ABSTRACT
Gastrointestinal ischemia happens by splanchnic artery stenosis, thrombus, or physiological vasoconstriction during a low-blood-stream state. However, even if arterial stenosis exists in the upper gastrointestinal tract, ischemic injury is very rare due to rich collateral circulation. The authors experienced 92-year-old female patient with vomiting, epigastric pain, and hematemesis. An electrocardiogram showed paroxysmal atrial fibrillation. The patient had diffuse and segmental mucosal edema, erythema, and hemorrhage in the second part of the duodenum on esophagogastroduodenoscopy (EGD). On abdomen computed-tomography angiography, stenosis of the celiac and superior mesenteric arteries was observed, and segmental concentric wall thickness was seen from the proximal second portion of the duodenum to the proximal jejunum. The patient was treated with PPI and fluid therapy for one week. At follow-up EGD, the mucosa had improved compared with the previous EGD examination. In conclusion, ischemic injury rarely affects the duodenum and jejunum; however, it can develop in the presence of inducing factors.
Subject(s)
Female , Humans , Abdomen , Angiography , Arteries , Atrial Fibrillation , Collateral Circulation , Constriction, Pathologic , Duodenitis , Duodenum , Edema , Electrocardiography , Endoscopy, Digestive System , Enteritis , Erythema , Fluid Therapy , Follow-Up Studies , Hematemesis , Hemorrhage , Ischemia , Jejunum , Mesenteric Artery, Superior , Mucous Membrane , Splanchnic Circulation , Thrombosis , Upper Gastrointestinal Tract , Vasoconstriction , VomitingABSTRACT
Marginal zone B-cell lymphoma of the gastrointestinal tract most commonly affects the stomach. Endoscopic findings of primary gastrointestinal lymphoma are various and heterogeneous. Lesions may appear as ulcers, erosions, or erythemas. Gastrointestinal lymphomas presenting as multiple polyps on endoscopy are rare. No case of marginal zone B-cell lymphoma manifesting as multiple polyps has been reported on the stomach, although a few cases have been reported in the colon. We present a rare case of a 77-year-old female patient diagnosed as primary gastric marginal zone B-cell lymphoma presenting as multiple polyps. She was fully treated by combination chemotherapy.
Subject(s)
Aged , Female , Humans , Colon , Drug Therapy, Combination , Endoscopy , Erythema , Gastrointestinal Tract , Lymphoma , Lymphoma, B-Cell, Marginal Zone , Polyps , Stomach , UlcerABSTRACT
Gastrointestinal melanosis is observed most frequently in the colon it also can develop in the ileum, duodenum and esophagus very rarely. Melanosis ilei was thought that causative materials such as aluminum, magnesium, silicate, titanium and other compounds entered the body through the ingestion of agents. We experienced a case of melanosis in the terminal ileum that a 65-year-old female patient ingested 10 g edible charcoal everyday for 3 years to address symptoms of chronic abdominal pain. In Korea, edible charcoal has been considered to be an effective folk remedy for patients with diarrhea or chronic abdominal pain. In our case, a follow up colonoscopy was performed 3.5 years after the termination of the ingestion of edible charcoal, at which point pigmentation was faded color intensity. In conclusion, it is thought that melanosis ilei is a rare disease by ingestion of causative materials and is discontinuous, local and reversible disease.
Subject(s)
Aged , Female , Humans , Abdominal Pain , Aluminum , Capsule Endoscopy , Charcoal , Colon , Colonoscopy , Diarrhea , Duodenum , Eating , Esophagus , Follow-Up Studies , Ileum , Korea , Magnesium , Medicine, Traditional , Melanosis , Microscopy, Electron , Pigmentation , Rare Diseases , Silicates , TitaniumABSTRACT
Inflammatory cloacogenic polyp is a polypoid protruding lesion arising from the transitional zone of the anorectal junction. It has a distinctive endoscopic, histological appearance, but it may macroscopically resemble anorectal malignancy. It is important to beware of the possibility of adenoma and malignancy when finding lesions at the anorectal junction. The management of inflammatory cloacogenic polyp is endoscopic or surgical excision. We report here on a 62 year old man who had an anorectal polyp. The initial impression was hemorrhoid or anorectal malignancy. He underwent surgical intervention, and the histology showed inflammatory cloacogenic polyp.
Subject(s)
Adenoma , Hemorrhoids , PolypsABSTRACT
Cystic Brunner's gland hyperplasia is a benign lesion of the duodenum that may not be familiar to gastroenterologists because of its rarity. Moreover, cystic Brunner's gland hyperplasia with intacystic inverted growth is more uncommon lesion. Here, we report a case of cystic Brunner's gland hyperplasia in a 34-year-old man. An endoscopy of the upper digestive tract revealed the presence of a 1.2 cm sized polypoid mass of the duodenal second portion. Endoscopic submucosal dissection was performed to remove the mass. Microscopically, a cystic lesion was seen in the submucosa underneath the normal surface duodenal mucosa. Hyperplastic Brunner's glands were seen close by the cyst. The cyst was lined by a layer of columnar epithelium similar to that of Brunner's gland ducts with no cytologic atypia. Also, a part of the cyst lining was inverted into the cyst lumen with fibrovascular core. Therefore, The final diagnosis was a cystic Brunner's gland hyperplasia with intracystic inverted growth.
Subject(s)
Adult , Humans , Brunner Glands , Duodenum , Endoscopy , Epithelium , Gastrointestinal Tract , Hyperplasia , Mucous MembraneABSTRACT
BACKGROUND: Fatigue is one of the most common problems in terminally ill cancer patients in North America and Europe. However, fatigue has been almost neglected by health care professionals and even by patients and their families in Korea. We studied the prevalence and characteristics of fatigue in cancer patients who were admitted to St. Vincent's Hospital. METHODS: Ninety-three competent patients who were admitted to the cancer or hospice ward were asked to answer whether they had fatigue or other cancer related problems on three occasions on April 4, 11 and 18, 2006. Additional demographic data were also analyzed. RESULTS: Thirty (32.3%) of the 93 patients responded that they had fatigue. The response was from 20/71 male and 10/22 female patients. The median age was 66 years (range 35-84 years). The ECOG performance status was 1, 2 and 3 in 10, 12 and 8 patients respectively. Lung cancer (21 patients) was the most common malignancy followed by gastric cancer, colon cancer and other cancers. Fourteen patients received chemotherapy, 13 patients received supportive care and 3 patients received chemoradiotherapy. Other cancer related symptoms were pain (17 patients), anorexia (16 patients), sleep disturbance (14 patients), and anxiety and depression. The severity of fatigue was grade 1, 2, 3 in 17, 6 and 7 patients respectively. Twenty-eight patients had anemia based on the WHO scale, and there was no relationship between the grade of fatigue and hemoglobin level. CONCLUSIONS: Fatigue was a frequent symptom in cancer patients (32%) and more frequent in female patients (45%). More attention needs to be paid to the significance of fatigue in cancer patients.
Subject(s)
Female , Humans , Male , Anemia , Anorexia , Anxiety , Chemoradiotherapy , Colonic Neoplasms , Delivery of Health Care , Depression , Drug Therapy , Europe , Fatigue , Hospices , Korea , Lung Neoplasms , North America , Prevalence , Stomach Neoplasms , Terminally IllABSTRACT
The incidence of opportunistic infection has decreased since the introduction of highly active antiretroviral therapy, so lymphoma is now far and away the most lethal complication of acquired immunodeficiency syndrome. We have experienced four cases of NHL in AIDS patients. The first patient was a 37 year old male who presented with left sided hemiplegia due to CNS lymphoma. The second patient was a 40 year old male who was admitted because of jaundice; he was diagnosed as having lymphoma that exclusively involved the liver. The third patient was a 38-year-old male who presented with palpable mass in the left cervical region, which was diagnosed as lymphoma. Above three cases were confirmed as diffuse large B cell lymphoma. The fourth patient presented with a protruding swollen chest wall mass on the right side of his chest, this was determined pathologically to be the Burkitt's type. The latter case is the first report of NHL involving the chest wall musculature in a Korean AIDS patient.
Subject(s)
Male , Humans , Aged , Adult , Tomography, X-Ray Computed , Lymphoma, Non-Hodgkin/complications , Fatal Outcome , Diagnosis, Differential , Biopsy , Acquired Immunodeficiency Syndrome/complicationsABSTRACT
Malignant duodeno-colic fistula is a rare complication of advanced colon cancer. The right colon cancer adjacent to the hepatic flexure can occasionally invade into the pancreas or duodenum, but the formation of fistula between the duodenum and colon is very rare. The patients usually complain chronic diarrhea, vomiting and belching of foul smelling gas. This results in physiologic complications such as weight loss, malnutrition, and electrolyte imbalance. It is well known that the barium enema is the most useful diagnostic procedure. We experienced the case of duodeno-colic fistula that arose from the right colon cancer, and the fistula was directly confirmed by an endoscopic examination.