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A Rare Case of Signet Ring Cell Carcinoma Arising on Duodenal Brunner’s Gland Hyperplasia Successfully Treated Via Endoscopic Resection 一例罕见的十二指肠布鲁纳氏腺增生引发的印戒细胞癌,经内镜下切除术成功治愈
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0014
Hae Rin Lee, B. Lee, Kyung Bin Kim, Gwang Ha Kim, M. Lee, Dong Chan Joo
Signet-ring cell carcinoma (SRCC) is a rare tumor that most commonly occurs in the stomach. Duodenal SRCCs are extremely uncommon and account for approximately 1% of duodenal adenocarcinomas. Although Brunner’s gland hyperplasia (BGH) is a benign duodenal condition, studies have reported several cases of adenocarcinoma originating in an area of BGH. We report a rare case of early-stage SRCC originating in an area of BGH that was successfully treated using endoscopic mucosal resection. Based on the mucin phenotype observed in this case, it is reasonable to conclude that SRCC originated from gastric metaplasia in the area of BGH. Although BGH is a benign condition, careful evaluation is warranted for early detection of combined neoplasms.
信号环细胞癌(SRCC)是一种罕见的肿瘤,最常见于胃部。十二指肠 SRCC 极其罕见,约占十二指肠腺癌的 1%。虽然布鲁纳氏腺增生(BGH)是一种良性十二指肠疾病,但有研究报告了几例起源于布鲁纳氏腺增生区域的腺癌。我们报告了一例罕见的起源于BGH区域的早期SRCC病例,该病例采用内镜粘膜切除术成功治疗。根据在该病例中观察到的粘蛋白表型,可以合理地断定SRCC起源于BGH区域的胃化生。尽管BGH是一种良性病变,但仍应仔细评估,以便及早发现合并肿瘤。
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引用次数: 0
What Is the Optimal Drug Regimen for Helicobacter pylori Eradication Therapy? 根除幽门螺旋杆菌疗法的最佳用药方案是什么?
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0022
Ji Hyun Kim, Sung Chul Park
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引用次数: 0
Current Status and Future Perspectives of Tegoprazan-Based Helicobacter pylori Eradication Therapy 基于替戈普拉赞的幽门螺杆菌根除疗法的现状与未来展望
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0023
J. Noh
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引用次数: 0
Successful Endoscopic Vacuum-Assisted Closure Therapy for Esophageal Perforation: A Case Report 食管穿孔的成功内镜真空辅助闭合疗法:病例报告
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0025
Jung Huh, Jinsun Yang, Seung Joo Kang, Hyoun Woo Kang, Hyeon Jong Moon, Su Hwan Kim, Bokyung Kim, Ji Won Kim, Kooklae Lee, Y. Seong, K.-W. Kim
Esophageal perforation can lead to serious complications, and rapid diagnosis and treatment significantly affect the prognosis. Endoscopic vacuum-assisted closure (EndoVAC) therapy is widely accepted as a safe, well-tolerated, effective, versatile and practical procedure for the management of esophageal perforation in selected patients. We report the successful use of EndoVAC therapy for management of an esophageal perforation secondary to foreign body removal. A 56-year-old man presented to the emergency department for evaluation of chest pain after swallowing the plastic shell of a pill. Emergency endoscopy revealed an esophageal wall laceration (approximately 3 cm) and microperforation. The esophageal laceration and microperforation were limited to the mid-esophagus. The patient underwent EndoVAC therapy, which was repeated every 3–4 days for a total of six sessions over a period of 21 days. We observed improvement in the esophageal injury with granulation tissue formation during the fifth session. Subsequent follow-up evaluation, including esophagography and chest computed tomography confirmed complete healing of the esophageal injury. Following resumption of diet, the patienton a was discharged without any complications.
食管穿孔可导致严重的并发症,快速诊断和治疗对预后有重要影响。内镜真空辅助闭合(EndoVAC)疗法被广泛认为是一种安全、耐受性好、有效、多用途且实用的治疗食管穿孔的方法。我们报告了 EndoVAC疗法成功用于治疗异物取出后继发的食管穿孔。一名 56 岁的男子因吞食药片的塑料外壳后出现胸痛而到急诊科就诊。急诊内镜检查发现食管壁裂口(约 3 厘米)和微穿孔。食管裂伤和微穿孔仅限于食管中段。患者接受了 EndoVAC 治疗,每 3-4 天重复一次,共治疗 6 次,历时 21 天。在第五次治疗中,我们观察到食管损伤有所改善,肉芽组织形成。随后的随访评估(包括食管造影和胸部计算机断层扫描)证实食管损伤完全愈合。患者恢复饮食后出院,未出现任何并发症。
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引用次数: 0
Prevalence and Temporal Trend of Gastric Preneoplastic Lesions in Asia 亚洲胃癌前病变的发病率和时间趋势
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0024
Hee Seok Moon
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引用次数: 0
Fungal Infection in Upper Gastrointestinal Tract 上消化道真菌感染
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0029
Ayoung Lee, Sung Woo Jung, Jung Mogg Kim
Mycoses refer to infectious diseases caused by fungi. Fungal infections are rare and mainly occur as opportunistic infections in immunocompromised patients. Candida species are the most common cause of mycosis; however, members of the order Mucorales or genus Aspergillus may also cause serious fungal infections in immunocompromised hosts. Fungal infections of the gastrointestinal (GI) tract can be asymptomatic or may present with abdominal pain, bloating, diarrhea, or GI bleeding. Although rare, thorough understanding of fungal infections of the upper GI tract encountered in real-world clinical settings can enable early diagnosis and prompt initiation of treatment to improve patient prognosis.
真菌病是指由真菌引起的传染病。真菌感染非常罕见,主要发生在免疫力低下的患者身上,是一种机会性感染。念珠菌是真菌病最常见的致病菌,但粘菌目或曲霉属的成员也可能导致免疫力低下的宿主发生严重的真菌感染。胃肠道(GI)真菌感染可能没有症状,也可能表现为腹痛、腹胀、腹泻或消化道出血。上消化道真菌感染虽然罕见,但透彻了解在实际临床环境中遇到的真菌感染情况,可以及早诊断并及时开始治疗,从而改善患者的预后。
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引用次数: 0
Rare Bacterial Infection of the Stomach 罕见的胃部细菌感染
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0015
Hyun Myung Cho, Su Jin Kim, Jin Ook Jang, Jung Wook Lee
An acidic environment, gastric emptying, and abundant blood supply inhibit bacterial infection of the stomach. Helicobacter pylori can evade these defense mechanisms and is a well-known etiological contributor to chronic gastritis. Non-H. pylori bacterial infections such as acute phlegmonous gastritis, gastric syphilis, gastric tuberculosis, and gastric actinomycosis are uncommon and owing to their nonspecific findings, are diagnostically challenging in patients without a high index of clinical suspicion. Predisposition to bacterial infection is attributable to an increase in the prevalence of medical conditions and factors that precipitate immunosuppression, in addition to high rates of gastric mucosal injury associated with endoscopic procedures. Gastric bacterial infection negatively affects patients’ quality of life, increases the socioeconomic burden, and may occasionally be fatal. Therefore, physicians should be familiar with the endoscopic features and clinical manifestations of non-H. pylori bacterial infections of the stomach.
酸性环境、胃排空和充足的血液供应可抑制胃部细菌感染。幽门螺旋杆菌可以躲避这些防御机制,是众所周知的慢性胃炎的致病因素。非幽门螺杆菌细菌感染,如急性痰性胃炎、胃梅毒、胃结核和胃放线菌病并不常见,而且由于其非特异性结果,对于临床怀疑指数不高的患者来说,诊断具有挑战性。除了与内窥镜手术相关的高胃黏膜损伤率之外,导致免疫抑制的内科疾病和因素的发病率增加也是易受细菌感染的原因。胃部细菌感染会对患者的生活质量造成负面影响,增加社会经济负担,偶尔还可能致命。因此,医生应熟悉胃部非幽门螺杆菌感染的内镜特征和临床表现。
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引用次数: 0
Comparison of Tegoprazan- and Lansoprazole-Based Fourteen-Day Triple Therapies as First-Line Treatments for Helicobacter pylori Eradication 基于替戈普拉赞和兰索拉唑的十四天三联疗法作为根除幽门螺旋杆菌一线疗法的比较
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0012
Seok-Mo Kang, Nam-Hoon Kim, Seokhyeon Jeong, Jong Wook Kim, Jung Rock Moon, Yoon Suk Lee, Jun Hyuk Son
Objectives: Tegoprazan, a novel potassium-competitive acid blocker with rapid and effective antisecretory activity, was approved for the treatment of Helicobacter pylori infections in Korea in March 2020. However, real-world data regarding tegoprazan-based therapies are scarce. We compared the efficacies of tegoprazan- and lansoprazole-based triple therapies (TTs).Methods: Between March 2020 and February 2023, this study enrolled patients diagnosed with H. pylori infections who were prescribed either 14-day tegoprazan- or lansoprazole-based TTs as first-line treatments. Their medical records were retrospectively reviewed to compare H. pylori eradication rates and the rates of patient adherence to the recommended therapy.Results: A total of 670 patients diagnosed with H. pylori infections were prescribed 14-day TT regimens between March 2020 and February 2023 at Ilsan Paik Hospital (Goyang, Korea). Of those enrolled in the study, 64 received tegoprazan-based TT and 295 received lansoprazole-based TT as their first-line treatment. The H. pylori eradication rates for tegoprazan- and lansoprazole-based TTs were 76.6% and 75.6%, respectively, in the intent-to-treat population; the rates were 88.9% and 88.4%, respectively, in the per-protocol population (non-inferiority test, p=0.03 and p=0.01 in the respective populations). No significant differences were observed between the two groups with regards to treatment adherence rates (84.4% vs. 85.1%, p=0.78).Conclusions: As a first-line treatment for H. pylori eradication, 14-day tegoprazan-based TT demonstrated non-inferior efficacy compared with 14-day lansoprazole-based TT.
目的:特戈普拉赞是一种新型钾竞争性酸阻滞剂,具有快速有效的抗分泌活性,2020 年 3 月在韩国获准用于治疗幽门螺旋杆菌感染。然而,有关替戈普拉赞疗法的真实世界数据却很少。我们比较了替戈拉赞和兰索拉唑三联疗法(TTs)的疗效:方法:2020 年 3 月至 2023 年 2 月期间,本研究招募了被诊断为幽门螺杆菌感染的患者,这些患者接受了为期 14 天的替戈拉赞或兰索拉唑三联疗法作为一线治疗。我们对这些患者的病历进行了回顾性审查,以比较幽门螺杆菌根除率和患者对推荐疗法的依从率:2020年3月至2023年2月期间,一山百医院(韩国高阳市)共为670名确诊为幽门螺杆菌感染的患者开出了14天TT治疗处方。在参与研究的患者中,64 人接受了以替戈拉赞为基础的 TT,295 人接受了以兰索拉唑为基础的 TT 作为一线治疗。在意向治疗人群中,替戈普拉赞和兰索拉唑TT的幽门螺杆菌根除率分别为76.6%和75.6%;在按协议治疗人群中,这两种药物的根除率分别为88.9%和88.4%(非劣效性检验,在各自人群中的P=0.03和P=0.01)。两组患者的治疗依从率无明显差异(84.4% vs. 85.1%,p=0.78):作为根除幽门螺杆菌的一线治疗方法,与基于兰索拉唑的14天TT疗法相比,基于替戈普拉赞的14天TT疗法的疗效并不逊色。
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引用次数: 0
Clinical Characteristics and Outcomes in Patients With Localized Gastric Langerhans Cell Histiocytosis: A Case Series 局部胃朗格汉斯细胞组织细胞增生症患者的临床特征和预后:病例系列
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0019
Tae-Se Kim, Soomin Ahn, Y. Min, Hyuk Lee, J. Lee, P. Rhee, Jae J. Kim, B. Min
Objectives: Localized gastric Langerhans cell histiocytosis (LCH) characterized by abnormal proliferation of Langerhans cells in the stomach without systemic involvement, is rare; therefore, the clinical characteristics and outcomes of LCH remain unclear. We investigated the clinical characteristics and outcomes in patients diagnosed with localized gastric LCH and have also discussed treatment strategies for this rare disease.Methods: The study included seven patients diagnosed with localized gastric LCH at our hospital between September 1997 and December 2023. We retrospectively reviewed medical records and analyzed the clinicopathological characteristics and patient outcomes.Results: Endoscopically, localized gastric LCH appeared as a small erosion in the distal part of the stomach. Positron emission tomography-computed tomography revealed normal findings in 100.0% (4/4) of patients during pre-treatment workup. Immunohistochemical analysis using S-100 and CD1a showed immunopositive cells in all tested patients. Of the six patients who underwent follow-up, two (33.3%) showed metachronous recurrence at a location distinct from the initial site. However, all patients eventually showed spontaneous regression of the disease, and no gastric LCH-induced mortality was observed during follow-up.Conclusions: Careful and regular surveillance may be sufficient for patients with localized gastric LCH without systemic involvement.
研究目的局部胃朗格汉斯细胞组织细胞增生症(LCH)的特征是胃中朗格汉斯细胞的异常增生,但没有全身受累,这种疾病非常罕见;因此,LCH的临床特征和预后仍不清楚。我们研究了被诊断为局部胃LCH患者的临床特征和预后,并探讨了这种罕见疾病的治疗策略:研究纳入了 1997 年 9 月至 2023 年 12 月期间在我院确诊的 7 例局部胃 LCH 患者。我们回顾性地查阅了病历,分析了临床病理特征和患者预后:内镜下,局部胃 LCH 表现为胃远端小糜烂。在治疗前的检查中,100.0%(4/4)的患者正电子发射计算机断层扫描结果显示正常。使用 S-100 和 CD1a 进行的免疫组化分析显示,所有受检患者的细胞均呈免疫阳性。在接受随访的六名患者中,有两名(33.3%)患者的复发部位与初始部位不同。不过,所有患者的病情最终都自然消退,随访期间也未观察到胃LCH引起的死亡:结论:对于没有全身受累的局部胃LCH患者来说,定期进行仔细监测就足够了。
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引用次数: 0
Parasitic Diseases of Upper Gastrointestinal Tract 上消化道寄生虫病
Pub Date : 2024-06-10 DOI: 10.7704/kjhugr.2024.0026
Heung Up Kim
Korea was a hotspot for parasitic infections until modern times. However, following economic development, improved health and hygiene and farming methods, and successful implementation of active deworming programs, human parasites are rare. Currently, medical and scientific advances have improved the survival rate of elderly and immunocompromised hosts, and immunosuppressants are widely administered for treatment, which may predispose patients to parasitic and various opportunistic infections. Furthermore, globalization has led to the entry of an increasing number of individuals from various countries into Korea, which increases the risk of transmission of parasites from foreign countries into Korea. However, parasitic diseases will tend to disappear in Korea, which may lead to reduced proficiency and diagnostic rate of existing stool tests, and new diagnostic methods tailored to Korea are unavailable. Currently, endoscopy is widely used as a standard method for gastrointestinal disease evaluation in Korea, and endoscopically detected parasites or parasite-induced abnormalities are useful to establish diagnosis in many cases. In this article, the author summarize the current status of endoscopic detection of parasitic diseases affecting the upper gastrointestinal tract.
直到近代,韩国一直是寄生虫感染的热点地区。然而,随着经济的发展、健康卫生和耕作方法的改善,以及积极驱虫计划的成功实施,人类寄生虫已经很少见了。目前,医学和科学的进步提高了老年人和免疫力低下宿主的存活率,并广泛使用免疫抑制剂进行治疗,这可能使患者容易感染寄生虫和各种机会性感染。此外,全球化导致越来越多的人从不同国家进入韩国,这也增加了寄生虫从外国传播到韩国的风险。然而,寄生虫病在韩国将趋于消失,这可能会导致现有粪便检测的熟练程度和诊断率降低,而适合韩国的新诊断方法却无法获得。目前,内窥镜检查作为胃肠道疾病评估的标准方法在韩国被广泛使用,内窥镜检测到的寄生虫或寄生虫引起的异常在很多情况下有助于确诊。在本文中,作者总结了内窥镜检测上消化道寄生虫病的现状。
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引用次数: 0
期刊
The Korean Journal of Helicobacter and Upper Gastrointestinal Research
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