Annals of Coloproctology

Case Reports

Benign GI diease,Rare disease & stoma,Complication

Intestinal Perforation as a Paradoxical Reaction to Antitubercular Therapy: A Case Report: Sung Hoon Kang, Hee Seok Moon, Jae Ho Park, Ju Seok Kim, Sun Hyung Kang, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Jae Kyu Sung, Hyun Yong Jeong, Kyung Ha Lee; Ann Coloproctol. 2021;37(Suppl 1):S18-S23. Published online May 15, 2020; DOI: https://doi.org/10.3393/ac.2020.03.16.1

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Paradoxical reactions to tuberculosis (TB) treatment are characterized by an initial improvement of the clinical symptoms followed by clinical or radiological deterioration of existing tuberculous lesions, or by development of new lesions. Intestinal perforation in gastrointestinal TB can occur as a paradoxical reaction to antitubercular therapy. A 55-year-old man visited the outpatient department with lower abdominal pain and weight loss. He was diagnosed with intestinal TB and started antitubercular therapy. After 3 months of antitubercular therapy, a colonoscopy revealed improvement of the disease. Three days after the colonoscopy, the patient visited the emergency room complaining of abdominal pain. Abdominal computed tomography revealed extraluminal air-filled spaces in the pelvic cavity. We diagnosed a small bowel perforation and performed an emergency laparotomy and a right hemicolectomy with small bowel resection. This report describes the case of intestinal perforation presenting as a paradoxical reaction to antitubercular and provides a brief literature review.

Citations

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Réaction paradoxale tuberculeuse
L.-D. Azoulay, A.-L. Houist, E. Feredj, W. Vindrios, S. Gallien
La Revue de Médecine Interne.2024; 45(5): 279. CrossRef
Left hand abscess as a paradoxical reaction during treatment of disseminated tuberculosis in immunocompetent patient: case report and review of literature
Aisha Alharbi, Aseel Aljahdali, Mohamed Firoze Ahamed, Hassan Almarhabi
BMC Infectious Diseases.2024;[Epub] CrossRef
Paradoxical Reaction to Antitubercular Treatment Causing Colonic Obstruction
Akira Hokama, Yuiko Oishi, Erika Koga, Sayuri Takehara, Jiro Fujita
Chonnam Medical Journal.2022; 58(1): 52. CrossRef
Multiple drugs

Reactions Weekly.2021; 1881(1): 189. CrossRef

Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab: Tae Kyun Kim, Sun Hyung Kang, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, Hyuk Soo Eun; Ann Coloproctol. 2017;33(2):74-77. Published online April 28, 2017; DOI: https://doi.org/10.3393/ac.2017.33.2.74

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Abstract PDF

For inflammatory bowel disease (IBD), antitumor necrosis factor treatment offers a new direction for both patients and medical doctors. This treatment has dramatically improved the quality of life for patients with ulcerative colitis and Crohn disease (CD). However, with increasing usage and longer follow-up periods, a wider range of possible adverse effects may be encountered. We report an unusual case of pulmonary sarcoidosis developed during the treatment of a patient with CD by using infliximab. A 30-year-old male who had been treated for CD with infliximab for 18 months was admitted due to abnormal opacities on chest radiography. Chest computed tomography displayed clustered small nodules in both lobes and enlarged multiple lymph nodes. The patient was diagnosed with sarcoidosis from the results of a biopsy of the subcarinal lymph node. Lung lesions were improved five months after infliximab was stopped.

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Persistent Constitutional Symptoms and Cholestasis During Anti-TNF Therapy as a Harbinger of a Surprising Condition
Julio Maria Fonseca Chebli, Rogerio Khalil Akkari Evangelista, Liliana Andrade Chebli
Gastroenterology.2024; 166(2): e1. CrossRef
Sarcoidosis: federal clinical guidelines for diagnosis and treatment
A. G. Chuchalin, S. N. Avdeev, Z. R. Aisanov, O. P. Baranova, S. E. Borisov, N. A. Geppe, A. A. Vizel’, I. Yu. Vizel’, A. A. Zaicev, N. Y. Kravchenko, M. M. Ilkovich, O. V. Lovacheva, A. B. Malakhov, A. G. Malyavin, D. V. Petrov, V. V. Romanov, I. V. Sivo
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Development of pulmonary sarcoidosis in Crohn’s disease patient under infliximab biosimilar treatment after long-term original infliximab treatment: a case report and literature review
Shin Kashima, Kentaro Moriichi, Katsuyoshi Ando, Nobuhiro Ueno, Hiroki Tanabe, Sayaka Yuzawa, Mikihiro Fujiya
BMC Gastroenterology.2021;[Epub] CrossRef
An update on the diagnosis and management of ocular sarcoidosis
De-Kuang Hwang, Shwu-Jiuan Sheu
Current Opinion in Ophthalmology.2020; 31(6): 521. CrossRef
Assessment of the effect of alpha-tocopherol on the course of newly diagnosed pulmonary sarcoidosis: a comparative study
A. A. Vizel, D. A. Culver, I. Yu. Vizel, G. R. Shakirova, E. A. Bakunina
Tuberculosis and Lung Diseases.2020; 98(10): 33. CrossRef
Radiological Patterns of Lung Involvement in Inflammatory Bowel Disease
Diletta Cozzi, Chiara Moroni, Gloria Addeo, Ginevra Danti, Monica Marina Lanzetta, Edoardo Cavigli, Massimo Falchini, Fabio Marra, Claudia Lucia Piccolo, Luca Brunese, Vittorio Miele
Gastroenterology Research and Practice.2018; 2018: 1. CrossRef
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Reactions Weekly.2017; 1657(1): 238. CrossRef

Inflammatory Fibroid Polyp in the Jejunum Causing Small Bowel Intussusception: Sung Hoon Kang, Seok Won Kim, Hee Seok Moon, Jae Kyu Sung, Hyun Yong Jeong, Jin Su Kim, Gyu Sang Song; Ann Coloproctol. 2015;31(3):106-109. Published online June 30, 2015; DOI: https://doi.org/10.3393/ac.2015.31.3.106

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Abstract PDF

Intussusceptions are defined as the telescoping of one segment of the gastrointestinal tract into an adjacent distal segment. In the small bowel, intussusceptions are typically caused by benign processes, but can occasionally be caused by inflammatory fibroid polyps, which often present as intussusception and bowel obstruction. These polyps are rare, benign, tumorous lesions in the gastrointestinal tract and are typically observed in the stomach, but can occur anywhere in the gastrointestinal tract. Any case of a jejunojejunal intussusception caused by inflammatory fibroid polyps is considered rare, and we report the case of a 51-year-old woman with an inflammatory fibroid polyp of the jejunum presenting as an intussusception who was successfully treated with a resection.

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PÓLIPO FIBROSO INFLAMATÓRIO EM TRATO GASTROINTESTINAL, UM DIAGNÓSTICO DIFERENCIAL DE INTUSSUSCEPÇÃO INTESTINAL EM ADULTO: RELATO DE CASO E REVISÃO
Raul Valério Ponte, Priscila Ferreira de Lima e Souza, Raíra Marques Oliveira, Bruna Viana Teles Rebouças, Sarah Mombach de Arruda, Isabella Siqueira Oliveira, Kalyne Saraiva Fontenele de Araújo, Maria Eduarda Lima Lobão Maia
Revista Contemporânea.2024; 4(9): e5834. CrossRef
Jejunal Intussusception Secondary to a Large Inflammatory Fibroid Polyp: A Case Report and Discussion of Differential Diagnosis
Asma Khalid Abu-Salah, Eric Brocken, Hector Mesa, Katrina Collins, Mirella Marino
Case Reports in Pathology.2023; 2023: 1. CrossRef
Inflammatory fibroid polyp (Vanek's tumor) causing double compound ileo-ileal intussusception in an adult patient, a case report
Ahmed Gadoura, Farah Mohammed, Mohamed Abdulkarim, Ammar Ibn Yasir, Dafalla Shani, Nadir Salih
International Journal of Surgery Case Reports.2022; 93: 106947. CrossRef
Adult intussusception due to ileal polyp - A case report
Tahmina Hakim
International Journal of Surgery Case Reports.2022; 99: 107554. CrossRef
Ileal Intussusception in an Adult Caused by a Locally Invasive Inflammatory Fibroid Polyp: A Case Report
Luiz M. Nova, Paul Lopez, Clara Cerezo, Concepción Llanos, Irene Amat
Revista Española de Patología.2021; 54(1): 65. CrossRef
Adult Jejuno-jejunal intussusception due to inflammatory fibroid polyp
Yi-Kai Kao, Jian-Han Chen
Medicine.2020; 99(36): e22080. CrossRef
Adult Jejuno-Jejunal Intussusceptions due to Gastrointestinal Stromal Tumor
Jayabal Pandiaraja
Indian Journal of Medical and Paediatric Oncology.2020; 41(04): 602. CrossRef
Laparoscopic Resection of a Jejunal Inflammatory Fibroid Polyp that Caused Occult Gastrointestinal Bleeding, Diagnosed via Capsule Endoscopy and Double-Balloon Enteroscopy: A Case Report
Chizu Kameda, Hideaki Miwa, Ryohei Kawabata, Daiki Marukawa, Masahiro Murakami, Shingo Noura, Junzo Shimizu, Junichi Hasegawa
Clinical Endoscopy.2018; 51(4): 384. CrossRef
Inflammatory fibroid polyps of the appendix: different presentation and literature review
Ibrahim Albabtain, Hassan Arishi, Slava Albaghli, Jumanah Aljahani
Journal of Surgical Case Reports.2018;[Epub] CrossRef
Pólipo fibroideo inflamatorio del tracto gastrointestinal: 10 años de experiencia del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
A.F. Romano-Munive, R. Barreto-Zuñiga, J.A. Rumoroso-García, P. Ramos-Martínez
Revista de Gastroenterología de México.2016; 81(3): 134. CrossRef
Inflammatory fibroid polyp of the gastrointestinal tract: 10 years of experience at the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
A.F. Romano-Munive, R. Barreto-Zuñiga, J.A. Rumoroso-García, P. Ramos-Martínez
Revista de Gastroenterología de México (English Edition).2016; 81(3): 134. CrossRef

Original Article

Only the Size of Resected Polyps Is an Independent Risk Factor for Delayed Postpolypectomy Hemorrhage: A 10-Year Single-Center Case-Control Study: Hee Seok Moon, Sun Wook Park, Dong Hwan Kim, Sun Hyung Kang, Jae Kyu Sung, Hyun Yong Jeong; Ann Coloproctol. 2014;30(4):182-185. Published online August 26, 2014; DOI: https://doi.org/10.3393/ac.2014.30.4.182

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Purpose

A colonoscopic polypectomy is an important procedure for preventing colorectal cancer, but it is not free from complications. Delayed hemorrhage after a colonoscopic polypectomy is one infrequent, but serious, complication. The aim of this study was to identify the risk factors for delayed hemorrhage after a colonoscopic polypectomy.

Methods

This was a retrospective case-control study based on medical records from a single gastroenterology center. The records of 7,217 patients who underwent a colonoscopic polypectomy between March 2002 and March 2012 were reviewed, and 92 patients and 276 controls were selected. Data collected included comorbidity, use of antiplatelet agents, size and number of resected polyps, histology and gross morphology of resected polyps, resection method, and use of prophylactic hemostasis.

Results

The average time between the procedure and bleeding was 2.71 ± 1.55 days. Univariate and multivariate analyses revealed that the size of the polyps was the only and most important predictor of delayed hemorrhage after a colonoscopic polypectomy (odds ratio, 2.06; 95% confidence interval, 1.12-1.27; P = 0.03).

Conclusion

The size of resected polyps was the only independent risk factor for delayed bleeding after a colonoscopic polypectomy. The size of a polyp, as revealed by the colonoscopic procedure, may aid in making decisions, such as the decision to conduct a prophylactic hemostatic procedure.

Citations

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Risk factors for delayed colorectal postpolypectomy bleeding: a meta-analysis
Xuzhen Zhang, Xiaoxing Jiang, Liang Shi
BMC Gastroenterology.2024;[Epub] CrossRef
Risk factors of delayed post-polypectomy bleeding after treatment of gastrointestinal polyps with snare-assisted endoscopic sub-mucosal dissection
Xiuyan Lu, Ji Ma
Journal of Minimal Access Surgery.2023; 19(2): 272. CrossRef
Endoscopic management of delayed bleeding after polypectomy of small colorectal polyps: two or more clips may be safe
Xue-Feng Guo, Xiang-An Yu, Jian-Cong Hu, De-Zheng Lin, Jia-Xin Deng, Ming-Li Su, Juan Li, Wei Liu, Jia-Wei Zhang, Qing-Hua Zhong
Gastroenterology Report.2022;[Epub] CrossRef
Blood group O is a risk factor for delayed post-polypectomy bleeding
Hiroto Furuhashi, Akira Dobashi, Naoto Tamai, Nana Shimamoto, Masakuni Kobayashi, Shingo Ono, Yuko Hara, Hiroaki Matsui, Shunsuke Kamba, Hideka Horiuchi, Akio Koizumi, Tomohiko R. Ohya, Masayuki Kato, Keiichi Ikeda, Hiroshi Arakawa, Kazuki Sumiyama
Surgical Endoscopy.2021; 35(12): 6882. CrossRef
Prophylactic clip application for large pedunculated polyps before snare polypectomy may decrease immediate postpolypectomy bleeding
Jae Seung Soh, Myeongsook Seo, Kyung-Jo Kim
BMC Gastroenterology.2020;[Epub] CrossRef
Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Hyun Lim, Eun Jeong Gong, Byung-Hoon Min, Seung Joo Kang, Cheol Min Shin, Jeong-Sik Byeon, Miyoung Choi, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun
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Clinical Practice Guideline for the Management of Antithrombotic Agents in Patients Undergoing Gastrointestinal Endoscopy
Hyun Lim, Eun Jeong Gong, Byung-Hoon Min, Seung Joo Kang, Cheol Min Shin, Jeong-Sik Byeon, Miyoung Choi, Chan Guk Park, Joo Young Cho, Soo Teik Lee, Ho Gak Kim, Hoon Jai Chun
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Risk factors for delayed hemorrhage after colonoscopic postpolypectomy: Polyp size and operative modality
Changqin Liu, Ruijin Wu, Xiaomin Sun, Chunhua Tao, Zhanju Liu
JGH Open.2019; 3(1): 61. CrossRef
Adverse events related to colonoscopy: Global trends and future challenges
Su Young Kim, Hyun-Soo Kim, Hong Jun Park
World Journal of Gastroenterology.2019; 25(2): 190. CrossRef
Complications Following Colonoscopy in a Nationwide Standard Cohort: A Retrospective Case-control Study
Ji Woo Kim, Su Young Kim, Jung Hye Choi, Hyun-Soo Kim, Jung Kuk Lee, Yun Tae Kim, Geunu Park, Dae Ryong Kang
The Korean Journal of Gastroenterology.2019; 73(3): 152. CrossRef
Post-polypectomy bleeding after colonoscopy on uninterrupted aspirin/non steroideal antiflammatory drugs: Systematic review and meta-analysis
Flavia Pigò, Helga Bertani, Giuseppe Grande, Federica Abate, Sara Vavassori, Rita Luisa Conigliaro
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Management of complex polyps of the colon and rectum
Fernando A. Angarita, Adina E. Feinberg, Stanley M. Feinberg, Robert H. Riddell, J. Andrea McCart
International Journal of Colorectal Disease.2018; 33(2): 115. CrossRef
Prospective analysis of delayed colorectal post-polypectomy bleeding
Soo-Kyung Park, Jeong Yeon Seo, Min-Gu Lee, Hyo-Joon Yang, Yoon Suk Jung, Kyu Yong Choi, Hungdai Kim, Hyung Ook Kim, Kyung Uk Jung, Ho-Kyung Chun, Dong Il Park
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Polyp Resection - Controversial Practices and Unanswered Questions
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Case Reports

A Case of Primary Ovarian Lymphoma Presenting as a Rectal Submucosal Tumor: Il Soon Jung, Seul Young Kim, Kyu Seup Kim, Kwang Hun Ko, Jae Kyu Sung, Hyun Young Jeong, Ji Yeoun Kim, Hee Seok Moon; J Korean Soc Coloproctol. 2012;28(2):111-115. Published online April 30, 2012; DOI: https://doi.org/10.3393/jksc.2012.28.2.111

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Primary ovarian lymphoma is a rare malignancy whose symptoms or signs are usually nonspecific. In this article, we report a very rare case initially presenting as a rectal submucosal-tumor-like lesion with a defecation disturbance caused by primary ovarian lymphoma with bilateral involvement. A 42-year-old woman visited chungnam national university hospital complaining of persistent defecation disturbance for 6 months. Colonoscopy demonstrated compression of the rectum by an extrinsic mass mimicking a rectal submucosal tumor. Magnetic resonance imaging detected bilateral ovarian tumors, 9.3 cm and 5.4 cm each in diameter, compressing the rectum without enlarged lymph nodes. The diagnosis was established following a bilateral adnexectomy and histological studies of the excised tissue. The tumor was classified as a diffuse large B-cell lymphoma. The patient was prescribed six cycles of standard CHOP (cyclophosphamide, hydroxydaunorubicin, vincristine, prednisolone) regimen and is presently on treatment.

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Rectal follicular lymphoma
F. Castro-Poças, T. Araújo, A. Duarte, C. Lopes, M. Mascarenhas-Saraiva
International Journal of Colorectal Disease.2016; 31(2): 479. CrossRef

Recurrent Renal Leiomyosarcoma Mimicking a Colonic Submucosal Tumor: A Case Report: Yun Jeung Kim, Hee Seok Moon, Eaum Seok Lee, Jae Kyu Sung, Hyun Yong Jeong, Ji Yeon Kim, Dae Young Kang; J Korean Soc Coloproctol. 2011;27(5):270-274. Published online October 31, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.5.270

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A primary leiomyosarcoma of the kidney is a rare, but highly aggressive, neoplasm, accounting for only 0.1% of all invasive renal tumors. Local or systemic recurrence is common, but a leiomyosarcoma is difficult to diagnose preoperatively. We recently encountered an interesting case of an unusual recurrence of a renal leiomyosarcoma. A 57-year-old woman visited our hospital complaining of lower abdominal pain. Four years previously, she had undergone a left nephrectomy. She had a primary leiomyosarcoma of the kidney that had been misdiagnosed as a renal cell carcinoma. Colonoscopy revealed the presence of a lesion similar to a submucosal tumor in the descending colon. Postoperative pathologic examination confirmed that the mass was a recurrent leiomyosarcoma. We report this unusual case and present a review of the literature.

Citations

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A Rare Case of Colonic Leiomyosarcoma in Association with Ulcerative Colitis
Daisuke Akutsu, Yuji Mizokami, Hideo Suzuki, Masahiko Terasaki, Toshiaki Narasaka, Tsuyoshi Kaneko, Hirofumi Matsui, Tsuyoshi Enomoto, Taiki Sato, Ichinosuke Hyodo
Internal Medicine.2016; 55(19): 2799. CrossRef

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