Intestinal Research

Original Article

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

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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Behind the Ink: Unmasking Asymptomatic Micro-perforations Following Endoscopic Tattooing
Woo Suk Kim, Tasur Seen, Joel Baum, Aaron Walfish
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
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Percutaneous Endoscopic Gastrostomy Tube Gone Wrong: Endoscopic Closure to the Rescue
Jahnvi Dhar, Naveen Kumar, Pankaj Gupta, Rakesh Kochhar, Jayanta Samanta
Journal of Digestive Endoscopy.2021; 12(03): 169. CrossRef
Symptomatic Pneumoperitoneum After Gastrostomy Tube Placement Managed by Pneumocentesis
Tim Brotherton, Anuj Chhaparia, Michael Presti, Gregory Sayuk, Jill Elwing
ACG Case Reports Journal.2021; 8(11): e00700. CrossRef
TWO APPROACHES TO PNEUMOPERITONEUM: SURGERY AND CONSERVATIVE
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
Joo Hyun Lim, Seung Ho Choi, Changhyun Lee, Ji Yeon Seo, Hae Yeon Kang, Jong In Yang, Su Jin Chung, Joo Sung Kim
Intestinal Research.2016; 14(4): 333. CrossRef
The role of surgery in the treatment of endoscopic complications
Peter Dixon, Gopal C. Kowdley, Steven Clark Cunningham
Best Practice & Research Clinical Gastroenterology.2016; 30(5): 841. CrossRef
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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Case Report

A Case of Localized Amyloid Light-Chain Amyloidosis in the Small Intestine: Jong Hyo Choi, Bong Min Ko, Cheol Kim, Hee Kyung Kim, Jae Pil Han, Su Jin Hong, Jong Ho Moon, Moon Sung Lee; Intest Res 2014;12(3):245-250. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.245

Abstract PDF PubReader ePub

Amyloidosis is characterized by the abnormal deposition of extracellular amyloid fibrils. Cases involving amyloid light-chain amyloidosis in the small intestine have been reported infrequently in Korea. Here, we report a case of localized light chain protein amyloidosis in the small intestine. Esophagogastroduodenoscopy, push enteroscopy, and capsule endoscopy revealed submucosal tumor-like lesions, multiple shallow ulcers, and several erosions in the distal duodenum and jejunum. An endoscopic biopsy established the diagnosis of amyloidosis. In through an immunohistochemical analysis, the presence of lambda light chain protein was detected. The patient had no evidence of an underlying clonal plasma cell disorder or additional organ involvement. Therefore, we concluded that the patient had localized amyloidosis of the small intestine.

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A systematic review of the literature on localized gastrointestinal tract amyloidosis: Presentation, management and outcomes
Mariuxi Alexandra Viteri Malone, David Alfonso Alejos Castillo, Heitor Tavares Santos, Anahat Kaur, Tarek Elrafei, Lewis Steinberg, Abhishek Kumar
European Journal of Haematology.2024; 113(4): 400. CrossRef
Iatrogenic Sigma Perforation in a Patient with Localized Rectal and Sigma AL Amyloidosis: A Forensic Case and a Literature Review
Giuseppe Davide Albano, Stefania Zerbo, Simone Di Franco, Elisabetta Orlando, Eleonora Formisano, Antonina Argo, Beatrice Belmonte
Forensic Sciences.2024; 4(3): 453. CrossRef
Systemic Immunoglobulin Light Chain Amyloidosis Involving the Large Intestine
Renugadevi Swaminathan, Samuel Igbinedion, Sudha Pandit
ACG Case Reports Journal.2021; 8(5): e00578. CrossRef
Unusual case of amyloidosis presenting as a jejunal mass
Sachin Mohan, Elliot Graziano, James Campbell, Irshad H Jafri
BMJ Case Reports.2021; 14(5): e240226. CrossRef
Gastrointestinal AA amyloidosis secondary to chronic pyelonephritis presenting with refractory diarrhea and severe hypoalbuminemia
Tomoko Tanaka, Tatsushi Naito, Yohei Midori, Takuto Nosaka, Kazuto Takahashi, Kazuya Ofuji, Hidetaka Matsuda, Masahiro Ohtani, Katsushi Hiramatsu, Yoshiaki Imamura, Osamu Yokoyama, Hironobu Naiki, Yasunari Nakamoto
Clinical Journal of Gastroenterology.2021; 14(6): 1642. CrossRef
Morphological and Immunohistochemical Characteristics of Experimental Mandibular Fractures Healing Process
A. A. Matchin, A. A. Stadnikov, E. V. Nosov, S. Kh. Kiriakidi
Journal of Anatomy and Histopathology.2019; 8(1): 44. CrossRef
Specific Clinical and Morphological Characteristics of Amyloidosis of the Stomach and Duodenum
Z. V. Gioeva, L. M. Mikhaleva
Journal of Anatomy and Histopathology.2019; 8(1): 39. CrossRef
Localized Gastrointestinal ALλ Amyloidosis
Tomoya Iida, Kentaro Yamashita, Hiroshi Nakase
Clinical Gastroenterology and Hepatology.2018; 16(9): e93. CrossRef
Small Bowel Amyloidosis
Raghav Bansal, Umer Syed, Jacob Walfish, Joshua Aron, Aaron Walfish
Current Gastroenterology Reports.2018;[Epub] CrossRef
Systemic amyloidosis with gastrointestinal involvement: Diagnosis from endoscopic and histological views
Tomoya Iida, Hiroo Yamano, Hiroshi Nakase
Journal of Gastroenterology and Hepatology.2018; 33(3): 583. CrossRef

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Original Article

Does Metformin Affect The Incidence of Colonic Polyps and Adenomas in Patients with Type 2 Diabetes Mellitus?: Youn Hee Cho, Bong Min Ko, Shin Hee Kim, Yu Sik Myung, Jong Hyo Choi, Jae Pil Han, Su Jin Hong, Seong Ran Jeon, Hyun Gun Kim, Jin Oh Kim, Moon Sung Lee; Intest Res 2014;12(2):139-145. Published online April 29, 2014; DOI: https://doi.org/10.5217/ir.2014.12.2.139

Abstract PDF PubReader

Background/Aims

Colorectal cancer (CRC) develops from colonic adenomas. Type 2 diabetes mellitus (DM) is associated with a higher risk of CRC and metformin decreases CRC risk. However, it is not certain if metformin affects the development of colorectal polyps and adenomas. This study aimed to elucidate if metforminaffects the incidence of colonic polyps and adenomas in patients with type 2 DM.

Methods

Of 12,186 patients with type 2 DM, 3,775 underwent colonoscopy between May 2001 and March 2013. This study enrolled 3,105 of these patients, and divided them in two groups: 912 patients with metformin use and 2,193 patients without metformin use. Patient clinical characteristics, polyp and adenoma detection rate in the two groups were analyzed retrospectively.

Results

The Colorectal polyp detection rate was lower in the metformin group than in the non-meformin group (39.4% vs. 62.4%, P<0.01). Colorectal adenoma detection rate was significantly lower in the metformin group than in the non-metformin group (15.2% vs. 20.5%, P<0.01). Fewer advanced adenomas were detected in the metformin group than in the non-metformin group (12.2% vs. 22%, P<0.01). Multivariate analysis identified age, sex, Body mass index and metformin use as factors associated with polyp incidence, whereas only metforminwas independently associated with decreased adenoma incidence (Odd ratio=0.738, 95% CI=0.554-0.983, P=0.03).

Conclusions

In patients with type 2 DM, metformin reduced the incidence of adenomas that may transform into CRC. Therefore, metformin may be useful for the prevention of CRC in patients with type 2 DM.

Citations

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Metformin for primary prevention of colorectal neoplasms in adenoma-free populations: a systematic review and dose-response meta-analysis
Mengdan Shen, Shan Lu, Zihao Xu, Feifei Zhou, Li-Ting Sheng, Qiang Yu
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Is Metformin Associated with a Lower Prevalence of Polyps, Adenomas, and Colorectal Carcinoma in Patients with Diabetes Mellitus?
Maria Inês Canha, Gonçalo Ramos, Rita Prata, Pedro Lages Martins, Marta Viúla Ramos, João Coimbra
Journal of Gastrointestinal Cancer.2024; 55(1): 435. CrossRef
Metformin administration in prevention of colorectal polyps in type 2 diabetes mellitus patients
Xiao-Qing Wu, Li-Hua Deng, Qian Xue, Xia Li, Meng-Han Li, Jing-Tong Wang
World Journal of Clinical Cases.2024; 12(20): 4206. CrossRef
Anti-cancer Efficacy of Metformin: Recent Updates on Breast and Other Cancers
Md. Imtiazul Kabir, Robin Kumar, Lakshmi Sai Pratyusha Bugata, Komal Raina
Current Pharmacology Reports.2023; 9(5): 284. CrossRef
Metformin Use Is Inversely Associated with Prevalent, but Not Incident Colorectal Adenomas
Anna Krigel, Snow Trinh T. Nguyen, Nawar Talukder, Ching-Ho Huang, Carlos Buitrago, Gabriel Karkenny, Benjamin Lebwohl, Julian A. Abrams, James L. Araujo
Digestive Diseases and Sciences.2022; 67(10): 4886. CrossRef
Effect of metformin on thyroid cancer risk in patients with acromegaly: A preliminary observational study
Cem Sulu, Ayyuce Begum Bektas, Suleyman Sami Guzel, Kubilay Tay, Serdar Sahin, Emre Durcan, Hande Mefkure Ozkaya, Pinar Kadioglu
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Suppressive effects of metformin on colorectal adenoma incidence and malignant progression
Min Deng, Siqin Lei, Dongdong Huang, Hui Wang, Shuli Xia, Enping Xu, Yihua Wu, Honghe Zhang
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Use of metformin and risk of breast and colorectal cancer
Gad Rennert, Hedy S. Rennert, Naomi Gronich, Mila Pinchev, Stephen B. Gruber
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Diabetes Mellitus: a Clinical Condition Associated with Metabolic Syndrome and Colorectal Cancer Risk
Vesna Brzacki, Aleksandar Nagorni, Manolis Kallistratos, Athanasios Manolis, Dragan Lovic
Current Pharmacology Reports.2019; 5(4): 205. CrossRef
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Muhamad Noor Alfarizal Kamarudin, Md. Moklesur Rahman Sarker, Jin-Rong Zhou, Ishwar Parhar
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Postoperative adjuvant chemotherapy is associated with a lower incidence of colorectal adenomas in patients with previous colorectal cancer
Hee Seung Lee, Sung Bae Kim, Hyun Jung Lee, Soo Jung Park, Sung Pil Hong, Jae Hee Cheon, Won Ho Kim, Tae Il Kim
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Yonsei Medical Journal.2017; 58(2): 347. CrossRef
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Mirabella Zhao, Donghua Liao, Jingbo Zhao
World Journal of Diabetes.2017; 8(6): 249. CrossRef
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Yoon Suk Jung, Chan Hyuk Park, Chang Soo Eun, Dong Il Park, Dong Soo Han
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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 Articles

Endoscopic Mucosal Resection of Early Colon Cancer: Additional Therapy and Clinical Outcomes: Sang Gyune Kim, Chang Beom Ryu, Moon Sung Lee, Bong Min Ko, Sung Won Jung, Su Jin Hong, Young Seok Kim, Jin Oh Kim, Kye Won Kwon, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):65-70. Published online December 22, 2004

Abstract PDF: Background/Aims
The prevalence of early colon cancer is increasing and endoscopic removal of it has been widely accepted. After endoscopic resection, a number of remnant or recurrent tumors were managed successfully through salvage endoscopic mucosal resection (EMR) or argon plasma coagulation (APC). This study evaluated the outcomes of EMR for early colon cancer and efficacy of additional therapy in preventing recurrence. Methods: During the period from March 2001 to April 2004, a total of 50 early colon cancers were resected and analyzed retrospectively. EMR was performed either piecemeal by snare and cap aspiration or en bloc by conventional EMR and submucosal dissection. The patients were followed up at 3, 6, 12, 24 months and median follow up period was 21.8 months. By using the magnifying endoscopy, If the endoscopists judged the tumors incompletely excised or recurred. APC and EMR as additional therapy were done. Results: 50 early colon cancers comprised 44 mucosal cancers and 6 submucosal cancers in which en bloc resection was 34 (68%) and piecemeal resection was 16 (32%). Apart from the 13 cases which is unable to decide its lateral margin free because of piecemeal resection, Complete resection rate was 26/37(70.3%). The 20 cases receiving additional therapy consisted of en bloc resection 8 cases and piecemeal resection 12 cases. Recurrence rate of previous additional therapy was 1/20(5%) and had no significant difference with no additional therapy. Conclusions: For endoscopic treatment of early colon cancer En bloc resection is much better than piecemeal resection. Because of its high complete resection rate. But, in case of suggestive incomplete resection, recurrence rate will be decreased through the additional therapy. The long term results of additional therapy after EMR for Early colon cancer seem to be required for more study. (Intestinal Research 2004;2:65-70)

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Clinical Study for Gastrointestinal Carcinoid Tumor; Aspect of Endoscopic, Endosonographic Findings and Endoscopic Treatment: Bong Min Ko, Chang Beom Ryu, Moon Sung Lee, Kye Won Kwon, Sang Gyune Kim, Sung Won Jung, Su Jin Hong, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):89-95. Published online December 22, 2004

Abstract PDF: Background/Aims
Because screening for colonic cancer includes colonoscopy, more of carcinoid tumors may be diagnosed at an earlier stage. Metastatic disease is rare in lesions smaller than 1cm and common in lesions larger than 2cm. Small lesions are managed with local excision or endoscopic resection. Endoscopic resection, a major advance in endoscopy, provides an endoscopic option for management of carcinoid tumor of the GI tract. We study to evaluate the efficacy and safety of high-frequency probe EUS-assisted endoscopic resection in the management of carcinoid tumor of the GI tract, to evaluate of clinical usefulness of cap aspiration method in comparison with snare polypectomy. Methods: For 31 patients, snare polypectomy and cap aspiration lumpectomy were performed between February 2001 and September 2004 after evaluating by endosonography. Results: EUS examination confirmed that all of the rectal carcinoid tumor were hypoechic mass confined to the second or third layer of the rectum. The rate of complete removal of carcinoid tumors with aspiration lumpectomy was significantly higher than with snare polypectomy (p<0.05). Conclusions: EUS can provide precise information about size, layer of origin, and echogenicity of the carcinoid tumor. It is useful in the diagnosis of carcinoid of the rectum and can have an important role in the choice of therapy. Endoscopic resection with cap is a useful and safe method for resection of small carcinoid tumor of the rectum according to endoscopic shape and EUS findings. (Intestinal Research 2004;2:89-94)

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High Dose Midazolam versus Propofol plus Midazolam in Conscious Sedation during Colonoscopy: Sung Won Jung, Sang Kyune Kim, Moon Sung Lee, Bong Min Ko, Su Jin Hong, Chang Beom Ryu, Young Seok Kim, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):107-112. Published online December 22, 2004

Abstract PDF: Background/Aims
Colonoscopy under sedation has grown in popularity recently. Midazolam and propofol are generally used for conscious sedation during colonoscopy. In comparison of midazolma, propofol is shorter-acting hypnotic agent and has shorter plasma half-life and it was reported that combined use of propofol with benzodiazepines, barbiturates or opioids enhanced sedative effect by drug interaction. We investigated the effect of high dose midazolam and combined use of midazolam and propofol in conscious sedation during colonoscopy. Methods: We injected midazolam intravenously in 61 patients for sedation before colonoscopy. We divided patients into two groups; one group was injected with additional midazolam (31 patients, high dose midazolam group) and the other was injected with additional propofol (30 patients, combined group). We compared followings in both groups; 1) decrease of systolic and diastolic blood pressure, heart rate, respiration rate per minute, and oxygen saturation rate 2) recovery time 3) degree of amnesia 4) content of patient 5) adverse effects. Results: There is no significant difference between two groups in sex and mean age. In both groups, significant difference was not observed in decrease of systolic and diastolic blood pressure, heart rate, respiration rate, and peripheral blood oxygen saturation rate (p>0.05). Recovery time was shorter in combined group than in high dose midazolam group (p<0.05). Content of patients was higher in combined group (p<0.05), Fatal adverse effect was not found in both groups. Conclusions: Combine use of midazolam and propofol is more effective sedative method than use of high dose midazolam because of shorter recovery time and increased content of patients without increasing adverse effect. (Intestinal Research 2004;2:107-112)

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Brief Report

A case of Small Bowel Obstruction due to Jejunal Adenocarcinoma Diagnosed by Double-balloon Enteroscopy: Su Jin Hong, Jun Yong Bae, Moon Sung Lee, Sung Won Jung, Sang Gyune Kim, Bong Min Ko, Chang Beom Ryu, Young Seok Kim, Jin Oh Kim, Chan Sup Shim, Boo Sung Kim; Intest Res 2004;2(2):124-128. Published online December 22, 2004

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Original Articles

Usefulness of a Self-expandable Metal Stent Through the Scope for Malignant Colorectal Obstruction: Chang Beom Ryu, Hwan Yeol Kim, Kang An Kwon, In Sup Jung, Su Jin Hong, Jin Oh Kim, Joo Young Cho, Joon Sung Lee, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim; Intest Res 2003;1(1):45-50. Published online May 27, 2003

Abstract PDF: Background/Aims
The optimal palliative treatment of unresectable colorectal malignant obstruction is still debated. Recently, successful short-term palliation of malignant colorectal obstruction using self-expandable metal stents has been reported by several groups of investigators. Aims: The aim of this study was to evaluate the clinical usefulness of these self-expandable metal stents (SEMS) through the scope for the treatment of malignant colorectal cancer. Methods: Between May 1999 and December 2002, 35 patients (M:F=19:16) with malignant colorectal obstruction were treated for relief from the obstruction with endoscopically guided intubation of a SEMS through the working channel of an endoscope. Uncovered stents were intserted in 29 patients and covered stents in 6 patients. The technical and clinical success rates and complication were evaluated. Results: The sites of obstructions were on the rectum (n=3), sigmoid colon (n=9), descending colon (n=9), transverse colon (n=8) and ascending colon (n=6). SEMS insertion was successful in 34 of 35 patients (97%). In 31 of 34 patients with successful placement of the stent, symptoms of obstruction resolved within 72 hours. Two patients underwent the formal bowel preparation and elective single-stage surgery without complication 10 and 60 days after stent placement. Perforation occurred in 1 patients during stent placement and died. The mean follow up was 144 days (5-610 days). Stent migration occurred in 7 patients during follow-up who were 2 (33.3%) of 6 patients with covered stent and 5 (17.8%) of 28 patients with uncovered stent. After migration of stents, another stent was reinserted in 3 of 7 patients. Obstruction of the stent because of tumor ingrowth and overgrowth was observed in 4 patients with uncovered stent. Conclusions: SEMS placement through the working channel of an endoscope provide not only palliative decompression in cases with inoperable malignant colorectal obstruction but preoperative decompression to undergo the one-step surgery in patients with malignant colorectal obstruction. (Intestinal Research 2003;1:45-50)

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Analysis of Early Colon Cancers Diagnosed by Endoscopic Resection: Bong Roung Kim, Jin O Kim, Seong Hwan Kim, Sang Ho Lee, In Seop Jung, Su Jin Hong, Chang Byum Ryu, Joo Yung Cho, Moon Sung Lee, Chan Sup Shim, Boo Sung Kim, So Young Jin; Intest Res 2003;1(1):51-54. Published online May 27, 2003

Abstract PDF: Backgrounds/Aims: The aim of this study was to analyze clinicopathologic feature of early colon cancer diagnosed by endoscopic resection. Methods: 41 early colon cancers from 22 patients endoscopically removed during the period from 2001.1~2002.6 were analysed. Results: 22 patients who were diagnoised as early colon cancer patient had totally 210 colonic polyps and 41 early colonic cancers. Most common age of distributuion was 6th decade. Of the 41 early colon cancers, malignant polyps less than 5 mm in size were in 43%, 6~10 mm in 10%, 11~20 mm in 21%, >21 mm in 26%. Malignant polyps were more common in left side colon than right side colon (7:3). Endoscopic shapes of early colon cancers were mostly sessile type (sessile type were in 90.2%). Conclusions: Significant fraction of early colon cancers were less than 1 cm in size. To detect and treat early colon cancers more earlier, It is advisable to remove all of the colon polyps even though small polyps. (Intestinal Research 2003;1:51-54)

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