The Usefulness of Endoscopic Ultrasonography and Endoscopy in Diagnosing Depth of Invasion of Early Gastric Cancer for the Selection of Proper Candidates for Endoscopic Mucosal Resection / 대한소화기내시경학회지

BACKGROUND/AIMS: If a cancer lesion without ulcer can be correctly staged as mucosal, it can be a candidate for curative endoscopic treatment such as endoscopic mucosal resection. The aim of this study was to evaluate the usefulness of EUS and endoscopy in diagnosing mucosal cancer of stomach. METHODS: Findings of endoscopy and EUS were independently reviewed by the conventional criteria for diagnosing depth of invasion and compared with histologic findings in 65 patients having EGC without ulcers. RESULTS: Overall accuracy of diagnosing depth of invasion were 69% by endoscopy and 78% by EUS. The accuracy rates according to the macroscopic type by endoscopy were 86% (12/14) for type I, 75% (3/4) for type IIa, 75% (9/12) for type IIa+IIc, 50% (2/4) for type IIc+IIa, 66% (19/29) for type IIc and 0% (0/2) for type IIc+IIb. The accuracy rates according to the macroscopic type by EUS were 93% (13/ 14) for type I, 50% (2/4) for type IIa, 75% (9/12) for type IIa+IIc, 50% (2/4) for type IIc+IIa, 83% (24/29) for type IIc and 50% (1/2) for type IIc+IIb. All lesions that were classified as limited to the mucosa on both conventional endoscopy and EUS in type I (n=9), IIa (n=2), IIa+IIc (n=2) and IIc (n=11) were limited to the mucosa by histologic findings. CONCLUSIONS: This study suggests that if both modalities show the findings of mucosal lesion in type I and IIc of EGC, endoscopic mucosal resection may be considered as a curative treatment.

A Case of Peutz-Jeghers Syndrome with Intussusception / 대한소화기내시경학회지

Peutz-Jeghers syndrome is a rare autosomal dominant disorder defined by hamartomatous polyps of gastrointestinal tracts and the occurrence of melanin spots on the mucocutaneous surface. This syndrome has important complications such as malignant transformation, gastrointestinal bleeding, and intussusception. About 50% of patients with Peutz-Jeghers syndrome involved Intussusception. A case of Peutz-Jeghers syndrome with intussusception was recently experienced and herein reported.