Intestinal Research

Original Article

Risk Factors for Delayed Post-Polypectomy Bleeding: Min Jung Kwon, You Sun Kim, Song I Bae, Young Il Park, Kyung Jin Lee, Jung Hwa Min, Soo Yeon Jo, Mi Young Kim, Hye Jin Jung, Seong Yeon Jeong, Won Jae Yoon, Jin Nam Kim, Jeong Seop Moon; Intest Res 2015;13(2):160-165. Published online April 27, 2015; DOI: https://doi.org/10.5217/ir.2015.13.2.160

<b>Background/Aims</b><br/>

Among the many complications that can occur following therapeutic endoscopy, bleeding is the most serious, which occurs in 1.0-6.1% of all colonoscopic polypectomies. The aim of this study was to identify risk factors of delayed post-polypectomy bleeding (PPB).

Methods

We retrospectively reviewed the data of patients who underwent colonoscopic polypectomy between January 2003 and December 2012. We compared patients who experienced delayed PPB with those who did not. The control-to-patient ratio was 3:1. The clinical data analyzed included polyp size, number, location, and shape, patient' body mass index (BMI), preventive hemostasis, and endoscopist experience.

Results

Of 1,745 patients undergoing colonoscopic polypectomy, 21 (1.2%) experienced significant delayed PPB. We selected 63 age- and sex-matched controls. Multivariate logistic regression analysis showed that polyps >10 mm (odds ratio [OR], 2.605; 95% confidence interval [CI], 1.035-4.528; P=0.049), a pedunculated polyp (OR, 3.517; 95% CI, 1.428-7.176; P=0.045), a polyp located in the right hemicolon (OR, 3.10; 95% CI, 1.291-5.761; P=0.013), and a high BMI (OR, 3.681; 95% CI, 1.876-8.613; P=0.013) were significantly associated with delayed PPB.

Conclusions

Although delayed PPB is a rare event, more caution is needed during colonoscopic polypectomies performed in patients with high BMI or large polyps, pedunculated polyps, or polyps located in the right hemicolon.

Citations

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Case Reports

Successful Treatment of Postoperative Fistula with Infliximab in a Patient with Crohn's Disease: Seong Yeon Jeong, Jeong Seop Moon, Kyu Joo Park, You Sun Kim; Intest Res 2014;12(1):74-77. Published online January 28, 2014; DOI: https://doi.org/10.5217/ir.2014.12.1.74

Abstract PDF PubReader

Nearly 80% of patients with Crohn's disease (CD) require surgical treatment for complications or failure of medical management. We managed a 31-year-old man with CD who presented with a post-operative fistula. The patient had undergone surgery due to multiple strictures and a fistula. However, a new fistula developed that connected to the intraperitoneal abscess. Intravenous antibiotics were started and multiple percutaneous drainage tubes were inserted to treat the abdominal abscess. However, the amount of drainage was consistently high, even one month after the operation. To treat the postoperative fistula, 5 mg/kg of infliximab was started, and the amount of drainage decreased dramatically to less than 10 cc a day. Some studies have reported that infliximab decreases the recurrence of CD after surgery. The effect of infliximab on post-operative fistulas in patients with CD has not been sufficiently studied. Our results indicated that the use of infliximab to treat post-operative fistula should be explored further in future clinical studies.

Citations

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Treatment of abdominal fistulas in Crohn�s disease and monitoring with abdominal ultrasonography
Nadia Moreno Sánchez, José María Paredes, Tomas Ripollés, Javier Sanz de la Vega, Patricia Latorre, María Jesús Martínez, José Richart, José Vizuete, Eduardo Moreno-Osset
Revista Española de Enfermedades Digestivas.2020;[Epub] CrossRef
Factors Associated with Anxiety and Depression in Korean Patients with Inactive Inflammatory Bowel Disease
Min Chul Kim, Yoon Suk Jung, Young Seok Song, Jung In Lee, Jung Ho Park, Chong Il Sohn, Kyu Yong Choi, Dong Il Park
Gut and Liver.2016;[Epub] CrossRef
Efficacy and safety of CT‐P13, a biosimilar of infliximab, in patients with inflammatory bowel disease: A retrospective multicenter study
Yoon Suk Jung, Dong Il Park, Young Ho Kim, Ji Hyun Lee, Pyoung Ju Seo, Jae Hee Cheon, Hyoun Woo Kang, Ji Won Kim
Journal of Gastroenterology and Hepatology.2015; 30(12): 1705. CrossRef
The clinical characteristics of patients with free perforation in Korean Crohn’s disease: results from the CONNECT study
Young Seok Doh, You Sun Kim, Song I Bae, Jong Pil Im, Jae Hee Cheon, Byong Duk Ye, Ji Won Kim, Young Sook Park, Ji Hyun Lee, Young-Ho Kim, Joo Sung Kim, Dong Soo Han, Won Ho Kim
BMC Gastroenterology.2015;[Epub] CrossRef

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A Case of Ulcerative Colitis Patient with Colonic Stenosis and Enterocutaneous Fistula: Seong Yeon Jeong, You Sun Kim, Kyeong Sam Ok, Sun Ok Kwon, Jin Nam Kim, Jeong Seop Moon, Yun Kyung Kang, Seong Woo Hong; Intest Res 2012;10(4):388-391. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.388

Abstract PDF: Ulcerative colitis (UC) is one of the chronic inflammatory bowel diseases (IBD), characterized by a diffuse mucosal inflammation limited to the colon. Complications of UC include stricture, colorectal cancer, and toxic colitis. UC patients rarely present with a stenosis or fistula, and strictures develop in less than 5% of patients with UC. We present a patient with UC, accompanied by unusual complications that involved not only a stricture but also a fistula and abscess. A 49-year-old female was presented with a left flank pain and fever that had begun two weeks before admission. She had received a diagnosis of UC 20 years ago and had it treated for 2 years in a local hospital. However, she arbitrarily stopped visiting the hospital and relied on home remedies. An abdominopelvic CT scan revealed luminal narrowing and extra-peritoneal fistula formation in the descending colon. Fistula was connected with a subcutaneous abscess in the left flank. She had undergone total colectomy and ileo-anal anastomosis. On the pathologic exam, the long standing UC with severe stenosis was observed without malignant change. It cannot be emphasized enough that a correct therapeutic approach and an appropriate follow-up schedule are very important for patients with UC. (Intest Res 2012;10:388-391)

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Original Article

Clinical Significance of Erosive or Ulcerative Lesions Isolated in Terminal Ileum: Sun Ok Kwon, You Sun Kim, Myoung Ki Oh, Sun Young Kim, In Hye Cha, Seong Yeon Jeong, Joo Yeon Cho, Jin Nam Kim, Jeong Seop Moon; Intest Res 2012;10(4):350-356. Published online October 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.4.350

Abstract PDF: Background/Aims
Although terminal ileal erosive or ulcerative lesions are frequently observed on colonoscopic examination, their clinical significance are unclear. We evaluated clinical course and significance of isolated terminal ileal erosive or ulcerative lesions. Methods: We retrospectively analyzed clinical features, number, size and histologic findings of 186 patients with isolated terminal ileal erosive or ulcerative lesions on colonoscopic examination from December 2003 to February 2012. Results: The indications for colonoscopy included screening for colorectal cancer or surveillance in 122 patients (65.6%), evaluations for symptoms in 64 patients (34.4%). Of the 186 patients, 170 underwent biopsy at the terminal ileal lesions. Histologic findings were mostly non-specific chronic inflammation except two cases of Crohn's disease, one case of cytomegalovirus ileitis, and one case of intestinal tuberculosis. Forty six patients underwent follow-up colonoscopy and the mean duration was 17.8±14.2 months (range, 1-64 months). Of those who showed non-specific ileitis (44 patients), 35 (79.5%) showed resolution of lesions without specific treatment. In the remaining 9 (20.5%) patients, lesions were continued and two patients were diagnosed as Crohn's disease and Behcet's ileitis, respectively. There were no significant differences in the duration of follow-up, presence of symptoms, number and size of terminal ileal lesions between the patients who resolved and not resolved. Conclusions: Most isolated terminal ileal erosive or ulcerative lesions reveal non-specific histological findings and have a propensity to resolve without treatment. However, in small portions of patients, isolated terminal ileal lesions need careful attention because it is possible to be early inflammatory bowel diseases. (Intest Res 2012;10:350-356)

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