Intestinal Research

Original Article

Colorectal neoplasia

A survey of current practices in post-polypectomy surveillance in Korea: Jeongseok Kim, Tae-Geun Gweon, Min Seob Kwak, Su Young Kim, Seong Jung Kim, Hyun Gun Kim, Eun Ran Kim, Sung Noh Hong, Eun Sun Kim, Chang Mo Moon, Dae Seong Myung, Dong Hoon Baek, Shin Ju Oh, Hyun Jung Lee, Ji Young Lee, Yunho Jung, Jaeyoung Chun, Dong-Hoon Yang, on behalf of the Intestinal Tumor Research Group of the Korean Association for the Study of Intestinal Diseases (KASID); Intest Res 2024;22(2):186-207. Published online April 25, 2024; DOI: https://doi.org/10.5217/ir.2023.00109

Abstract PDF Supplementary Material PubReader ePub: Background/Aims
We investigated the clinical practice patterns of post-polypectomy colonoscopic surveillance among Korean endoscopists.
Methods
In a web-based survey conducted between September and November 2021, participants were asked about their preferred surveillance intervals and the patient age at which surveillance was discontinued. Adherence to the recent guidelines of the U.S. Multi-Society Task Force on Colorectal Cancer (USMSTF) was also analyzed.
Results
In total, 196 endoscopists completed the survey. The most preferred first surveillance intervals were: a 5-year interval after the removal of 1–2 tubular adenomas < 10 mm; a 3-year interval after the removal of 3–10 tubular adenomas < 10 mm, adenomas ≥ 10 mm, tubulovillous or villous adenomas, ≤ 20 hyperplastic polyps < 10 mm, 1–4 sessile serrated lesions (SSLs) < 10 mm, hyperplastic polyps or SSLs ≥ 10 mm, and traditional serrated adenomas; and a 1-year interval after the removal of adenomas with highgrade dysplasia, >10 adenomas, 5–10 SSLs, and SSLs with dysplasia. In piecemeal resections of large polyps ( > 20 mm), surveillance colonoscopy was mostly preferred after 1 year for adenomas and 6 months for SSLs. The mean USMSTF guideline adherence rate was 30.7%. The largest proportion of respondents (40.8%–55.1%) discontinued the surveillance at the patient age of 80–84 years.
Conclusions
A significant discrepancy was observed between the preferred post-polypectomy surveillance intervals and recent international guidelines. Individualized measures are required to increase adherence to the guidelines.

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Reviews

Cancer

Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 revised edition: Su Young Kim, Min Seob Kwak, Soon Man Yoon, Yunho Jung, Jong Wook Kim, Sun-Jin Boo, Eun Hye Oh, Seong Ran Jeon, Seung-Joo Nam, Seon-Young Park, Soo-Kyung Park, Jaeyoung Chun, Dong Hoon Baek, Mi-Young Choi, Suyeon Park, Jeong-Sik Byeon, Hyung Kil Kim, Joo Young Cho, Moon Sung Lee, Oh Young Lee, Korean Society of Gastrointestinal Endoscopy, Korean Society of Gastroenterology, Korean Association for the Study of Intestinal Diseases; Intest Res 2023;21(1):20-42. Published online January 31, 2023; DOI: https://doi.org/10.5217/ir.2022.00096

Abstract PDF Supplementary Material PubReader ePub

Colonoscopic polypectomy is effective in decreasing the incidence and mortality of colorectal cancer (CRC). Premalignant polyps discovered during colonoscopy are associated with the risk of metachronous advanced neoplasia. Postpolypectomy surveillance is the most important method for managing advanced metachronous neoplasia. A more efficient and evidence-based guideline for postpolypectomy surveillance is required because of the limited medical resources and concerns regarding colonoscopy complications. In these consensus guidelines, an analytic approach was used to address all reliable evidence to interpret the predictors of CRC or advanced neoplasia during surveillance colonoscopy. The key recommendations state that the high-risk findings for metachronous CRC following polypectomy are as follows: adenoma ≥10 mm in size; 3 to 5 (or more) adenomas; tubulovillous or villous adenoma; adenoma containing high-grade dysplasia; traditional serrated adenoma; sessile serrated lesion containing any grade of dysplasia; serrated polyp of at least 10 mm in size; and 3 to 5 (or more) sessile serrated lesions. More studies are needed to fully comprehend the patients who are most likely to benefit from surveillance colonoscopy and the ideal surveillance interval to prevent metachronous CRC.

Citations

Citations to this article as recorded by

The histologic features, molecular features, detection and management of serrated polyps: a review
Jin-Dong Wang, Guo-Shuai Xu, Xin-Long Hu, Wen-Qiang Li, Nan Yao, Fu-Zhou Han, Yin Zhang, Jun Qu
Frontiers in Oncology.2024;[Epub] CrossRef
Screening and surveillance for hereditary colorectal cancer
Hee Man Kim, Tae Il Kim
Intestinal Research.2024; 22(2): 119. CrossRef
Prediction of Lymph Node Metastasis in T1 Colorectal Cancer Using Artificial Intelligence with Hematoxylin and Eosin-Stained Whole-Slide-Images of Endoscopic and Surgical Resection Specimens
Joo Hye Song, Eun Ran Kim, Yiyu Hong, Insuk Sohn, Soomin Ahn, Seok-Hyung Kim, Kee-Taek Jang
Cancers.2024; 16(10): 1900. CrossRef
Strategies to improve screening colonoscopy quality for the prevention of colorectal cancer
Joo Hye Song, Eun Ran Kim
The Korean Journal of Internal Medicine.2024; 39(4): 547. CrossRef
Efficacy of Oral Sulfate Tablet and 2 L-Polyethylene Glycol with Ascorbic Acid for Bowel Preparation: A Prospective Randomized KASID Multicenter Trial
Yunho Jung, Hyun Gun Kim, Dong-Hoon Yang, Hyoun Woo Kang, Jae Jun Park, Dong Hoon Baek, Jaeyoung Chun, Tae-Geun Gweon, Hyeon Jeong Goong, Min Seob Kwak, Hyun Jung Lee, Soo-Kyung Park, Jong Hoon Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Korean Guidelines for Postpolypectomy Colonoscopic Surveillance: 2022 Revision
Su Young Kim
The Korean Journal of Medicine.2023; 98(3): 102. CrossRef
Clinical characteristics and risk factors related to polyposis recurrence and advanced neoplasm development among patients with non-hereditary colorectal polyposis
Jihun Jang, Jihye Park, Soo Jung Park, Jae Jun Park, Jae Hee Cheon, Tae Il Kim
Intestinal Research.2023; 21(4): 510. CrossRef
Summary and comparison of recently updated post-polypectomy surveillance guidelines
Yoon Suk Jung
Intestinal Research.2023; 21(4): 443. CrossRef
Strategy for post-polypectomy colonoscopy surveillance: focus on the revised Korean guidelines
Yong Soo Kwon, Su Young Kim
Journal of the Korean Medical Association.2023; 66(11): 652. CrossRef

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Inflammatory bowel diseases

Prevention and management of viral hepatitis in inflammatory bowel disease: a clinical practice guideline by the Korean Association for the Study of Intestinal Diseases: Soo-Kyung Park, Chang Hwan Choi, Jaeyoung Chun, Heeyoung Lee, Eun Sun Kim, Jae Jun Park, Chan Hyuk Park, Bo-In Lee, Yunho Jung, Dong-Il Park, Do Young Kim, Hana Park, Yoon Tae Jeen, IBD Research Group of the Korean Association for the Study of Intestinal Diseases; Intest Res 2020;18(1):18-33. Published online January 30, 2020; DOI: https://doi.org/10.5217/ir.2019.09155

Abstract PDF PubReader ePub

The treatment of inflammatory bowel disease (IBD) has been revolutionized for the last 10 years by the increasing use of immunomodulators and biologics. With immunosuppression of this kind, opportunistic infection is an important safety concern for patients with IBD. In particular, viral hepatitis is determined by the interaction between the virus and the host’s immunity, and the risk of reactivation increases if immunity is compromised by immunosuppression therapy. Parts of Asia, including Korea, still show intermediate endemicity for the hepatitis A virus and hepatitis B virus compared with the United States and Western Europe. Thus, members of IBD research group of the Korean Association for the Study of Intestinal Diseases have produced a guideline on the prevention and management of viral hepatitis in IBD.

Citations

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Iranian Consensus Guideline for Pharmacotherapy with Biologics and Small Molecules Drugs in Adults with Inflammatory Bowel Diseases
Niloofar Khoshnam-Rad, Homayoon Vahedi, Anahita Sadeghi, Mansoor Rastegarpanah, Soha Namazi, Amir Anushiravani, Ali Reza Sima, Shabnam Shahrokh, Sudabeh Alatab, Reza Malekzadeh
Middle East Journal of Digestive Diseases.2023; 15(2): 83. CrossRef
Protective role of flavonoids quercetin and silymarin in the viral-associated inflammatory bowel disease: an updated review
Elham Zarenezhad, Hussein T. Abdulabbas, Ahmed Shayaa Kareem, Seyed Amin Kouhpayeh, Silvia Barbaresi, Sohrab Najafipour, Abdulbaset Mazarzaei, Mitra Sotoudeh, Abdolmajid Ghasemian
Archives of Microbiology.2023;[Epub] CrossRef
The impact of medication belief on adherence to infliximab in patients with Crohn’s disease
Shuyan Li, Yan Ma, Hongling Sun, Zijun Ni, Shurong Hu, Yan Chen, Meijuan Lan
Frontiers in Pharmacology.2023;[Epub] CrossRef
SARS-CoV-2 vaccination for adult patients with inflammatory bowel disease: expert consensus statement by KASID
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung
Intestinal Research.2022; 20(2): 171. CrossRef
Clinical Course of Hepatitis B Viral Infection in Patients Undergoing Anti-Tumor Necrosis Factor α Therapy for Inflammatory Bowel Disease
Ji Min Lee, Shu-Chen Wei, Kang-Moon Lee, Byong Duk Ye, Ren Mao, Hyun-Soo Kim, Soo Jung Park, Sang Hyoung Park, Eun Hye Oh, Jong Pil Im, Byung Ik Jang, Dae Bum Kim, Ken Takeuchi
Gut and Liver.2022; 16(3): 396. CrossRef
Antiviral Prophylaxis Against Hepatitis B Virus in Patients Treated with Anti-Tumor Necrosis Factor α Agents for Inflammatory Bowel Disease
Eun Ae Kang, Jae Hee Cheon
Gut and Liver.2022; 16(4): 501. CrossRef
Risk of Hepatitis B Virus (HBV) Reactivation in Patients with Immune-Mediated Inflammatory Diseases Receiving Biologics: Focus on the Timing of Biologics after Anti-HBV Treatment
Soo Min Ahn, Jonggi Choi, Byong Duk Ye, Suk-Kyun Yang, Ji Seon Oh, Yong‑Gil Kim, Chang-Keun Lee, Bin Yoo, Sang Hyoung Park, Seokchan Hong
Gut and Liver.2022; 16(4): 567. CrossRef
Inflammatory bowel disease in Korea: epidemiology and pathophysiology
Jung Won Lee, Chang Soo Eun
The Korean Journal of Internal Medicine.2022; 37(5): 885. CrossRef
Viral Hepatitis in Patients with Inflammatory Bowel Disease
Seung Hwan Shin, Sang Hyoung Park
The Korean Journal of Gastroenterology.2022; 80(2): 51. CrossRef
Vaccination strategies for Korean patients with inflammatory bowel disease
Yoo Jin Lee, Eun Soo Kim
The Korean Journal of Internal Medicine.2022; 37(5): 920. CrossRef
Current Status of Opportunistic Infection in Inflammatory Bowel Disease Patients in Asia: A Questionnaire-Based Multicenter Study
Hong Yang, Zhihua Ran, Meng Jin, Jia-Ming Qian
Gut and Liver.2022; 16(5): 726. CrossRef
Do We Have an Opportunity to Avoid Opportunistic Infections in Asian Patients with Inflammatory Bowel Disease?
Suhyun Park, Sang Hyoung Park
Gut and Liver.2022; 16(5): 663. CrossRef
Natural history of inflammatory bowel disease: a comparison between the East and the West
Eun Mi Song, Suk-Kyun Yang
Intestinal Research.2022; 20(4): 418. CrossRef
Hepatobiliary Impairments in Patients with Inflammatory Bowel Diseases: The Current Approach
Vlad Alexandru Ionescu, Gina Gheorghe, Valentin Nicolae Varlas, Ana Maria Alexandra Stanescu, Camelia Cristina Diaconu
Gastroenterology Insights.2022; 14(1): 13. CrossRef
Viral infections in inflammatory bowel disease: Tips and tricks for correct management
Vincenzo Craviotto, Federica Furfaro, Laura Loy, Alessandra Zilli, Laurent Peyrin-Biroulet, Gionata Fiorino, Silvio Danese, Mariangela Allocca
World Journal of Gastroenterology.2021; 27(27): 4276. CrossRef
SARS-CoV-2 Vaccination for Adult Patients with Inflammatory Bowel Disease: Expert Consensus Statements by KASID
Yoo Jin Lee, Seong-Eun Kim, Yong Eun Park, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 117. CrossRef
Current status of inflammatory bowel diseases in Korea
Suk-Kyun Yang
Journal of the Korean Medical Association.2021; 64(9): 572. CrossRef
A clinical case of ulcerative colitis in a patient with viral hepatitis
E. D. Kosmachova, M. S. Iakovenko, K. A. Yumukian
South Russian Journal of Therapeutic Practice.2020; 1(3): 95. CrossRef

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Original Article

Colorectal neoplasia

Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohort study and literature review: Eun Ae Kang, Seung Jun Han, Jaeyoung Chun, Hyun Jung Lee, Hyunsoo Chung, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyun Chae Jung; Intest Res 2019;17(1):135-143. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00085

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Spontaneous intramural small bowel hematoma (SISBH) is an extremely rare complication of anticoagulant or antiplatelet therapy. We assessed the clinical characteristics and outcomes of patients with SISBH according to the anatomical location of the hematoma.
Methods
From January 2003 to February 2016, medical records for all patients hospitalized for SISBH at 2 tertiary referral hospitals were retrospectively reviewed. The primary outcome was requirement for surgery.
Results
A total of 37 patients were enrolled. The mean age was 74.1 years. Among them, 33 patients (89.2%) were taking anticoagulant and/or antiplatelet agents. Duodenal intramural hematoma was detected in 4 patients (10.8%), jejunal in 16 (43.2%), and ileal in 17 (45.9%). Compared to jejunal and ileal involvement, duodenal intramural hematoma was significantly associated with high Charlson comorbidity index and low levels of white blood cells, hemoglobin, and platelets in the blood. SISBH in the duodenum was related to thrombocytopenia in 3 patients following systemic chemotherapy for malignancy. All patients with SISBH showed clinical improvement with conservative therapy. Mean length of hospital stay was 9.35 days. Independent predictors of a hospital stay of more than 7 days were body weight less than 60 kg (odds ratio [OR], 12.213; 95% confidence interval [CI], 1.755–84.998; P=0.011) and a history of cerebrovascular accidents (OR, 6.667; 95% CI, 1.121–39.650; P=0.037).
Conclusions
Compared to jejunal and ileal involvement, thrombocytopenia may result in spontaneous duodenal intramural hematoma among patients who are treated with systemic chemotherapy for malignancies. Patients with SISBH have excellent clinical outcomes with conservative therapy regardless of the anatomical location of the hematoma.

Citations

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A Case of Direct-Acting Oral Anticoagulant-Induced Intramural Colon Hematoma Successfully Treated by Laparoscopic Surgery
Daisuke Tomita, Shigeo Toda, Ryo Miyazaki, Shuichiro Matoba, Hiroya Kuroyanagi
Cureus.2024;[Epub] CrossRef
Spontaneous Intramural Small Bowel Hematoma in an Elderly Man with Multiple Myeloma
Sigrid L. Williamson, Aishwarya Suresh, Adrian Ong
The American Surgeon™.2023; 89(6): 2816. CrossRef
Intramural duodenal hematoma: diagnosis and management of a rare entity
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española (English Edition).2023; 101(7): 515. CrossRef
Hematoma intramural duodenal: diagnóstico y manejo de una entidad infrecuente
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española.2023; 101(7): 515. CrossRef
Jejunal intramural haematoma in a captive African lion (Panthera leo)
Richelle G. Butcher, Baukje Lenting, Alison S. Clarke, Kelly Buckle, Cristina Gans
Veterinary Record Case Reports.2023;[Epub] CrossRef
Spontaneous Duodenal Hematoma: A Rare Complication of Triple Antithrombotic Therapy Case Report
Mazin N Habhab, Asad J Torabi, Julie M Clary, George E Revtyak
Future Cardiology.2023; 19(2): 71. CrossRef
Intestinal Spontaneous Intramural Hematoma Secondary to Anticoagulation Therapy: A Case Report
Karim El Aidaoui, Wahib Lahlou, Abderrahim Bourial, Nawal Bouknani, Chafik El Kettani
Cureus.2023;[Epub] CrossRef
Intramural Hematoma of Gastrointestinal Tract in People with Hemophilia A and B
Wei-Jung Teng, Ching-Huei Kung, Mei-Mei Cheng, Jia-Ruey Tsai, Chia-Yau Chang
Journal of Clinical Medicine.2023; 12(9): 3093. CrossRef
Endoscopic management of intramural spontaneous duodenal hematoma: A case report
Giorgio Valerii, Vittorio Maria Ormando, Carlo Cellini, Luca Sacco, Carmelo Barbera
World Journal of Gastroenterology.2022; 28(20): 2243. CrossRef
Warfarin-induced spontaneous intramural small bowel hematoma presenting as an acute abdomen: A case report
Ding-Han Chen, Khay-Seng Soh, Ying-Tso Wang, Te-Chun Shen
Medicine.2022; 101(35): e30335. CrossRef
Spontaneous duodenal haematoma in a patient taking rivaroxaban
Rebeca de Barros Lopes, Finn McLennan Battleday, Toby Calvert, Rob Gwynne‐Jones, Rebecca Thomas
ANZ Journal of Surgery.2021;[Epub] CrossRef
SPONTANEOUS INTRAMURAL SMALL-BOWEL HEMATOMA: A CAUSE OF ACUTE ABDOMEN IN ANTICOAGULATED PATIENTS
Sergio Gil Rojas, Luis Miguel Estela Villa, Elsa María Jiménez Vicente
Revista Española de Enfermedades Digestivas.2021;[Epub] CrossRef
Small Bowel Obstruction
Allison A. Aka, Jesse P. Wright, Teresa DeBeche-Adams
Clinics in Colon and Rectal Surgery.2021; 34(04): 219. CrossRef
Double Trouble: Spontaneous Duodenal Hematoma of Pancreatic Origin
Luísa Martins Figueiredo, David Valadas Horta, Jorge A. Reis
GE - Portuguese Journal of Gastroenterology.2019; 26(6): 458. CrossRef

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Case Report

Metronidazole-induced encephalopathy in a patient with Crohn's disease: Jihye Kim, Jaeyoung Chun, Jae Yong Park, Seung Wook Hong, Joo Young Lee, Jin Woo Kang, Seongjun Hwang, Sang-Bae Ko, Jong Pil Im, Joo Sung Kim; Intest Res 2017;15(1):124-129. Published online January 31, 2017; DOI: https://doi.org/10.5217/ir.2017.15.1.124

Abstract PDF PubReader ePub

Metronidazole is a widely used antibiotic for the treatment of anaerobic bacterial infections. Metronidazole-induced encephalopathy (MIEP) is a rare but potentially reversible disease. The mechanism of MIEP remains unclear, and differences in the neurotoxic effects of oral versus intravenous (IV) metronidazole administration have not yet been determined. We report the case of a Crohn's disease (CD) patient who experienced encephalopathy immediately after a single IV dose of metronidazole following long-term exposure to the oral form of the drug. The 64-year-old man with intractable CD experienced a sudden change in mental status, aphasia, and muscle weakness after IV administration of metronidazole. He had previously taken metronidazole orally for 13 years and received intermittent IV metronidazole treatments for CD exacerbation. Brain magnetic resonance imaging (MRI) showed high-intensity signals in the bilateral medial thalamus and the midbrain and pontine tegmentum on fluid-attenuated inversion recovery images. After discontinuation of metronidazole, the high-intensity brain MRI signals resolved and the patient's mental status dramatically improved; however, the patient exhibited mild cognitive dysfunction 2 months after the onset of encephalopathy.

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Unveiling the Neurotoxicity of Metronidazole: A Clinical Conundrum
Gollapudi Hithesh, Swathy Moorthy, Lakshmi M, Emmanuel Bhaskar
Cureus.2024;[Epub] CrossRef
Diffuse subcortical white matter restriction: An uncommon finding on metronidazole toxicity
Mehri Salari, Masoud Etemadifar, Helia Ashourizadeh
The Neuroradiology Journal.2023; 36(1): 119. CrossRef
MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy
Ambreen Fatima, Sachin Khanduri, Sadaf Sultana, Surbhi ., Saim A Siddiqui, Ashkrit Gupta, Vaibhav Pathak, Mohsin Mulani, Salma Khan, Tanya Bansal
Cureus.2022;[Epub] CrossRef
The Influence of Omeprazole on the Dissolution Processes of pH-Dependent Magnetic Tablets Assessed by Pharmacomagnetography
Guilherme A. Soares, Deivid W. Pires, Leonardo A. Pinto, Gustavo S. Rodrigues, André G. Prospero, Gabriel G. A. Biasotti, Gabriela N. Bittencourt, Erick G. Stoppa, Luciana A. Corá, Ricardo B. Oliveira, José R. A. Miranda
Pharmaceutics.2021; 13(8): 1274. CrossRef
Metronidazole-induced encephalopathy: a systematic review
Caspar Godthaab Sørensen, William Kristian Karlsson, Faisal Mohammad Amin, Mette Lindelof
Journal of Neurology.2020; 267(1): 1. CrossRef
Gut microbiota mediates intermittent-fasting alleviation of diabetes-induced cognitive impairment
Zhigang Liu, Xiaoshuang Dai, Hongbo Zhang, Renjie Shi, Yan Hui, Xin Jin, Wentong Zhang, Luanfeng Wang, Qianxu Wang, Danna Wang, Jia Wang, Xintong Tan, Bo Ren, Xiaoning Liu, Tong Zhao, Jiamin Wang, Junru Pan, Tian Yuan, Chuanqi Chu, Lei Lan, Fei Yin, Enriq
Nature Communications.2020;[Epub] CrossRef
Anti-protozoal Activity of Conifer Green Needle Complex against Trichomonas vaginalis
Lidia B. Kulyashova, Natalia Roschina, Tamara V. Nikitina, Vagif S. Soultanov
Natural Product Communications.2019; 14(1): 1934578X1901400. CrossRef
Reversible metronidazole-induced neurotoxicity after 10 weeks of therapy
Wafa AlDhaleei, Ayesha AlMarzooqi, Nouran Gaber
BMJ Case Reports.2018; : bcr-2017-223463. CrossRef

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Images of the Issue

A patient presenting with abdominal pain radiating to the back: Jaeyoung Chun; Intest Res 2016;14(3):289-291. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.289

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Original Article

Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

Abstract PDF PubReader ePub

Background/Aims

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Citations

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Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
Myung Hee Kim, Hee Seok Moon, In Sun Kwon, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
Medicine.2020; 99(29): e20799. CrossRef
Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program
Jung Ho Bae, Changhyun Lee, Hae Yeon Kang, Min-Sun Kwak, Eun Young Doo, Ji Yeon Seo, Ji Hyun Song, Sun Young Yang, Jong In Yang, Seon Hee Lim, Jeong Yoon Yim, Joo Hyun Lim, Goh Eun Chung, Su Jin Chung, Eun Hyo Jin, Boram Park, Joo Sung Kim
Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intestinal Research.2018; 16(1): 134. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
Intestinal Research.2018; 16(3): 502. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study
Eun Mi Song, Hyo-Joon Yang, Hyun Jung Lee, Hyun Seok Lee, Jae Myung Cha, Hyun Gun Kim, Yunho Jung, Chang Mo Moon, Byung Chang Kim, Jeong-Sik Byeon
Digestive Diseases and Sciences.2017; 62(11): 3138. CrossRef
Is colorectal cancer screening necessary before 50 years of age?
Yoon Suk Jung
Intestinal Research.2017; 15(4): 550. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Risk factors of missed colorectal lesions after colonoscopy
Jeonghun Lee, Sung Won Park, You Sun Kim, Kyung Jin Lee, Hyun Sung, Pil Hun Song, Won Jae Yoon, Jeong Seop Moon
Medicine.2017; 96(27): e7468. CrossRef

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Letters to the Editor

Author's Reply: Jaeyoung Chun, Jong Pil Im; Intest Res 2015;13(2):184-185. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.184

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Original Article

Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis: Jaeyoung Chun, Changhyun Lee, Ji-eun Kwon, Sung Wook Hwang, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2015;13(1):50-59. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.50

Abstract PDF PubReader

Background/Aims

Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.

Methods

We retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×10⁵ polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.

Results

A total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).

Conclusions

The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.

Citations

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Case Report

A Case of Immune Thrombocytopenic Purpura Associated with Preexisting Ulcerative Colitis Treated with Colectomy and Splenectomy: Jee Hye Kwon, Changhyun Lee, Ji Min Choi, Yoo Min Han, Young Hoon Choi, June Young Lee, Hyuk Yoon, Jaeyoung Chun, Kyu Joo Park, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(4):310-316. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.310

Abstract PDF

Ulcerative colitis is a chronic inflammatory bowel disease of unknown etiology, associated with extraintestinal manifestations, including the rarely reported immune thrombocytopenic purpura. Here, we present a case of immune thrombocytopenic purpura associated with preexisting ulcerative colitis. The patient was diagnosed with ulcerative colitis 13 years ago. Two years after diagnosis, he presented with hematochezia and active ulcerative colitis. Despite steroid use, the platelet count gradually decreased to 21,000/mm3. Hematochezia and the platelet count recovered after the administration of cyclosporine, and ulcerative colitis was in near complete remission for 11 years. However, the patient was re-admitted for hematochezia and thrombocytopenia persisting over a month. Medical management including increased doses of steroids in combination with cyclosporin failed to control hematochezia and thrombocytopenia. Immune thrombocytopenic purpura was suspected on the basis of normocellular marrow with a normal number of megakaryocytes. To treat uncontrolled colitis and steroid-refractory thrombocytopenia, total proctocolectomy with ileal pouch-anal anastomosis and splenectomy were performed. The patient was followed up for 10 months after surgery and was found to be in good health with a normal platelet count. Therefore, colectomy alone or in combination with splenectomy should be considered in cases of life-threatening ulcerative colitis complicated with steroid-refractory immune thrombocytopenic purpura. (Intest Res 2013;11:310-316)

Citations

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Journal of Inflammation Research.2022; Volume 15: 6373. CrossRef
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The Korean Journal of Gastroenterology.2014; 64(4): 234. CrossRef

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