A case of a primary segmental omental infarction in an adult / 대한내과학회지

A rare primary segmental omental infarction in an adult. Infarction of a part of the greater omentum has been recognized as an uncommon condition that may mimic other acute abdominal conditions, particularly acute appendicitis and acute cholecystitis. The presentation and course are seldom typical of appendicitis or cholecystitis. A greater omental infarction may occur without a recognizable cause, and may be termed "primary" (idiopathic), but in some cases, a cause is discovered, such as; mechanical interference with the blood supply to the omentum secondary to torsion, or systemic disorders such as cardiac, vascular, and hematological disease. The inflammatory necrotic mass resulting from the infarction produces somatic pain at its location in the abdomen. For unknown reasons the infarction occurs most commonly in the right half of the abdomen, especially the lower quadrant. An sign of peritoneal irritation, tenderness, and muscle guarding are the principal findings elicited on palpitation of the abdomen. Occasionally, a point of exquisite tenderness may be detected; this usually corresponds to the site of the infarction. Recognizing the typical imaging featuresan ovoid or cake-like mass in the omental fat with surrouding inflammatory changesof this condition is important, as most cases can be managed without surgery. We report a case of an adult patient with acute abdominal pain who was diagnosed with a right-sided segmental omental infarction.

Two Cases of Phytobezoars Treated by Adminsitration of Coca-Cola by Oral Route / 대한소화기학회지

Bezoars are concretions of foreign bodies found in the gastrointestinal tract. In the past, most common method for the treatment of bezoar was surgical management. However, the current treatment methods include chemical dissolution and endoscopic mechanical lithotripsy. There were few reports on the treatment of phytobezoars by nasogastric Cola lavage. However, there was no report succeeded by oral route alone. In our two cases, phytobezoars were treated by oral administration of Coca-Cola. Our patients drank 700-800 mL of Coca-Cola daily, and after two months, complete dissolutions of bezoars were achieved. We report two cases of phytobezoars completely treated by drinking Coca-Cola.

A Case of Inflammatory Fibroid Polyp of the Cecum Causing Intussusception / 대한소화기내시경학회지

Inflammatory fibroid polyp is a polypoid lesion of the gastrointestinal tract, composed of fibrous tissue, blood vessels, and inflammatory infiltration often dominated by eosinophilic leukocytes. It is infrequent, localized, and non-neoplastic condition. It is most often formed in the gastric antrum and ileum, and rarely in the esophagus, small bowel or colon. The polyp in the stomach is mainly located in the submucosa of the antrum, and may cause intermittent epigastric pain, vomiting, antral obstructive symptoms or rarely bleeding. When present in small bowel, it is usually localized in the ileum and presents with obstructive symptoms but clincal manifestations are different according to the location. Intussusception resulting from the mass is not common. We report a case of inflammatory fibroid polyp of the cecum causing intussusception. A 42-year-old male patient was referred to the hospital for the evaluation of right lower quadrant abdominal pain and palpable mass. A contrast-enhanced CT scan of the whole abdomen and colonoscopic examination revealed intussusception with a cecal mass. Inflammatory fibroid polyp causing intussusception was histologically confirmed by surgical wedge resection.

Emphysematous Pyelonephritis, Ureteritis, and Cystitis which Occur Simultaneously in a Diabetic Neurogenic Bladder Patient / 대한신장학회잡지

Since the first case was known by Kelly and MacCallum in 1898, gas-forming bacterial infection of the urinary tract has been reported infrequently. This disease occurs more frequently in diabetics or women, and is mainly caused by aerobic Gram negative bacteria, most commonly E. coli. Although the pathogenesis of gas formation in this disease is still poorly understood, glucose fermentation by the causative bacteria has been considered as the main mechanism. In the literature, the majority of cases reported were emphysematous pyelonephritis and/or emphysematous cystitis, together or separately. But simultaneous development of emphysematous infection of kidney, ureter and bladder has been reported very rarely and no case has been reported yet in Korea. We report a case of emphysematous pyelonephritis, ureteritis, and cystitis which occurred simultaneously in 35-year-old female patient with diabetic renal failure and neurogenic bladder.