Esophageal Bezoar in a Patient with Achalasia: Case Report and Literature Review

Esophageal bezoars are rare, but are recognized as a distinct clinical entity. They are known to occur in patients with esophageal structural and functional abnormalities, but only a few cases of the development of esophageal bezoars in patients with esophageal motility disorders have only been described. We report a rare case of an esophageal bezoar that developed in a patient with achalasia, and review the literature concerning esophageal bezoars associated with esophageal motility disorders.

Malignant Fibrous Histiocytoma Arising from the Omentum Presenting as Hemoperitoneum

Malignant fibrous histiocytoma (MFH) is an uncommon soft-tissue sarcoma that occurs primarily in the extremities and rarely involves the retroperitoneum and abdomen. A 63-year-old man was admitted to the emergency room because of epigastric pain. Computed tomography revealed a large heterogeneous enhanced mass originating from the omentum with hemoperitoneum. The patient underwent laparoscopic omental mass excision and hematoma evacuation. Histological examination of the resected tumor revealed MFH. This case was therefore omental MFH presenting with hemoperitoneum.

A case of adrenal cystic lymphangioma / 대한내과학회지

Cystic lesions of adrenal gland are rare and those are most often identified incidentally during radiological investigation, surgery for unrelated process or at the time of autopsy. Most of cystic lesions are usually asymptomatic and less than 10 cm in diameter. Clinical management of an adrenal cyst can be aided by the imaging findings. Surgery is indicated for large and complicated cysts, parasitic cysts, uncertain cyst, and functioning or malignant cysts. We present a case of a 36-year-old female with the benign and non-functioning cyst that was detected by clinical assay and imaging study. The 4 X 2 cm right adrenal cyst contained linear calcification and septation. Laparoscopic resection and histologic findings were compatible with epithelial cyst of lymphangiomatous type of adrenal gland. With this case, diagnostic features of adrenal cysts are discussed.

The Effect of Itopride, a New Prokinetic, on Acid Reflux Symptoms and Variables in Patients with GERD / 대한소화관운동학회지

BACKGROUND/AIMS: Itopride is a newly developed prokinetic agent enhancing gastric motility through both antidopaminergic and anti-acetylcholinesterase actions. The importance of esophageal motor dysfunction in the pathogenesis of gastro-esophageal reflux disease (GERD) makes it interesting to examine the effect of itopride on esophageal acid exposure. METHODS: The effect of itopride on esophageal 24-hour acid reflux variables was studied in 26 patients with GERD symptoms, pre-entry total acid exposure time (pH<4) of more than 5% and mild esophagitis (Savary-Miller grade I, II) by endoscopy. Ambulatory 24-hour pH monitoring and symptom assessment were performed after treatment with itopride 50 mg or 100 mg t.i.d for 4 weeks by a randomization allocation schedule with an open label. RESULTS: In both itopride groups, total symptom scores were decreased after treatment significantly. Itopride 300 mg was significantly more effective than 150 mg in decreasing the total time and total percent time of intraesophageal pH below 4, and DeMeester score. Consequently, no serious adverse effects were reported after administration in both groups. CONCLUSIONS: Itopride 100 mg t.i.d is effective to decrease pathologic reflux in patients with GERD. Therefore, it has a therapeutic potential for this diseases.