A Case of Acute Lower Gastrointestinal Bleeding from a Benign Appendiceal Ulcer / 대한소화기내시경학회지

A hemorrhoid is the most common cause of acute lower gastrointestinal (LGI) bleeding. Diverticulosis, angiodysplasia and ischemic colitis can also cause LGI bleeding. Acute LGI bleeding from the appendix is very rare. We experienced a case of a 33-year-old woman with acute LGI bleeding from the appendix. Colonoscopy demonstrated an active hemorrhage from the orifice of the appendix. The patient was treated with a appendectomy, and a histological examination showed the presence of a small ulcer with inflamed granulation tissue in the mucosa and submucosa.

Non-traumatic Small Bowel Perforation: Comparisons of the Clinical Features of 20 Years Ago with Present

The majority of small bowel perforations are caused by an abdominal trauma. However, non-traumatic causes should not be ignored. The etiology of a non-traumatic small bowel perforation is varies and has chronological characteristics. This retrospective study was undertaken to investigate the chronological changes in non-traumatic small bowel perforations over the past twenty years, according to the clinical features, surgical methods, and the prognosis of those with a non-traumatic small bowel perforation. The results of this study showed that the incidence of a bacterial enteritis induced small bowel perforation has significantly decreased, and inflammatory bowel disease or collagen disease has become the major causes of a non-traumatic small bowel perforation. Moreover, geriatric patients over 70 years of age are more vulnerable to a non-traumatic small bowel perforation.

Patency Rate of Prosthetic Arteriovenous Fistula Correlated with the Sites

PURPOSE: Patency of the arteriovenous fistula remains the most important support for patients with end stage renal disease. Prosthetic materials have been used only when autogenous arteriovenous fistula procedure is not feasible, because of the relatively low patency in prosthetic arteriovenous fistula. We designed this study to determine the appropriateness of primary prosthetic arteriovenous fistula. METHOD: Twenty-one consecutive patients who underwent prosthetic arteriovenous fistula formation on the arm in Chosun university hospital from Mar. 1998 to Feb. 2001 were retrospectively analysed. RESULT: The median patency in radio-antecubital fistula, brachio-antecubital fistula, and brachio-axillary fistula was 9.6, 11.4, and 16.6 months, respectively. The primary assisted patency rates in radio-antecubital fistula and brachio-antecubital fistula were 44.9% and 70.0% at the first year, respectively (P=0.03). The secondary patency rates in radio-antecubital fistula and brachio-antecubital fistula were 71.4% and 80.0% at the first year and 28.6% and 48.0% at the second year, respectively (0.02). CONCLUSION: The patency rates according to the site of prosthetic arteriovenous fistula were statistically significant in the radio-antecubital fistula and brachio-antecubital fistula groups. Nevertheless, the patency rates of the brachio-axillary fistula group were statistically insignificant. Primary brachio-antecubital fistula with PTFE creation showed favorable patency rates and many other benefits. Therefore, we suggest primary brachio-antecubital fistula with PTFE as the appropriate arteriovenous access in patients with poor vessel condition.

Giant Liposarcoma Arising in the Mesentery

A liposarcoma is the most common soft tissue sarcoma in adults with an incidence of betwen 9.8 and 16% of all soft tissue sarcomas. Among the various histological types, a dedifferentiated liposarcoma has rarely been reported. We experienced a case of a giant 7 kg dedifferentiated liposarcoma arising in the mesentery of a 57-year old male patient. Abdominal computed tomography showed a huge lipoid mass occupying the whole abdomen. A surgical excision was carried out. Histologically, the tumor was composed of a well-differentiated liposarcomatous area and a leiomyosarcoma-like dedifferentiated area. The authors reviewed the prognostic factors and treatments for a liposarcoma.

Giant Liposarcoma Arising in the Mesentery

A liposarcoma is the most common soft tissue sarcoma in adults with an incidence of betwen 9.8 and 16% of all soft tissue sarcomas. Among the various histological types, a dedifferentiated liposarcoma has rarely been reported. We experienced a case of a giant 7 kg dedifferentiated liposarcoma arising in the mesentery of a 57-year old male patient. Abdominal computed tomography showed a huge lipoid mass occupying the whole abdomen. A surgical excision was carried out. Histologically, the tumor was composed of a well-differentiated liposarcomatous area and a leiomyosarcoma-like dedifferentiated area. The authors reviewed the prognostic factors and treatments for a liposarcoma.