A case of eosinophilic gastroenteritis with diffuse small bowel edema and ascites / 대한내과학회지

Eosinophilic gastroenteritis is an uncommon disorder of stomach, small bowel and colon characterized by peripheral blood eosinophilia, eosinophilic infiltration of the gut wall, and variable clinical symptoms. This disease was first described by Kaijser in 1937, and its cause was poorly understood. It may be related to allergy, which combines allergic rhinitis, allergic asthma, atopic dermatitis, food allergy and elevated IgE. The clinical symptoms and signs are variable according to the extents and depths of the eosinophilic infiltration. Endoscopic findings may show normal, nodular, ulcerative, or hemorrhagic mucosal changes, and biopsy findings reveal eosinophilic infiltration of mucosal and muscular layer. We diagnosed and treated a case of diffuse serosal eosinophilic gastroenteritis associated with ascites in a patient with allergic asthma who had severe abdominal pain, distention and watery diarrhea, and she dramatically responded to corticosteroid therapy.

A Case of a Solid and Papillary Epithelial Neoplasm of the Pancreas Associated with Malignant Change / 대한소화기내시경학회지

The solid and papillary epithelial neoplasm of the pancreas is a relatively uncommon disease. It accounts for approximately 1 to 2 percent of all exocrine pancreatic tumors. This benign or low grade malignant tumor is reported to occur predominantly in young women and rarely in men. Recurrence and development of metastasis after resection are found only in a small fraction of the general population. A case is herein reported involving a solid and papillary epithelial neoplasm of the pancreas which extensively spread to nearby organs, in a 34 year-old man. Chief complaints were black stool. Physical examination revealed tenderness on the left upper quadrant of the abdomen. Esophagogastroduodenoscopy revealed multiple cardiac variceal bleeding. Abdominal sonography and CAT scan findings showed a huge lobulated mass on the left upper quadrant area with an internal necrotic portion. Surgical findings showed determined a splenic vein tumor thromboembolus, portal vein involvement, distal stomach involvement, and multiple colonic invasion. Therefore, distal pancreatectomy, wedge resection of the stomach, splenetomy, segmental resection of the transverse colon, and excision of the mass were all performed. Pathologic examination revealed a solid and papillary epithelial neoplasm in the pancreatic tail with a marked dilated splenic vein filled with tumor thromboembolus. The patient has been under chemotherapy since then, and is being closely observed.

Diagnostic usefulness of serum gamma-glutamyl transferase ( GGT ) activity in fatty liver and relationship with other factors / 대한내과학회지

BACKGROUND: Gamma-glutamyl transferase(GGT) has found wide application as a diagnostic test in hepatobiliary disease, and has been used as the best single marker of alcohol intake. In spite of the wide use of GGT in clinical practice, knowledge concerning the distribution and the determinants of this risk factor in the normal population is spared in Korea. We tried to obtain a better evaluation of specificity of serum GGT by analysis of a large population of health examination. METHODS: GGT was measured in 17,140 males aged 17-86 years and 12,125 females aged 18-90 years screened in a health survey program. RESULTS: In multiple regression analyses, serum GGT level showed strong positive association with fatty liver, body mass index, serum levels of AST, ALT triglyceride, uric acid, alkaline phosphatase, systolic blood pressure, and diastolic blood pressure, and weakly positive association with serum levels of creatinine, total cholesterol, and fasting blood sugar. In females, menopause were positively associated with GGT. CONCLUSIONS: An elevated serum GGT levels is a strong indicator of hepatobiliary dysfunction or fatty liver. However, proper interpretation of a serum GGT elevation should be carefully considered in correlation with clinical data and laboratory findings.