Usefulness of Gastroscope in Patients with Incomplete Colonoscopy

BACKGROUND/AIMS: Conventional colonoscopy is limited in some patients with several causes, such as fixed angulation, extensive loop or adhesion. Therefore, small-caliber scopes are considered alternatives to unsuccessful conventional colonoscopy. The aim of this study is to evaluate the usefulness of gastroscope in patients with unsuccessful colonoscopy. METHODS: From May 2008 to April 2009, a total of 2,548 colonoscopies were performed in Wonkwang University Hospital. The gastroscope was used subsequently when conventional colonoscopy failed. RESULTS: There were 27 cases (1.06%) of unsuccessful colonoscopy. The causes of failure were assessed as fixed angulation of the sigmoid colon (59.2%, 16/27), excessive looping (14.8%, 4/27), stricture (14.8%, 4/27), sigmoid diverticulosis (7.4%, 2/27), and adhesion of transverse colon (3.7%, 1/27). The average time of intubation to cecum with the gastroscope was 7 minutes and 28 seconds (range, 2 to 20 minutes). With the gastroscope, 77.8% (21/27) were intubated to the cecum. The pain score of gastroscope was reduced, as compared with that of conventional colonoscopy (4.95 vs. 5.94, P<0.001). CONCLUSIONS: Gastroscope would be a useful alternative tool in patients with unsuccessful colonoscopy.

A Case of Angiosarcoma in Rectum

Angiosarcoma is a malignant vascular neoplasm that usually involves the skin or soft tissues. A primary rectal angiosarcoma is exceedingly rare. A 77-year-old female was admitted to the hospital for evaluation of constipation and hematochezia. The patient had a history of uterine cervix carcinoma which was treated with surgery and radiation therapy. A colonoscopy revealed a friable, ulceroinfiltrative tumor with multiple hyperemic mucosae in the rectum. Microscopically, the tumor exhibited vasoformative growth with nuclear atypism and numerous mitoses. The tumor cells were strongly positive for CD31, CD34, and Factor VIII. We report a case of rectal angiosarcoma that developed after radiation therapy.

A Case of Angiosarcoma in Rectum

Angiosarcoma is a malignant vascular neoplasm that usually involves the skin or soft tissues. A primary rectal angiosarcoma is exceedingly rare. A 77-year-old female was admitted to the hospital for evaluation of constipation and hematochezia. The patient had a history of uterine cervix carcinoma which was treated with surgery and radiation therapy. A colonoscopy revealed a friable, ulceroinfiltrative tumor with multiple hyperemic mucosae in the rectum. Microscopically, the tumor exhibited vasoformative growth with nuclear atypism and numerous mitoses. The tumor cells were strongly positive for CD31, CD34, and Factor VIII. We report a case of rectal angiosarcoma that developed after radiation therapy.