A Case of Meckel's Enterolith / 대한소화기내시경학회지

The term enterolith refers to concretions formed within the gastrointestinal tract. Enteroliths are thought to result from stasis and are usually found proximal to an area of stricture or within diverticulum. Meckel's diverticulum occurs in 1% to 3% of the population at autopsy and is the most common congenital anomaly of the gastrointestinal tract. Common complications of Meckel's diverticulum include hemorrhage, infection, inflammation, and intussusception. However, enterolith formation in a Meckel's diverticulum, which referred to as Meckel's enterolith, is rare. A 58-year-old female who experienced constipation and low abdominal pain for 20 years, was admitted due to severe low abdominal pain for 3 days. A 3 2 cm sized, lozenge-shaped radiopaque stone with peripheral dense calcification and radiolucent center, located between two areas of stricture in the distal ileum, was observed in abdominal radiograph, abdominal sonogram, small bowel study, and CT scan. Pathologic findings after surgery reveal an enterolith in Meckel's diverticulum without ectopic gastric mucosa. The case of Meckel's enterolith is herein reported.

A Case of Hydrogen Peroxide Induced Colitis / 대한소화기내시경학회지

Hydrogen peroxide has been used for various medical purposes and also recommended in the disinfection process for endoscopes. However, hydrogen peroxide as a cause of chemical colitis or disinfectant colitis has been infrequently reported. The endoscopic findings of hydrogen peroxide induced colitis revealed pseudomembranous-like enteritis such as white plaques, erythema, foamy liquid, patchy, granularity, and ulcerations, resulting from effervescence caused by the release of oxygen from the breakdown of hydrogen peroxide. A 36 year-old single male, who had 30 ml of 3% hydrogen peroxide inserted into his anus the day before due to sexual reasons, was hospitalized as a result of suffering from hematochezia, tenesmus, and lower abdominal pain. Colonoscopy revealed discrete or confluent white plaques adherent to the colonic mucosa, severe erythema on the surrounding mucosa, patchy granularity, and scattered ulcerations up to 28 cm from the anal verge. Pathologic finding revealed inflammatory cells infiltration, variable sized vacuoles, vascular congestion, hemorrhage, fibrin deposition and ulcerations with regenerating epithelium in the lamina propria, consistent with acute mucosal injury caused by hydrogen peroxide. A case of hydrogen peroxide induced colitis is herein reported.

Endoscopic Ligation Therapy for Gastric Angiodysplasia / 대한소화기내시경학회지

Gastric angiodysplasia may be responsible for up to 2% to 6% of upper gastrointestinal bleeding. Moreover, gastric angiodysplasia may be particularly difficult to treat and is usually associated with a high rebleeding rate. Bleeding due to gastric angiodypsplasia is usually treated by various endoscopic approaches, including argon and Nd:YAG laser photocoagulation, monopolar or biopolar electrocoagulation, heater probe, or injection. Associated complications of these methods, however, such as perforation, acute bleeding during the procedure, or delayed massive hemorrhage have been reported. Recently a few reports have been suggested that endoscopic ligation therapy is a safe, effective treatment for gastric angiodysplasia. A 70-year-old man, who had undergone subtotal gastrectomy for perforation of a duodenal ulcer for 20 years, was admitted due to melena and dizziness persisting for 1 week. A gastroscopy revealed a single angiodysplasia with active bleeding just above the anastomotic site of the remnant stomach. Endoscopic ligation therapy was performed successfully and the bleeding stopped immediately after endoscopic ligation. Since then, no recurrence of bleeding has been reported to date.

A Case of Spindle Cell Carcinoma of the Esophagus / 대한소화기내시경학회지

Spindle cell carcinoma of the esophagus containing both carcinomatous and sarcomatous elements is rare, accounting for approximately 1- 2% of all esophageal neoplasms. Terms used to describe this lesion include carcinosarcoma, pseudosarcoma, polypoid carcinoma, pseudosarcomatous squamous cell carcinoma and spindle cell variant of squamous cell carcinoma. Spindle cell carcinomas were originally classified as carcinosarcomas or pseu- dosarcomas, depending on the morphology and bilologic behavior of the particular lesian. However, pseudosarcoma and carcinosarcoma appear to be the same pathologic entity with varying degrees of anaplastic spindle cell metaplasia of the carcinomatous portion of the tumor. Thus, these lesions have been clsssified together as spindle cell carcinomas. A 59 year-old man who experienced weight loss for 4 months was hospitalized as a result of suffering from dysphagia for 2 months. A diffuse bulky protruding mass with superficial ulceration and easy friability on 25 to 35 cm from the incisors, which invaded the right intermediate bronchus and involved the right paratracheal and subcarnial lymph nodes, were obsetved in esophagogram, endoscopy and chest CT. Pathologic finding, including immunoreactivity to cytokeratin and vimentin, was consistent with spindle cell carcinoma. We report a case of spindle cell carcinoma of the esophagus.

A Case of Gastric Anisakiasis Causing Mallory - Weiss Syndrome / 대한소화기내시경학회지

Anisakiasis is an infection in humans caused by larval nematodes of the family Anisakidae and is encountered in people who eat inadequately prepared raw, salt-water fish or "sashimi". This clinical syndrome is characterized by severe cramping abdominal pain, nausea, and vomiting. Because Koreans like to eat raw fish, anisakiasis of the stomach has been reported occasionally, but the incidences of upper gastrointestinal bleeding caused by anisakiasis has been very rare. The present case is a 30 year-old male Admitted with an episode of hematemesis. A gastrofibroscopy revealed a mucosal laceration and the larva of Anisakis on the esophagogastric junction. We report one case of Mallory-Weiss Syndrome due to gastric Anisakis larva, confirmed by an endoscopy.

A Case of Lung Abscess in an Achalasia Patient / 대한소화기내시경학회지

Esophagea1 achalasia is a disease of unkown etiology characterized by abscenee of peristalsis in the body of the esophagus and failure of the lower esaphageal sphincter to relax in response to swallow. The cause has been suggested by the lack or abscence of ganglion cell in Auerbach's plexus. About 10% of patients with achalasis develop pulmonary complication such as aspiration pnuemonia, pulmonary fibrosis, pulmonary tuberculosis, culosis, bronchiectasis, lung abscess and bronchial asthma. Although aspiration pneumonia is the most common pulmonary complication in patients with achalasia, lung abscess is the extremely rare complication. A 48 years old female, who has experienced dysphagia and regurgitation for several years, is hospitalized because of high fever, cough and sputurn for 2 weeks. Lung abscess in apicoposterior segment of left upper lobe is observed in X-ray and chest CT. The findings of esophagogram, esophagogastroscopy and esophageal manometry are consistent with achalasia. We report a case of lung abscess associated with achalasia.