Intestinal Research

Choong Kee Park

9 Articles

A Case of Perforated Gastrointestinal Stromal Tumor in the Jejunum as a Rare Cause of Acute Abdomen: Seong Yeol Kim, Jong Hyeok Kim, Dong Seon Park, Gil Su Jang, Eun Yeong Hong, Jung Sun An, So Yeon Kim, Ho Young Kim, Dong Hoon Kim, Ji Won Park, Il Hyun Baek, Choong Kee Park; Intest Res 2013;11(2):134-136. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.134

Preoperative diagnosis of Gastrointestinal Stromal Tumors (GISTs) in the small intestine is often delayed until complications such as hemorrhage, bowel obstruction or perforation develop. Such GISTs are usually asymptomatic and tumor perforation is an uncommon clinical presentation. In this report, we review the diagnosis, pathology and treatment of a 32-year-old male with a perforated GIST in the jejunum who presented with symptoms of acute abdomen. Abdominal computed tomography (CT) showed a ruptured huge tumor with inhomogeneous density in the small intestine. The patient underwent a complete tumor excision and jejunal segmental resection. A histopathological examination of the tumor confirmed that it was a GIST. Postoperatively, the patient received medical treatment, using oral Imatinib 400 mg daily for 10 months without any signs of disease recurrence. Prognosis is worse in ruptured GISTs and in these cases, complete surgical resection of the tumor must be followed by adjuvant therapy with Imatinib. (Intest Res 2013;11:134-136)

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Prognostic Significance of Ki-67 Expression in Patients Undergoing Surgical Resection for Gastrointestinal Stromal Tumor
Seong Yeon Jeong, Won Wo Park, You Sun Kim, Young Il Park, Seung Hyup Kim, Won Jae Yoon, Jeong Seop Moon, Byung Mo Lee, Seong Woo Hong, Yun Kyung Kang
The Korean Journal of Gastroenterology.2014; 64(2): 87. CrossRef

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A Case of Acute Colonic Diverticulitis as a Complication of Colonoscopy: Dong Seon Park, Ji Won Park, Seong Yeol Kim, Gil Su Jang, Eun Yeong Hong, Jung Sun An, So Yeon Kim, Il Hyun Baek, Jong Hyeok Kim, Choong Kee Park; Intest Res 2013;11(2):146-148. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.146

Abstract PDF

Colonoscopy is a good diagnostic tool and facilitates treatment of various colonic diseases. Nevertheless, it can induce many serious complications such as perforation and hemorrhage. Diverticulitis has also been reported as a serious complication of colonoscopy, with an incidence ranging from 0.04% to 0.08%. A 44-year-old male with chronic hepatitis B was presented with general weakness, myalgia, and febrile sensation. After admission for evaluation, pneumonia detected in the left upper and lower lobe and treated. We performed colonoscopy for screening and found multiple colonic diverticula in the right side of the colon. After 48 hours, the patient complained of abdominal pain and febrile sensation. Physical examination revealed tenderness in the right side of the abdomen. Abdomen-pelvis computed tomography showed bowel wall thickening of the cecum and ascending colon and multiple inflamed diverticula at the cecum with pericolic fat infiltration and fluid collection. We diagnosed the patient with acute diverticulitis after colonoscopy. Thereafter, he was treated with bowel rest and broad-spectrum intravenous antibiotics, and recovered. With a review of the relevant literature, we report a case of acute colonic diverticulitis as a complication of colonoscopy. (Intest Res 2013;11:146-148)

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Postcolonoscopy Diverticulitis
Mahmoud E. Essam, Iosif Beintaris, Matthew D. Rutter
ACG Case Reports Journal.2024; 11(5): e01362. CrossRef
Post-colonoscopy diverticulitis: A systematic review
Zi Qin Ng, Jih Huei Tan, Henry Chor Lip Tan, Mary Theophilus
World Journal of Gastrointestinal Endoscopy.2021; 13(3): 82. CrossRef
Diverticular Bleeding: A Clinical Image
Christopher F Brewer, Yayha Al Abed
Cureus.2021;[Epub] CrossRef
Colonoscopy-Induced Acute Diverticulitis
Se Ryeong Park, Young Seok Bae, Jong Ik Park, Jun Sik Min, Yong Kim
Journal of the Korean Geriatrics Society.2016; 20(2): 108. CrossRef

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A Clinical Review of the Intussusception in Adult: Su Jin Kim, Cheol Hee Park, Yong Min Kim, Seong Yeol Kim, Seung Yeon Chun, Chin Woo Kwon, Ji Won Park, Kyoung Oh Kim, Il Hyun Baek, Kyo Sang Yoo, Jong Hyeok Kim, Choong Kee Park; Intest Res 2012;10(2):183-188. Published online April 30, 2012; DOI: https://doi.org/10.5217/ir.2012.10.2.183

Abstract PDF

Background/Aims
Intussusception is uncommon in adults compared with children. The present study aimed to review our experience of adult intussusceptions and discuss the preoperative diagnosis and management. Methods: A retrospective review was performed for 25 patients, at least 18 years old. These patients were diagnosed as intestinal intussusceptions at Hallym University Sacred Heart Hospital from January 1999 to October 2010. Results: There were 14 male and 11 female with a mean age of 55 years. The most common symptom was abdominal pain. The preoperative diagnostic rate was 92% because of the use of an abdominal computed tomography (CT) and an ultrasound. A total of 9 (36%) patients had enteroenteric intussusception, 8 had ileocolic, 1 had ileocecal and 7 patients had colocolic intussusception. A discrete pathologic process was present in 22 (88%) patients and the remaining 3 (12%) patients were idiopathic. There were 12 small bowel lesions and 10 colonic lesions. Neoplasms were the most common etiology of intussusceptions. Of the cases with a defined colonic cause, 8 (80%) were malignant. Overall, 12 (48%) patients underwent primary resection of the intussusception without prior reduction, 11 (44%) patients had reduction of their intussusception followed by resection. Conclusions: Adult colonic intussusception is usually associated with malignancy. All patients with obstruction of unknown cause or lead point on CT should consider surgical exploration. (Intest Res 2012;10: 0-188)

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Adult intussusception caused by inverted Meckel's diverticulum treated with operation
Sung Yun Lee, Jae Yoon Jeong, Seung Hyun Hong, Seung Min Woo, Su Heui Lee, Hyun Joo You, Dong Won Kim
Yeungnam University Journal of Medicine.2016; 33(2): 116. CrossRef
Conservative Management of Adult Small Bowel Intussusception Detected at Abdominal Computed Tomography
Ju Sun Kim, Jae Hoon Lim, Jin Ho Jeong, Wan Sung Kim
The Korean Journal of Gastroenterology.2015; 65(5): 291. CrossRef
Adult intussusceptions: preoperative predictive factors for malignant lead point
Kil Hwan Kim, Hwan Namgung, Dong Guk Park
Annals of Surgical Treatment and Research.2014; 86(5): 244. CrossRef
A Case of Small Bowel Intussusception Caused by Jejunal Hamartoma Confused as Hepatitis A in an Adult
Joon Hur, Gu-Min Cho, Young Ook Eum, Ji Young Park, Mi Sung Kim, Byung Seong Ko, Hyang Mi Shin, Seung-Myoung Son
Yeungnam University Journal of Medicine.2012; 29(2): 110. CrossRef

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A Case of Henoch-Schönlein Purpura with Suspicious Focal Bowel Necrosis in an Adult: Su Jin Kim, Cheol Hee Park, So Yeon Kim, In Joung Lee, Chul Min Park, Chang Beom Cho, Jin Woo Kwon, Ji Won Park, Kyung Rim Huh, Kyoung Oh Kim, Il Hyun Baek, Kyo Sang Yoo, Jong Hyeok Kim, Choong Kee Park; Intest Res 2011;9(2):148-152. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.148

Abstract PDF: Henoch-Schönlein purpura (HSP) is a vasculitis of the small vessels of the skin, joints, gastrointestinal tract, and kidneys characterized by immunoglobulin A deposits in the involved organs. HSP is typified by the classic tetrad of purpura, arthralgia, abdominal pain, and renal involvement. It is common in childhood, but may also occur in adults and can be accompanied by severe complications. Gastrointestinal symptoms occur in up to 85% of patients, and gastrointestinal involvement can manifest as severe problems including intussusception, obstruction, and perforation. The disease course is often self-limited, but severe manifestations occasionally require surgical intervention. We report the case of a 24-year-old man with HSP who presented with abdominal pain and vomiting. Computerized tomography revealed thickening of the ileal wall and multifocal disrupted prominent mucosal enhancement. These findings suggested hemorrhagic enteritis and mucosal necrosis. After treatment with high dose corticosteroids, the lesion improved and surgical intervention was avoided. Our experience suggests that corticosteroid therapy may help in controlling HSP with suspicious small bowel necrosis. (Intest Res 2011;9:148-152)

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The Efficacy of Propofol Alone versus Midazolam Plus Propofol for Colonoscopy: Cheol Hee Park, Soung Hoon Chang, Jae One Jung, Joon Ho Moon, Woon Geon Shin, Jong Pyo Kim, Kyung Oh Kim, Taeho Hahn, Kyo-Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Choong Kee Park; Intest Res 2006;4(2):87-94. Published online December 30, 2006

Abstract PDF: Background/Aims
Recent studies showed that propofol and midazolam act synergistically in combination and therefore it may be superior to sedation with propofol alone in terms of sedating efficacy. We compared the effect of propofol alone and combined use of propofol and midazolam during colonoscopy. Methods: P (propofol alone) group received propofol (2-2.5 ml/kg/hr) plus normal saline (3 ml) and MP (propofol/midazolam) group received propofol (2-2.5 ml/kg/hr) plus midazolam (3 mg). We compared followings in both groups; 1) induction and total propofol dosage 2) induction and procedure time 3) recovery time 4) satisfaction of patients and doctors 5) adverse effects. Results: Induction (9 vs. 12 ml) and total (17 vs. 22 ml) propofol dosage were lower in MP group than P group (p＜0.05). Induction (3.6 vs. 5.5 min) time was shorter in MP group than P group (p＜0.05). In both groups, significant difference was not observed in the change of blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate. Fatal adverse effect was not found in both groups. Conclusions: Combined use of propofol and midazolam is more effective sedative method than the use of propofol alone because of rapid induction and lower propofol dosage without increasing adverse effects. (Intestinal Research 2006;4:87-94)

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Risk Factor of Ischemic Colitis and Usefulness of High-Resolution Ultrasonography: Woon Geon Shin, Cheol Hee Park, Jae One Jung, Joon Ho Moon, Kyoung Oh Kim, Yong Woo Chung, Gwang Ho Baek, Taeho Hahn, Kyo-Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Sea Hyub Kae, Kwan Seop Lee, Choong Kee Park; Intest Res 2006;4(1):32-38. Published online June 30, 2006

Abstract PDF: Background/Aims
Although the majority of ischemic colitis have excellent prognosis by supportive management, there are a lot of controversies in relation to the prognostic factors. Lately, role of sonography has been emphasized in colonic ischemia. The aim of this study is the identification of the prognostic factors and the usefulness of high-resolution ultrasonography in detecting involved site and severity of ischemic colitis. Methods: The clinical databases were reviewed between April 1999 and March 2004. 60 cases were diagnosed as ischemic colitis. Clinical characteristics, coexisting illness, segment of colon involved, and sonographic finding were analyzed. Results: The poor prognosis group was significantly older than the good prognosis group (p=0.017). The difference in involved colonic segment between the two groups was statistically significant (p=0.001). However, in logistic regression, only right colonic involvement was an independent poor prognostic factor (95% confidence interval, 1.7-46.4; p=0.01). Ultrasonography had a sensitivity of 85% and a specificity of 82%. Conclusions: Only right colonic involvement was an independent poor prognostic factor. Noninvasive high-resolution ultrasonography was a valuable technique for the detection and the follow-up of colonic ischemia. Therefore, sigmoidoscopy and sonography are preferable to heavy going colonoscopy in severe colonic ischemia. (Intestinal Research 2006;4:32-38)

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Adult Intussusception: Three-dimensional Reconstruction of Computed Tomography: Joon Ho Moon, Cheol Hee Park, Kyoung Oh Kim, Taeho Hahn, Kyo-Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Choong Kee Park; Intest Res 2006;4(1):69-72. Published online June 30, 2006

Abstract PDF: Intussusceptions in adults are relatively rare. About 70% to 90% of cases have demonstrable etiologies, and 40% of them are caused by malignant neoplasm. Diagnosis may be difficult with conventional diagnostic techniques due to the low incidence and the rare consideration to intussusception in adults. Computed tomography (CT) is now widely used in the evaluation of abdominal mass and nonspecific abdominal pain that may be the first presentation of an intussusception. But, CT is often not successful in determining the specific causes of the intussusception, as the lead point in many cases is small and often hidden within the intussuscepted mass. We report two cases of adult intussusceptions by sigmoid colon cancer with three-dimensional reconstruction of conventional CT. (Intestinal Research 2006;4:69-73)

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The Safety of Colonoscopy Using Sedation with Propofol: Jong Pyo Kim, Cheol Hee Park, Jae One Jung, Joon Ho Moon, Woon Geon Shin, Kyoung Oh Kim, Tae Ho Han, Kyo Sang Yoo, Sang Hoon Park, Jong Hyeok Kim, Choong Kee Park; Intest Res 2005;3(1):11-17. Published online June 30, 2005

Abstract PDF: Background/Aims
The usage of sedative agents like midazolam or propofol and a desire for efficient and safe endoscopy have contributed to changes in the practice of endoscopic sedation. The clinical efficacy and safety of propofol as premedication for outpatient colonoscopy is under evaluation in Korea. We compared propofol to low-dose midazolam for colonoscopy with conscious sedation. Methods: Outpatients undergoing colonoscopy were randomized to receive either propofol or low-dose midazolam (0.05 mg/kg). Total 92 patients were divided into 2 groups (propofol group: 51, low-dose midazolam group: 41). Induction of sedation, procedure and recovery time, patient's and doctor's satisfaction, complications were evaluated. Results: There was no significant difference between two groups in sex ratio and mean age. The changes in blood pressure, pulse rate, respiration rate and oxygen saturation were not significant in both groups. Patients receiving propofol tolerated colonoscopy much more than those with low-dose midazolam. Major complications such as hemodynamic instability or apnea did not occur in both groups. Conclusions: Propofol was safe and effective premedication for conscious sedation in colonoscopy. Propofol has several advantages over low-dose midazolam. (Intest Res 2005;3:11-17)

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Correlation of Abdominal Sonography with Colonoscopy in Inflammatory and Infectious Bowel Disease: Cheol Hee Park, Jong Hyeok Kim, Jin Cheol Park, Do Kyun Jin, Kil Chan Oh, Chul Sung Park, Kyoung Oh Kim, Kyo-Sang Yoo, Taeho Hahn, Sang Hoon Park, Choong Kee Park, Kwan Seop Lee; Intest Res 2004;2(2):77-82. Published online December 22, 2004

Abstract PDF: Background/Aims
Colonoscopy is the most important tool in the evaluation of the bowel diseases. But it needs bowel preparation, causes pain, hemorrhage, and even perforation in acute stage. Since the development of the high resolution ultrasonography, ultrasonography is widely used in the evaluation of the bowel diseases. It does not need bowel preparation and can be used in acute stage. We compared the results obtained by abdominal ultrasonography with the endoscopic findings to evaluate the location and extent of bowel disease. Methods: Ultrasonographic scan and colonoscopy were performed in 70 patients with ulcerative colitis (n=16), Crohn's disease (n=7), tuberculous colitis (n=10), infectious colitis (n=37). Bowel wall thickness was compared with endoscopic findings in a segment-by-segment comparison. A bowel wall thickness of 4 mm or more was considered pathologic. Results: Sensitivity and specificity of ultrasonography were 86%, 97% in ulcerative colitis, 83%, 88% in Crohn's disease, 83%, 97% in tuberculous colitis, 81%, 96% in infectious colitis and 83%, 96% in total patients. Conclusions: Abdominal ultrasonography may be helpful in evaluating the location and extent of bowel disease and especially, follow-up examination in inflammatory bowel disease. (Intestinal Research 2004;2:77-82)

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