ABSTRACT
A duodenal diverticulum is common and usually originates in the second portion of the duodenum. The majority of diverticula are asymptomatic; however, they may sometimes present with symptoms such as obstruction, hemorrhage, perforation, jaundice and pancreatitis. Active bleeding from a duodenal diverticulum is rare, and moreover, Dieulafoy's lesion as a cause is quite rare with very few cases reported so far. The use of endoscopic methods instead of surgery in achieving hemostasis has been on the increase with the widespread use and improvement in endoscope instrumentation and accessories. Of these methods, the use of endoscopic hemoclipping for Dieulafoy's lesion is considered more effective and safe than the use of other methods, such as injection and thermal methods. We report here a case of a bleeding Dieulafoy's lesion in a duodenal diverticulum treated by endoscopic hemoclipping.
Subject(s)
Diverticulum , Duodenum , Endoscopes , Hemorrhage , Hemostasis , Hemostasis, Endoscopic , Jaundice , PancreatitisABSTRACT
Ectopic gastric mucosa is known to occur throughout the gastrointestinal tract. Ectopic gastric mucosa in the duodenum is classified into the developmental (heterotopic gastric mucosa) and acquired types (gastric metaplasia). Gastric metaplasia may be present in up to 64% of normal individuals but heterotopic gastric mucosa is quite rare. A heterotopic gastric mucosa in the duodenum may be asymptomatic but can give rise to perforation, hemorrhage, and intestinal obstruction in rare cases. Therefore, periodic endoscopic surveillance is recommended in these cases. Endoscopically, the appearance of a heterotopic gastric mucosa shows a mainly elevated lesion with multiple nodularity. We report a case of 1.5 x 1.2 cm sized polypoid lesion of the duodenum in an asymptomatic 31 year-old man. The mass was resected endoscopically and diagnosed as a heterotopic gastric mucosa.
Subject(s)
Adult , Humans , Duodenum , Gastric Mucosa , Gastrointestinal Tract , Hemorrhage , Intestinal Obstruction , Metaplasia , PolypsABSTRACT
The gastric carcinoma displays various macroscopic appearances ranging from well defined protuberant to diffuse infiltrating tumors but its histological diagnosis is usually simple when performing an endoscopic biopsy. A few gastric cancinomas resemble submucosal tumors (SMT). A gastric carcinoma with a SMT-like appearance is extremely rare, and reportedly accounts for 0.1% to 0.63% of all resected gastric carcinomas in Japan. A histological diagnosis of a SMT-like gastric carcinoma by repeated endoscopic biopsies is often difficult as the tumors are almost entirely covered with normal mucosa. When one sees the lesions in an upper gastrointestinal endoscopy, one should be careful about the location of depression, redness and coating that deviates from the top of the tumor. Here we report two cases of SMT-like gastric carcinomas, diagnosed by the usual endoscopic biopsy method and treated with surgery, with an accompanying review of the recent literature.
Subject(s)
Adenocarcinoma , Biopsy , Depression , Diagnosis , Endoscopy, Gastrointestinal , Japan , Mucous MembraneABSTRACT
BACKGROUND/AIMS: The effects of curcumin on the growth of human colon cancer cell lines, HT-29 and WiDr cells were examined and the effects of 5-fluorouracil (5-FU) were also studied. METHODS: The growth of HT-29 and WiDr cells were examined by counting cell number on two and four days treatment with 1-40 micrometer of curcumin, and 0.1 microgram/mL, 0.3 microgram/mL of 5-FU. The reversibility of curcumin was examined on one day to seven days treatment with 10 micrometer curcumin after seeding to 2 10(4) cells/well. To examine the inhibitory effects of curcumin, cell cycle analysis was done on the HT-29 cells after four days treatment with 20 micrometer curcumin. RESULTS: Curcumin inhibited the growth of HT-29 and WiDr cells in a dose-dependent fashion. The growth rate of the group in which curcumin was removed by media change 24 hours after the treatment of curcumin was not different from that of control group. Curcumin combined with 5-FU markedly inhibited the growth of HT-29 and WiDr cells compared to curcumin or 5-FU alone. After four days treatment of HT-29 cells with 20 micrometer curcumin, the fraction of cells in G2-M phase was 35.3% in curcumin group, much higher than 13.8% of the control group. CONCLUSIONS: Curcumin significantly inhibited the growth of HT-29 and WiDr cells in a dose- dependent, reversible fashion.