Intestinal Research

Original Articles

Colorectal neoplasia

Clinical features and outcomes in spontaneous intramural small bowel hematoma: cohort study and literature review: Eun Ae Kang, Seung Jun Han, Jaeyoung Chun, Hyun Jung Lee, Hyunsoo Chung, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Nayoung Kim, Dong Ho Lee, Hyun Chae Jung; Intest Res 2019;17(1):135-143. Published online October 10, 2018; DOI: https://doi.org/10.5217/ir.2018.00085

Abstract PDF Supplementary Material PubReader ePub

Background/Aims
Spontaneous intramural small bowel hematoma (SISBH) is an extremely rare complication of anticoagulant or antiplatelet therapy. We assessed the clinical characteristics and outcomes of patients with SISBH according to the anatomical location of the hematoma.
Methods
From January 2003 to February 2016, medical records for all patients hospitalized for SISBH at 2 tertiary referral hospitals were retrospectively reviewed. The primary outcome was requirement for surgery.
Results
A total of 37 patients were enrolled. The mean age was 74.1 years. Among them, 33 patients (89.2%) were taking anticoagulant and/or antiplatelet agents. Duodenal intramural hematoma was detected in 4 patients (10.8%), jejunal in 16 (43.2%), and ileal in 17 (45.9%). Compared to jejunal and ileal involvement, duodenal intramural hematoma was significantly associated with high Charlson comorbidity index and low levels of white blood cells, hemoglobin, and platelets in the blood. SISBH in the duodenum was related to thrombocytopenia in 3 patients following systemic chemotherapy for malignancy. All patients with SISBH showed clinical improvement with conservative therapy. Mean length of hospital stay was 9.35 days. Independent predictors of a hospital stay of more than 7 days were body weight less than 60 kg (odds ratio [OR], 12.213; 95% confidence interval [CI], 1.755–84.998; P=0.011) and a history of cerebrovascular accidents (OR, 6.667; 95% CI, 1.121–39.650; P=0.037).
Conclusions
Compared to jejunal and ileal involvement, thrombocytopenia may result in spontaneous duodenal intramural hematoma among patients who are treated with systemic chemotherapy for malignancies. Patients with SISBH have excellent clinical outcomes with conservative therapy regardless of the anatomical location of the hematoma.

Citations

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Drug-Induced Spontaneous Intramural Hematoma of the Gastrointestinal Tract: A Real-World Pharmacovigilance Analysis
Xuehong Wang, Min Luo, Wenyu Li, Yuqian Zhou
Journal of Cardiovascular Pharmacology.2025; 85(4): 297. CrossRef
Idiopathic Duodenal Hematoma: A Case Report and Literature Review
Ebtesam Al-Najjar, Abdullah Esmail, Bayan Khasawneh, Saifudeen Abdelrahim, Maen Abdelrahim
Reports.2025; 8(2): 73. CrossRef
A Case of Direct-Acting Oral Anticoagulant-Induced Intramural Colon Hematoma Successfully Treated by Laparoscopic Surgery
Daisuke Tomita, Shigeo Toda, Ryo Miyazaki, Shuichiro Matoba, Hiroya Kuroyanagi
Cureus.2024;[Epub] CrossRef
Spontaneous Intramural Small Bowel Hematoma in an Elderly Man with Multiple Myeloma
Sigrid L. Williamson, Aishwarya Suresh, Adrian Ong
The American Surgeon™.2023; 89(6): 2816. CrossRef
Intramural duodenal hematoma: diagnosis and management of a rare entity
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española (English Edition).2023; 101(7): 515. CrossRef
Hematoma intramural duodenal: diagnóstico y manejo de una entidad infrecuente
Álvaro Pérez-Rubio, Juan Carlos Sebastián-Tomás, Sergio Navarro-Martínez, Marta Córcoles Córcoles, Carlos Domingo del Pozo
Cirugía Española.2023; 101(7): 515. CrossRef
Jejunal intramural haematoma in a captive African lion (Panthera leo)
Richelle G. Butcher, Baukje Lenting, Alison S. Clarke, Kelly Buckle, Cristina Gans
Veterinary Record Case Reports.2023;[Epub] CrossRef
Spontaneous Duodenal Hematoma: A Rare Complication of Triple Antithrombotic Therapy Case Report
Mazin N Habhab, Asad J Torabi, Julie M Clary, George E Revtyak
Future Cardiology.2023; 19(2): 71. CrossRef
Intestinal Spontaneous Intramural Hematoma Secondary to Anticoagulation Therapy: A Case Report
Karim El Aidaoui, Wahib Lahlou, Abderrahim Bourial, Nawal Bouknani, Chafik El Kettani
Cureus.2023;[Epub] CrossRef
Intramural Hematoma of Gastrointestinal Tract in People with Hemophilia A and B
Wei-Jung Teng, Ching-Huei Kung, Mei-Mei Cheng, Jia-Ruey Tsai, Chia-Yau Chang
Journal of Clinical Medicine.2023; 12(9): 3093. CrossRef
Endoscopic management of intramural spontaneous duodenal hematoma: A case report
Giorgio Valerii, Vittorio Maria Ormando, Carlo Cellini, Luca Sacco, Carmelo Barbera
World Journal of Gastroenterology.2022; 28(20): 2243. CrossRef
Warfarin-induced spontaneous intramural small bowel hematoma presenting as an acute abdomen: A case report
Ding-Han Chen, Khay-Seng Soh, Ying-Tso Wang, Te-Chun Shen
Medicine.2022; 101(35): e30335. CrossRef
Spontaneous duodenal haematoma in a patient taking rivaroxaban
Rebeca de Barros Lopes, Finn McLennan Battleday, Toby Calvert, Rob Gwynne‐Jones, Rebecca Thomas
ANZ Journal of Surgery.2021;[Epub] CrossRef
SPONTANEOUS INTRAMURAL SMALL-BOWEL HEMATOMA: A CAUSE OF ACUTE ABDOMEN IN ANTICOAGULATED PATIENTS
Sergio Gil Rojas, Luis Miguel Estela Villa, Elsa María Jiménez Vicente
Revista Española de Enfermedades Digestivas.2021;[Epub] CrossRef
Small Bowel Obstruction
Allison A. Aka, Jesse P. Wright, Teresa DeBeche-Adams
Clinics in Colon and Rectal Surgery.2021; 34(04): 219. CrossRef
Double Trouble: Spontaneous Duodenal Hematoma of Pancreatic Origin
Luísa Martins Figueiredo, David Valadas Horta, Jorge A. Reis
GE - Portuguese Journal of Gastroenterology.2019; 26(6): 458. CrossRef

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Characteristics and outcomes of endoscopically resected colorectal cancers that arose from sessile serrated adenomas and traditional serrated adenomas: Ji Yeon Seo, Seung Ho Choi, Jaeyoung Chun, Changhyun Lee, Ji Min Choi, Eun Hyo Jin, Sung Wook Hwang, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim; Intest Res 2016;14(3):270-279. Published online June 27, 2016; DOI: https://doi.org/10.5217/ir.2016.14.3.270

Abstract PDF PubReader ePub

Background/Aims

The efficacy and safety of endoscopic resection of colorectal cancer derived from sessile serrated adenomas or traditional serrated adenomas are still unknown. The aims of this study were to verify the characteristics and outcomes of endoscopically resected early colorectal cancers developed from serrated polyps.

Methods

Among patients who received endoscopic resection of early colorectal cancers from 2008 to 2011, cancers with documented pre-existing lesions were included. They were classified as adenoma, sessile serrated adenoma, or traditional serrated adenoma according to the baseline lesions. Clinical characteristics, pathologic diagnosis, and outcomes were reviewed.

Results

Overall, 208 colorectal cancers detected from 198 patients were included: 198 with adenoma, five with sessile serrated adenoma, and five with traditional serrated adenoma. The sessile serrated adenoma group had a higher prevalence of high-grade dysplasia (40.0% vs. 25.8%, P<0.001) than the adenoma group. During follow-up, local recurrence did not occur after endoscopic resection of early colorectal cancers developed from serrated polyps. In contrast, two cases of metachronous recurrence were detected within a short follow-up period.

Conclusions

Cautious observation and early endoscopic resection are recommended when colorectal cancer from serrated polyp is suspected. Colorectal cancers from serrated polyp can be treated successfully with endoscopy.

Citations

Citations to this article as recorded by

Small sessile serrated polyps might not be at a higher risk for future advanced neoplasia than low-risk adenomas or polyp-free groups
Eun Hyo Jin, Ji Yeon Seo, Jung Ho Bae, Jooyoung Lee, Ji Min Choi, Yoo Min Han, Joo Hyun Lim
Scandinavian Journal of Gastroenterology.2022; 57(1): 99. CrossRef
The incidence and risk factors of sessile serrated adenomas in left side colon cancer patients after curative surgery
Myung Hee Kim, Hee Seok Moon, In Sun Kwon, Ju Seok Kim, Sun Hyung Kang, Jae Kyu Sung, Eaum Seok Lee, Seok Hyun Kim, Byung Seok Lee, Hyun Yong Jeong
Medicine.2020; 99(29): e20799. CrossRef
Improved Real-Time Optical Diagnosis of Colorectal Polyps Following a Comprehensive Training Program
Jung Ho Bae, Changhyun Lee, Hae Yeon Kang, Min-Sun Kwak, Eun Young Doo, Ji Yeon Seo, Ji Hyun Song, Sun Young Yang, Jong In Yang, Seon Hee Lim, Jeong Yoon Yim, Joo Hyun Lim, Goh Eun Chung, Su Jin Chung, Eun Hyo Jin, Boram Park, Joo Sung Kim
Clinical Gastroenterology and Hepatology.2019; 17(12): 2479. CrossRef
Clinical outcomes of surveillance colonoscopy for patients with sessile serrated adenoma
Sung Jae Park, Hyuk Yoon, In Sub Jung, Cheol Min Shin, Young Soo Park, Na Young Kim, Dong Ho Lee
Intestinal Research.2018; 16(1): 134. CrossRef
Surveillance colonoscopy in patients with sessile serrated adenoma
Ji Hyung Nam, Hyoun Woo Kang
Intestinal Research.2018; 16(3): 502. CrossRef
Identification of risk factors for sessile and traditional serrated adenomas of the colon by using big data analysis
Jeung Hui Pyo, Sang Yun Ha, Sung Noh Hong, Dong Kyung Chang, Hee Jung Son, Kyoung‐Mee Kim, Hyeseung Kim, Kyunga Kim, Jee Eun Kim, Yoon‐Ho Choi, Young‐Ho Kim
Journal of Gastroenterology and Hepatology.2018; 33(5): 1039. CrossRef
Endoscopic Resection of Cecal Polyps Involving the Appendiceal Orifice: A KASID Multicenter Study
Eun Mi Song, Hyo-Joon Yang, Hyun Jung Lee, Hyun Seok Lee, Jae Myung Cha, Hyun Gun Kim, Yunho Jung, Chang Mo Moon, Byung Chang Kim, Jeong-Sik Byeon
Digestive Diseases and Sciences.2017; 62(11): 3138. CrossRef
Is colorectal cancer screening necessary before 50 years of age?
Yoon Suk Jung
Intestinal Research.2017; 15(4): 550. CrossRef
Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages
Hyo‐Joon Yang, Sungkyoung Choi, Soo‐Kyung Park, Yoon Suk Jung, Kyu Yong Choi, Taesung Park, Ji Yeon Kim, Dong Il Park
Journal of Gastroenterology and Hepatology.2017; 32(7): 1328. CrossRef
Risk factors of missed colorectal lesions after colonoscopy
Jeonghun Lee, Sung Won Park, You Sun Kim, Kyung Jin Lee, Hyun Sung, Pil Hun Song, Won Jae Yoon, Jeong Seop Moon
Medicine.2017; 96(27): e7468. CrossRef

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Usefulness of the Cytomegalovirus Antigenemia Assay in Patients With Ulcerative Colitis: Jaeyoung Chun, Changhyun Lee, Ji-eun Kwon, Sung Wook Hwang, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2015;13(1):50-59. Published online January 29, 2015; DOI: https://doi.org/10.5217/ir.2015.13.1.50

Abstract PDF PubReader

Background/Aims

Patients with ulcerative colitis (UC) are at high risk for cytomegalovirus (CMV) reactivation. The usefulness of the CMV antigenemia assay in active UC patients has rarely been studied. We assessed whether the assay detects CMV colitis and predicts clinical outcomes in patients with UC.

Methods

We retrospectively reviewed the medical records of patients hospitalized for moderate-to-severe UC from 2003 to 2012. Positive CMV antigenemia was defined as ≥1 pp65-positive cell per 2×10⁵ polymorphonuclear neutrophils. CMV colitis was defined as the presence of inclusion bodies and/or positive immunohistochemistry in the colonic mucosa. The primary outcome was steroid refractoriness, defined as the absence of clinical improvement after intravenous high-dose steroid administration.

Results

A total of 43 patients were enrolled. CMV antigenemia was detected in 12 (27.9%) patients. Positive CMV antigenemia was significantly associated with CMV colitis (P =0.001). The sensitivity and specificity of positive CMV antigenemia for diagnosing CMV colitis were 66.7% and 87.1%, respectively. Steroid refractoriness was found in 11 of 12 (91.7%) and 12 of 31 (38.7%) patients with positive and negative CMV antigenemia, respectively (P =0.002). The independent predictors for steroid refractoriness were positive CMV antigenemia (adjusted odds ratio [OR], 7.73; 95% confidence interval [CI], 1.22-49.19; P =0.030) and a shorter duration from the diagnosis of UC (adjusted OR, 0.99; 95% CI, 0.98-0.99; P =0.025).

Conclusions

The CMV antigenemia assay shows low sensitivity but high specificity for detecting CMV colitis and may predict steroid-refractory UC. Early rescue therapy might be considered in UC patients positive for CMV antigenemia.

Citations

Citations to this article as recorded by

The association between antigenemia, histology with immunohistochemistry, and mucosal PCR in the diagnosis of ulcerative colitis with concomitant human cytomegalovirus infection
Tsukasa Yamawaka, Hiroki Kitamoto, Masanori Nojima, Tomoe Kazama, Kohei Wagatsuma, Keisuke Ishigami, Shuji Yamamoto, Yusuke Honzawa, Minoru Matsuura, Hiroshi Seno, Hiroshi Nakase
Journal of Gastroenterology.2023; 58(1): 44. CrossRef
Predictive Factors of Cytomegalovirus Viremia during the Clinical Course of Anti-Neutrophil Cytoplasmic Antibody (ANCA)-Associated Vasculitis: A Single Center Observational Study
Makoto Harada, Ryohei Iwabuchi, Akinori Yamaguchi, Daiki Aomura, Yosuke Yamada, Kosuke Sonoda, Yutaka Kamimura, Koji Hashimoto, Yuji Kamijo
Journal of Clinical Medicine.2023; 12(1): 351. CrossRef
A quick guide to diagnosis and treatment of cytomegalovirus infection in the gut: current dilemmas
Iļja Drjagunovs, Sniedze Laivacuma, Indra Zeltiņa, Aleksejs Derovs
Proceedings of the Latvian Academy of Sciences. Section B. Natural, Exact, and Applied Sciences..2022; 76(5-6): 585. CrossRef
Iranian kidney transplant recipients with COVID‐19 infection: Clinical outcomes and cytomegalovirus coinfection
Hamideh Molaei, Leila Khedmat, Eghlim Nemati, Zohreh Rostami, Seyed Hassan Saadat
Transplant Infectious Disease.2021;[Epub] CrossRef
Granulocyte and Monocyte Adsorptive Apheresis for Ulcerative Colitis in a Patient with Low Bone Mineral Density Due to Fanconi-Bickel Syndrome
Makoto Tanaka, Mayuko Nakanishi, Hajime Miyazaki, Ryuichi Morita, Hiroki Eguchi, Yoshiya Takeda, Masanobu Katayama, Motoo Tanaka, Masamichi Bamba, Tadashi Shigematsu
Internal Medicine.2021; 60(15): 2413. CrossRef
Fulminant amebic colitis in a patient with concomitant cytomegalovirus infection after systemic steroid therapy: A case report
Naoki Shijubou, Toshiyuki Sumi, Koki Kamada, Takeyuki Sawai, Yuichi Yamada, Tatsuru Ikeda, Hisashi Nakata, Yuji Mori, Hirofumi Chiba
World Journal of Clinical Cases.2021; 9(15): 3726. CrossRef
Risk Factors of Cytomegalovirus Reactivation in Ulcerative Colitis Patients: A Meta-Analysis
Yafei Qin, Grace Wang, Dejun Kong, Guangming Li, Hongda Wang, Hong Qin, Hao Wang
Diagnostics.2021; 11(11): 1952. CrossRef
High mucosal cytomegalovirus DNA helps predict adverse short-term outcome in acute severe ulcerative colitis
Saransh Jain, Divya Namdeo, Pabitra Sahu, Saurabh Kedia, Peush Sahni, Prasenjit Das, Raju Sharma, Vipin Gupta, Govind Makharia, Lalit Dar, Simon PL Travis, Vineet Ahuja
Intestinal Research.2021; 19(4): 438. CrossRef
Current Diagnostic and Therapeutic Approaches to Cytomegalovirus Infections in Ulcerative Colitis Patients Based on Clinical and Basic Research Data
Yoshihiro Yokoyama, Tsukasa Yamakawa, Takehiro Hirano, Tomoe Kazama, Daisuke Hirayama, Kohei Wagatsuma, Hiroshi Nakase
International Journal of Molecular Sciences.2020; 21(7): 2438. CrossRef
Ulcerative Colitis and Cytomegalovirus Infection: From A to Z
Fadi H Mourad, Jana G Hashash, Viraj C Kariyawasam, Rupert W Leong
Journal of Crohn's and Colitis.2020; 14(8): 1162. CrossRef
Cytomegalovirus and Inflammatory Bowel Diseases (IBD) with a Special Focus on the Link with Ulcerative Colitis (UC)
Alexandre Jentzer, Pauline Veyrard, Xavier Roblin, Pierre Saint-Sardos, Nicolas Rochereau, Stéphane Paul, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
Microorganisms.2020; 8(7): 1078. CrossRef
A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology
Ali Y. Fakhreddine, Catherine T. Frenette, Gauree G. Konijeti
Gastroenterology Research and Practice.2019; 2019: 1. CrossRef
Antiviral Treatment for Colonic Cytomegalovirus Infection in Ulcerative Colitis Patients Significantly Improved Their Surgery Free Survival
Yinghong Wang, Pankaj Aggarwal, Xiuli Liu, Haiyan Lu, Lei Lian, Xianrui Wu, Shibin Guo, Nitin Aggarwal, Bret Lashner, Bo Shen
Journal of Clinical Gastroenterology.2018; 52(4): e27. CrossRef
Cytomegalovirus Enterocolitis and Cytomegalovirus Colitis Complicating Ulcerative Colitis
Kiyotaka Okawa, Tetsuya Aoki, Wataru Ueda, Koji Sano, Hiroshi Ono, Syusuke Nakauchi
Nippon Daicho Komonbyo Gakkai Zasshi.2018; 71(10): 470. CrossRef
Approach to cytomegalovirus infections in patients with ulcerative colitis
Sung Chul Park, Yoon Mi Jeen, Yoon Tae Jeen
The Korean Journal of Internal Medicine.2017; 32(3): 383. CrossRef
Cytomegalovirus and ulcerative colitis: Place of antiviral therapy
Sylvie Pillet
World Journal of Gastroenterology.2016; 22(6): 2030. CrossRef
Targeting cytomegalovirus during ulcerative colitis flare-ups
Hiroshi Nakase, Kei Onodera
Expert Review of Gastroenterology & Hepatology.2016; 10(10): 1119. CrossRef
Risk Factors and Clinical Outcomes Associated with Cytomegalovirus Colitis in Patients with Acute Severe Ulcerative Colitis
Ho-Su Lee, Sang Hyoung Park, Sung-Han Kim, Jihun Kim, Jene Choi, Hyo Jeong Lee, Wan Soo Kim, Jeong-Mi Lee, Min Seob Kwak, Sung Wook Hwang, Dong-Hoon Yang, Kyung-Jo Kim, Byong Duk Ye, Jeong-Sik Byeon, Seung-Jae Myung, Yong Sik Yoon, Chang Sik Yu, Jin-Ho Ki
Inflammatory Bowel Diseases.2016; 22(4): 912. CrossRef
When is an Assay of Cytomegalovirus Antigenemia Useful in Detecting Cytomegalovirus Colitis?
Kyeong Ok Kim
Intestinal Research.2015; 13(2): 182. CrossRef
A Clinical Significance of Assessing Cytomegalovirus Infection Status in Patients With Ulcerative Colitis
Sooyun Chang, Jae Hee Cheon
Intestinal Research.2015; 13(1): 2. CrossRef
Author's Reply
Jaeyoung Chun, Jong Pil Im
Intestinal Research.2015; 13(2): 184. CrossRef
Evaluation of a multiplex PCR assay for detection of cytomegalovirus in stool samples from patients with ulcerative colitis
Saifun Nahar
World Journal of Gastroenterology.2015; 21(44): 12667. CrossRef

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Prediction of Tumor Recurrence in Patients with Non-Gastric Gastrointestinal Stromal Tumors Following Resection according to the Modified National Institutes of Health Criteria: Seung Hyeon Jang, Ji Eun Kwon, Jee Hyun Kim, June Young Lee, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, Jong Pil Im; Intest Res 2014;12(3):229-235. Published online July 25, 2014; DOI: https://doi.org/10.5217/ir.2014.12.3.229

Abstract PDF PubReader ePub

Background/Aims

Few studies have investigated the prognosis of non-gastric gastrointestinal stromal tumors (GISTs) under the modified National Institutes of Health (NIH) consensus criteria in Korea. This study aims to clarify the clinical usefulness of the modified NIH criteria for risk stratification.

Methods

From January 2000 through October 2012, 88 patients who underwent curative resection for primary GISTs were included in this study. The enrolled patients were stratified to predict recurrence by the original NIH criteria and modified NIH criteria.

Results

In all, 88 patients had non-gastric GISTs, including 82 and 6 patients with GISTs of the small intestine and colorectum, respectively. The mean age was 57.3±13.0 years, and the median follow-up duration was 3.40 years (range, 0.02-12.76 years). All patients who were placed in the intermediate-risk category according to the original NIH criteria were reclassified into the high-risk category according to the modified NIH criteria. Therefore, the proportion of cases in the intermediate-risk category declined to 0.0% from 25.0% (22/88), and the proportion of cases in the high-risk category increased to 43.2% (38/88) from 18.2% (16/88) under the modified NIH criteria. Among the 22 reclassified patients, 6 (27.3%) suffered a recurrence during the observational period, and the recurrence rate of high-risk category patients was 36.8% (14/38).

Conclusions

Patients in the high-risk category according to the modified NIH criteria had a high GIST recurrence rate. Therefore, the modified NIH criteria are clinically useful in selecting patients who need imatinib adjuvant chemotherapy after curative surgical resection.

Citations

Citations to this article as recorded by

Survival outcome and impact of delayed imatinib therapy in gastric gastrointestinal stromal tumors
R. Jansuwan, S. Samphao, Wongsakorn Chaochankit
Frontiers in Surgery.2025;[Epub] CrossRef
Population-based long-term prognosis analysis of subcutaneous gastrointestinal stromal tumors
Luojie Liu, Xinyu Shao
Surgical Endoscopy.2024; 38(12): 7298. CrossRef
Radiologic Review of Small Bowel Malignancies and Their Mimicking Lesions
Jong Soo Lee, So Hyun Park, Seung Joon Choi
Journal of the Korean Society of Radiology.2023; 84(1): 110. CrossRef
Assessment of a Real-world Learning Curve for the Endoscopic Resection of Gastric Gastrointestinal Stromal Tumors
Ying Sun, Luojie Liu, Dongtao Shi, Chao Ma, Xiaodan Xu
Journal of International Medical Research.2023;[Epub] CrossRef
Gastrointestinal Stromal Tumors of the Stomach and Esophagus
Lauren Theiss, Carlo M. Contreras
Surgical Clinics of North America.2019; 99(3): 543. CrossRef
Comparison of Different Risk Classification Systems in 558 Patients with Gastrointestinal Stromal Tumors after R0-Resection
Michael Schmieder, Doris Henne-Bruns, Benjamin Mayer, Uwe Knippschild, Claudia Rolke, Matthias Schwab, Klaus Kramer
Frontiers in Pharmacology.2016;[Epub] CrossRef
A High Risk Group in the Modified National Institutes of Health Consensus Criteria for the Gastrointestinal Stromal Tumor: A Clear Indication of the Adjuvant Imatinib
Dong Kyung Chang
Intestinal Research.2014; 12(3): 176. CrossRef

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Case Reports

A Case of Immune Thrombocytopenic Purpura Associated with Preexisting Ulcerative Colitis Treated with Colectomy and Splenectomy: Jee Hye Kwon, Changhyun Lee, Ji Min Choi, Yoo Min Han, Young Hoon Choi, June Young Lee, Hyuk Yoon, Jaeyoung Chun, Kyu Joo Park, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(4):310-316. Published online October 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.4.310

Abstract PDF

Ulcerative colitis is a chronic inflammatory bowel disease of unknown etiology, associated with extraintestinal manifestations, including the rarely reported immune thrombocytopenic purpura. Here, we present a case of immune thrombocytopenic purpura associated with preexisting ulcerative colitis. The patient was diagnosed with ulcerative colitis 13 years ago. Two years after diagnosis, he presented with hematochezia and active ulcerative colitis. Despite steroid use, the platelet count gradually decreased to 21,000/mm3. Hematochezia and the platelet count recovered after the administration of cyclosporine, and ulcerative colitis was in near complete remission for 11 years. However, the patient was re-admitted for hematochezia and thrombocytopenia persisting over a month. Medical management including increased doses of steroids in combination with cyclosporin failed to control hematochezia and thrombocytopenia. Immune thrombocytopenic purpura was suspected on the basis of normocellular marrow with a normal number of megakaryocytes. To treat uncontrolled colitis and steroid-refractory thrombocytopenia, total proctocolectomy with ileal pouch-anal anastomosis and splenectomy were performed. The patient was followed up for 10 months after surgery and was found to be in good health with a normal platelet count. Therefore, colectomy alone or in combination with splenectomy should be considered in cases of life-threatening ulcerative colitis complicated with steroid-refractory immune thrombocytopenic purpura. (Intest Res 2013;11:310-316)

Citations

Citations to this article as recorded by

Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review
Ahmed Hussein Subki, Manal Ismail Bokhary, Sultan Abdulrahman Alandijani, Mohannad Abdulrahman Aljehani, Ahmed Wasel Alharbi, May Alzahrani, Saud Suliman Almuhammadi, Bassim Tahseen Albeirouti, Mohamed Abdulmajid Abduljabar, Silvio Danese
Journal of Inflammation Research.2022; Volume 15: 6373. CrossRef
A Case of Immune Thrombocytopenic Purpura Accompanying Ulcerative Colitis
Hyun Tae Kim, Tae Oh Kim, Hyung Jun Kim, Soon Il Lee, Gi Jung Jeon, Eun Ji Lee, Seunghyun Park, Taehoon No
The Korean Journal of Gastroenterology.2014; 64(4): 234. CrossRef

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Clinical Characteristics of Lower Gastrointestinal Cancer in Crohn's Disease: Case Series of 5 Patients: Ji Min Choi, Changhyun Lee, Yoo Min Han, Minjong Lee, Dong Kee Jang, Jeehye Kwon, Jong Pil Im, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung; Intest Res 2013;11(2):127-133. Published online April 30, 2013; DOI: https://doi.org/10.5217/ir.2013.11.2.127

Abstract PDF

Crohn's disease is a chronic inflammatory disease that can involve the entire gastrointestinal tract. Several studies indicate that Crohn's patients with long disease duration have an increased risk of small bowel or colorectal cancer. In Korea, only a few cases of Crohn's disease-related small bowel or colorectal cancer have been reported. Here, we described 3 cases of colorectal cancer and 2 cases of small bowel cancer in patients with Crohn's disease. Among 5 patients, 3 had Crohn's disease-related lower gastrointestinal malignancy and the other 2 had sporadic lower gastrointestinal malignancies. Since the diagnosis of Crohn's disease-related lower gastrointestinal malignancy tends to be delayed, the development of malignancy should be considered in patients with long duration of Crohn's disease if patients have refractory symptoms despite intensive medical treatment. Surgical consultation should not be delayed. (Intest Res 2013;11:127-133)

Citations

Citations to this article as recorded by

Metastatic Recurrence of Small Bowel Cancer in Crohn's Disease
Ji Min Choi, Changhyun Lee, Jong Pil Im
The Korean Journal of Gastroenterology.2014; 63(4): 258. CrossRef

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A Case of Chronic Colonic Pseudo-obstruction with Visceral Myopathy: Kyoung Sup Hong, Kyu Joo Park, Sung Hye Park, Sang Gyun Kim, Hyun Chae Jung, In Sung Song, Joo Sung Kim; Intest Res 2008;6(2):145-149. Published online December 30, 2008

Abstract PDF: Chronic colonic pseudo-obstruction is a rare disease that results in colorectal dilatation without any obstructing lesions. Colonic dilatation does not usually cause colonic wall thickening and colonic visceral myopathy with muscular hypertrophy has not been reported in Korea. A 31-year-old female patient was transferred for treatment of refractory constipation accompanied by megacolon. She had suffered from recurrent attacks of severe abdominal pain with the sensation of a mass in the left lower quadrant. An abdominal CT revealed a large luminal dilatation of the sigmoid colon where massive stool was impacted. There was no obstructing lesion or luminal dilatation of the rectum. To relieve her refractory symptoms, a total colectomy with an ileorectal anastomosis was performed. Pathologic examination of the sigmoid colon revealed that the muscle layers were dysplastic and hypertrophied, and the innervations into the muscle fibers were markedly decreased. She was discharged without any intra-abdominal symptoms. (Intest Res 2008;6:145-149)

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A Case of Cytomegalovirus Colitis Complicated by Perforation after Short-term Steroid Therapy in a Patient with Eosinophilia: Jong Pil Im, Yoon Kyung Jeon, Sang Gyun Kim, Joo Sung Kim, Hyun Chae Jung, In Sung Song; Intest Res 2007;5(1):81-86. Published online June 30, 2007

Abstract PDF: Cytomegalovirus (CMV) infection is a rare event that has been reported mainly in immunocompromised patients who have HIV infection or receive immunosuppressive medication. Although CMV infection is generally asymptomatic in healthy individuals, CMV colitis in immunocompetent host can be potentially severe disease with significant morbidity, especially in older patients. We report a case of CMV colitis complicated by colonic perforation after short term steroid therapy in a patient with eosinophilia who has no evidence of immunosuppression. A high index of suspicion is crucial for early diagnosis of CMV colitis especially in older patients, even though obvious evidence of immunodeficiency is lacking. Colonoscopic examination including multiple biopsies is mandatory for diagnosis of CMV colitis, and antiviral agents should be started once the diagnosis is confirmed. (Intest Res 2007;5:81-86)

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