ABSTRACT
The most common metastatic sites of gastric cancer are liver, lung, bone and adrenal gland. However, skin metastases from gastric cancer are relatively rare. We herein report a case of advanced gastric cancer with perianal skin metastasis in a 70-year-old male. On admission, patient presented with epigastric pain. Endoscopy and abdominal CT scan demonstrated the stage IV gastric cancer. He had one painless nodule on perianal skin area, biopsy of that lesion showed a feature of poorly differentiated adenocarcinoma clinically from the stomach. We suspected that the perianal lesion was originated from gastric cancer.
Subject(s)
Aged , Humans , Male , Anal Canal , Neoplasm Staging , Skin Neoplasms/diagnosis , Stomach Neoplasms/diagnosisABSTRACT
Capsule endoscopy is being increasingly used for investigating GI bleeding of an obscure origin and also the bleeding that's due to Crohn's disease. Capsule endoscopy is a safe procedure with few complications. Complications of capsule endoscopy are capsule retention, incomplete small bowel examination, swallowing disorders and technical complications. However, capsule retention still remains a major concern. Crohn's disease may rarely show its first manifestation as GI bleeding. We present here a case of obscure GI bleeding in which the diagnosis of isolated Crohn's enteritis was made by using wireless CE. The retained capsule at the jejunal stricture of Crohn's disease was successfully retrieved by performing double balloon enteroscopy.
Subject(s)
Capsule Endoscopy , Constriction, Pathologic , Crohn Disease , Deglutition Disorders , Diagnosis , Double-Balloon Enteroscopy , Gastrointestinal Hemorrhage , Hemorrhage , MethodsABSTRACT
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract, and they represent about 2% of all neoplasms of the gastrointestinal tract. GISTs primarily affect the stomach (50~60%), but they can also affect the small intestine (20~30%), large intestine (7%) and esophagus (1%). The clinical manifestations of GISTs vary according to the location and size of the mass. GISTs are generally KIT (CD117)-positive and are diagnosed by immunohistochemistry. Tumor size and mitotic activity are the best predictive prognostic features. The treatment of choice for primary GIST is complete surgical resection with a negative margin. A 78-year-old man who presented with melena and diffuse abdominal pain was admitted to our hospital. Esophagogastroduodenoscopy, colonoscopy, angiography and an RBC scan were performed but we were unable to locate the focus of the hemorrhage. A gastrointestinal stromal tumor (GIST) of the jejunum was diagnosed after laparotomy.
Subject(s)
Aged , Humans , Abdominal Pain , Angiography , Colonoscopy , Endoscopy, Digestive System , Esophagus , Gastrointestinal Hemorrhage , Gastrointestinal Stromal Tumors , Gastrointestinal Tract , Hemorrhage , Immunohistochemistry , Intestine, Large , Intestine, Small , Jejunum , Laparotomy , Melena , StomachABSTRACT
Hyperplastic polyps occur either sporadically or as a symptom of polyposis syndrome. When individuals exceed 50 polyps, they are diagnosed with hyperplasic polyposis. Moreover, since such cases are even more sporadic than hyperplastic polyps, the course toward this occurrence has not been properly evaluated. A change to malignancy in hyperplastic polyps is rare; however, when multiple lesions are present, the tendency increases. Colorectal polyposis syndromes with gastric polyps include familial adenomatous polyposis, Gardners syndrome, Peutz-Jeghers syndrome, juvenile polyposis and others with a non-genetic origin. Three cases of multiple colorectal hyperplastic polyposis with gastric hyperplastic polyposis have been reported worldwide; however, a case associated with multiple colonic adenomas has not yet been reported. This study reviews the existing literature and reports our recent experience of a case, in which a 53 year-old man with colorectal and gastric hyperplastic polyposis with associated multiple colonic adenomas.
Subject(s)
Humans , Middle Aged , Adenoma , Adenomatous Polyposis Coli , Colon , Gardner Syndrome , Hyperplasia , Peutz-Jeghers Syndrome , PolypsABSTRACT
The stomach is the most frequently noted site (50~60%) of gastrointestinal stromal tumor. This tumor is categorized into three subtypes (the spindle cell type, the epithelioid type or mixed type) according to the shape of the cells that make up the tumor. We herein report on a case of gastrointestinal stromal tumor with an epithelioid subtype in a 60-year-old male. On admission, the patient presented with epigastric pain and melena. Endoscopy revealed a submucosal tumor with a central ulcer at the gastric body. Gastric wedge resection was performed. The tumor cells showed a rounded shape and positive staining for CD117. Because the epithelioid type gastrointestinal stromal tumor is unusual in Korea, we report here on this case along with a review of the relevant literature.
Subject(s)
Humans , Male , Middle Aged , Endoscopy , Gastrointestinal Stromal Tumors , Hemorrhage , Korea , Melena , Stomach , UlcerABSTRACT
The stomach is the most frequently noted site (50~60%) of gastrointestinal stromal tumor. This tumor is categorized into three subtypes (the spindle cell type, the epithelioid type or mixed type) according to the shape of the cells that make up the tumor. We herein report on a case of gastrointestinal stromal tumor with an epithelioid subtype in a 60-year-old male. On admission, the patient presented with epigastric pain and melena. Endoscopy revealed a submucosal tumor with a central ulcer at the gastric body. Gastric wedge resection was performed. The tumor cells showed a rounded shape and positive staining for CD117. Because the epithelioid type gastrointestinal stromal tumor is unusual in Korea, we report here on this case along with a review of the relevant literature.
Subject(s)
Humans , Male , Middle Aged , Endoscopy , Gastrointestinal Stromal Tumors , Hemorrhage , Korea , Melena , Stomach , UlcerABSTRACT
There has been a number of reports recently describing the pathogen potential of irregular asporogenous gram positive rods (IGPR), also referred as coryneforms or diphtheroids. This may be due to a greater number of opportunistic infections occurring in patients who are immunosuppressed or implanted with prostheses. The documentation of endocarditis caused by IGPR is difficult. Because all the result of culture is not always positive and these cultures need long-period incubation, and there are sometimes pseudo-positive cases due to the contamination in blood sampling. An early diagnosis and adequate treatment are important for the better result. We describe the case of bio prosthetic valve endocarditis in a 61-year-old woman who enduring chronic hemodialysis. This is the first case reported of bioprosthetic valve endocarditis by Corynebacterium in Korea.
Subject(s)
Female , Humans , Middle Aged , Corynebacterium , Early Diagnosis , Endocarditis , Gram-Positive Rods , Korea , Opportunistic Infections , Prostheses and Implants , Renal DialysisABSTRACT
Percutaneous transluminal coronary angioplasty of chronic total coronary artery occlusions are at a high risk of failure and complication. We report a case of arteriovenous fistula with drainage into the coronary sinus during the percutaneous transluminal coronary angioplasty of the chronic total occlusion of circumflex coronary artery. We think that the arteriovenous fistula of this case was occurred by the guide wire- induced trauma. But after 20-30 minutes later, the injection of contrast no longer detectd arteriovenous fistula. Later we recommended coronary artery bypass graft surgery to the patient, but he refused. Thereafter he received conservative treatment and dyspnea, chest pain were improved.
Subject(s)
Humans , Angioplasty , Angioplasty, Balloon, Coronary , Arteriovenous Fistula , Chest Pain , Coronary Artery Bypass , Coronary Sinus , Coronary Vessels , Drainage , Dyspnea , TransplantsABSTRACT
Upper gastrointestinal bleeding in infant and children is much less common than that in adults. Upper gastrointestinal bleeding in infants and young children is most often acssociated with stress ulcer or erosions, but in older children it may also be caused by duodenal ulcer, esophagitis, and esophageal varices. Because the total blood volume of a child is relatively small and can deplete rapidly, gastrointestinal bleeding is a catastrophic event. However, it is not associated with significant mortality except in those with a severe primary illness. Data on therapeutic endoscopy for pediatric gastrointestinal bleeding are limited to case reports. The hemoclip has recently been added to armamentaria of endoscopic devices. This method has several advantages, including fewer complication and the fact that less expertise is needed to achieve permanent hemostasis. We report a case of successful endoscopic control of a bleeding duodenal ulcer using with a hemoclip in a 22-month-old boy. Endoscopic hemoclipping would be a safe and efficacious treatment for control of bleeding from peptic ulcers in children.
Subject(s)
Adult , Child , Humans , Infant , Male , Blood Volume , Duodenal Ulcer , Endoscopy , Esophageal and Gastric Varices , Esophagitis , Hemorrhage , Hemostasis , Mortality , Peptic Ulcer , UlcerABSTRACT
Hemorrhagic colitis may be seen as a complication of inflammatory bowel disease, as well as infectious colitis related to several pathogens, including enterohemorrhagic E. coli, Shigella, Yersinia and Campylobacter. Also, it is seen in the form of antibiotic-associated hemorrhagic colitis. However, Escherichia coli serotype O157:H7 is now recognized as an important identifiable cause of hemorrhagic colitis. Occasionally, patients with E. coli serotype O157:H7 infection are diagnosed as having thrombotic thrombocytopenic purpura (TTP), a condition similar to hemolytic uremic syndrome (HUS) but with more prominent neurological findings and less renal involvement. We report a case in a 47-year-old woman who developed hemorrhagic colitis complicated by TTP, responded to steroid and antibiotic treatment.
Subject(s)
Female , Humans , Middle Aged , Campylobacter , Colitis , Enterohemorrhagic Escherichia coli , Escherichia coli , Hemolytic-Uremic Syndrome , Inflammatory Bowel Diseases , Purpura, Thrombotic Thrombocytopenic , Shigella , YersiniaABSTRACT
Methotrexate is commonly used in rheumatoid arthritis as an anti-inflammatory agent, but treatment with methotrexate can lead to severe side effects, especially pulmonary complication. Interstitial pneumonitis is one of the most important pulmonary adverse effects of methotrexate and most patient present with a subacute febrile illness and peripheral eosinophilia is seen in about a half of patients. Almost all patients have abnormal chest roentgenograms and bibasilar interstitial infiltration with alveolar pulmonary consolidations is the most characteristic finding. Interstitial inflammation with mononuclear cell infiltration is a characteristic pathologic feature and findings that suggest acute hypersensitivity pneumonitis, such as bronchiolitis, granuloma formation with giant cells, and infiltration with eosinophils are often present. Methotrexate-induced pneumonitis is a potentially life threatening and unpredictable complication but it is difficult to make a definite diagnosis in the absence of high index of clinical suspicion. Early recognition and appropriate management may avoid the serious outcome. Herein we report a case of methotrexate-induced pneumonitis in a patient with rheumatoid arthritis.
Subject(s)
Humans , Alveolitis, Extrinsic Allergic , Arthritis, Rheumatoid , Bronchiolitis , Diagnosis , Eosinophilia , Eosinophils , Giant Cells , Granuloma , Inflammation , Lung Diseases, Interstitial , Methotrexate , Pneumonia , ThoraxABSTRACT
Nail toxicity following systemic chemotherapy is common. Onychopathy during the period of neutropenia following chemotherapy may cause subungual abscesses and serious infection. Despite taxoid-related toxicity being increasingly reported since 2000, there are still phase II systemic chemotherapy studies using taxoid that have never mentioned nail changes. Recently, new criteria for the evaluation of nail toxicity have been suggested. The present report is the first of its kind, in Korea, to describe a case of docetaxel-associated onychopathy, which improved following a reduction in the docetaxel dose.