The Clinical Characteristics of Endobronchial Anthracofibrotic Pigmentation / 결핵및호흡기질환

OBJECTIVES: Endobronchial anthracofibrotic pigmentation, which presents as dark black or brown pigmentation mucosal changes of multiple bronchi combined with bronchial fibrosis and obstruction, is not a rare finding when performing diagnostic bronchoscopy for Koreans. This study was performed to define the clinical characteristics and to determine the association of these finding with the Korean life style and such other diseases as coal workers, pneumoconiosis or tuberculosis in the patients with anthracofibrotic pigmentation. METHODS: This retrospective analysis was conducted on 70 (5.2%) patients with endobronchial anthracofibrotic pigmentation, among a total of 1340 patients who underwent bronchoscopy. The distinctive clinical features, the personal life style, the past medical history, the histology and microbiology, the radiologic finding and the natures of the bronchoscopic lesions were analyzed. RESULTS: This mean age of the patients with anthracofibrotic pigmentation was 60.6+/-9.2 year old and the male to female ratio was 1:1.7. The common respiratory symptoms of these patients were coughing and sputum (81%, 57/70), and this was followed in order by dyspnea and hemoptysisir. The symptoms were not related with smoking and an occupational history such as being a coal worker and so on. Pneumonia was most common finding on the radiologic studies. On bronchoscopy, the right middle lobe bronchus was most commonly involved. The most common associated disease was tuberculosis, and 40 cases (57.1%) were diagnosed by AFB staining, TB PCR, bronchoscopic guided tissue biopsy and a past history of tuberculosis. Other diseases related with anthracotic pigmentation were hypertension, diabetes, COPD, lung cancer, pneumoconiosis and asthma. CONCLUSION: These results suggest that endobronchial anthracofibrotic pigmentation was mostly related with pulmonary tuberculosis rather than with coal- related disease. Endobronchial anthracofibrotic pigmentation was more prevalent in older age females in Korea.

A Case of Small Bowel Perforation Associated with Sclerosing Encapsulating Peritonitis in Patient with Intermittent Peritoneal Dialysis (IPD) / 대한신장학회잡지

Sclerosing ecapsulating peritonitis (SEP) first described by Gandhi and Humyn at 1980 is generally recognized, but uncommon complication of continous ambulatory peritoneal dialysis (CAPD) and the prognosis is very poor. A 62-year old female was admitted to our hospital with chief complaint of abdominal pain, nausea, vomiting. On physical examination, abdominal pain was not detected. Abdominal CT demonstrated paralytic ileus and adhesion in proximal ileum. She underwent adhesilolysis of ileum and repair of perforated ileum. We experienced one case of SEP presenting small bowel perforation and peritonitis in patient with IPD. We report this case with review of the literature.