• Title/Summary/Keyword: gastrointestinal endoscopy

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A Rare Duodenal Subepithelial Tumor: Duodenal Schwannoma

  • Kahng, Dong Hwahn;Kim, Gwang Ha;Park, Sang Gyu;Lee, So Jeong;Park, Do Youn
    • Clinical Endoscopy
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    • v.51 no.6
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    • pp.587-590
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    • 2018
  • Schwannomas are uncommon neoplasms that arise from Schwann cells of the neural sheath. Gastrointestinal schwannomas are rare among mesenchymal tumors of the gastrointestinal tract, and only a few cases have been reported to date. Duodenal schwannomas are usually discovered incidentally and achieving a preoperative diagnosis is difficult. Schwannomas can be distinguished from other subepithelial tumors on endoscopic ultrasonography; however, any typical endosonographic features of duodenal schwannomas have not been reported due to the rarity of these tumors. Immunohistochemistry is essential to distinguish schwannomas from gastrointestinal stromal tumors and leiomyomas. We report a case of duodenal schwannoma found incidentally during a health checkup endoscopy. On endoscopic ultrasonography, this tumor was suspected as a gastrointestinal stromal tumor; therefore, the patient underwent laparoscopic wedge resection of the tumor. Histopathology and immunohistochemistry confirmed that the duodenal lesion was a benign schwannoma.

Three Year Old Male with Multiple Dieulafoy Lesions Treated with Epinephrine Injections via Therapeutic Endoscopy

  • Baldwin, Christina L.;Wilsey, Michael
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.19 no.4
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    • pp.276-280
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    • 2016
  • Dieulafoy lesions, vascular anomalies typically found along the gastrointestinal tract, have been viewed as rare and obscure causes of sudden intestinal bleeding, especially in pediatric patients. Since their discovery in the late 19th century, the reported incidence has increased. This is due to an increased awareness of, and knowledge about, their presentation and to advanced endoscopic diagnosis and therapy. Our patient was a three-year-old male, without a complex medical history. He presented to the emergency department with acute hematemesis with blood clots and acute anemia requiring blood transfusion. Endoscopy revealed four isolated Dieulafoy lesions along the lesser curvature of the stomach, which were treated with an epinephrine injection. The Dieulafoy lesion, although thought to be rare, should be considered when investigating an acute gastrointestinal bleed. These lesions have been successfully treated endoscopically. Appropriate anticipation and preparation for diagnosis and therapy can lead to optimal outcomes for the pediatric patient.

Detection of Gastrointestinal Cancer using Linked Color Imaging and Blue Light Imaging (위장관암 발견에 있어 Linked Color Imaging와 Blue Light Imaging의 유용성)

  • Yoo, In Kyung;Cho, Joo Young;Osawa, Hiroyuki
    • Journal of Digestive Cancer Research
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    • v.7 no.2
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    • pp.31-39
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    • 2019
  • The early detection of early gastric cancer (EGC) is important. However, the sensitivity of conventional white light imaging (WLI) in detecting EGC had been reported to range only from 77% to 84%. Although the resolution of endoscopes has been remarkably developed, precancerous lesions such as adenomas and microscopic early cancers are difficult to diagnose with general endoscopy. Linked Color Imaging (LCI) magnifies the differences in color for easy detection. Therefore, it produces a bright image from a distance and is performed for screening endoscopy. The 410 nm wavelength of BLI (Blue Light Imaging) helps to detect cancer by showing microstructure and microvessels in the mucosal superficial layer. This review will focus on the utility of Image enhanced endoscopy (IEE) techniques in diagnosis of gastrointestinal cancer.

Intestinal Perforation Caused by Lumboperitoneal Shunt Insertion Repaired with an Over-the-Scope Clip

  • Naoki Ishizuka;Eiji Komatsu
    • Clinical Endoscopy
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    • v.55 no.1
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    • pp.146-149
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    • 2022
  • Lumboperitoneal or ventriculoperitoneal shunt insertion is a standard therapy for hydrocephalus that diverts cerebrospinal fluid from the subarachnoid space into the peritoneal cavity. Gastrointestinal perforations due to this procedure occur rarely; however, accepted treatment strategies have not yet been established. Hence, the most common treatment approaches are open surgery or spontaneous closure without endoscopy. We report the case of a small intestinal perforation in a 73-year-old-woman that occurred after the insertion of a lumboperitoneal shunt. A positive cerebrospinal fluid culture and high cerebrospinal fluid white blood cell count indicated a retrograde bacterial infection, and computed tomography revealed that the peritoneal tip of the shunt catheter was located in the lumen of the gastrointestinal tract. We repaired the perforation endoscopically using an over-the-scope clip, and the patient's recovery was uneventful. Use of an over-the-scope clip could be an effective and minimally invasive treatment for intestinal perforations caused by lumboperitoneal or ventriculoperitoneal shunt insertion.

Endoscopic Treatment of Iatrogenic Perforation of Sigmoid Diverticulum: A Case Report of Multidisciplinary Management

  • Giacomo Emanuele Maria Rizzo;Giuseppina Ferro;Giovanna Rizzo;Giovanni Di Carlo;Alessandro Cantone;Gaetano Giuseppe Di Vita;Carmelo Sciume
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.292-296
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    • 2022
  • Iatrogenic perforations are severe complications of gastrointestinal endoscopy; therefore, their management should be adequately planned. A 77-year-old man with a history of diverticulosis underwent a colonoscopy for anemia. During the procedure, an iatrogenic perforation occurred suddenly in the sigmoid colon, near a severe angle among the numerous diverticula. Through-the-scope clips were immediately applied to treat it and close mucosal edges. Laboratory tests showed increased levels of inflammation and infection, and although there were no complaints of abdominal pain, the patient had an extremely distended abdomen. A multidisciplinary board began management based on a conservative approach. Pneumoperitoneum was treated with computed tomography-assisted drainage. After 72 hours, his intestinal canalization and laboratory tests were normal. Though this adverse event is rare, a multidisciplinary board should be promptly gathered upon occurrence, even if the patient appears clinically stable, to consider a conservative approach and avoid surgical treatment.

Polyposis of gastrointestinal tract after COVID-19 mRNA vaccination: a report of two cases

  • Jun Ho Kim;Eun Hye Oh;Dong Soo Han
    • Clinical Endoscopy
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    • v.57 no.3
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    • pp.402-406
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    • 2024
  • Cronkhite-Canada syndrome is a rare gastrointestinal polyposis syndrome with distinctive clinical features and endoscopic findings. Diagnosis can be challenging without suspicion, and the disease carries high mortality due to complications such as infection, gastrointestinal bleeding, and malignancies. This paper presents two cases of Cronkhite-Canada syndrome occurring after coronavirus disease 2019 (COVID-19) mRNA vaccination. Both cases exhibited typical clinical findings, including hypogeusia, onychodystrophy, alopecia, and weight loss. Typical polyposis in the gastrointestinal tract was confirmed through endoscopies. As symptomatic treatment did not improve the symptoms, corticosteroids were administered, and symptoms and laboratory test results improved immediately. The patients improved upon corticosteroids tapering. These cases illustrate typical presentations of Cronkhite-Canada syndrome and the course of the disease following corticosteroid treatment. Additionally, they suggest the possibility that Cronkhite-Canada syndrome may be triggered by COVID-19 mRNA vaccination.