An adrenal gland abscess after N-butyl-2-cyanoacrylate (Histoacryl(R)) injection therapy for gastric varices bleeding / 대한내과학회지

N-butyl-2-cyanoacrylate (Histoacryl(R)) is used to obtain hemostasis in gastric variceal bleeding. Known complications of Histoacryl(R) injection therapy include bleeding, perforation, stenosis, and embolism. We report a case of adrenal abscess as a very rare complication of Histoacryl(R) injection. A 40-year-old male with liver cirrhosis was admitted with acute gastric variceal bleeding. Sclerotherapy using Histoacryl(R) mixed with lipiodol (3 mL) was successful. Twenty-seven months later, he was readmitted complaining of left flank pain and a fever of 39degreesC. Abdominal computed tomography (CT) showed a heterogeneous enhancing solid and cystic mass (6.1x3.0 cm) at the left adrenal gland. A left adrenalectomy was performed and the pathological examination confirmed a Histoacryl(R)-related adrenal abscess. We present this case along with a brief review of the literature

Two Cases of Benign and Malignant Lesion Caused Ileocolic Intussusception: Preoperative Colonoscopic Reduction was Attempted for These Patients / 대한소화기내시경학회지

In contrast to the idiopathic cause of intussusception in children, adult intussusception in most patients is associated with organic causes. The majority of these patients are brought to the operating room with the preoperative diagnosis of bowel obstruction, and the surgeon discovers an intussusception intraoperatively. But the increasing use of abdominal CT may improve the ability to diagnose intussusception. There is no universal agreement upon the correct treatment of adult intussusception, although most authors agree that surgical intervention is necessary. In the more recent reports, colonoscopic reduction of intussusception has been reported for selected patients. For patients in whom the involved ileum is extremely long, it is advisable to attempt an operative reduction or colonoscopic reduction selectively. Thus, we report here on two patients with benign and malignant lesion, respectively, that caused ileocolic intussusception; preoperative colonoscopic diagnosis and reduction were attempted for these patients, although the patients were not reduced by colonoscopic procedure.

A Case of Small Bowel Obstruction due to a Mushroom Bezoar / 대한소화기내시경학회지

A mushroom bezoar is an unusual type of bezoar and a rare cause of small bowel obstruction, with the only cases being previously described in the foreign literature. Common sites of obstruction are the gastric outlet, the terminal ileum as well as segments of pre-existing gastrointestinal stenosis of various etiologies. Predisposing factors include a high fiber intake, inadequate chewing, gastric hyposecretion and hypomotility, and a previous gastrectomy and vagotomy. Computed tomography has the capability of directly showing the bezoar and displaying the resulting small bowel obstruction. We report a case of incomplete small bowel obstruction in a 38-year-old woman, caused by a mushroom bezoar in the terminal ileum.

Secondary Amyloidosis in Patient with Spinal Cord Injury: Renal and Thyroid Amyloidosis / 대한신장학회잡지

Amyloidosis is an acquired or inherited disorder with protein folding and degradation characterizing the deposition of the proteinaceous material in the extracellular matrix of one or several organs. Secondary amyloidosis resulting from the deposition of serum amyloid A protein, occurs 1-5% during the lifetime of patients with chronic inflammatory disorders such as rheumatoid arthritis and ankylosing spondylitis. In addition, chronic pyelonephritis and pressure sores in patient with spinal cord injury are documented as risk factors of secondary amyloidosis. Thus, the efforts to treat and prevent the development of secondary amyloidosis and to preserve the renal function should focus on avoiding the chronic inflammatory state and a pathologic study of doubtful organs for early diagnosis should be performed. We have experienced one case of secondary amyloidosis in patient with spinal cord injury which involves with kidney and thyroid gland.