Endoscopic Hemoclipping in a Terminal Ileal Dieulafoy's Lesion / 대한소화기내시경학회지

Dieulafoy's lesion is an uncommon source of massive gastrointestinal hemorrhage. The lesion predominantly occurs in the proximal stomach, but may occur in all parts of the gastrointestinal tract including small bowel, colon and rectum. We herein report a case of a patient who presented with hematochezia from Dieulafoy's lesion of the terminal ileum with adherent blood clots. Bleeding was successfully controlled with endoscopic treatment by utilizing hemoclipping.

A Case of Endoscopic Treatment of Bleeding in Duodenal Dieulafoy's Lesion / 대한소화기내시경학회지

Dieulafoy's lesions are often unrecognized cause of obscure, massive gastrointestinal bleeding, reported to be 0.3~1.5% of cases of major gastrointestinal bleeding. It is characterized by severe bleeding from rupture of an exposed submucosal artery. Dieulafoy's lesion is usually occured in the lesser curvature of the stomach within 6 cm of the gastroesophageal junction. Similar lesions have also been described in the esophagus, duodenum, small intestine, colon, and rectum. The diagnosis is made by endoscopy, angiography, laparoscopy, or laparotomy. Endoscopy showed protruding and eroded artery with pulsatile bleeding or adherent thrombus. Currently, various therapeutic options are available to the endoscopist for the treatment of Dieulafoy's lesions. Therapeutic endoscopy should now become first-line therapy for Dieulafoy's lesions. We experienced a rare case of bleeding from the duodenal Dieulafoy's lesion. Endoscopic hemoclipping was performed successfully. We report this case with a review of the literature.

A Case of Hydrogen Peroxide Proctitis / 대한소화기내시경학회지

Hydrogen peroxide is a safe and useful disinfectant that has achieved widespread utility in various clinical settings. However, hydrogen peroxide may cause mucosal damage and contact injury when applied to the surface of the gut wall. Endoscopically, hydrogen peroxide colitis and proctitis can mimic acute ulcerative colitis, ischemic colitis, or pseudomembranous colitis such as mucosal whitening, erythema, frothy bubbles, granularity and ulceration. We have experienced a case of hydrogen peroxide proctitis in a 37- year-old female patient. She visited our hospital due to symptoms such as hematochezia, anal pain and pelvic pain after insertion of 15 mL of 3% hydogen peroxide. Colonscopy revealed rectal mucosal whitening, severe erythema and scattered small ulcerations up to 12 cm from the anal verge. Pathologic finding revealed neutrophil infiltration in the lamina propria and intact colonic crypt. Herein we report a case of hydrogen peroxide proctitis with reviewed literatures.

Two Cases of Multiple Carcinoid Tumors of the Rectum / 대한소화기내시경학회지

Carcinoid tumors of the rectum are relatively uncommon and comprise only about one percent of all rectal neoplasms. Typically, rectal carcinoids present as small, solitary submucosal nodules and have benign course. But, multicentricity is rare. The frequency of an associated second malignancy is about 13%. The explanation of the high frequency of other neoplasms associated with carcinoid tumors is still unclear. We have experienced two cases of multiple carcinoid tumors of the rectum, one was coexisted with adenocarcinoma of the sigmoid colon. They presented with mass on the right inguinal area and hematochezia. Carcnoids was found incidentally. Because the tumors measured 15 mm or less in diameter, did not infiltrate beyond the submucosal layer and had no histological atypia, carcinoids was treated by endoscopic polypectomy and mucosal resection. Thereafter, one underwent surgery for adenocarcinoma of the sigmoid colon. Herein we present our experience with reviewed literatures.

A Case of Severe Hypersensitivity Reaction to Para-Amino Salicyic Acid / 대한정형외과학회잡지

Hypersensitivity reactions against para-aminos alicylic have been recorded infrequently in the literature. It is the purpose of this report to emphasize the possible occurence of severe reactions which may result in death if unrecognized. The recognition of the early signs and symptoms of a hypersensitivity reaction to antituberculous drugs is all important because serious consequences can ensue from continued administration of the drug after the first sign of a reaction. This case present acute liver failure as part of a generalized hypersensititivity reaction to para-aminosalicylic acid, based on clinical findings liver function test, course and response to cortison derivatives.

A Follow up Study of the Extensor-Extensor Many Tailed Operation for Leprous Claw Hands / 대한정형외과학회잡지

Sixty four leprous claw hands had been operated on for intrinsic replacement extensor-extensor many tailed at the Department of Orthopedic Surgery, Kyungpook National University Hospital during the period from 1966 to 1970. The follow up study was carried out for fourty-one hands from one year to four years and nine months after operation, and evaluated by the following assessments. 1. Fully open hand assessment 2. Lumbrical position assessment 3. Hook position assessment 4. Closed fist assessment 5. Mechanics of closing 6. Separate finger movement in lumbrical position The results obtained were as follows: 1. The most of the cases were median-ulnar palsy. 2. The majority of them were in third decade young men. 3. Satisfactory result was 63.5% in appearance, 70.8% in function, 62.8% according to the patients statement, and 61.1% in overall total assessment. 4. As complication two cases of severe adhesion of the grafted tendons and significant lateral deviation on nine fingers were noted. 5. Preoperative and postoperative physiotherapy contributed a important roll in the end results.