The Korean Journal of Internal Medicine Vol. 29, No. 5 (Suppl. 1)
WCIM 2014 SEOUL KOREA 263
Poster Session
PS 1086 Gastroenterology (Gastrointestinal Tract) A Case of Colon Cancer Arising in Ulcerative Colitis Complicated by Colonic Stricture
Hae Jin Shin1, Jong Seok Ju1, Hee Seok Moon1, Sun hyung Kang1, Jae Kyu Sung1, Hyun Yong Jeong1
Division of Gastroenterology, Department of Internal Medicine, Chungnam National University Hospital, Korea1
Ulcerative colitis, the chronic inflammation of the colon, causes chronic intestinal complications. A colonic stricture in ulcerative colitis is relatively rare and if accompa- nied by colonic stricture, we should keep in mind the possibility of a malignant tumor.
A 47-year-old woman with an 11 year-history of ulcerative colitis was admitted because of abdominal pain. On abdominal computed tomography, colonic stricture and colon cancer were suspected. After a total proctocolectomy and ileal pouch anal anastomosis, pathologic specimens showed diffuse chronic infl ammation of the mu- cosa and submucosa with atrophy, lymphoid hyperplasia, squamous metaplasia and a 0.4 × 0.3 cm moderately differentiated adenocarcinoma which invaded the muscularis mucosae.
PS 1087 Gastroenterology (Gastrointestinal Tract) Severe Melanosis Coli Dramatically Improved by With- drawing the Anthraquinone Containing Dietary Supple- ments - A Case Report
Jae Keun Park1, Seung Lee1, Yong Woo Ahn1, Byung Chul Yoon1 Department of Internal Medicine, Hanyang University School of Medicine, Korea1
Melanosis coli represents brownish discoloration of the colonic mucosa and submuco- sa. This pigmentation of the colon develops in persons who chronically use anthraqui- none-type laxatives (aloe, senna, rhubarb, and frangula, cascara sagrada, etc.). The pig- mentation of the colon is due to accumulation apoptotic cells which are ingested by macrophages. These lipofuscin pigment containing macrophages transport into lamina propria. Melanosis coli is known to be benign and reversible, and have no specific symptoms. Diagnosis of melanosis coli is made by endoscopic fi nding and previous medication history. Melanosis coli can be improved within a year by discontinuing the offending medication. In our case, patient was not using any laxatives but using an- thraquinone containing dietary supplements for her constipation. We report a case of melanosis Coli dramatically improved by discontinuing the anthraquinone containing dietary supplements.
Key Words: Melanosis coli, Endoscopy, Anthraquinone, Dietary supplements
PS 1088 Gastroenterology (Gastrointestinal Tract) Acute Diverticulitis Induced by Colonoscopy
Se Ryeong Park1, Hong Gyun Kim1, Jun Sik Min1, Jong Ik Park1 Busan Bohun Hospital, Korea1
A diverticulum is a pouch-like structure that can form in the muscular wall of the co- lon, particularly at points where blood vessels enter. Diverticulitis means Infl ammation of a diverticulum which occurs when there is thinning and breakdown of the diver- ticular wall. This may be caused by increased pressure within the colon or hardened particles of stool or by some kind of infection, however still obvious mechanism is not investigated yet. Diverticulosis is often found during various tests, such as fl exible sig- moidoscopy, colonoscopy, or barium enema.In this article, we would report a rare case of acute diverticulitis occurs after colonoscopy procedure.A 65-year-old man visited our hospital for polypectomy, which diagnosed by colonoscopy at other hospital a year ago. This patient had no abdominal pain or tenderness, and peripheral blood test ap- peared within normal range. So polypectomy was done by colonoscopy to the 11 large intestinal polyps. During execusing colonoscopy, several diverticulum was detected.
Just after fi nishing the procedure, patient complained severe abdominal pain and ten- derness on LUQ and epigastric area. Peripheral blood test showed mild infl ammation, such as CRP increased into 2.05mg/dl and diverticulitis detected in ascending colon by abdominal enhanced CT.We treated by antibiotics, ceftriaxone and metronidazole combination therapy. The symtpom relieved after three days and peripheral blood test was normalized.It is considered that colonoscopy has caused diverticulitis, the reason could be air pressure or infection during the procedure.
