A Case of Synchronous Four Gastric Cancer / 대한소화기내시경학회지

The incidence of synchronous gastric cancer is variously reported to be 2.07%, 5.22%, 6.5%, 8.6%, or 9% and has been increasing recently, probably with advance in the diagnosis of gastric cancer. Our case in presentation is a 70-year-old male patient who had total gastrectomy and esopbagiojunostomy done for synchronous four gastric cancer. Each has different histologic types, Some of these lesions are not suspected before operation and are found almost by chance during histologic examinations after surgery performed only to remove main lesion. So we report this case with a review of literatures.

A Case of Solitary Rectal Ulcer Syndrome / 대한소화기내시경학회지

Solitary rectal ulcer syndrome (SRUS), which has a characteristic histopathologic features, is an uncommon disease in young adults of either sex. The common clinical features are bloody stool and anal pain. By rectosigmoidoscopy, the lesions are typically seen as single or multiple shallow ulcers with hyperemic margins or polypoid mass. Variable appearance of the ulcer may cause coinical confusion mimicking even a malignant neoplasm. The condition is essentially benign and may persist unchanged for many years. Therefore, it is most important to distinguish solitary ulcer from rectal malignancy. We report a case of solitary rectal ulcer syndrome canfirmed by histopathologic finding, the initial clinical diagnosis was a malignant neoplasm.

A Case of Granulocytic Sacoma in Esophagus / 대한소화기내시경학회지

Granulocytic sarcoma.(chloroma) is a localized tumor mass composed of immature cells of the granulocytic series infiltrating an extramedullary site. The tumor may involve anywhere in the body, especially orbit, bone, epidural space and lymph node, but there is no case involved the esophagus. In a 34-year-old male presented with sudden anset of dysphagia, esophagoscopic examination revealed concentric narrowing of the esophageal lumen wirith alight granular mucosa in the midesophagus, which hiatologically proved to b a granulocytic sarcoma. Peripheral blood and bone marrow aspiration smears showed blastic crisis of chronic myelocytic leukemia. After the systemic chemotherapy, dysphagia and mid-esophageal luminal narrowing disappeared completely.

Clinical Observations of 66 Endoscopic Gastric Polypectomies / 대한소화기내시경학회지

Advance in fiberoptic endoscopy have improved diagnostic capabilities and management in patients with gastric polyps and increased experience with endoscopic polypectomy offers the most simple and safe method in removal of gastric polyps. Sixty six endoscopic gastric polypectomies was performed in 59 patients who visited Chonnam National University Hospital from 1980 to 1989 The results obtained were as follows. 1) The most patients were in the seventh decade followed by fifth, fourth decade. The ratio of male to female was 1: 1.95. 2) The common clinical symptoms with which patients presented were epigastric discomfort (54. 2%), epigastric pain (44.1%), indigestion (16.9%), nausea and vomiting (13.6%) and hematemesis (3.4%). The associated diseases of gastric polyp were chronic superficial gastritis (28.8%), chronic atrophic gastritis (13.6%), benign gastric ulcer, gastric caecer, cancer of ampulla of Vater. 3) The number of patients with single gastric polyp wa 47 (79.7%), and that of multiple gastric polyps was 12 (20.3%). The most common location of gastric polyps was gastric antrum (66.6%) follawed by gastric body (27.3%) and gastric fundus (6.1%). 4) The removed polyps were mostly 1.0 cm to 2.0 cm in size and in the gross findings by Yamadas classification, type IV (48.5%) was most common. 5) Histogical examinations revealed that 49.6% of remoyed polyps were hyperplastic polys and 18. 7% of those were adenomatous polyps. Only one case of adenomatous polyp had contaied focally malignant change of mucosa. 6) Almost all cases were in the absenee of significant complications, but three patients showed bleeding at the site of polypectomy, which controlled by conservative means.