ABSTRACT
Common complications of the intestinal tuberculosis are perforation, obstruction, fistulas, and malabsorption. Massive gastrointestinal bleeding is an extremely rare complication of intestinal tuberculosis. Moreover, this may be the first report in the world on transcatheter arterial embolization against the massive bleeding from intestinal tuberculosis patient. We experienced a case of lower gastrointestinal bleeding due to extensive intestinal tuberculosis as massive as vital sign was unstable. Colonoscopy and esophagogastroduodenoscopy did not reveal bleeding focus. Active jejunal bleeding was suspected by technetium99m labelled RBC scintigraphy. Emergency superior mesenteric artery angiography showed active bleeding focus from jejunal branch of artery and transcatheter arterial embolization was tried with microcoil. After embolization, he had no more hematochezia and vital sign became stabilized. On third hospital day, upper endoscopy was done using pediatric colonoscopy and there were multiple circular ulcers on the proximal jejunum but no evidence of mesenteric ischemia. Small bowel tuberculosis should be suspected as a cause of lower gastrointestinal bleeding in case of negative colonoscopy and upper endoscopy. We suggest that the transcatheter embolization could be taken into consideration as a first-line method of treatment for massive bleeding from intestinal tuberculosis before surgical resection.
Subject(s)
Humans , Angiography , Arteries , Colonoscopy , Emergencies , Endoscopy , Endoscopy, Digestive System , Fistula , Gastrointestinal Hemorrhage , Hemorrhage , Ischemia , Jejunum , Mesenteric Artery, Superior , Radionuclide Imaging , Tuberculosis , Ulcer , Vital SignsABSTRACT
Congenital solitary nonparasitic cysts of the liver are rare condition in all age groups. Since 1856, only approximately 900 cases having been reported in the world literature. Epidermoid cysts of the liver are extremely rare type of congenital nonparasitic hepatic cysts, characterized by a fibrous wall entirely lined with stratified squamous epithelium, but lacking hair or skin appendages. This condition has yet to be reported in Korea. Because they have a potential for malignant transformation, it is important to totally resect the epidermoid cyst of the liver. Recently, we experienced a case of 44-year-old female patient with epidermoid cyst of the liver, which condition was complicated by a secondary infection. For this patient, an enucleation of entire cyst was performed. Given the rarity of this case, the following is a report of this case and a review of the relevant literature.
Subject(s)
Adult , Female , Humans , Coinfection , Epidermal Cyst , Epithelium , Hair , Korea , Liver , SkinABSTRACT
BACKGROUND: The non-alcoholic fatty liver is characterised by accumulation of triglycerides within liver parenchymal cells without intake of alcohol. Leptin is produced by peripheral adipose cells and it's blood concentrations are positively correlated with blood insulin levels, independent of body mass index. Non-alcoholic fatty liver is associated with insulin resistance and hyperinsulinemia even in lean subjects. Therefore, we aimed to elucidate whether hyperleptinemia is associated with non-alcoholic fatty liver, independent of age and obesity. METHODS: The age, weight, BMI and blood laboratory data such as LFT, lipid profiles, insulin, and leptin were analyzed on 26 control subjects and 30 non-alcoholic fatty liver subjects with BMI above 25 kg/m2 in male adults. RESULTS: There was no significant difference in their age, height, weight, and BMI between normal control group and non-alcoholic fatty liver group. But, blood triglyceride, leptin, and insulin level of patients with non-alcoholic fatty liver were significantly higher than those of normal control group. CONCLUSION: Blood leptin levels of non-alcoholic fatty liver group were significantly higher than that of control group. Thus, high circulating leptin concentrations may play a role in the pathogenesis of non-alcoholic fatty liver, regardless of age and obesity.
Subject(s)
Adolescent , Adult , Humans , Male , Body Mass Index , Fatty Liver , Hyperinsulinism , Insulin , Insulin Resistance , Leptin , Liver , Obesity , TriglyceridesABSTRACT
No abstract available.
Subject(s)
Angioplasty , Budd-Chiari Syndrome , Heart Ventricles , StentsABSTRACT
Polymyositis is an inflammatory, autoimmune disease of the skeletal muscle characterized by symmetrical, proximal muscle weakness, elevated muscle enzymes, and characteristic features on electromyogram and muscle biopsy. The kidneys are generally spared and myoglobinuric renal failure is very rare in polymyositis. There have been infrequent reports of polymyositis developing myoglobinuric renal failure secondary to rhabdomyolysis. The flare-up may occur in polymyositis, usually manifest within several weeks to months of achieving a remission. But, rhabdomyolysis and myoglobinuric renal failure was a very rare feature of the relapse of polymyositis. We present a case report of patient with polymyositis who initially presented and relapsed as rhabodomyolysis that lead to myoglobinuric, oliguric renal failure and required transient dialytic support.