Intestinal Research

Case Report

IBD

Pediatric Crohn’s disease with severe morbidity manifested by gastric outlet obstruction: two cases report and review of the literature: Eun Sil Kim, Ji Hyung Park, Yon Ho Choe, Mi Jin Kim; Intest Res 2021;19(4):472-477. Published online October 29, 2020; DOI: https://doi.org/10.5217/ir.2020.00072

Crohn’s disease (CD) presenting as gastric outlet obstruction is rare but serious clinical presentation of CD causing severe morbidity. However, there have been few case reports concerning this disorder in East Asian children and adolescents. The current case report describes 2 pediatric patients with CD who had had gastric outlet obstruction as an initial symptom of CD. Two pediatric patients developed postprandial vomiting, bloating, and unintentional weight loss. The upper endoscopy result indicated that there was pyloric obstruction with mucosal edema, inflammation and ulcers. The serologic test and colonoscopy results suggested CD. These patients were treated with infliximab, and endoscopic balloon dilation without surgery and showed remarkable improvement in obstructing symptoms with maintaining clinical and biochemical remission. This case report elucidates the benefits of early intervention using infliximab and endoscopic balloon dilation to improve gastric outlet obstruction and achieve baseline recovery in patients with upper gastrointestinal B2 phenotype of CD.

Citations

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Upper gastrointestinal tract involvement of Crohn disease: clinical implications in children and adolescents
Eun Sil Kim, Mi Jin Kim
Clinical and Experimental Pediatrics.2022; 65(1): 21. CrossRef

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Original Article

Diagnostic and prognostic value of preoperative ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography for colorectal cancer: comparison with conventional computed tomography: Joo Young Lee, Soon Man Yoon, Jeong Tae Kim, Ki Bae Kim, Mi Jin Kim, Jae Geun Park, Taek-Gu Lee, Sang-Jeon Lee, Sung Soo Koong, Joung-Ho Han, Hee Bok Chae, Seon Mee Park, Sei Jin Youn; Intest Res 2017;15(2):208-214. Published online April 27, 2017; DOI: https://doi.org/10.5217/ir.2017.15.2.208

Abstract PDF PubReader ePub

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

¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) has been used for preoperative staging of colorectal cancer (CRC). However, the diagnostic accuracy of FDG-PET/CT for detection of lymph node or distant metastasis and its prognostic role have not been well established. We therefore evaluated the diagnostic and prognostic value of FDG-PET/CT in comparison with conventional CT for CRC.

Methods

We investigated 220 patients who underwent preoperative FDG-PET/CT and CT, followed by curative surgery for CRC. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG-PET/CT and CT for detection of lymph node metastasis and distant metastasis were evaluated. In addition, we assessed the findings of FDG-PET/CT and CT according to outcomes, including cancer recurrence and cancer-related death, for evaluation of prognostic value.

Results

For detection of lymph node metastasis, FDG-PET/CT had a sensitivity of 44%, a specificity of 84%, and an accuracy of 67%, compared with 59%, 65%, and 62%, respectively, for CT (P=0.029, P=0.000, and P=0.022). For distant metastasis, FDG-PET/CT had a sensitivity of 79%, a specificity of 94%, and an accuracy of 93%, compared with 79%, 87%, and 86%, respectively, for CT (P=1.000, P=0.004, and P=0.037). In addition, positive findings of lymph node metastasis and distant metastasis on FDG-PET/CT were associated significantly with cancer recurrence or cancer-related death (P=0.009, P=0.001, respectively).

Conclusions

Preoperative FDG-PET/CT had a higher specificity and accuracy compared to CT for detection of lymph node metastasis and distant metastasis of CRC. In addition, FDG-PET/CT could be a valuable prognostic tool for CRC.

Citations

Citations to this article as recorded by

Nuclear medicine based multimodal molecular imaging facilitates precision medicine for gastrointestinal tumors
Jing Zhao, Fei Wang, Rong-Fu Wang
World Chinese Journal of Digestology.2024; 32(10): 727. CrossRef
Tomographie par émission de positons en cancérologie digestive
C. Aveline, F. Montravers
EMC - Radiologie et imagerie médicale - Abdominale - Digestive.2024; 42(1): 1. CrossRef
Retrospective audit: Utility of PET scan in routine preoperative rectal cancer staging
Michelle Zhiyun Chen, Xinyi Zhang, Milton Mui, Joseph C. H. Kong, Alexander G. Heriot, Jodie Ellis‐Clark
ANZ Journal of Surgery.2023; 93(3): 617. CrossRef
Impact of routine preoperative 18FDG PET/CT on the surgical management of primary colorectal cancer
Mónica Mogollón‐González, Raquel Conde‐Muiño, Antonio Rodríguez‐Fernández, Mar Navarro‐Pelayo, Mireia Domínguez‐Bastante, Pablo Palma
Journal of Surgical Oncology.2023; 128(2): 295. CrossRef
Investigating ultra-low-dose total-body [18F]-FDG PET/CT in colorectal cancer: initial experience
Hui Tan, Danjie Cai, Xiuli Sui, Chi Qi, Wujian Mao, Yiqiu Zhang, Guobing Liu, Haojun Yu, Shuguang Chen, Pengcheng Hu, Jianying Gu, Hongcheng Shi
European Journal of Nuclear Medicine and Molecular Imaging.2022; 49(3): 1002. CrossRef
Tailoring the clinical management of colorectal cancer by 18F-FDG PET/CT
Yang Shi, Meiqi Wang, Jiyu Zhang, Zheng Xiang, Can Li, Jingjing Zhang, Xing Ma
Frontiers in Oncology.2022;[Epub] CrossRef
Clinical TNM staging for esophageal, gastric, and colorectal cancers in the era of neoadjuvant therapy: A systematic review of the literature
Hideaki Shimada, Takeo Fukagawa, Yoshio Haga, Shin‐ichi Okazumi, Koji Oba
Annals of Gastroenterological Surgery.2021; 5(4): 404. CrossRef
The significant value of predicting prognosis in patients with colorectal cancer using 18F-FDG PET metabolic parameters of primary tumors and hematological parameters
Junyan Xu, Yi Li, Silong Hu, Linjun Lu, Zhiqi Gao, Huiyu Yuan
Annals of Nuclear Medicine.2019; 33(1): 32. CrossRef
Optimal Interval for 18F-FDG-PET After Chemoradiotherapy for Rectal Cancer
Kazushige Kawai, Hiroaki Nozawa, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Koji Oba, Toshiaki Watanabe
Clinical Colorectal Cancer.2018; 17(2): e163. CrossRef
Preoperative PET/CT 18F-FDG Standardized Uptake by Lymph Nodes as a Significant Prognostic Factor in Patients with Colorectal Cancer
Ruohua Chen, Yining Wang, Xiang Zhou, Gang Huang, Jianjun Liu
Contrast Media & Molecular Imaging.2018; 2018: 1. CrossRef

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Case Reports

A Case of Colonic Perforation following Colonoscopy in Collagenous Colitis: Youn Sun Park, Byung Ik Jang, Tae Nyeun Kim, Jong Ryul Eun, Jae Won Choi, Kyu Hyung Lee, Kyeong Ok Kim, Si Hyung Lee, Mi Jin Kim; Intest Res 2007;5(1):77-80. Published online June 30, 2007

Abstract PDF: Collagenous colitis is a clinicopathological syndrome characterized by: (1) chronic watery diarrhea and crampy abdominal pain and (2) thickened subepithelial collagen band and increased intraepithelial lymphocytes on histology. The mucosa generally appears endoscopically normal, although some nonspecific abnormalities such as patchy erythema, an abnormal vascular pattern or erythema may be found in upto one third of cases. Collagenous colitis is generally regarded as a benign disease and serious complication are uncommon. The frequency of colonic perforation in collagenous coliltis is unknown, but is probably very rare. Only 16 patients, excluding our cases, have so far been reported. We report a case of a 80-year-old woman with collagenous colitis who presented with colonic perforation two days after the colonoscopy. (Intest Res 2007;5:77-80)

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Recur of Malignant Mixed Mullerian Tumor of the Ovary in Intestine: Ji Eun Lee, Jang Won Sohn, Hee Jung Moon, Sang Hoon Lee, Youn Sun Park, Jae Won Choi, Kook Hyun Kim, Jong Ryul Eun, Byung Ik Jang, Tae Nyeun Kim, Jae Hwang Kim, Mi Jin Kim; Intest Res 2006;4(1):53-56. Published online June 30, 2006

Abstract PDF: Malignant mixed mullerian tumor (MMMT) is rare tumor of the ovary, representing less than 1% of all ovarian malignancies. MMMT is an uncommon tumor containing epithelial and mesenchymal components. Most of all were heterologous type and 80% occur in postmenopausal women. It is a aggressive and rapidly progressive tumor. MMMT is highly malignant and the prognosis is poor because of frequent metastasis and recurrance. The survival rate is very low in spite of surgery, chemotherapy and radiotherapy. The optimal treatment is still controversial. We experienced one recur case of malignant mixed mullerian tumor of the ovary in intestine and report with brief review of literature. (Intestinal Research 2006;4:53-56)

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