Intestinal Research

Original Article

Miscellaneous

Primary epiploic appendagitis: compared with diverticulitis and focused on obesity and recurrence: Youn I Choi, Hyun Sun Woo, Jun-Won Chung, Young Sup Shim, Kwang An Kwon, Kyoung Oh Kim, Yoon Jae Kim, Dong Kyun Park; Intest Res 2019;17(4):554-560. Published online October 14, 2019; DOI: https://doi.org/10.5217/ir.2018.00148

Background/Aims
There is limited data to compare the clinical characteristics and recurrence rates between left-sided primary epiploic appendagitis (PEA) versus left-sided acute colonic diverticulitis (ACD), and right-sided PEA versus right-sided ACD, respectively.
Methods
We retrospectively reviewed the medical records and radiologic images of the patients who presented with left-sided or right-sided acute abdominal pain and had computer tomography performed at the time of presentation showing radiological signs of PEA or ACD between January 2004 and December 2014. We compared the clinical characteristics of left PEA versus left ACD and right PEA versus right ACD, respectively.
Results
Fifty-six patients (left:right = 27:29) and 308 patients (left:right = 24:284) were diagnosed with symptomatic PEA and ACD, respectively. Left-sided PEA were statistically significantly younger (50.2 ± 15.4 years vs. 62.1 ± 15.8 years, P= 0.009), more obese (body mass index [BMI]: 26.3 ± 2.9 kg/m2 vs. 22.3 ± 3.1 kg/m2 , P< 0.001), and had more tendencies with normal or mildly elevated high-sensitivity C-reactive protein (hsCRP) (1.2 ± 1.3 mg/dL vs. 8.4 ± 7.9 mg/dL, P< 0.001) than patients with left-sided ACD. The discriminative function of age, BMI and CRP between left-sided PEA versus left-sided ACD was 0.71 (cutoff: age ≤ 59 years, sensitivity of 66.7%, specificity of 77.8%), 0.83 (cutoff: BMI > 24.5 kg/m2 , sensitivity of 80.0%, specificity of 80.0%) and 0.80 (cutoff: CRP < 1.8 mg/dL, sensitivity of 72.2%, specificity of 85.7%).
Conclusions
If patients with left lower quadrant abdominal pain are less than 60 years, obese (BMI > 24.5 kg/m2 ) with or without normal to mild elevated CRP levels (CRP < 1.8 mg/dL), it might be necessary for clinicians to suspect the diagnosis of PEA rather than ACD.

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Diagnosis and treatment of epiploic appendagitis in a Middle Eastern country: An observational retrospective analysis of 156 cases
Ayman El‐Menyar, Syed G. A. Naqvi, Omer Al‐Yahri, Abdelaziz MA Abusal, Abdulwahhab Al‐Shaikhli, Sadia Sajid, Husham Abdelrahman, Ahmad G. Kloub, Muhamed Ibnas, Rifat Latifi, Yasser M. R. Toble, Hassan Al‐Thani
World Journal of Surgery.2024; 48(6): 1363. CrossRef
Epiploic Adipose Tissue (EPAT) in Obese Individuals Promotes Colonic Tumorigenesis: A Novel Model for EPAT-Dependent Colorectal Cancer Progression
Rida Iftikhar, Patricia Snarski, Angelle N. King, Jenisha Ghimire, Emmanuelle Ruiz, Frank Lau, Suzana D. Savkovic
Cancers.2023; 15(3): 977. CrossRef
Recurrencia en pacientes con apendagitis epiploica: un reporte de caso
Mía Alejandra Gómez Corrales, Fabian Andrés Chávez Ecos, Jackeline Alexandra Espinoza Utani, Carlos Alberto Dávila Hernández
Revista colombiana de Gastroenterología.2023; 38(1): 94. CrossRef

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Case Report

Drug-induced eosinophilic pneumonia in a patient with Crohn's disease: diagnosis and treatment using fraction of exhaled nitric oxide: Jina Yeo, Hyun Sun Woo, Sang Min Lee, Yoon Jae Kim, Kwang An Kwon, Dong Kyun Park, Jung Ho Kim, Kyoung Oh Kim, Jun-Won Chung; Intest Res 2017;15(4):529-534. Published online October 23, 2017; DOI: https://doi.org/10.5217/ir.2017.15.4.529

Abstract PDF PubReader ePub

Oral 5-aminosalicylic acid agents (mesalazine and sulfasalazine) and azathioprine are the mainstays of treatment for inflammatory bowel disease. Reports of pulmonary toxicity induced by oral 5-aminosalicylic acid agents or azathioprine in patients with inflammatory bowel disease are very rare; to date, only 38 cases have been reported worldwide. We, herein, report a case involving a 26-year-old man who was diagnosed with eosinophilic pneumonia after using mesalazine and azathioprine for the treatment of Crohn's disease and recovered after treatment. We also found that the fraction of exhaled nitric oxide level was elevated in this patient. After treatment, the fraction of exhaled nitric oxide level decreased and the symptoms improved. The present case shows that fraction of exhaled nitric oxide is related to the disease activity and treatment effectiveness of druginduced eosinophilic pneumonia.

Citations

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Exploratory disproportionality analysis of potentially drug-induced eosinophilic pneumonia using United States Food and Drug Administration adverse event reporting system
Ashwin Kamath
Scientific Reports.2025;[Epub] CrossRef
Qualitative and quantitative study of intermolecular weak interactions for aminosalicylic acid isomers by terahertz spectroscopy
Yuan Tang, Zhi Li, Shan Tu, Yulai She, Yongying Gan
International Journal of Quantum Chemistry.2022;[Epub] CrossRef
Spontaneous resolution of focal eosinophilic myositis of the adductor pollicis complicated by lung lesions
Sayuri Yamashita, Hidenaga Kawasumi, Makiko Kimura, Mutsuto Tateishi
Modern Rheumatology Case Reports.2020; 4(1): 106. CrossRef
lncRNACNN3-206 activates intestinal epithelial cell apoptosis and invasion by sponging miR-212, an implication for Crohn's disease
Na Li, Rui-Hua Shi
World Journal of Gastroenterology.2020; 26(5): 478. CrossRef
Expression alteration of long non-coding RNAs and their target genes in the intestinal mucosa of patients with Crohn’s disease
Na Li, Ruihua Shi
Clinica Chimica Acta.2019; 494: 14. CrossRef
Mesalazin-induced eosinophilic pneumonia in a 15-year-old boy with ulcerative colitis
G. N. Yankinа, L. V. Gorlenko, E. V. Loshkova, E. I. Kondratyeva, E. Yu. Tuteva, A. A. Terenteva, V. A. Zhelev, E. V. Mikhalev, T. A. Shemyakinа, T. S. Krivonogova, N. A. Ryzhakova, E. V. Romanova
Bulletin of Siberian Medicine.2019; 18(3): 245. CrossRef
Oxidative Stress and Effect of Treatment on the Oxidation Product Decomposition Processes in IBD
Ewa Dudzińska, Magdalena Gryzinska, Katarzyna Ognik, Paulina Gil-Kulik, Janusz Kocki, Vladimir Jakovljevic
Oxidative Medicine and Cellular Longevity.2018;[Epub] CrossRef

7,095 View
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5 Web of Science
7 Crossref

Original Articles

Usefulness of endoscopic resection using the band ligation method for rectal neuroendocrine tumors: Ju Seung Kim, Yoon Jae Kim, Jun-Won Chung, Jung Ho Kim, Kyoung Oh Kim, Kwang An Kwon, Dong Kyun Park, Jung Suk An; Intest Res 2016;14(2):164-171. Published online April 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.2.164

Abstract PDF PubReader ePub

<b>Background/Aims</b><br/>

Rectal neuroendocrine tumors (NETs) are among the most common of gastrointestinal NETs. Due to recent advances in endoscopy, various methods of complete endoscopic resection have been introduced for small (≤10 mm) rectal NETs. However, there is a debate about the optimal treatment for rectal NETs. In our study, we aimed to evaluate the efficacy and feasibility of endoscopic resection using pneumoband and elastic band (ER-BL) for rectal NETs smaller than 10 mm in diameter.

Methods

A total of 55 patients who were diagnosed with rectal NET from January 2004 to December 2011 at Gil Medical Center were analyzed retrospectively. Sixteen patients underwent ER-BL. For comparison, 39 patients underwent conventional endoscopic mucosal resection (EMR).

Results

There was a markedly lower deep margin positive rate for ER-BL than for conventional EMR (6% [1/16] vs. 46% [18/39], P=0.029). Four patients who underwent conventional EMR experienced perforation or bleeding. However, they recovered within a few days. On the other hand, patients whounderwent endoscopic resection using a pneumoband did not experience any complications. In multivariate analysis, ER-BL (P=0.021) was independently associated with complete resection.

Conclusions

ER-BL is an effective endoscopic treatment with regards to deep margin resection for rectal NET smaller than 10 mm.

Citations

Citations to this article as recorded by

Endoscopic treatments for rectal neuroendocrine tumors: a systematic review and network meta-analysis
Jie Chen, Jianfang Ye, Xiong Zheng, Jianyong Chen
Journal of Gastrointestinal Surgery.2024; 28(3): 301. CrossRef
Endoscopic mucosal resection using anchored snare Tip-in versus precut technique for small rectal neuroendocrine tumors
Seung Wook Hong, Dong-Hoon Yang, Yoo Jin Lee, Dong Hoon Baek, Jaeyoung Chun, Hyun Gun Kim, Sung Joo Kim, Seung-Mo Hong, Dae-Seong Myung
The Korean Journal of Internal Medicine.2024; 39(2): 238. CrossRef
Outcome of Endoscopic Resection of Rectal Neuroendocrine Tumors ≤ 10 mm
Roberta Elisa Rossi, Maria Terrin, Silvia Carrara, Roberta Maselli, Alexia Francesca Bertuzzi, Silvia Uccella, Andrea Gerardo Antonio Lania, Alessandro Zerbi, Cesare Hassan, Alessandro Repici
Diagnostics.2024; 14(14): 1484. CrossRef
Clinical outcomes of endoscopic resection for rectal neuroendocrine tumors: Advantages of endoscopic submucosal resection with a ligation device compared to conventional EMR and ESD
Yuki Kamigaichi, Ken Yamashita, Shiro Oka, Hirosato Tamari, Yasutsugu Shimohara, Tomoyuki Nishimura, Katsuaki Inagaki, Yuki Okamoto, Hidenori Tanaka, Ryo Yuge, Yuji Urabe, Koji Arihiro, Shinji Tanaka
DEN Open.2022;[Epub] CrossRef
Endoscopic Mucosal Resection in Children
David S. Vitale, Kelly Wang, Laith H. Jamil, Kenneth H. Park, Quin Y. Liu
Journal of Pediatric Gastroenterology and Nutrition.2022; 74(1): 20. CrossRef
Rectal neuroendocrine tumors: Current advances in management, treatment, and surveillance
Camilla Gallo, Roberta Elisa Rossi, Federica Cavalcoli, Federico Barbaro, Ivo Boškoski, Pietro Invernizzi, Sara Massironi
World Journal of Gastroenterology.2022; 28(11): 1123. CrossRef
Comparison of underwater endoscopic mucosal resection and endoscopic submucosal dissection of rectal neuroendocrine tumors (with videos)
Sung Sil Park, Kyung Su Han, Bun Kim, Byung Chang Kim, Chang Won Hong, Dae Kyung Sohn, Hee Jin Chang
Gastrointestinal Endoscopy.2020; 91(5): 1164. CrossRef
Treatment Results of Endoscopic Mucosal Resection with a Ligation Device for Duodenal Neuroendocrine Tumors
Ai Fujimoto, Motoki Sasaki, Osamu Goto, Tadateru Maehata, Yasutoshi Ochiai, Motohiko Kato, Atsushi Nakayama, Teppei Akimoto, Jyunko Kuramoto, Yuichiro Hayashi, Kaori Kameyama, Naohisa Yahagi
Internal Medicine.2019; 58(6): 773. CrossRef
Endoscopic submucosal resection with an endoscopic variceal ligation device for the treatment of rectal neuroendocrine tumors
Masahide Ebi, Shoko Nakagawa, Yoshiharu Yamaguchi, Yasuhiro Tamura, Shinya Izawa, Yasutaka Hijikata, Takaya Shimura, Yasushi Funaki, Naotaka Ogasawara, Makoto Sasaki, Takashi Joh, Kunio Kasugai
International Journal of Colorectal Disease.2018; 33(12): 1703. CrossRef
Neuroendocrine neoplasms of rectum: A management update
Emilio Bertani, Davide Ravizza, Massimo Milione, Sara Massironi, Chiara Maria Grana, Dario Zerini, Alessandra Nella Piccioli, Giuseppe Spinoglio, Nicola Fazio
Cancer Treatment Reviews.2018; 66: 45. CrossRef

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Usefulness of Sigmoidoscopy in Pseudomembranous Colitis: Focused on the Comparison with Immunological Assay for C. difficile Toxin and the Role as a Predictive Factor for Clinical Outcome: Jun-Won Chung, Jeong-Sik Byeon, Kwi-Sook Choi, Benjamin Kim, Seunghyun Kwon, Byong Duk Ye, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2007;5(1):45-51. Published online June 30, 2007

Abstract PDF: Background/Aims
Pseudomembranous colitis (PMC) shows a diverse clinical course. The aim of this study is to evaluate the usefulness of sigmoidoscopy in PMC. Methods: Sigmoidoscopic findings and medical records were analyzed in 74 patients with PMC (male：female=38：36, 62⁑16 years). Sigmoidoscopic grades of PMC were classified into mild (n=45) when pseudomembrane covered ＜1/3 of lumen, moderate (n=18) when it covered 1/3-2/3 of lumen, and severe (n=11) when its extent was ＞2/3 of lumen. Results: In comparison to sigmoidoscopy, diagnostic sensitivity of enzyme immunoassay (EIA) for C. difficile toxin A was 29%. EIA sensitivity was 38% in mild, 28% in moderate, 0% in severe sigmoidoscopic grade (p=0.02). Risk factors for severe sigmoidoscopic grade were ileus, nasogastric tube insertion, and serum albumin below 2.3 g/dL. Initial treatment success rate was lower in severe grade (33%) than mild (96%) and moderate grade (83%) (p＜0.01). One year mortality rate was lower in severe grade (17%) than mild (85%) and moderate grade (84%) (p=0.01). Old age and severe sigmoidoscopic grade were risk factors for death. Conclusions: Sigmoidoscopic severity grading may be useful in the prediction of prognosis in PMC patients. Sigmoidoscopy may also be useful in the diagnosis of PMC, especially in patients with severe PMC. (Intest Res 2007;5:45-51)

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Clinical Factors Predicting the Detection of Abnormalities by Double Balloon Endoscopy in Patients with Obscure Overt Gastrointestinal Bleeding: Jun-Won Chung, Jeong-Sik Byeon, Kee Don Choi, Kwi-Sook Choi, Benjamin Kim, Seung-Jae Myung, Suk-Kyun Yang, Jin-Ho Kim; Intest Res 2006;4(2):95-100. Published online December 30, 2006

Abstract PDF: Background/Aims
The most frequent indication of double balloon endoscopy (DBE) is obscure gastrointestinal bleeding (OGIB). The aim of the study was to evaluate the clinical factors predicting the detection of bleeding focus by DBE in patients with overt OGIB. Methods: Twenty eight patients (male：female=16：12, 13-82 years) with overt OGIB who underwent DBE were enrolled. Medical records were reviewed and analyzed. Results: Bleeding focus was found in 21 patients (75.0%). Age, gender, time interval between the last blood passage and DBE, transfusion amount, hemodynamic instability, and the number of past bleeding episodes were not different between patients whose bleeding focus was found by DBE and those whose bleeding focus was not found. Duration of bleeding was significantly longer in patients whose bleeding focus was found by DBE than those whose bleeding focus was not found (196.8⁑238.5 vs. 15.5⁑13.7 days, p=0.04). Conclusions: Duration of bleeding may be a useful clinical parameter which predicts the detection of bleeding focus by DBE in overt OGIB. (Intestinal Research 2006;4:95-100)

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Clinical Characteristics and Long-term Course of Ulcerative Colitis in Korea: Young Min Kim, Sang Hyoung Park, Suk-Kyun Yang, Jae-Won Choe, Sai-Hui Kim, Jeong-Sik Byeon, Seung-Jae Myung, Yun Kyung Cho, Chang-Sik Yu, Kwi-Sook Choi, Jun-Won Chung, Benjamin Kim, Kee Don Choi, Jin-Ho Kim; Intest Res 2006;4(1):12-21. Published online June 30, 2006

Abstract PDF: Background/Aims
Clinical characteristics of ulcerative colitis (UC) in Asian populations are not well recognized. We therefore investigated the clinical features and natural history of UC in Korea. Methods: We retrospectively analyzed 304 Korean UC patients first diagnosed at Asan Medical Center between June 1989 and August 2005. Results: The male to female ratio was 0.94：1 and the median age at diagnosis was 40.0 years (range, 12-72 years). At diagnosis, proctitis was noted in 134 patients (44.1%), left-sided colitis in 69 (22.7%), and extensive colitis in 101 (33.2%). Disease activity at diagnosis was mild in 149 patients (49.0%), moderate in 125 (41.1%), and severe in 26 (8.6%). In addition, 4 (1.3%) asymptomatic patients were detected as a result of a screening colonoscopy. Clinical remission after the first attack was documented in 97.4% of patients. The cumulative relapse rates at 1, 5, 10 years were 30.2%, 72.0%, and 88.4%, respectively. The cumulative risk of proximal extension in patients with proctitis or left-sided colitis was 33.0% at 5 years and 44.5% at 10 years. The cumulative probability of colectomy was 2.0% at 1 year, 2.8% at 3 years, and 3.3% at 5-15 years. The cumulative survival rates at 1, 5, and 10 years were 100%, 99.4%, and 97.4%, respectively. Conclusions: Clinical features of Korean UC patients at diagnosis are similar to those of Westerners. However, UC in Koreans may have a milder course than in Westerners, since Koreans have a lower rate of colectomy. (Intestinal Research 2006;4:12-21)

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