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정지윤 ( Ji Yun Jung ),김준성 ( Joon Sung Kim ),김병욱 ( Byung Wook Kim ),박성민 ( Sung Min Park ),김기준 ( Gi Jun Kim ),류승지 ( Seung Ji Ryu ),김영욱 ( Young Wook Kim ),지정선 ( Jeong Seon Ji ),최황 ( Hwang Choi ) 대한소화기학회 2016 대한소화기학회지 Vol.67 No.3
Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is a widely accepted and well established procedure because of its curative potential and low invasiveness compared with surgery. Perforation is a potential major complication during ESD, and non-surgical treatments such as endoscopic closure with clips are sufficient in most cases. Here, we report a case of perigastric abscess that occurred as a complication of ESD for EGC. The patient improved with administration of antibiotics without surgical intervention. (Korean J Gastroenterol 2016;67:142-145)
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김영욱 ( Young Wook Kim ),최황 ( Hwang Choi ),김기준 ( Gi Jun Kim ),류승지 ( Seung Jee Ryu ),박성민 ( Sung Min Park ),김준성 ( Joon Sung Kim ),지정선 ( Jeong Seon Ji ),김병욱 ( Byung Wook Kim ),이보인 ( Bo In Lee ),최명규 ( Myung 대한소화기학회 2016 대한소화기학회지 Vol.67 No.2
목적: 혈변 환자 평가를 위해 대장내시경이 꼭 시행되어야 하는 것이 아님에도 불구하고, 일반적으로 국내에서 의사들은 혈변을 주소로 내원한 환자들에게 대장내시경을 권고하고 있다. 이번 연구는 혈변 평가를 위해 시행된 대장내시경의 진단적 가치를 확인하고자 하였다. 대상 및 방법: 총 321명의 혈변 환자를 대상으로 후향적으로 대장내시경 결과를 검토하였다. 결과: 치핵이 가장 흔한 진단이었고(217예, 67.6%) 선종은 그다음으로 흔한 발견 병소였다(93예, 29.0%). 악성 종양(18예, 5.6%)은 모두 구불결장 이하 범위에서 확인되었다. 결장염 및 직장염, 급성 치열, 직장 유암종, 숙변 궤양 등은 임상적 추정 및 구불결장경에 의한 진단이 가능하며, 정확한 진단을 위한 대장내시경의 추가적 이득은 없었다. 결론: 대장내시경이 유발하는 부작용 및 비용을 고려할 때 혈변 평가에 있어 구불결장경 이상의 이득은 제한적이다. 그러므로 혈변 평가에 있어 우선 구불결장경을 고려하여야 한다. Background/Aims: Although colonoscopy is not indicated in patients with hematochezia, many surgeons, internists, and physicians are recommending colonoscopy for these patients in Korea. The aim of this study is to evaluate the diagnostic value of colonoscopy for patients with hematochezia. Methods: We retrospectively reviewed the data of colonoscopy between January 2010 and December 2010. A total of 321 patients among 3,038 colonoscopies (10.6%) underwent colonoscopy to evaluate the cause of hematochezia. The patients with previous colorectal surgery (2) or polypectomy (5) were excluded. We analyzed endoscopic diagnoses. Advanced neoplastic polyps were defined as adenomas with villous histology or high grade dysplasia, or adenomas more than 10 mm in diameter. Results: Hemorrhoid was the most common diagnosis (217 cases, 67.6%). Polyps were detected in 93 patients (29.0%), but advanced neoplastic polyps were found in only 14 cases (4.4%). Colorectal cancers were diagnosed in 18 patients (5.6%) including 14 rectal cancers. There was no cancer located above sigmoid-descending junction. Diverticuli were detected in 41 patients (12.8%) but there was only one case of suspected diverticular bleeding. Colitis was diagnosed in 24 patients (7.5%). Other lesions included acute anal fissure, rectal tumor, stercoral ulcer, and radiation proctitis. Conclusions: The colonoscopy had little value in patients with hematochezia because the most pathologic lesions were located below sigmoid colon. The first choice of diagnosis in patients with hematochezia is sigmoidoscopy.
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