Intestinal Research

Original Articles

Inflammatory Bowel Diseases

The role of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio in ulcerative colitis: Yujin Jeong, Seong Ran Jeon, Hyun Gun Kim, Jung Rock Moon, Tae Hee Lee, Jae Young Jang, Jun-Hyung Cho, Jun Seok Park, Heesu Park, Ki-hun Lee, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Suyeon Park; Intest Res 2021;19(1):62-70. Published online May 8, 2020; DOI: https://doi.org/10.5217/ir.2019.09156

Background/Aims
Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can serve as biomarkers for diagnosing and assessing disease activity in ulcerative colitis (UC). We investigated their clinical significance in UC.
Methods
We analyzed 48 patients with UC who underwent measurement of fecal calprotectin (FC) and endoscopy and 96 age- and sex-matched healthy controls. NLR and PLR were compared between the patients and healthy controls. The endoscopic activity was divided into 2 groups: group 1 (mild to moderate inflammation) and group 2 (severe inflammation) according to the Mayo endoscopic subscore in UC.
Results
To diagnose UC, the optimal cutoff of NLR and PLR was 2.26 (sensitivity 54.2%; specificity 90.6%; positive likelihood ratio 5.778, 95% confidence interval [CI] 2.944–11.339; area under the curve [AUC] 0.774, 95% CI, 0.690–0.859) and 179.8 (sensitivity 35.4%; specificity 90.6%; positive likelihood ratio 3.778, 95% CI 1.821–7.838; AUC 0.654, 95% CI 0.556–0.753), respectively. The optimal cutoff to differentiate group 1 and group 2 was 3.44, 175.9, and 453 µg/g for NLR, PLR, and FC, respectively (sensitivity, 63.6% vs. 90.9% vs. 81.8%; specificity, 81.1% vs. 78.4% vs. 73.0%; positive likelihood ratio, 3.364 vs. 4.205 vs. 3.027; AUC, 0.714 vs. 0.897 vs. 0.813). PLR had the highest AUC and positive likelihood ratio.
Conclusions
NLR and PLR help differentiate patients with UC from healthy controls. NLR, PLR, and FC indicate endoscopic activity and may reflect intestinal mucosal conditions.

Citations

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Fatma Abdel-Kader Attia Mohamed, Eman Refaat Youness, Marwa M. Hassan, Nesma Hassan Hasanein Ashour
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İlyas TENLİK, Orhan COŞKUN, Mustafa ÇAPRAZ, Volkan GÖKBULUT, Ömer ÖZTÜRK
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Ioan Sabin Poenariu, Lidia Boldeanu, Bogdan Silviu Ungureanu, Daniel Cosmin Caragea, Oana Mariana Cristea, Vlad Pădureanu, Isabela Siloși, Anca Marinela Ungureanu, Răzvan-Cristian Statie, Alina Elena Ciobanu, Dan Ionuț Gheonea, Eugen Osiac, Mihail Virgil
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Habibe İnci, Fatih İnci
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Danny Con, Bridgette Andrew, Steven Nicolaides, Daniel R van Langenberg, Abhinav Vasudevan
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Su Hyun Park, Sang Hyoung Park
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The Usefulness of Extended Inflammation Parameters and Systemic Inflammatory Response Markers in the Diagnostics of Autoimmune Hepatitis
Weronika Domerecka, Anna Kowalska-Kępczyńska, Iwona Homa-Mlak, Agata Michalak, Radosław Mlak, Marcin Mazurek, Halina Cichoż-Lach, Teresa Małecka-Massalska
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José Ignacio Cristóbal, Francisco Javier Duque, Jesús Usón-Casaús, Rafael Barrera, Esther López, Eva María Pérez-Merino
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Wan Feng, Yajun Liu, Lei Zhu, Luzhou Xu, Hong Shen
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Evaluation of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Chronic Plaque Psoriasis
Sudeshna Mondal, Samudra Guha, Abanti Saha, Loknath Ghoshal, Debabrata Bandyopadhyay
Indian Journal of Dermatology.2022; 67(4): 477. CrossRef
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Endoscopy within 7 days after detecting high calprotectin levels can be useful for therapeutic decision-making in ulcerative colitis
Ho Min Yong, Sung-Jo Park, Seong Ran Jeon, Heesu Park, Hyun Gun Kim, Tae Hee Lee, Junseok Park, Jin-Oh Kim, Joon Seong Lee, Bong Min Ko, Hyeon Jeong Goong, Suyeon Park
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Blake O. Langley, Sara E. Guedry, Joshua Z. Goldenberg, Douglas A. Hanes, Jennifer A. Beardsley, Jennifer Joan Ryan
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Natsuki Ishida, Satoru Takahashi, Yusuke Asai, Takahiro Miyazu, Satoshi Tamura, Shinya Tani, Mihoko Yamade, Moriya Iwaizumi, Yasushi Hamaya, Satoshi Osawa, Takahisa Furuta, Ken Sugimoto
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Reappraisal of Pneumoperitoneum After Percutaneous Endoscopic Gastrostomy: Won Young Park, Tae Hee Lee, Joon Seong Lee, Su Jin Hong, Seong Ran Jeon, Hyun Gun Kim, Joo Young Cho, Jin Oh Kim, Jun Hyung Cho, Sang Wook Lee, Young Kwan Cho; Intest Res 2015;13(4):313-317. Published online October 15, 2015; DOI: https://doi.org/10.5217/ir.2015.13.4.313

Abstract PDF PubReader ePub

Background/Aims

Pneumoperitoneum is recognized as a benign and self-limiting finding after the insertion of a percutaneous endoscopic gastrostomy (PEG) tube, while complicated pneumoperitoneum is rarely reported. The aim of this study was to reappraise pneumoperitoneum following PEG.

Methods

We retrospectively reviewed 193 patients who underwent PEG from May 2008 to May 2014. All patients had a follow-up upright chest or simple abdominal radiograph after PEG. Pneumoperitoneum was quantified by measuring the height of the air column under the diaphragm and graded as small (<2 cm), moderate (2-4 cm), or large (>4 cm). Clinically significant signs were defined as fever, abdominal tenderness or leukocytosis occurring after PEG insertion.

Results

Of the 193 study patients, 9 (4.6%) had a pneumoperitoneum visualized by radiographic imaging, graded as small in 5 patients, moderate in 2 patients and large in 2 patients. Clinically significant signs were observed in 5 (55.5%) patients with fever reported in 4 patients, abdominal tenderness in 4 patients and leukocytosis in 4 patients. The time to resolution of free air was 2-18 days. Two patients (22.2%) with moderate or large pneumoperitoneum after PEG died from either pneumonia or septic shock.

Conclusions

The clinical course of pneumoperitoneum after PEG is not always benign and self-limiting. These findings suggest that clinicians should not neglect a moderate or large pneumoperitoneum, particularly in patients who have an altered mental status or received antibiotics, since peritoneal irritation cannot be observed under these circumstances.

Citations

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Cureus.2025;[Epub] CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Gut and Liver.2024; 18(1): 10. CrossRef
Endoscopic Complications Are More Frequent in Levodopa–Carbidopa Intestinal Gel Treatment via JET-PEG in Parkinson’s Disease Patients Compared to Nutritional PEG in Non-Parkinson’s Disease Patients
Laura Gombošová, Jana Deptová, Ivana Jochmanová, Tatiana Svoreňová, Eduard Veseliny, Mária Zakuciová, Vladimír Haň, Alexandra Lacková, Kristína Kulcsárová, Miriama Ostrožovičová, Joaquim Ribeiro Ventosa, Lenka Trcková, Ivica Lazúrová, Matej Škorvánek
Journal of Clinical Medicine.2024; 13(3): 703. CrossRef
Clinical practice guidelines for percutaneous endoscopic gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
Clinical Endoscopy.2023; 56(4): 391. CrossRef
Pneumoperitoneum After Jejunostomy Tube Placement Managed by Needle Decompression: A Case Report
Khalid Al Shamousi, Masoud Salim Kashoob, Jawahir Lal, Said A Al-Busafi
Cureus.2023;[Epub] CrossRef
Clinical Practice Guideline for Percutaneous Endoscopic Gastrostomy
Chung Hyun Tae, Ju Yup Lee, Moon Kyung Joo, Chan Hyuk Park, Eun Jeong Gong, Cheol Min Shin, Hyun Lim, Hyuk Soon Choi, Miyoung Choi, Sang Hoon Kim, Chul-Hyun Lim, Jeong-Sik Byeon, Ki-Nam Shim, Geun Am Song, Moon Sung Lee, Jong-Jae Park, Oh Young Lee
The Korean Journal of Gastroenterology.2023; 82(3): 107. CrossRef
Incidence of Pneumoperitoneum After Gastrostomy Tube Removal
Anas Mahmoud, Nizar Alyassin, Eyad Baghal, Ruhin Yuridullah, Yana Cavanagh, Matthew A Grossman
Cureus.2023;[Epub] CrossRef
Prevention and management of major complications in percutaneous endoscopic gastrostomy
Kurt Boeykens, Ivo Duysburgh
BMJ Open Gastroenterology.2021; 8(1): e000628. CrossRef
Massive Incidental Pneumoperitoneum in an Amyotrophic Lateral Sclerosis Patient
Jasmin Jaber, Nur Magadle, Lojain Arda, Francisco J Somoza-Cano
Cureus.2021;[Epub] CrossRef
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Jahnvi Dhar, Naveen Kumar, Pankaj Gupta, Rakesh Kochhar, Jayanta Samanta
Journal of Digestive Endoscopy.2021; 12(03): 169. CrossRef
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Tim Brotherton, Anuj Chhaparia, Michael Presti, Gregory Sayuk, Jill Elwing
ACG Case Reports Journal.2021; 8(11): e00700. CrossRef
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Şehmus Ölmez, Bünyamin Sarıtaş, Mesut Aydın, Banu Kara
Gastroenterology Nursing.2020; 43(4): 317. CrossRef
Diagnosis and treatment of pediatric benign pneumoperitoneum
Shou-Xing Duan, Zong-Bo Sun, Guang-Huan Wang, Jun Zhong, Wen-Hui Ou, Ma-Xian Fu, Fu-Sheng Wang, Shu-Hua Ma, Jian-Hong Li
Medicine.2017; 96(2): e5814. CrossRef
Thirty-day mortality after percutaneous gastrostomy by endoscopic versus radiologic placement: a systematic review and meta-analysis
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The role of surgery in the treatment of endoscopic complications
Peter Dixon, Gopal C. Kowdley, Steven Clark Cunningham
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Pneumoperitoneum After Percutaneous Endoscopic Gastrostomy: Does It Have Clinical Significance?
Ju Yup Lee, Kyung Sik Park
Intestinal Research.2015; 13(4): 295. CrossRef

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Double-Balloon Enteroscopy in Elderly Patients: Is It Safe and Useful?: Dae Han Choi, Seong Ran Jeon, Jin-Oh Kim, Hyun Gun Kim, Tae Hee Lee, Woong Cheul Lee, Byung Soo Kang, Jun-Hyung Cho, Yunho Jung, Wan Jung Kim, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2014;12(4):313-319. Published online October 27, 2014; DOI: https://doi.org/10.5217/ir.2014.12.4.313

Abstract PDF PubReader ePub

Background/Aims

Providers may be hesitant to perform double-balloon enteroscopy (DBE) in the elderly because the increased number of co-morbidities in this population poses a greater risk of complications resulting from sedation. There are limited data on the use of DBE in the elderly. Here, we assessed the safety and efficacy of DBE in the elderly compared to those in younger patients.

Methods

We retrospectively analyzed the medical records of 158 patients who underwent 218 DBEs. Patients were divided into an elderly group (age ≥65 years; mean 71.4±5.4; n=34; 41 DBEs) and a younger group (age <65 years; mean 39.5±13.5; n=124; 177 DBEs).

Results

In both groups, the most common indication for DBE was obscure gastrointestinal bleeding. Mucosal lesions (33.3% vs. 60.9%; P=0.002) were the most common finding in both groups, followed by tumors (30.8% vs. 14.1%; P=0.036). The elderly were more likely to receive interventional therapy (51.3% vs. 23.5%; P=0.001). The diagnostic yield of DBE was slightly higher in the elderly group (92.3% vs. 86.5%; P=0.422), but was not statistically significant. The therapeutic success rate of DBE was 100% in the elderly group compared to 87.5% in the younger group (P=0.536). The overall DBE complication rate was 1.8% overall, and this rate did not differ significantly between the groups (2.6% vs. 1.7%; P=0.548).

Conclusions

DBE is safe and effective in the elderly, and has a high diagnostic yield and high therapeutic success rate.

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Hey-Long Ching, Federica Branchi, David S Sanders, David Turnbull, Reena Sidhu
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Clinical Comparison for Colon Polyps between Right and Left Colon in Koreans: Wook Hyun Um, Hyun Gun Kim, Seong Ran Jeon, Tae Hee Lee, Wan Jung Kim, Bong Min Ko, Jin-Oh Kim, Joo Young Cho, Joon Seong Lee, Moon Sung Lee; Intest Res 2012;10(4):372-378. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.372

Abstract PDF

Background/Aims
Comparative studies of colon polyps between right and left colon in Korean population are limited. We investigated the clinical characteristics of the patients according to polyp location and compared the results of the morphological and histological analysis of right and left colon polyps. Methods: The study was performed prospectively for the patients who underwent colon polypectomy for health check-ups in a single tertiary center. The patients were classified into three groups by the location of the polyps: right group (from the cecum to the splenic flexure), left group (from the descending colon to the anus), and total group. The size, the morphology, the location and the pathology of the polyps were evaluated. Results: From June 2010 to June 2011, Overall 2596 polyps from 950 patients (male=646) were analyzed. Colon polyps were right side-shift with increased patients age (P<0.001). The incidence of polyps was most common in sigmoid colon (26.5%). Polyps less than 5 mm size were more common in left colon (P<0.001) and flat polyps larger than 1 cm in right colon (P=0.006), respectively. In histopathological findings, the distribution of advanced adenoma was not different according to the location, however tubular adenomas and serrated adenomas (P<0.001) were more common in right colon. Female was more distributed in right group, respectively (P<0.001). Conclusions: In a single center study, colon polyps were more distributed in right colon with age and in females. Also flat polyps larger than 1cm, tubular adenoma and serrated adenoma were found in larger proportion in right colon. (Intest Res 2012;10:372-378)

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Clinicopathological features of colorectal polyps in 2002 and 2012
Yoon Jeong Nam, Kyeong Ok Kim, Chan Seo Park, Si Hyung Lee, Byung Ik Jang
The Korean Journal of Internal Medicine.2019; 34(1): 65. CrossRef

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Capsule Endoscopy for Suspected Small Bowel Bleeding in Patients with Portal Hypertension: Gang Il Cheon, Jin Oh Kim, Sung Wook Hong, Seong Ran Jeon, Tae Hee Lee, Hyun Gun Kim, Won Young Cho, Wan Jung Kim, Min Jeong Kim, Sung Won Jeong, Jae Young Jang, Bong Min Ko, Joo Young Cho, Joon Seong Lee; Intest Res 2011;9(2):129-138. Published online August 30, 2011; DOI: https://doi.org/10.5217/ir.2011.9.2.129

Abstract PDF: Background/Aims
In Korea, limited data are available on small bowel bleeding in patients with portal hypertension. This study reports on the use of capsule endoscopy in cases of suspected small bowel bleeding in patients with portal hypertension. Methods: Capsule endoscopy was used at our hospital to evaluate small bowel disease in 501 cases from July 2003 to June 2010. Of those cases, nine patients with portal hypertension due to liver cirrhosis with suspected small bowel bleeding were selected for the study. A retrospective analysis was performed using data from medical records. Results: Six of the nine (66.7%) patients were males with an average age of 53.4 years. The average hemoglobin level was 8.1 g/dL. Abnormalities noted during capsule endoscopy included portal hypertensive enteropathy in all nine cases (100%), jejunal varices in four (44.4%), jejunal and ileal angiodysplasia in five (55.5%), multiple small bowel erosions in one (11.1%), granularity of the jejunal mucosa in one (11.1%), and small bowel erythema in three (33.3%). Active bleeding from jejunal varices was detected in two patients (22.2%). Despite having no obvious active bleeding during the capsule endoscopy, four patients (44.4%) were diagnosed with portal hypertensive enteropathy with obscure small bowel bleeding. Conclusions: Capsule endoscopy is a useful diagnostic tool for the evaluation of small bowel bleeding in patients with portal hypertensive enteropathy. Additional prospective and multicenter studies on the use of capsule endoscopy are needed to evaluate the incidence and clinical importance of portal hypertensive enteropathy. (Intest Res 2011;9:129-138)

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Case Report

A Case of Gastrointestinal Stromal Tumor of the Jejunum with Hemorrhage Which was Preoperatively Diagnosed by Double Balloon Enteroscopy: Sang Hoon Han, Chang Bum Ryu, Hyun Sik Na, Sang Gyune Kim, Bong Min Ko, Kye Won Kwon, Su Jin Hong, Young Suk Kim, Jin Oh Kim, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2006;4(2):110-113. Published online December 30, 2006

Abstract PDF: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tracts that usually arise in the stomach and small intestine. Recent studies, suggest that they originate from gastrointestinal pacemaker cells (interstitial cell of Cajal). In most cases symptoms are nonspecific and diagnosis is achieved incidentally after radiologic evaluation. Some patients initially present with obscure GI bleeding and are diagnosed after sugical intervention. We report a patient who presented with hematochezia who was diagnosed preoperatively with gastrointestinal stromal tumor of the jejunum by double-balloon enteroscopy and multi-directional computed tomogram. (Intestinal Research 2006;4:110-114)

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Original Article

Usefulness of Double Balloon Enteroscopy in Small Bowel Disease: Jun Hwan Wi, Jin Oh Kim, In Seop Jung, Bong Min Ko, Joo Young Cho, Joon Seong Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2005;3(2):140-144. Published online December 30, 2005

Abstract PDF: Background/Aims
Conventional studies for small bowel such as small bowel series, enteroscopy with Push, Sonde and Ropeway method had some limitations such as high missing rate, incomplete study, long procedure time and patient inconvenience. Double balloon enteroscopy is a promising method to overcome these limitations. Our aim was to evaluate the usefulness of double balloon enteroscopy. Methods: Between Nov. 2004 and Feb. 2005, 24 patients with suspected small bowel disease underwent double balloon enteroscopy. Results: Indications for double balloon enteroscopy were obscure gastrointestinal bleeding, chronic abdominal pain and Crohn's disease etc. Thirty eight cases of double balloon enteroscopy in 24 patients were performed. We could identify positive diagnostic findings in 20 of the 24 patients. In 16 obscure gastrointestinal bleeding patients, the causes of bleeding were 7 small bowel ulcers, 4 angiodysplasias, 3 Crohn's diseases etc. Procedure-related complications were not observed in any patients. Conclusions: Double balloon enteroscopy is a useful and safe diagnostic tools in small bowel disease with high diagnostic accuracy (83%). (Intestinal Research 2005;3:140-144)

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