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1.
Gut and Liver ; : 46-50, 2018.
Artigo em Inglês | WPRIM | ID: wpr-739941

RESUMO

BACKGROUND/AIMS: The aim of this study was to investigate the effects of rebamipide on tight junction proteins in the esophageal mucosa in a rat model of gastroesophageal reflux disease (GERD). METHODS: GERD was created in rats by tying the proximal stomach. The rats were divided into a control group, a proton pump inhibitor (PPI) group, and a PPI plus rebamipide (PPI+R) group. Pantoprazole (5 mg/kg) was administered intraperitoneally to the PPI and PPI+R groups. An additional dose of rebamipide (100 mg/kg) was administered orally to the PPI+R group. Mucosal erosions, epithelial thickness, and leukocyte infiltration into the esophageal mucosa were measured in isolated esophagi 14 days after the procedure. A Western blot analysis was conducted to measure the expression of claudin-1, -3, and -4. RESULTS: The mean surface area of mucosal erosions, epithelial thickness, and leukocyte infiltration were lower in the PPI group and the PPI+R group than in the control group. Western blot analysis revealed that the expression of claudin-3 and -4 was significantly higher in the PPI+R group than in the control group. CONCLUSIONS: Rebamipide may exert an additive effect in combination with PPI to modify the tight junction proteins of the esophageal mucosa in a rat model of GERD. This treatment might be associated with the relief of GERD symptoms.


Assuntos
Animais , Ratos , Western Blotting , Claudina-1 , Claudina-3 , Refluxo Gastroesofágico , Leucócitos , Modelos Animais , Mucosa , Inibidores da Bomba de Prótons , Bombas de Próton , Prótons , Estômago , Proteínas de Junções Íntimas , Junções Íntimas
2.
Intestinal Research ; : 83-88, 2016.
Artigo em Inglês | WPRIM | ID: wpr-77858

RESUMO

Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%-30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.


Assuntos
Idoso , Feminino , Humanos , Dor Abdominal , Antibacterianos , Clostridioides difficile , Colo , Colonoscópios , Colonoscopia , Diarreia , Disbiose , Enterocolite Pseudomembranosa , Fezes , Seguimentos , Metronidazol , Microbiota , Mortalidade , Infecções Oportunistas , Recidiva , Doadores de Tecidos , Vancomicina
3.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 44-48, 2015.
Artigo em Coreano | WPRIM | ID: wpr-112437

RESUMO

Cytomegalovirus (CMV) is not a rare infection and is frequently observed in immuoncompromised patients. CMV infection is usually asymptomatic in immunocompetent patients however it can be a major cause of morbidity and mortality in immunocompromised patients. The diagnosis of CMV gastric ulcer is not easy because of the absence of characteristic endoscopic features and the difficulty in the identification of infection by routine histologic examinations. We experienced a case of CMV-associated giant gastric ulcer in a patient receiving immunosuppressive therapy. She was a 45-year-old woman with dermatomyositis and had received steroid therapy to control her disease. Epigastric pain developed during therapy and upper endoscopy revealed a gastric ulcer. Despite proton pump inhibitor therapy, her epigastric pain aggravated and follow-up endoscopy revealed a huge gastric ulcer approximately 10 cm in diameter. Histologic findings showed intracellular inclusion bodies after immunostaining which confirmed CMV-associated gastric ulcer. Steroid therapy was discontinued and she received proton pump inhibitors without antiviral agents. Her symptoms improved and follow-up endoscopy revealed successful healing of the CMV-associated gastric ulcer. If an unusual gastric ulcer develops in the immunocompromised patients, CMV gastric ulcer should be suspected and examination for inclusion bodies using CMV immunostaining should be considered.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Antivirais , Citomegalovirus , Dermatomiosite , Diagnóstico , Endoscopia , Seguimentos , Doença de Depósito de Glicogênio Tipo VI , Hospedeiro Imunocomprometido , Imunossupressores , Corpos de Inclusão , Mortalidade , Inibidores da Bomba de Prótons , Bombas de Próton , Esteroides , Úlcera Gástrica
4.
Clinical Endoscopy ; : 101-103, 2014.
Artigo em Inglês | WPRIM | ID: wpr-63800

RESUMO

Esophageal fibrovascular polyps are rare, benign, submucosal tumors of the upper digestive tract that usually have an indolent course until the lesion attains a very large size. The most frequent complaints associated with these tumors include dysphagia and foreign body sensation. However, a long pedunculated polyp can regurgitate into the pharynx or oral cavity and cause asphyxia and sudden death if the larynx is occluded. We describe the case of a 51-year-old man who experienced snoring and occasional asphyxia during sleep. Upper endoscopy was performed, which indicated the presence of a pedunculated esophageal polyp that regurgitated into the vocal cords. The polyp was removed using a polypectomy snare and was confirmed to be a fibrovascular polyp based on pathologic examination findings. Three months after the excision of the polyp, the patient was found to be doing well without any further occurrence of asphyxia or sleep disturbances.


Assuntos
Humanos , Pessoa de Meia-Idade , Asfixia , Morte Súbita , Transtornos de Deglutição , Endoscopia , Esôfago , Corpos Estranhos , Trato Gastrointestinal , Laringe , Boca , Faringe , Pólipos , Sensação , Proteínas SNARE , Ronco , Prega Vocal
5.
Clinical Endoscopy ; : 124-126, 2014.
Artigo em Inglês | WPRIM | ID: wpr-8117

RESUMO

No abstract available.


Assuntos
Neoplasias Esofágicas
6.
Gut and Liver ; : 7-12, 2014.
Artigo em Inglês | WPRIM | ID: wpr-208928

RESUMO

BACKGROUND/AIMS: Flumazenil was administered after the completion of endoscopy under sedation to reduce recovery time and increase patient safety. We evaluated patient satisfaction after endoscopy under sedation according to the timing of a postprocedural flumazenil injection. METHODS: In total, 200 subjects undergoing concurrent colonoscopy and upper endoscopy while sedated with midazolam and meperidine were enrolled in our investigation. We randomly administered 0.3 mg of flumazenil either immediately or 15 minutes after the endoscopic procedure. A postprocedural questionnaire and next day telephone interview were conducted to assess patient satisfaction. RESULTS: Flumazenil injection timing did not affect the time spent in the recovery room when comparing the two groups of patients. However, the subjects in the 15 minutes injection group were more satisfied with undergoing endoscopy under sedation than the patients in the immediate injection group according to the postprocedural survey (p=0.019). However, no difference in overall satisfaction, memory, or willingness to undergo a future endoscopy was observed between the two groups when the telephone survey was conducted on the following day. CONCLUSIONS: This study demonstrated that a delayed flumazenil injection after endoscopic sedation increased patient satisfaction without prolonging recovery time, even though the benefit of the delayed flumazenil injection did not persist into the following day.


Assuntos
Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período de Recuperação da Anestesia , Endoscopia/efeitos adversos , Flumazenil/administração & dosagem , Moduladores GABAérgicos/administração & dosagem , Memória/efeitos dos fármacos , Dor/epidemiologia , Satisfação do Paciente , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
7.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 78-83, 2013.
Artigo em Coreano | WPRIM | ID: wpr-173439

RESUMO

Intestinal metaplasia (IM) is recognized as a precancerous condition for intestinal type gastric cancer. Therefore, endoscopic diagnosis of IM is valuable for patients undergoing surveillance endoscopy. However, there are no standard endoscopic findings that distinguish it from the normal mucosa. Thus, biopsy is normally required to confirm the diagnosis of IM. Recently, the development of high-resolution image technique and some advanced endoscopic technologies such as chromoendoscopy, magnifying endoscopy with narrow band image and confocal laser endomicroscopy has significantly improved the ability to observe mucosal surface and identify IM. Although chromoendoscopy is time consuming, it is a useful method for diagnosis of IM. Narrow band imaging may enhance the accuracy of endoscopic surveillance of IM and dysplasia. Confocal laser endomicroscopy could provide in the real-time identification and classification of IM. Herein, we reviewed the clinical usefulness of white light endoscopy and several new endoscopic methods for the diagnosis of gastric intestinal metaplasia. Also, we will discuss appropriate follow-up period according to IM type and extension.


Assuntos
Humanos , Biópsia , Endoscopia , Seguimentos , Luz , Metaplasia , Azul de Metileno , Microscopia Confocal , Mucosa , Imagem de Banda Estreita , Lesões Pré-Cancerosas , Neoplasias Gástricas
8.
Clinical Endoscopy ; : 54-58, 2013.
Artigo em Inglês | WPRIM | ID: wpr-195031

RESUMO

BACKGROUND/AIMS: Laparoscopic Heller myotomy with antireflux procedure is considered to be a standard treatment for achalasia. Recently, peroral endoscopic myotomy (POEM) was developed and performed on patients with achalasia. However, there is no report on POEM use in South Korea. The aim of this study was to evaluate the technical feasibility of POEM in a porcine model. METHODS: POEM was performed on two mini pigs. We performed upper endoscopy under general anesthesia. A submucosal tunnel was created and the circular muscle layer was incised using several knives. The mucosal entry was closed using resolution clips. We performed a follow-up endoscopy and sacrificed the pigs 2 weeks after the POEM. The myotomy site was evaluated grossly and histologically. RESULTS: POEM was successfully performed on the two mini pigs. No injuries to any abdominal or mediastinal structures occurred. Two weeks after the POEM, the esophageal mucosa healed without any endoscopic evidence of complications. Necropsy revealed that the circular muscle layer was completely lost and replaced with fibrotic tissue. CONCLUSIONS: We found that POEM is a technically feasible method which can be performed on an animal model. However, to ensure safe use on patients with achalasia, further studies on technical methods and long-term follow-up examinations are required.


Assuntos
Animais , Humanos , Anestesia Geral , Sacarose Alimentar , Endoscopia , Acalasia Esofágica , Esôfago , Estudos de Viabilidade , Seguimentos , Modelos Animais , Mucosa , Músculos , República da Coreia , Suínos
9.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 167-172, 2013.
Artigo em Inglês | WPRIM | ID: wpr-30353

RESUMO

BACKGROUND/AIMS: Preoperative diagnosis of peritoneal metastasis is extremely important to select the appropriate treatment strategy and predict the prognosis for patients with gastrointestinal cancer. However, imaging techniques have a limited capacity for detecting peritoneal metastasis. We therefore evaluated the feasibility of percutaneous ultrathin flexible peritoneoscopy in an animal model. MATERIALS AND METHODS: Percutanous ultrathin flexible peritoneoscopy was performed on two mini-pigs under general anesthesia. We punctured the abdominal wall at the anti-Mcburney and umbilical regions using a 16-gauge angiocatheter. Guidewire was inserted through the angiocatheter and we then enlarged the puncture using a biliary dilation catheter and a 6- to 8-mm balloon dilator catheter. After track formation, we inserted a 4.9-mm ultrathin endoscope into the abdominal cavity. The peritoneal cavity was examined, and peritoneal and liver biopsy was performed. The puncture was closed with a single suture. After the procedure, we monitored the general condition of the pigs for 2 weeks. RESULTS: Percutaneous ultrathin flexible peritoneoscopy was successfully performed regardless of the puncture site location. Peritoneal and liver biopsy was also successfully executed. The mean procedure time was 20 minutes. Formation of the abdominal track was not easily accomplished with standard endoscopic equipment. Nevertheless, none of the abdominal organs were injured. The post-procedure course was uneventful. Minor scarring was observed at the incision site 2 weeks after the procedure. CONCLUSIONS: Percutanous ultrathin flexible peritoneoscopy is a relatively simple and technically feasible method. However, dedicated accessories for fascial dilation should be developed to ensure the safety of human patients undergoing this procedure.


Assuntos
Animais , Cavidade Abdominal , Parede Abdominal , Anestesia Geral , Biópsia , Catéteres , Cicatriz , Endoscópios , Estudos de Viabilidade , Neoplasias Gastrointestinais , Laparoscopia , Fígado , Metástase Neoplásica , Cavidade Peritoneal , Peritônio , Prognóstico , Punções , Suturas , Suínos
10.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 276-279, 2012.
Artigo em Inglês | WPRIM | ID: wpr-134387

RESUMO

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Jacarés e Crocodilos , Diagnóstico Precoce , Endoscopia , Corpos Estranhos , Força da Mão , Arcada Osseodentária , Mucosa , Estômago , Instrumentos Cirúrgicos
11.
The Korean Journal of Helicobacter and Upper Gastrointestinal Research ; : 276-279, 2012.
Artigo em Inglês | WPRIM | ID: wpr-134386

RESUMO

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.


Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Jacarés e Crocodilos , Diagnóstico Precoce , Endoscopia , Corpos Estranhos , Força da Mão , Arcada Osseodentária , Mucosa , Estômago , Instrumentos Cirúrgicos
12.
The Korean Journal of Internal Medicine ; : 243-243, 2012.
Artigo em Inglês | WPRIM | ID: wpr-179604
13.
Clinical Endoscopy ; : 440-443, 2012.
Artigo em Inglês | WPRIM | ID: wpr-147463

RESUMO

Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches including enteroscopy have recently been performed for small bowel bleeding. We report two cases of massive ileal Dieulafoy lesion bleeding diagnosed and treated successfully by single balloon enteroscopy with a review of the literature.


Assuntos
Endoscopia , Hemorragia Gastrointestinal , Hemorragia , Íleo , Mucosa
14.
Gut and Liver ; : 503-507, 2010.
Artigo em Inglês | WPRIM | ID: wpr-37197

RESUMO

BACKGROUND/AIMS: Elderly patients with advanced gastric cancer (AGC) have generally been excluded from clinical trials, and there are few data available on the treatment of these patients. The efficacy of palliative S-1 monotherapy as a first-line treatment regimen for elderly patients has not been well elucidated. METHODS: For this study, 25 AGC patients were enrolled between January 1, 2007 and March 31, 2009; 4 cases were recurrent AGC and 21 cases were metastatic AGC at the time of diagnosis. These patients received S-1 therapy at a dose of 40 mg/m2 twice daily for 14 days every 3 weeks. All of the patients were older than 70 years. RESULTS: The median follow-up duration, the median progression-free survival, and the overall survival time were 8.7 months (range, 4.9 to 12.5 months), 4.9 months (range, 3.5 to 6.3 months), and 10.8 months (range, 6.6 to 15.0 months), respectively. Grade 3/4 nonhematologic toxicities were rare. Grade 3/4 neutropenia was noted in two patients. The partial response rate was 21.7% and stable disease was observed in 34.8% of the patients. Two patients (8%) died due to chemotherapy-associated toxicity during treatment (septic shock/intracranial hemorrhage). CONCLUSIONS: Oral S-1 chemotherapy seems to be effective as a first-line treatment regimen for elderly patients with metastatic or recurrent AGC. However, elderly patients receiving S-1 treatment should undergo continuous toxicity monitoring, since they are highly susceptible to adverse effects.


Assuntos
Idoso , Humanos , Intervalo Livre de Doença , Seguimentos , Neutropenia , Neoplasias Gástricas
15.
The Korean Journal of Internal Medicine ; : 239-245, 2010.
Artigo em Inglês | WPRIM | ID: wpr-86079

RESUMO

BACKGROUND/AIMS: Endoscopic papillary balloon dilation (EPBD) is a safe and effective method for the treatment of choledocholithiasis, but previous studies have rarely reported the appropriate ballooning time (BT). We prospectively evaluated the safety and efficacy of EPBD according to BT in patients undergoing bile duct stone removal. METHODS: Seventy consecutive patients with bile duct stones were randomly assigned to receive EPBD with either conventional (n = 35, 60 seconds) or short (n = 35, 20 seconds) BT. RESULTS: EPBD alone achieved complete bile duct clearance in 67 patients (long BT, n = 33, 94.3%; short BT, n = 34, 97.1%; p = 0.808). We also found no significant difference in the rate of complete duct clearance, including procedures that used mechanical lithotripsy, between the long and short BT groups (97.1% vs. 100%; p = 0.811). Mild pancreatitis was noted in four (11.4%) patients in the long BT group and two (5.7%) patients in the short BT group, but this incidence was not significantly different. CONCLUSIONS: The study showed that EPBD using both 20-sec and 60-sec BTs is safe and effective for the treatment of bile duct stones. Short and long BTs produced comparable outcomes.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , /efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica , Coledocolitíase/diagnóstico por imagem , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento
16.
Gut and Liver ; : 122-125, 2010.
Artigo em Inglês | WPRIM | ID: wpr-190612

RESUMO

Large-cell neuroendocrine carcinoma of the colon is a rare entity with a prognosis that is usually poor due to the high likelihood of early metastasis. A 61-year-old man had surgery for colon cancer of the transverse colon and cecum. Microscopic examination of the tumor showed that the location was the proximal transverse colon, with small nests containing rosettes and palisading patterns of large tumor cells with faintly granular cytoplasm. The immunohistochemistry was positive for synaptophysin and chromogranins. The tumors were diagnosed as a large-cell neuroendocrine carcinoma of the colon. In addition, the tumor of the cecum showed microscopic findings consistent with a well-differentiated adenocarcinoma. The immunohistochemical panel showed that the tumor was negative for neuroendocrine markers. There were no clinical findings suggestive of hormone hypersecretion. Cancer metastasis was found in the peritoneum section of the small bowel. Postoperative chemotherapy was applied. The patient was alive with good performance after, and there was no sign of tumor progression. This is the first case of a synchronous large-cell neuroendocrine carcinoma and adenocarcinoma of the colon. The patient was treated successfully with debulking surgery and systemic chemotherapy.


Assuntos
Humanos , Pessoa de Meia-Idade , Adenocarcinoma , Carcinoma Neuroendócrino , Ceco , Cromograninas , Colo , Colo Transverso , Neoplasias do Colo , Citoplasma , Imuno-Histoquímica , Metástase Neoplásica , Neoplasias Primárias Múltiplas , Peritônio , Prognóstico , Sinaptofisina
17.
Gut and Liver ; : 60-67, 2010.
Artigo em Inglês | WPRIM | ID: wpr-152059

RESUMO

BACKGROUND/AIMS: Bacterial infection is accepted as a precipitating factor in cholesterol gallstone formation, and recent studies have revealed the presence of Helicobacter species in the hepatobiliary system. We utilized the polymerase chain reaction (PCR) to establish the presence of bacterial DNA, including from Helicobacter species, in gallstones, bile juice, and gallbladder mucosa from patients with gallstones. METHODS: At cholecystectomy, 58 gallstones, 48 bile samples, and 46 gallbladder mucosa specimens were obtained and subjected to nested PCR using specific 16S rRNA primers of H. pylori and other bacteria. Bacterial species were identified by DNA sequencing analysis. Bacterial 16S rRNA was detected in 25 out of 36 mixed-cholesterol gallstones, 1 out of 10 pure-cholesterol gallstones, and 9 out of 12 pigmented stones. Furthermore, 16S rDNA sequencing identified Escherichia coli, Pseudomonas, Citrobacter, Klebsiella, and Helicobacter species. RESULTS: Helicobacter DNA was detected in 4 out of 58 gallstones, 6 out of 48 bile samples, and 5 out of 46 gallbladder specimens. Direct sequencing of Helicobacter amplicons confirmed strains of H. pylori in all four gallstones, five out of six bile samples, and three out of five gallbladder specimens. Almost all mixed-cholesterol gallstones appear to harbor bacterial DNA, predominantly E. coli. CONCLUSIONS: H. pylori was also found in the biliary system, suggesting that these bacteria are of etiological importance in gallstone formation.


Assuntos
Humanos , Bactérias , Infecções Bacterianas , Bile , Sistema Biliar , Colecistectomia , Colecistite , Colesterol , Citrobacter , DNA , DNA Bacteriano , DNA Ribossômico , Escherichia coli , Vesícula Biliar , Cálculos Biliares , Helicobacter , Helicobacter pylori , Klebsiella , Mucosa , Reação em Cadeia da Polimerase , Fatores Desencadeantes , Pseudomonas , Análise de Sequência de DNA
18.
Korean Journal of Gastrointestinal Endoscopy ; : 116-120, 2009.
Artigo em Coreano | WPRIM | ID: wpr-81628

RESUMO

The incidence of retroperitoneal abscess with fistula formation after acute pancreatitis is rare, but the mortality rate for patients with this condition is very high. The standard treatment for this condition has been surgical removal and drainage. However, recent studies have shown that percutaneous catheter drainage or noninvasive endoscopic abscess drainage with using endoscopic ultrasonography is effective and safe for the treatment of pancreatic and peripancreatic abscess. A retroperitoneal abscess with duodenal fistula that developed after acute pancreas and its endoscopic treatment has never been reported on in Korea. We experienced a 45-year-old man who had been treated for acute pancreatitis at other hospital, and he was then referred to our hospital and diagnosed as having a retroperitoneal abscess with fistula, which communicated with the third portion of duodenum, as assessed by abdominal CT and duodenoscopy. So we treated him with endoscopic double-pigtailed stent insertion through the fistulous tract and we drained the abscess. Endoscopic drainage may be a suitable alternative for the management of the retroperitoneal abscess with fistula that develops after acute pancreatitis.


Assuntos
Humanos , Pessoa de Meia-Idade , Abscesso , Catéteres , Drenagem , Duodenoscopia , Duodeno , Endossonografia , Fístula , Incidência , Coreia (Geográfico) , Pâncreas , Pancreatite , Stents
19.
The Korean Journal of Gastroenterology ; : 46-49, 2009.
Artigo em Coreano | WPRIM | ID: wpr-102222

RESUMO

Neuroendocrine carcinoma of the colon can be classified into small cell carcinoma and large cell neuroendocrine carcinoma. The incidence of neuroendocrine carcinoma is so low that the guideline for the treatment of large cell neuroendocrine carcinoma of the colon are not established. The prognosis of large cell neuroendocrine carcinoma of the colon is worse than that of conventional adenocarcinoma of the colon. We report a case of large cell neuroendocrine carcinoma of the colon that treated with right hemicolectomy and 6th sequential combination chemotherapy of 5-fluorouracil and cisplatin. There has been no evidence of the recurrence or metastasis of tumor for 6 months.


Assuntos
Adulto , Humanos , Masculino , Carcinoma de Células Grandes/diagnóstico , Carcinoma Neuroendócrino/diagnóstico , Neoplasias do Colo/diagnóstico , Colonoscopia , Tomografia Computadorizada por Raios X
20.
The Korean Journal of Gastroenterology ; : 15-22, 2009.
Artigo em Coreano | WPRIM | ID: wpr-17499

RESUMO

BACKGROUND/AIMS: This study was designed to compare the survival rates between patients with localized esophgeal cancer who were treated with concurrent chemoradiation therapy without surgery and patients who were treated with concurrent chemoradiation therapy including surgery. METHODS: Eighty-eight patients from January 1997 to December 2005 with locally advaned resectable esophageal cancer were selected and retrospectively analyzed. Survival period was defined as the time to death from the date of diagnosis or mid-monitor period of December 2005. Sixty-one patients were treated with chemoradiation therapy alone while twenty-seven patients were treated with chemoradiation therapy in addition to surgery as for curative intention. As for radiation therapy, 5,000-5,500 cGY was used. 5-Fluouracil and cisplatin were used for chemotherapy. The primary end point was overall survival time. The secondary end point was overall progression free survival time. RESULTS: There was no significant difference in tissue type, location and clinical staging, but the median age was significantly younger in the group treated with surgery (63.4 years) than the group treated without surgery (68.8 years). Median period analyzed was 17.3 months. Five year survival rate for the group with chemoradiation alone was 7.4% and 4% for the group with surgery. The median survival rate was 11+/-3 months for the group with chemoradiation alone and 10+/-6 months for the group with surgery, in which there was no statistical difference (p=0.697). CONCLUSIONS: There was no significant increase in survival rate in patients who were treated by chemoradiation with surgery compared with chemoradiation alone. Further analysis in terms of prospective study is needed.


Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Antineoplásicos/uso terapêutico , Terapia Combinada , Interpretação Estatística de Dados , Neoplasias Esofágicas/radioterapia , Estadiamento de Neoplasias , Taxa de Sobrevida
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