Esophageal Pyogenic Granuloma: Endosonographic Findings and Endoscopic Treatments

Pyogenic granuloma is a benign inflammatory vascular lesion, mainly found in the skin and oral mucosa. A few cases of pyogenic granuloma in the gastrointestinal tract have been reported, and the esophagus was the main site in these cases. These patients were diagnosed with pyogenic granuloma after they underwent upper endoscopy and biopsy. Endoscopic resection is a favorable treatment option for esophageal pyogenic granuloma. Recently, we observed characteristic endosonographic findings in two cases with esophageal pyogenic granuloma, which were then treated successfully by endoscopic resection.

A Submucosal Tumor-Like Recurrence of Early Esophageal Cancer after Endoscopic Submucosal Dissection

Early esophageal cancer is defined as a tumor invading the mucosa with or without lymph node or distant organ metastasis. In the current guidelines for early esophageal cancer, absolute indication for endoscopic resection include lesions limited to the epithelium or lamina propria mucosa not exceeding two-thirds of the circumference, and relative indications include lesions limited to the muscularis mucosa or the upper third of the submucosal layer and not accompanied by clinical evidence of lymph node metastasis. After endoscopic submucosal dissection for early esophageal cancer, locally recurrent cancer can occur, especially in the case of incomplete resection. Here, we report a rare case of a submucosal tumor-like recurrence after endoscopic resection of early esophageal cancer.

A Case of Papillary Thyroid Cancer Recurring as an Esophageal Submucosal Tumor / 전남의대학술지

A 75-year-old woman who underwent a total thyroidectomy for papillary thyroid cancer 7 years previously presented with a palpable neck mass. Computed tomography (CT) showed two metastatic masses on the thyroid bed and another mass that looked benign originating from the esophageal wall. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the esophageal wall that looked similar to a gastrointestinal stromal tumor. The mass on the esophagus had intense fluorodeoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT), which suggested the possibility of malignancy. Subsequently, after surgery, the mass in the esophagus was confirmed as a metastasis from the thyroid papillary carcinoma. Here we report this unusual case of papillary thyroid cancer that recurred as an esophageal submucosal tumor.

Mid-Term Results of Endovascular Repair for Traumatic Aortic Injury / 대한내과학회지

BACKGROUND/AIMS: Traumatic aortic injury (TAI) is rarely seen clinically, but is highly fatal. In determining how to treat TAI, there are many factors to consider, due to the complexity of concomitant injuries. The Society of Vascular Surgery recommends that thoracic endovascular aortic repair (TEVAR) should be preferentially performed over open surgical repair. We evaluated the efficacy of TEVAR based on our experiences in TAI treatment. METHODS: Between July 2008 and August 2011, we conducted a retrospective analysis of the patients who underwent TEVAR following TAI and analyzed factors including TAI type and sites, time from injury to repair, Injury Severity Score, and complications. Seven patients with multiple injuries underwent TEVAR in the acute setting. Follow-up was accomplished regularly by computed tomographic angiography (CTA). RESULTS: Type III aortic injury, rib fractures, and hemothorax were found in all patients. TEVAR was successfully performed. Completion angiography demonstrated complete exclusion of pseudoaneurysm without endoleakage, and perfusion of aortic arch vessels was maintained. There was no in-hospital mortality or evidence of spinal cord ischemia. The average follow-up duration was 30.4 +/- 23.9 months, and regular CTA revealed good durability of the stent-graft without late complications such as endoleakage, stent migration, or pseudoaneurysm formation. CONCLUSIONS: Through this study, we were able to identify good mid-term results of TEVAR in our hospital. TEVAR is thought to be a good modality with which to treat acute traumatic aortic injury, especially given the consideration of bleeding risk in trauma patients with multiple injuries.

Endoscopic Removal of Efferent Loop Bezoars in Postgastretomy Pateints

Efferent loop bezoars rarely occur. However when patients have a history of gastrectomy and gastrojejunal anastomosis, they are sometimes found. Small bowel obstruction by efferent loop bezoar has a mortality rate as high as 30%. Although various endoscopic procedures were reported to remove gastric bezoars, the traditional treatment option of small bowel bezoars is operative management. But as in the cases we describe here, endoscopic procedure may offer an effective alternative for efferent loop bezoars. Bezoars obstructing efferent loop were found in patients with history of gastrectomy and they were removed by endoscopy successfully.

A Case of Papillary Thyroid Cancer Recurring as an Esophageal Submucosal Tumor / 전남의대학술지

A 75-year-old woman who underwent a total thyroidectomy for papillary thyroid cancer 7 years previously presented with a palpable neck mass. Computed tomography (CT) showed two metastatic masses on the thyroid bed and another mass that looked benign originating from the esophageal wall. Endoscopic ultrasonography (EUS) showed a hypoechoic mass in the esophageal wall that looked similar to a gastrointestinal stromal tumor. The mass on the esophagus had intense fluorodeoxyglucose (FDG) uptake in positron emission tomography-computed tomography (PET-CT), which suggested the possibility of malignancy. Subsequently, after surgery, the mass in the esophagus was confirmed as a metastasis from the thyroid papillary carcinoma. Here we report this unusual case of papillary thyroid cancer that recurred as an esophageal submucosal tumor.