A Case of a Bleeding Duodenal Diverticulum by a Dieulafoy-like Lesion / 대한소화기내시경학회지

Duodenal diverticula are first reported by Chomel in 1710. Duodenal diverticula are relatively common in adults with a prevalence of 23% in ERCP. The most duodenal diverticulum is asymptomatic. Complications such as obstruction, cholangitis, biliary stones, ulceration, perforation and hemorrhage can occur in approximately 10%. However, relatively few cases of bleeding from a duodenal diverticulum have been reported. The cause of bleeding from a duodenal diverticulum is uncertain and various suspected etiologies were suggested, such as ectopic gastric mucosa, stasis-induced ulceration, erosion into major vessels, aortoenteric fistulas, intradiverticular polyp, aspirin-induced erosion. We report a case of a bleeding duodenal diverticulum by a Dieulafoy-like lesion and suggest this lesion as one of possible causes of bleeding in duodenal diverticulum.

A Case of the Duodenal Tuberculosis Presenting as Hematemesis / 대한소화기내시경학회지

Despite the modern advance in effective chemotherapy, gastrointestinal tuberculosis is considered to be relatively frequent in developing countries. The ileocecal region is the most common site of intestinal tuberculosis and duodenal involvement is rare. The isolated duodenal tuberculosis are reported 9 cases in Korea. The symptoms and signs of gastrointestinal tuberculosis are nonspecific and vague. In the absence of pulmonary tuberculosis, the diagnosis may be difficult. Pain and vomiting are common symptoms of duodenal tuberculosis. Patients may present with upper gastrointestinal bleeding. Therefore, tuberculosis should be considered in the differential diagnosis of gastrointestinal bleeding. We herein report a case of duodenal tuberculosis presenting as hematemesis and necessitating hospitalization. After anti-tuberculosis therapy, we have confirmed the healing of the lesion by the follow-up endoscopy, and review the current literature.

A Case of Acute Phlegmonous Esophagitis / 대한소화기내시경학회지

Phlegmonous esophagitis is an uncommon disease characterized by purulent infection of the esophageal wall, sparing the mucosa. Bacterial infection of the eosphagus is usually presented as a superimposed infection upon a preexisting viral or fungal esophagitis and most victims are immunocompromised hosts. A case was experienced involving an acute phlegmonous esophagitis in an 21-year-old man who was immunologically normal and whose main symptoms were epigastric pain and fever for one day. Esophagographic examination revealed a large ulceration of the eosphagus with exudation, and submucosal lesions. Due to its rarity, this case is herein reported with a review of the corresponding literature.

A Case of Rectal Carcinoid Tumor / 대한소화기내시경학회지

Carcinoid is a tumor that primarily affects the intestinal tract, which arises from entero-chromaffin cells. Rectal carcinoid tumor is a relatively rare neoplasm originated in Kul-chitszky cell and clinicians have the difficulties in predicting their malignant potential and in proper treatment. These cells are found to increase in the distal small intestine, are common in the appendix, and then decrease within the mucosa of the colon from cecum to rectum. In the cumulative world literature, the incidence of carcinoids of rectum is slightly higher than 10 percent. All of these tumors are within reach of the rigid procto-sigmoidoscope, most being located between 4 and 13 cm from the anal verge. Eighty five percent are found on the anterior and lateral walls. The tumors are usually submucosal and light yellowish or reddish color. The vast majority of rectal carcinoid tumors are be-nign, which can be treated by local excision safely. Lesions larger than 2 cm and invading the muscular wall of the rectum should be considered malignant, which are treated by more radical surgery such as abdominoperitoneal resection. We experienced a case of rectal carcinoid tumor, which was excised by endoscopic polypectomy, so we present this case with a review of relevant literatures.