal double lumen but also eccentric esophageal wall thickening and abnormally thin the other side esophageal wall, and this CT finding may also be important to diagnose IED.

Endoscopic activity in inflammatory bowel disease: clinical significance and application in practice

  • Kyeong Ok Kim
    • Clinical Endoscopy
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    • v.55 no.4
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    • pp.480-488
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    • 2022
  • Endoscopy is vital for diagnosis, assessing treatment response, monitoring and surveillance in patients with inflammatory bowel disease (IBD). With the growing importance of mucosal healing as a treatment target, the assessment of disease activity by endoscopy has been accepted as the standard of care for IBD. There are many endoscopic activity indices for facilitating standardized reporting of the gastrointestinal mucosal appearance in IBD, and each index has its strengths and weaknesses. Although most endoscopic indices do not have a clear-cut validated definition, endoscopic remission or mucosal healing is associated with favorable outcomes, such as a decreased risk of relapse. Therefore, experts suggest utilizing endoscopic indices for monitoring disease activity and optimizing treatment to achieve remission. However, the regular monitoring of endoscopic activity is limited in practice owing to several factors, such as the complexity of the procedure, time consumption, inter-observer variability, and lack of a clear-cut, validated definition of endoscopic response or remission. Although experts have recently suggested consensus-based definitions, further studies are needed to define the values that can predict long-term outcomes.

Two Cases of Jejunal Gastrointestinal Stromal Tumor Diagnosed by Capsule Endoscope (캡슐내시경으로 발견된 공장의 위장관 간질성 종양 2 예)

  • Choi, Jae-Won;Mun, Hui-Jeong;Jang, Byung-Ik;Kim, Tae-Nyeun;Song, Sun-Kyo;Bae, Young-Kyong;Lee, Ji-Eun
    • Journal of Yeungnam Medical Science
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    • v.23 no.1
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    • pp.131-137
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    • 2006
  • Small bowel tumors have been difficult to diagnose because of low incidence and absence of specific symptoms. There are no efficient and accurate tests available for diagnosis. Capsule endoscopy is an efficient diagnostic tool for small bowel disease and obscure gastrointestinal bleeding. We diagnosed two cases of small bowel gastrointestinal stromal tumor (GIST) diagnosed by capsule endoscopy that were treated by surgery. A 68 year old male presented with abdominal pain. The capsule endoscopy showed fungating ulcer mass at the jejunum. A 55 year female presented with melena. The capsule endoscopy showed an intraluminal protruding mass with a superficial ulcer at the jejunum. Two cases were diagnosed with GIST after surgery. We report these two case diagnosed by capsule endoscopy and review the medical literature.

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Gastrointestinal endoscopy's carbon footprint

  • Su Bee Park;Jae Myung Cha
    • Clinical Endoscopy
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    • v.56 no.3
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    • pp.263-267
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    • 2023
  • Climate change is a global emergency. Consequently, current global targets to combat the climate crisis include reaching net-zero carbon emissions by 2050 and keeping global temperature increases below 1.5 ℃. In 2014, the healthcare carbon footprint was 5.5% of the total national footprint. Gastrointestinal endoscopy (GIE) has a large carbon footprint compared to other procedures performed in healthcare facilities. GIE was identified as the third largest generator of medical waste in healthcare facilities for the following reasons: (1) GIE is associated with high case volumes, (2) GIE patients and relatives travel frequently, (3) GIE involves the use of many nonrenewable wastes, (4) single-use devices are used during GIE, and (5) GIE is frequently reprocessed. Immediate actions to reduce the environmental impact of GIE include: (1) adhering to guidelines, (2) implementing audit strategies to determine the appropriateness of GIE, (3) avoiding unnecessary procedures, (4) using medication rationally, (4) digitalization, (5) telemedicine, (6) critical pathways, (7) outpatient procedures, (8) adequate waste management, and (9) minimizing single-use devices. In addition, sustainable infrastructure for endoscopy units, using renewable energy, and 3R (reduce, reuse, and recycle) programs are necessary to reduce the impact of GIE on the climate crisis. Consequently, healthcare providers need to work together to achieve a more sustainable future. Therefore, strategies must be implemented to achieve net-zero carbon emissions in the healthcare field, especially from GIE, by 2050.