SCOPUS
KCI등재
상부소화관의 (上部消化管) 반복내시경검사예에 (反復內視鏡檢査例) 대한 관찰 = An Endoscopic Observation of the Patients Having Repeated Endoscopic Examination
저자
문영명 ; 강진경 ; 박인서 ; 최흥재 ( Young Myoung Moon ; Jin Kyung Dang ; In suh Park ; Heung Jae Choi )
발행기관
학술지명
권호사항
발행연도
1980
작성언어
-KDC
500
등재정보
SCOPUS,KCI등재,ESCI
자료형태
학술저널
발행기관 URL
수록면
15-23(9쪽)
제공처
The advances of upper gastrointestinal endoscopy in recent years have facilitated the ebservation on the conditions inside the esophagus, stomach and duodenum, and the diagnos- tic value of the endoscopic examination on various diseases has improved markedly. In some cases it is difficult in five the accurate diagnosis with single study and the repetitions are required for accurate diagnosis. Sometimes it is necessary to observe the change of lesions for proper management. We performed 6829 times of upper gastrointestinal endoscopy during the period from January, 1969 to August 15, 1978 in 6396 cases. Among them 316 cases had the endoscopic cxaminations twice or more. The results were as follow: The age distribution of 31() cases were from the age of 19 to 77 and the most of them e ere between 4th and 6th decades. The ratio of male to female was 3. 9: 1. 2. The cases had endoscopic examinations twice were 247 patients, thrice 42, four times 15, five times 6, six times 4 seven times 1 and nine times l. 3. The confirmed diagnoses of 31g cases were benign gastric ulcer in ]54 cases, gastritis in 5g cases, gastric cancer in 4g cases, duodenal ulcer in 26 cases and others in 44 cases. The numbers of patients having two diseases in each were 13 cases. 4. The reasons of repetition of endoscopy were followings as follow-up study in 285 times, uncertain diagnosis in 72 times, continuation of symptoms in 37 times, inadequate study of previous examination in 21 times, annual check in 20 times and pseudopositive result of X-ray in one time. 5. Endoscopy were repeated within one week from previous study in 72 times, 1-2 weeks in 89 times, 2-3 weeks in 51 times, 3-4 weeks in 30 times, 1-2 months in 47 times, 2-3 months in 21 times, 3-6 months in 36 times, 6-l3 months in 28 times, 1-2 years in 3z times, .2-3 years in 15 times and over 3 years from previous examination in 12 times. 6. Confirmed diagnosis were made with the first examinations in 245 cases, second in 60 cases, third in 6 cases and 4th in 2 cases. The diagnosis could not be made definitely in three cases even with the repetition of examinations. 7. In follow-up studies, the lesions were improved over moderate degree in 148 times out of 178 examinations of gastric ulcer, and 18 times out of 27 examinations of duodenal ulcer. In gastritis only g times showed improved lesions from 25 examinations. The gastric cancer recurred in 6 cases out of 20 after operation and the lesion was improved in one case out of 8 cases after chemotherapy without operation. 8. To confirm the lesions the endoscopic examinations were repeated 72 times and we could confirm the lesions in 68 times, but in 4 times the lesions could not be confirmed with repeated endoscopic examination. G. The patients with the benign gastric ulcer were diagr.osed to benign ulcer definitely with first examination in most cases, but 21 cases needed to be differentiated from malignant lesions at first examination and 12 cases were diagnosed to malignant ulcer at first exami- nations. 10. To get definite diagnosis the gastroscopy was repeated 20 times in gastric cancer. Among them 10 cases showed negative results in biopsy which were converted to positive with repeated biopsy in 4 cases, but in 6 cases the results of hiopsy in repeated study were negative whiche were confirmed to cancer after surgery. In 5 cases of gastric cancer the lesions looked like benign but in biopsy specimen malignant cells were seen which had repeated examination for confirmation. The remaining 5 cases had inadequate study at first but were confirmed at second examinations. Li. The reasons of unsatisfactory examinations in 21 cases were as follow: too much blood in stomach in 7 cases, food particle in stomach in 5 cases, examiner's carelessness in 3 cases, patients uncooperation in 2 cases, poor selection of instrument, poor expansion of stomach, barium coating and drug coating on stomach mucosa were one case in each.
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