ABSTRACT
Acute extensive ischemic gastritis is an extremely rare disease because the stomach has an abundant submucosal vascular plexus with a dual blood supply from the pancreaticoduodenal and gastroduodenal arteries. Smoking, hypertension, and atherosclerotic vascular diseases can be major risk factors for ischemic gastritis. Acute gastric ischemia presents as an acute abdomen with diarrhea or hematemesis that rapidly progresses to acute peritonitis, irreversible septic shock, and death if untreated. We report a case of acute extensive ischemic gastritis combined with tetraplegia due to cervical myelopathy and extensive atherosclerotic changes of the celiac trunk and abdominal aorta.
Subject(s)
Abdomen, Acute , Aorta, Abdominal , Arteries , Diarrhea , Gastritis , Hematemesis , Hypertension , Ischemia , Peritonitis , Quadriplegia , Rare Diseases , Risk Factors , Shock, Septic , Smoke , Smoking , Spinal Cord Diseases , Stomach , Vascular DiseasesABSTRACT
BACKGROUND/AIMS: Colonoscopic polypectomy is an effective tool for the treatment of colonic polyps. With the recent widespread use of colonoscopic polypectomy, there is a growing concern about iatrogenic complications, such as bleeding and perforation. The aim of this study is to analyze the clinical presentation and management of complications during colonoscopic polypectomy. METHODS: We retrospectively reviewed the medical records of colonoscopic examinations performed at 5 hospitals of Hallym University Medical Center between June 2005 and June 2008. RESULTS: A total of 26,773 colonoscopies and 4,123 colonoscopic polypectomy were performed. The overall rate of complication was 1.04% (43/4,123). Perforation occurred in 0.19% (8/4,123) of cases, and bleeding occurred in 0.85% (35/4,123) of cases. Perforation occurred in 0.05% of snare polypectomies, 1.09% of endoscopic mucosal resections (EMR), and 7.14% of endoscopic submucosal dissections (ESD). Bleeding occurred in 0.8% of snare polypectomies, 1.09% of EMRs, and 3.57% of ESDs. The complication rate of ESDs was higher than in EMRs and snare polypectomies (P<0.001). Endoscopic clippings were performed in 25% of perforation and 66.7% of bleeding cases. Medical treatment was successful in 75% of perforation and 100% of bleeding cases. CONCLUSIONS: Colonoscopic polypectomy is a safe procedure for the treatment of colonic polyps, but rarely, serious complications occur. Compared to a snare polypectomy or an EMR, the complication of an ESD occurs more frequently. Endoscopic treatment and further conservative management seems to be appropriate in most cases with complication.
Subject(s)
Academic Medical Centers , Colonic Polyps , Colonoscopy , Hemorrhage , Medical Records , Retrospective Studies , SNARE ProteinsABSTRACT
Brunner's gland adenoma is a rare benign proliferative lesion developing most commonly in the posterior wall of the duodenum. It is usually small in size and asymptomatic. Depending on its size or location, however, the clinical manifestations of this tumor may be variable from nonspecific symptoms to gastrointestinal bleeding or obstruction. Brunner's gland adenoma in the proximal jejunum is extremely rare. We report a very rare case of giant Brunner's gland adenoma developing in the proximal jejunum which presented as iron deficiency anemia and mimicked intussusceptions on radiologic studies.
Subject(s)
Adenoma , Anemia, Iron-Deficiency , Duodenum , Hemorrhage , Intussusception , Iron , JejunumABSTRACT
Hepatic pseudoaneurysms were once relatively uncommon and often associated with hepatic trauma. Currently, the main etiology of pseudoaneurysms is iatrogenic injuries with the increased use of percutaneous procedures and laparoscopic surgery. However, a spontaneous hepatic pseudoaneurysm is very rare. The clinical manifestations can include pain, swelling, thrombosis, bleeding, and rupture. Early detection is critical for the proper treatment, because ruptured pseudoaneurysms have high morbidity and mortality. We present a case of spontaneous pseudoaneurysm in the common hepatic artery that was treated successfully with transarterial coil embolization.
Subject(s)
Aneurysm, False , Hemorrhage , Hepatic Artery , Laparoscopy , Rupture , ThrombosisABSTRACT
POEMS syndrome is a plasma cell proliferative disorder is characterized by the presence of peripheral neuropathy (P), organomegaly (O), monoclonal gammopathy (M), endocrinopathy or edema (E) and skin change (S). It can be rarely related to multiple myeloma. A 48-year-old man was admitted to our hospital due to paresthesia of both inguinal areas and weakness of both lower extremities. He had a history of Castleman's disease, and showed features of polyneuropathy, multiple osteoblastic lesions, hepatosplenomegaly, pretibial pitting edema, and papilledema. The serum and urine electrophoresis were negative, but urine immunofixagion could detect monoclonal protein. Plasmacytoma was confirmed through the biopsy for the osteoblastic lesions. We present a case of combined POEMS syndrome and multiple myeloma with positive M protein only on immunofixation in order to share our experience with physicians and specialists.
Subject(s)
Humans , Middle Aged , Biopsy , Edema , Electrophoresis , Castleman Disease , Lower Extremity , Multiple Myeloma , Osteoblasts , Papilledema , Paraproteinemias , Paresthesia , Peripheral Nervous System Diseases , Plasma Cells , Plasmacytoma , POEMS Syndrome , Polyneuropathies , Skin , SpecializationABSTRACT
Brunner's gland hyperplasia is a tumor arising from the Brunner's gland and the lesions account for 10.6% of benign duodenal tumors. These lesions are usually asymptomatic and detected incidentally by endoscopy or by a UGI barium study. In the case of severe and atypical forms, these lesions cause bleeding, intestinal obstruction or intussuception. However, Brunner's gland hyperplasia causing an annular duodenal stricture and subsequent intestinal obstruction has been rarely reported. We report here a very rare case of Brunner's gland hyperplasia presenting as an annular stricture and obstruction.
Subject(s)
Barium , Constriction, Pathologic , Endoscopy , Hemorrhage , Hyperplasia , Intestinal ObstructionABSTRACT
Primary extranodal non-Hodgkin's lymphomas comprise approximately 10% of all non-Hodgkin's lymphomas. However, primary tracheal non-Hodgkin's lymphoma is extremely rare, being mainly mucosa-associated lymphoid tissue lymphoma. A 65-year-old female has dry cough for one year. She was diagnosed as diffuse large B-cell lymphoma via bronchoscopic-guided biopsy. She was treated with four cycles of the R-CHOP regimen and adjuvant radiotherapy. After completion of the combined treatment, the treatment response was complete remission, and the disease free survival was 26 months.