Peritonitis due to spontaneous rupture of the urinary bladder in an end stage renal disease patient with anuria / 대한내과학회지

Patients with nonfunctioning bladders, such as found in anuric renal failure, are prone to a severe form of urinary tract infection called pyocystis. Pyocystis is the accumulation of pus in the bladder. Anuric patients are often believed to be incapable of acquiring a urinary pathogen; thus, the urinary tract may be mistakenly discounted as a possible source of sepsis and bladder rupture. Although bladder rupture is normally associated with trauma, spontaneous bladder rupture may occur, especially in patients with mental disabilities, alcohol abuse and urinary tract infection. We report a rare case of a spontaneous intraperitoneal bladder rupture, probably precipitated by pyocystis. Symptoms and signs were atypical and included pain and vomiting with fever, abdominal distension and ascites. An abdominal CT and retrograde cystography showed a large quantity of intraperitoneal fluid and tearing in the dome of the bladder. Repair of the rupture site of the bladder after laparotomy was performed. However,, the patient expired due to peritonitis and pulmonary infection.

A Case of Polypoid Angiolipoma of the Distal Descending Colon as Cause of Hematochezia / 대한소화기내시경학회지

Angiolipoma is a benign tumor that is mainly observed in the subcutaneous tissue and is composed of mature adipose tissue and proliferative blood vessels. However, the condition is rare in the gastrointestinal tract including the colon. There was a case report of angiolipoma of the proximal ileum but there are no reports of angiolipoma of the colon in Korea. A 47-year-old man, who presented with intermittent left lower quadrant pain and hematochezia, underwent contrast enhancement CT, which revealed a huge mass with inhomogeneous density in the distal descending colon. The colonoscopy viewed a large polypoid mass with vascular engorgement, and a laparotomy was performed urgently due to the persistent abdominal pain, intussusception and hematochezia. The histology examination disclosed a benign angiolipoma. We report this case of symptomatic angiolipoma of the distal descending colon.