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캡슐내시경으로 진단된 공장의 다발성 위장관 간질종양 1예
김소연 ( So Yeon Kim ),박철희 ( Cheol Hee Park ),천승연 ( Seung Yeon Chun ),김수진 ( Su Jin Kim ),김종혁 ( Jong Hyeok Kim ),박충기 ( Choong Kee Park ),임만섭 ( Man Sup Lim ),서진원 ( Jin Won Seo ) 대한소화기학회 2012 대한소화기학회지 Vol.59 No.3
More than 90% cases of chronic gastrointestinal bleeding can be diagnosed by upper endoscopy and/or colonoscopy, and therefore, obscure gastrointestinal bleeding has been defined as bleeding of unknown origin that persists after these conventional endoscopic evaluation, Gastrointestinal stromal tumors (GISTs) are rare tumors, but the most common form of mesenchymal tumors of the gastrointestinal tract. Small bowel is the second most common primary site for GISTs, and accounts for 2-10% of chronic bleeding sites, GISTs usually present as a sporadic and solitary tumor, and a minority of the cases of multiple GISTs are discovered as forms of hereditary or idiopathic tumor syndromes, Small bowel tumor has been difficult to diagnose because of absence of accurate and proper diagnostic tools. Recently developed wireless capsule endoscopy helps in the diagnostic work-up of small bowel diseases. We report a case of multiple jejunal GISTs presenting melena in a 39-year-old male, which was diagnosed with wireless capsule endoscopy.
김수진 ( Su Jin Kim ),박철희 ( Cheol Hee Park ),김용민 ( Yong Min Kim ),김성열 ( Seong Yeol Kim ),천승연 ( Seung Yeon Chun ),권진우 ( Chin Woo Kwon ),박지원 ( Ji Won Park ),김경오 ( Kyoung Oh Kim ),백일현 ( Il Hyun Baek ),유교상 ( 대한장연구학회 2012 Intestinal Research Vol.10 No.2
Background/Aims: Intussusception is uncommon in adults compared with children. The present study aimed to review our experience of adult intussusceptions and discuss the preoperative diagnosis and management. Methods: A retrospective review was performed for 25 patients, at least 18 years old. These patients were diagnosed as intestinal intussusceptions at Hallym University Sacred Heart Hospital from January 1999 to October 2010. Results: There were 14 male and 11 female with a mean age of 55 years. The most common symptom was abdominal pain. The preoperative diagnostic rate was 92% because of the use of an abdominal computed tomography (CT) and an ultrasound. A total of 9 (36%) patients had enteroenteric intussusception, 8 had ileocolic, 1 had ileocecal and 7 patients had colocolic intussusception. A discrete pathologic process was present in 22 (88%) patients and the remaining 3 (12%) patients were idiopathic. There were 12 small bowel lesions and 10 colonic lesions. Neoplasms were the most common etiology of intussusceptions. Of the cases with a defined colonic cause, 8 (80%) were malignant. Overall, 12 (48%) patients underwent primary resection of the intussusception without prior reduction, 11 (44%) patients had reduction of their intussusception followed by resection. Conclusions: Adult colonic intussusception is usually associated with malignancy. All patients with obstruction of unknown cause or lead point on CT should consider surgical exploration. (Intest Res 2012;10:183-188)