Annals of Coloproctology

Original Article

Benign GI diease, Inflammatory bowel disease

Clinical Characteristics and Postoperative Outcomes of Patients Presenting With Upper Gastrointestinal Tract Crohn Disease: Joon Suk Moon, Jong Lyul Lee, Chang Sik Yu, Seok-Byung Lim, In Ja Park, Yong Sik Yoon, Chan Wook Kim, Suk-Kyun Yang, Byong Duk Ye, Sang Hyoung Park, Hassan Abdullah Alsaleem, Jin Cheon Kim; Ann Coloproctol. 2020;36(4):243-248. Published online March 16, 2020; DOI: https://doi.org/10.3393/ac.2019.10.16.1

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Purpose
Upper gastrointestinal (GI) tract involvement in Crohn disease (CD) is rare and effectiveness of surgical treatment is limited. The aim of this study was to evaluate characteristics and surgical outcomes of upper GI CD.
Methods
Medical records of 811 patients who underwent intestinal surgery for CD between January 2006 and December 2015 at a single institution were reviewed. Upper GI CD was defined by involvement of the stomach to the fourth portion of duodenum, with or without concomitant small/large bowel CD involvement according to a modification of the Montreal classification.
Results
We identified 24 patients (21 males, 3 females) who underwent surgery for upper GI CD. The mean age at diagnosis was 27 ± 12 years, the mean age at surgery was 33 ± 11 years, and the mean duration of CD was 73.6 ± 56.6 months. Fifteen patients (62.5%) had history of previous perianal surgery. Ten patients (41.7%) had duodenal or gastric stricture and 14 patients (58.3%) had penetrating fistula; patients with fistula were significantly more likely to develop complications (57.1% vs. 20.0%, P = 0.035). One patient with stricture had surgical recurrence. In seven patients with fistula, fistula was related to previous anastomosis. Patients with fistula had significantly longer hospital stays than those with stricture (16 days vs. 11 days, P = 0.01).
Conclusion
Upper GI CD is rare among CD types (2.96%). In patients with upper GI CD, penetrating fistula was associated with longer hospital stay and more complications.

Citations

Citations to this article as recorded by

Update S2k-Guideline Helicobacter pylori and gastroduodenal ulcer disease of the German Society of Gastroenterology, Digestive and Metabolic Diseases (DGVS)
Wolfgang Fischbach, Jan Bornschein, Jörg C. Hoffmann, Sibylle Koletzko, Alexander Link, Lukas Macke, Peter Malfertheiner, Kerstin Schütte, Dieter-Michael Selgrad, Sebastian Suerbaum, Christian Schulz
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Aktualisierte S2k-Leitlinie Helicobacter pylori und gastroduodenale Ulkuskrankheit der Deutschen Gesellschaft für Gastroenterologie, Verdauungs- und Stoffwechselkrankheiten (DGVS) – Juli 2022 – AWMF-Registernummer: 021–001

Zeitschrift für Gastroenterologie.2023; 61(05): 544. CrossRef
A systematic review and meta‐analysis of prevalence and clinical features of upper gastrointestinal (UGI) tract Crohn's disease in adults compared to non‐UGI types
Babak Tamizifar, Peyman Adibi, Maryam Hadipour, Vahid Mohamadi
JGH Open.2023; 7(5): 325. CrossRef
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
Profiling non-coding RNA levels with clinical classifiers in pediatric Crohn’s disease
Ranjit Pelia, Suresh Venkateswaran, Jason D. Matthews, Yael Haberman, David J. Cutler, Jeffrey S. Hyams, Lee A. Denson, Subra Kugathasan
BMC Medical Genomics.2021;[Epub] CrossRef
Surgical Treatment of Upper Gastrointestinal Tract Crohn Disease: A Long Way to Go to Identify the Optimal Method
Soo Yeun Park
Annals of Coloproctology.2020; 36(4): 207. CrossRef

Case Reports

A Granular Cell Tumor of the Rectum: A Case Report and Review of the Literature: Seung Yoon Yang, Byung Soh Min, Woo Ram Kim; Ann Coloproctol. 2017;33(6):245-248. Published online December 31, 2017; DOI: https://doi.org/10.3393/ac.2017.33.6.245

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Abstract PDF

A granular cell tumor (GCT) is an uncommon mesenchymal lesion that rarely occurs in the colon and the rectum. We describe the case of 51-year-old man with a 2-cm-sized rectal GCT 10 cm above the anal verge that was incidentally detected after a screening colonoscopy. Preoperative radiologic studies demonstrated a suspicious submucosal rectal mass with mesorectal fat infiltration, but without circumferential resection margin threatening, extramural vessel invasion, and regional lymph-node enlargement. The tumor was resected by using a transanal endoscopic operation (TEO) without immediate postoperative complications. The final pathology revealed that the tumor consisted of a GCT that had invaded the subserosa with clear margins. It had no other risk factors for malignancy according to Fanburg-Smith criteria. We systematically reviewed the English literature by using PubMed and Google Scholar. This report may be the first documented case in the literature to describe a TEO for a GCT that had invaded the subserosa in the rectum.

Citations

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Granular Cell Tumor of the Anal Canal: Case Report and Literature Review
Jorge Arche Prats, Diego García Prado, Gonzalo Campaña Villegas, Mónica Martínez Mardónez
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Rectal Granular Cell Carcinoma Requiring Abdominoperineal Resection
Michaelia S. Sunderland, Anthony Dakwar, Sowsan Rasheid
The American Surgeon™.2023; 89(4): 1304. CrossRef
Experience of surgical treatment in a granular cell tumor in the qscending colon: a case report
In-Kyeong Kim, Young-Tae Ju, Han-Gil Kim, Jin-Kwon Lee, Dong-Chul Kim, Jae-Myung Kim, Jin Kyu Cho, Ji-Ho Park, Ju-Yeon Kim, Chi-Young Jeong, Soon-Chan Hong, Seung-Jin Kwag
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Granular cell tumour. Case report.
P. Leszczyńska, M. Sobocińska, K. Ustymowicz, W. Romańczyk
Progress in Health Sciences.2023; 13(1): 107. CrossRef
Granular cell tumor of the perineum (clinical case)
R. R. Shakirov, O. Yu. Karpukhin, M. I. Ziganshin, I. S. Raginov
Koloproktologia.2023; 22(4): 121. CrossRef
A case report of rare granular cell tumor of the urinary bladder
Saman Anwar Wahid, Han N. Mohammed Fadhl, Alaa Abbas Ali, Rebaz Karim Mohammed
Urology Case Reports.2022; 42: 102034. CrossRef
Granular cell tumor of the cecum: Case report of mini invasive surgical resection and review of the literature
Roberto Cantella, Giuseppe Evola, Carla Di Stefano, Ezio Trusso Zirna, Marianna Iudica, Luigi Piazza
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Granular Cell Tumor of the Perianal Region
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Journal of Gastrointestinal Surgery.2020; 24(4): 907. CrossRef
A Rare Granular Cell Tumor with a Center Ulcer of the Rectum
Jeonghun Lee, Younghye Kim
Case Reports in Gastrointestinal Medicine.2020; 2020: 1. CrossRef
Granular Cell Tumors of the Cecum: Report of Two Cases and Review of Literature
Nam Yeol Cho, Yu-Ah Choi, Gye Sung Lee
Keimyung Medical Journal.2020; 39(2): 86. CrossRef
A rare case of tracheal granular cell tumor in a pediatric patient
Bojiang Chen, Linrui Xu, Min Xie, Weimin Li, Fengming Luo
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Hematochezia due to Angiodysplasia of the Appendix: Je-Min Choi, Seung-Hun Lee, Seung-Hyun Lee, Byung-Kwon Ahn, Sung-Uhn Baek; Ann Coloproctol. 2016;32(3):117-119. Published online June 30, 2016; DOI: https://doi.org/10.3393/ac.2016.32.3.117

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Abstract PDF

Common causes of lower gastrointestinal bleeding include diverticular disease, vascular disease, inflammatory bowel disease, neoplasms, and hemorrhoids. Lower gastrointestinal bleeding of appendiceal origin is extremely rare. We report a case of lower gastrointestinal bleeding due to angiodysplasia of the appendix. A 72-year-old man presented with hematochezia. Colonoscopy showed active bleeding from the orifice of the appendix. We performed a laparoscopic appendectomy. Microscopically, dilated veins were found at the submucosal layer of the appendix. The patient was discharged uneventfully. Although lower gastrointestinal bleeding of appendiceal origin is very rare, clinicians should consider it during differential diagnosis.

Citations

Citations to this article as recorded by

Appendiceal bleeding caused by vascular malformation: A case report
Qin Ma, Jin-Jie Du
World Journal of Clinical Cases.2024; 12(14): 2457. CrossRef
Appendiceal bleeding, a rare yet important cause of lower gastrointestinal bleed
Ayman Tabcheh, Johny Salem, Karim Zodeh, Ammar Ghazale
European Journal of Case Reports in Internal Medicine.2024;[Epub] CrossRef
A rare case of appendiceal haemorrhage causing life-threatening haematochezia
Howard H Y Tang, Daming Pan, Andrew Fitzdowse, Aaron Ow, Stephen Chan, Jason S C Tan
Journal of Surgical Case Reports.2024;[Epub] CrossRef
Beyond the Usual Suspects: Appendiceal Bleeding as the Surprising Cause of Lower Gastrointestinal (GI) Bleeding
Asher Siddiqui, Nowera Zafar, Mahdi Hakiminezhad, Zohaib Jamal, Imran Alam, Zeeshan Khawaja
Cureus.2024;[Epub] CrossRef
WITHDRAWN: Appendiceal bleeding caused by vascular malformation: A case report and literature review
Qin Ma, Jinjie Du
International Journal of Surgery Case Reports.2023; : 108903. CrossRef
Clinical features, treatments and prognosis of appendiceal bleeding: a case series study
Xiao-cun Xing, Jin-lin Yang, Xue Xiao
BMC Gastroenterology.2023;[Epub] CrossRef
Angiodysplasia of the appendix: a diagnostic challenge and the importance of colonoscopy
Obiajulu Johnson, Naomi Mackenzie, Jamil Choudhury, Sanjay Furtado
BMJ Case Reports.2023; 16(12): e255498. CrossRef
Appendiceal bleeding: A case report
Sheng-Yue Zhou, Mao-Dong Guo, Xiao-Hua Ye
World Journal of Clinical Cases.2022; 10(18): 6314. CrossRef
Appendiceal bleeding in an elderly male: a case report and a review of the literature
Yuto Maeda, Seiya Saito, Mayuko Ohuchi, Yuka Tamaoki, Jiro Nasu, Hideo Baba
Surgical Case Reports.2021;[Epub] CrossRef
Acute Eosinophilic Appendicitis: A Rare Cause of Lower Gastrointestinal Hemorrhage
So Ra Ahn, Joo Hyun Lee
The Korean Journal of Gastroenterology.2021; 78(2): 134. CrossRef
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Benign Solitary Cecal Ulcer Accompanied by Massive Lower Gastrointestinal Tract Hemorrhage.: Park, Jong Ik , Park, Sang Su , Kang, Sung Gu , Shin, Dong Gue , Yoon, Jin , Kim, Il Myung; J Korean Soc Coloproctol. 2006;22(6):424-427.

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Abstract PDF: A benign cecal ulcer is an uncommon lesion. The etiology remains unknown, and there are no pathognomonic lesions or symptoms. Lower gastrointestinal tract hemorrhage secondary to benign cecal ulcer is the most common complication. Herein, the case of a 24-year-old man with a benign cecal ulcer presenting with a massive lower gastrointestinal tract hemorrhage requiring transfusion until a exploratory laparotomy and right hemicolectomy, is reported with a review of the literature. Surgical intervention is warranted if malignancy is suspected or if the patient has signs of uncontrollable hemorrhage, perforation, or peritonitis.

Laparoscopy-assisted Surgical Removal of a Retained Wireless Capsule Endoscopy: A case report.: Lee, Sang Hoon , Han, Sang Ah , Park, Chi Min , Yun, Seong Hyeon , Lee, Woo Yong , Chun, HoKyung; J Korean Soc Coloproctol. 2006;22(3):192-196.

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Abstract PDF: Occult bleeding of the gastrointestinal tract is a major cause of iron deficiency anemia. Even with endoscopic evaluation of the upper and the lower gastrointestinal tract in these patients, in 30~50% of the cases, the cause of bleeding still remains undiscovered. Wireless capsule endoscopy (WCE) is a novel method of evaluating the small bowel mucosa by using a small capsule equipped with a camera and transmission device. Complications of WCE include impaction within the gastrointestinal tract, sometimes requiring surgical removal. The authors report a case of capsule impaction in the small bowel in a patient evaluated for anemia due to occult gastrointestinal tract bleeding. The patient is a 19 year-old female with a history of anemia since age 4. The stool guaiac test was positive, but upper and lower gastrointestinal tract endoscopy showed no abnormalities, so WCE was done. A short segment of circular ulcers with lumen narrowing were seen in the distal jejunum. Seven days after ingestion of the capsule, the patient denied passage of the capsule. Small bowel enteroclysis was performed, and the capsule was seen along with a segment of lumen narrowing distal to the site of retention. Surgery was done, and upon laparoscopic examination, the entire bowel appeared normal. Retrieval of the capsule was done along with a resection of an 8 cm segment of the small bowel. Three linear ulcers were seen in the resected bowel specimen. Pathology revealed no evidence of Crohn's disease or tuberculosis. The patient is still on iron supplements, but her hemoglobin level remains stable at 11~12 g/dl.

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