A case of gastritis cystica profunda with early gastric cancer / 대한내과학회지

We report a rare case of adenocarcinoma with multiple gastritis cystica profunda that develope in a 56-year-old man. We found early gastric cancer at the gastric angle. And some cystic lesion was present at lesser curvature of the body. Gastrectomy was performed for confirmation and treatment. Gastritis cystica profunda (GCP) is usually characterized by multiple cystic mass in the mucosa and submucosa of the stomach. It is rare disease which is mainly found at the stoma site of gastroenterostomy. Occasionally GCP develops in the stomach without previous history of surgery. Most common feature of GCP is sessile polypoid protrusion but, submucosal tumor, giant gastric mucosal fold and pedunculated mass are found. Some evidence suggests that downward adenocystic proliferation of glands is a dysplastic or precancerous change. But we know that these submucosal cystic lesion may not be precancerous. Thus cystic mass must be distinguished from Menetrier's disease, Zollinger-Eillison's syndrome, and other malignancy.

Diffuse Intestinal Hemangiomatosis Diagnosed by Endoscopy in a Patient with Anemia / 대한소화기내시경학회지

Gastrointestinal hemangiomatosis is a rare benign vascular lesion, which can produce massive or persistent blood loss. Numerous lesions, usually of the cavernous type, involve stomach, small bowel, and colon. The diagnosis of hemangiomatosis is difficult. It is diagnosed usually by endoscopic study or barium enema for bleeding or anemia evaluation in childhood. A 17-year-old female was admitted to our hospital with anemia and dizziness for several months. She was diagnosed as diffuse intestinal hemangiomatosis by gastroduodenoscopy and colonoscopy. Gastroduodenosocpic findings showed multiple, small, mound-like, reddish-purple hemangiomas on the lower body, fundus and prepyloric area of the stomach. Colonoscopic findings showed similar lesions on the ascending and descending colon. The polypoid lesion on the ascending colon was ligated by detachable snare due to bleeding. No other hemangioma was detected by ultrasonography, abdominal angiography or small bowel series. We report a case of diffuse hemangiomatosis, largely distrubuted in the stomach and colon, but without involvement of skin or other solid organ. The bleeding hemangioma on the ascending colon was treated by endoscopic ligation, and the anemia of the patient was improved.

Endoscopic Hemoclipping in a Terminal Ileal Dieulafoy's Lesion / 대한소화기내시경학회지

Dieulafoy's lesion is an uncommon source of massive gastrointestinal hemorrhage. The lesion predominantly occurs in the proximal stomach, but may occur in all parts of the gastrointestinal tract including small bowel, colon and rectum. We herein report a case of a patient who presented with hematochezia from Dieulafoy's lesion of the terminal ileum with adherent blood clots. Bleeding was successfully controlled with endoscopic treatment by utilizing hemoclipping.

A Case of Endoscopic Treatment of Bleeding in Duodenal Dieulafoy's Lesion / 대한소화기내시경학회지

Dieulafoy's lesions are often unrecognized cause of obscure, massive gastrointestinal bleeding, reported to be 0.3~1.5% of cases of major gastrointestinal bleeding. It is characterized by severe bleeding from rupture of an exposed submucosal artery. Dieulafoy's lesion is usually occured in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction. Similar lesions have also been described in the esophagus, duodenum, small intestine, colon, and rectum. The diagnosis is made by endoscopy, angiography, laparoscopy, or laparotomy. Endoscopy showed protruding and eroded artery with pulsatile bleeding or adherent thrombus. Currently, various therapeutic options are available to the endoscopist for the treatment of Dieulafoy's lesions. Therapeutic endoscopy should now become first-line therapy for Dieulafoy's lesions. We experienced a rare case of bleeding from the duodenal Dieulafoy's lesion. Endoscopic hemoclipping was performed successfully. We report this case with a review of the literature.