Weiss Syndrome by 0-ring Band Ligation / 대한소화기내시경학회지

BACKGROUND/AIMS: Mallory-Weiss syndrome refers to a laceration or lacerations in the region of the gastroesophageal junction due to vomiting, retching, or coughing induced by several causes, and preceding hematemesis. In the last several years, endoscopic therapies have dramatically changed the need for emergency surgery in patients with upper gastrointestinal bleeding. There is only little information however, regarding the indication criteria and the efficacy of endoscopic therapies in severe upper gastrointestinal bleeding, due to Mallory-Weiss syndrome. This study was designed to assess the usefulness and the indications of endoscopic O-ring band ligation. METHODS: Thirty patients with Mallory- Weiss syndrome who were experiencing a related hemorrhage were studied. Among these, 5 patients with active bleeding or a visible vessel revealed during an endoscopic examination were treated with O-ring band ligation. Patients with blood clots or linear tears received only conservative treatment.

Silicone - Covered Self - Expandable Metal Stents for the Palliation of Malignant Esophageal Obstruction and Esophagorespiratory Fistulas / 대한소화기내시경학회지

BACKGROUND: Esophageal cancer can induce progressive dysphagia and occasionally develop esophagorespiratory fistulas. Surgically incurable disease is present in over 60% of patients at the time of presentation and in such a means, relief of dysphagia is one of the important treatment modes in the majority of these patients. Implantation of stents is widely used for improvement of dysphagia and sealing of esophagorespiratary fistulas. METHODS: Silicone-covered self-expandable metal stents were used in 19 consecutive patients with malignant esophageal obstruction (n=14) or esophageal obstruction with esophagorespiratory fistulas (n=5). RESULTS: The stents were successfully inserted in all patients. Dysphagia improved in 18 of 19 patients (95%). All fistulas were sealed and symptoms due to bronchial aspiration disappeared. Complications occurred during follow-up including chest pain (11 patients), aspiration pneumonia (4 patients), reflux esophagitis (2 patients), stent migration (2 patients), tumor overgrowth (2 patients) and hemorrhage (1 patient). Three of the 4 patients with aspirtion pneumonias and a patient with hemorrhage suffered from dysfunction of upper esophageal sphincter after implantation of stents in upper esophageal carcinoma. But, Tumor ingrowth and perforation did not occur. Two patients died of massive hemorrhage and respiratory failure caused by aspiration pneumonia. CONCLUSION: These results suggest that implantation of silicone-covered self-expandable metal stents is a rapid and effective procedure for the palliative treatment of malignant esophageal obstruction and esophagorespiratory fistulas.

6 Cases of Acute Anisakiasis / 대한소화기내시경학회지

Anisakiasis is an accidental infection of human by larvae of marine mammals. It occurs when human ingest a raw or inadequately cooked saltwafer fish and squid infected with anisakis. The clinical symptoms are cramping abdominal pain, nausea, vomiting, diarrhea, tarry stool, and epigastric fulling sensation. We experienced six cases of acute gastric Anisakiasis and one case of duodenal Anisakiasis and all patients had a history of ingestion of raw sea fish and squid as "sashimi". Immediate endoscopic examination showed the whitish linear worm on stomach or doudenal bulb. Clinical symptoms was improved after removal by biopsy forcep. It is emphasized that endoscopic extraction of larva is the best procedure in manage of gastric or duodenal Anisakiasis.

Correlation of Endoscopic Redness with Histological Findings in Superficial Gastritis / 대한소화기내시경학회지

Superficial gastritis has been classified as a type of chronic gastritis, since a report of Schindler in GASTRLTIS, 1947. Howev~er, Benedict reported that superficial gastritis is only acute gastritis or shows normal mucosa histologically. The com mon endopical findings of chronic superficial gastritis were adherent mucus, edema, redness. The common redness which were encounterd are patchy redness and comb-like redness(Kammrotung). We studied the relationship between the redness of superficial gastritis and acute inflammatory changes histologically. Each case of superfieial gastritis was biopsied to redening and non-redening mucosa respectively. We collected 24 cases with 48 biopsy specimens. The results are as follows: Acute inflammatory changes were found only one case in redness and none in non-redness groups. There was no difference in acute inflammatory changes in two groups. The degree of mucosal atrophy were 62.5%, 66.7% in normal mucosa, 12.5%, 16.7~% in mild atrophy, 25%, 12.5% in moderate atrophy, 0%, 4.l% in severe atrophy with respect to redness and non-redness mucosa respectively. There was no difference in degree of mucosal atrophy in two groups. Mucosal atrophies were higher in older ages above 41 years old than below 40 and with increasing age, there was increasing tendency of mucosal atrophy. In conclusion, There was no relationships between mucosal redness and acute in flammatory changes histologically and also between mucosal redness and degree of atrophy.