Endoscopically Exposed Coil after Embolization for Bleeding Duodenal Ulcer / 대한소화기내시경학회지

Endoscopy has been the method of choice for the initial diagnosis and treatment of gastrointestinal bleeding. However, in the case of difficult localization or endoscopic failure, angiographic or surgical alternative may be recommended. The role of angiography has been emphasized recently to control upper GI bleeding. We experienced a case with deep ulcer displaying exposed vessel along the duodenal bulb, which imposed serious rebleeding risk. Although, active bleeding was controlled by the epinephrine injections in that patient, rebleeding risk was still high. So the patient underwent emergency angiography with embolization of the pancreaticoduodenal artery and gastroduodenal artery using multiple microcoils. Follow-up endoscopic examinations showed a coil protruding into the lumen from the ulcer bed, and the exposed coil at the ulcer base was completely by the regenerated epithelium three months later. Here in, we describe the rare case of a endodcopically exposed coil after embolization for bleeding duodenal ulcer which is the first case ever reported in Korea.

Infestation state of clonorchis sinensis in patients with pancreatobiliary diseases in ulsan: based on bile examination / 대한내과학회지

BACKGROUND: Bile examination is believed to be the most precise method for detecting Clonorchis sinensis (CS) eggs. We carried out bile examination to evaluate infestation state of CS in patients with pancreatobiliary diseases in Ulsan, known as an endemic area of CS infestation. METHODS: We examined CS eggs in bile in three hundreds and nine patients with pancreatobiliary diseases. The bile was obtained from endoscopic nasobiliary or percutaneous transhepatic biliary drainage tubes. RESULTS: The overall egg positive rate was 27.5% (35.3% in male, 17.6% in female). The egg positive rate was not significantly different according to the age group: 20.0% in thirties, 26.7% in forties, 24.2% in fifties, 29.9% in sixties, 36.2% in seventies and 16.7% in eighties or more. The egg positive rate according to the disease, except CS cholangitis, was not also statistically different: 32.6% in bile duct cancer, 38.5% in gallbladder cancer, 11.1% in ampulla of Vater cancer, 24.0% in pancreatic cancer, 26.4% in gallstone diseases and 12.5% in the reminder. The location of gallstone and whether CS related diseases or CS unrelated diseases did not affect the egg positive rates. The egg positive rate in patients with normal radiological findings including cholangiography was 17.0%. CONCLUSION: This result shows that regardless of age, sex, and sorts of diseases, the infestation rate of CS was very high. On the basis of our results, it is therefore presumes that clonorchiasis is still endemic disease in Korea.

A Case of Simultaneous Xanthogranulomatous Cholecystitis and Carcinoma of the Gallbladder

Xanthogranulomatous cholecystitis (XGC) is a rare inflammatory disease of the gallbladder. Not only does XGC occasionally present as a mass formation with adjacent organ invasion like a malignant neoplasm, it can also infrequently be associated with gallbladder cancer. In the situation, it is difficult to make a differential diagnosis between the diseases. Here, we describe a case of a simultaneous XGC and a carcinoma of the gallbladder in a 61-year-old woman. To the best of our knowledge, there are only a small number of reports on this combination of diseases.

A Case of Chronic Pancreatitis Associated with Liver Infarction and Acrodermatitis Enteropathica

Liver infarction and acrodermatitis enteropathica are rare complications of chronic pancreatitis. This report shows the case of a 56-year-old man who developed liver infarction due to portal vein thrombosis from chronic pancreatitis and acrodermatitis enteropathica during the course of his treatment. The rare combination of these complications in a patient with chronic pancreatitis has never previously been reported in the literature.