• Title/Summary/Keyword: Duodenoscopy

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Endoscopic Management of Ampullary Tumors (십이지장 팽대부 종양의 내시경적 치료)

  • Hwehoon Chung;Jae Keun Park
    • Journal of Digestive Cancer Research
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    • v.11 no.2
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    • pp.93-98
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    • 2023
  • Ampullary tumor is a rare disease whose prevalence rate has increased gradually in recent years with the increase in endoscopic examinations. Ampullary lesions are observed via endoscopy, and biopsy is done to determine whether such lesions are adenomas or carcinomas. Endoscopic papillectomy is performed on ampullary adenomas without intraductal lesions. Before the procedure, bleeding tendencies and pancreatitis are assessed, and the lesion is resected using a high-frequency wave and a thin wire snare. Thereafter, pancreatic duct stent insertion or clipping of the resection site is performed to prevent postprocedural pancreatitis. Although 47-93% of the patients achieve complete endoscopic papillary resection, the recurrence rate is 5-31%. Hence, regular follow-up via endoscopy is required.

A Case of Killian-Jamieson Diverticulum in the Esophagus (건상검진상 발견된 Killian-Jamieson Diverticulum 1예)

  • Seon, Sang Woo;Jung, Jae hyun;Lee, Eunsang;Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.27 no.2
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    • pp.134-137
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    • 2016
  • A Killian-Jamieson diverticulum (KJD) is an unfamillar and unusual cervical esophageal diverticulum. This diverticulum originates on the anterolateral aspect of the esophagus through the Killian-Jamieson's area that is formed between cricopharyngeal muscle and the lateral to longitudinal esophageal muscle. Recently, we experienced a patient who was found outpouching lesion on lateral side of left esophagus on the duodenoscopy. Then, a barium esophagography performed and in left lateral position demonstrated a left-sided diverticulum with a frontal projection, highly suggestive of a KJD. There are two ways of surgical approach to manage the KJD. First is external approach, another one is endoscopic approach. In common, external approach has been recommended for the treatment of KJD because of concern of nerve injury. We present a case of KJD that underwent external approach and sternocleidomastoid muscle flap in the management of KJD.

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A case of strongyloidiasis accompanied by duodenal ulcer (십이지장궤양을 동반한 분선충증 1례)

  • 김성용;김나영
    • Parasites, Hosts and Diseases
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    • v.30 no.3
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    • pp.231-234
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    • 1992
  • A 58-year-old chronic alcoholism patient, who complained of epigastric discomfort, nausea, and frequent loose stool was diagnosed as strongyloidiasis accompanied by duodenal ulcer. The symptoms first appeared two years ago and aggravated during the recent 3 months, and he lost 4 kg of his body weight. Stool examination revealed rhabditoid nematode larvae, which were confirmed as those of Strongyloides stercoralis after cultivation of them to alariform larvae. At duodenoscopy, duodenal ulcer was found. The patient was treated with albendagole (200 mg, bid, for 14 days) for stronglyloidiasis and with colloidal bismuth sulfate(240 mg, bid, for 6 weeks) for duodenal ulcer. After the medication, the symptoms of loose stool and epigastric discomfort were much improved and he was discharged with no clinical problems. This is an interesting case which suggests that S. stercoralis infection could be related with ulceration of the duodenal mucosa.

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Mesenteric Pseudocyst of the Small Bowel in Gastric Cancer Patient: A Case Report

  • Lee, Sang-Eok;Choi, In-Seok;Choi, Won-Jun;Yoon, Dae-Sung;Moon, Ju-Ik;Ra, Yu-Mi;Min, Hyun-Sik;Kim, Yong-Seok;Kim, Sun-Moon;Sohn, Jang-Sihn;Lee, Bong-Soo
    • Journal of Gastric Cancer
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    • v.12 no.1
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    • pp.43-45
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    • 2012
  • Mesenteric pseudocyst is rare. This term is used to describe the abdominal cystic mass, without the origin of abdominal organ. We presented a case of mesenteric pseudocyst of the small bowel in a 70-year-old man. Esophago-gastro-duodenoscopy showed a 3.5 cm sized excavated lesion on the posterior wall of angle. Endocopic biopsy confirmed a histologic diagnosis of the poorly differentiated adenocarcinoma, which includes the signet ring cell component. Abdominal computed tomography scan showed a focal mucosal enhancement in the posterior wall of angle of the stomach, a 2.4 cm sized enhancing mass on the distal small bowel loop, without distant metastases or ascites in rectal shelf, and multiple gallbladder stones. The patient underwent subtotal gastrectomy with gastroduodenostomy, segmental resection of the small bowel, and cholecystectomy. The final pathological diagnosis was mesenteric pseudocyst. This is the first case report describing incidentally detected mesenteric pseudocyst of the small bowel in gastric cancer patients.

Should asymptomatic young men with iron deficiency anemia necessarily undergo endoscopy?

  • Kim, Nam Hee;Park, Jung Ho;Park, Dong Il;Sohn, Chong Il;Choi, Kyuyong;Jung, Yoon Suk
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1084-1092
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    • 2018
  • Background/Aims: There has been no evidence for the necessity of endoscopy in asymptomatic young men with iron deficiency anemia (IDA). To determine whether endoscopy should be recommended in asymptomatic young men with IDA, we compared the prevalence of gastrointestinal (GI) lesions between young men (< 50 years) with IDA and those without IDA. Methods: We conducted a case-control study on asymptomatic young men aged < 50 years who underwent both esophagogastroduodenoscopy (EGD) and colonoscopy as part of a health checkup between 2010 and 2014. Results: Of 77,864 participants, 128 (0.16%) had IDA and 512 subjects without IDA were matched for several variables including age. Young men with IDA had a significantly higher proportion of colorectal cancer (CRC) (0.8% vs. 0.0%, p = 0.045), villous adenoma (0.8% vs. 0.0%, p = 0.045), and inflammatory bowel disease (IBD; 2.3% vs. 0.4%, p = 0.025) than those without IDA. Additionally, the prevalence of advanced colorectal neoplasia (ACRN) tended to be higher in subjects with IDA than in those without IDA (3.1% vs. 1.0%, p = 0.084). The prevalence of significant lower GI lesions including ACRN and IBD was higher in subjects with IDA than in those without IDA (5.5% vs. 1.4%, p = 0.011). Regarding upper GI lesions, a positive association with IDA was observed only for gastric ulcer (4.7% vs. 1.0%, p = 0.011). Conclusions: GI lesions including CRC, villous adenoma, IBD, and gastric ulcer were more common in asymptomatic young men with IDA. Our results suggest that EGD and particularly colonoscopy should be recommended even in asymptomatic young men with IDA.

Automatic Anatomical Classification Model of Esophagogastroduodenoscopy Images Using Deep Convolutional Neural Networks for Guiding Endoscopic Photodocumentation

  • Park, Jung-Whan;Kim, Yoon;Kim, Woo-Jin;Nam, Seung-Joo
    • Journal of the Korea Society of Computer and Information
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    • v.26 no.3
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    • pp.19-28
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    • 2021
  • Esophagogastroduodenoscopy is a method commonly used for early diagnosis of upper gastrointestinal lesions. However, 10-20 percent of the gastric lesions are reported to be missed, due to human error. And countries including the US, the UK, and Japan, the World Endoscopy Organization (WEO) suggested guidelines about essential gastrointestinal parts to take pictures of so that all gastric lesions are observed. In this paper, we propose deep learning techniques for classification of anatomical sites, aiming for the system that informs practitioners whether they successfully did the gastroscopy without blind spots. The proposed model uses pre-processing modules and data augmentation techniques suitable for gastroscopy images. Not only does the experiment result with a maximum F1 score of 99.6%, but it also shows a error rate of less than 4% based on the actual data. Given the performance results, we found the model to be explainable with the potential to be utilized in the clinical area.