The Solitary Polypoid Ganglioneuroma of the Ascending Colon / 대한소화기내시경학회지

Ganglioneuromas are neuroectodermal tumors composed of varying amount of ganglion cells, nerve fibers, supporting cells of the enteric nervous system. Ganglioneuromas of the GI tract are rare tumors. A 50-year-old man came to our hospital due to the mass of liver and adrenal gland which was examined with ultrasonography at local medical center. On admission, abdominal magnetic resonance imaging was taken and liver biopsy was done. The mass of liver was hyperplastic nodule. At colonoscopy, about 0.3~0.8 cm sized six polyps were noted. Except the 0.6 cm sized semipedunculated polyp of the ascending colon, the others were tubular adenomas. Histological examination of the polyp of the ascending colon revealed localized proliferation of nerve fibers and ganglion cells. These cells are positive for S-100 protein by immunihistochemistry. Therefore, he was diagnosed with polypoid ganglioneuroma of the ascending colon. We report this case because the solitary ganglioneuroma in large intestine without systemic disease was rare.

A Case of Hemorrhagic Cerebral Infarction in Ulcerative Colitis

Ulcerative colitis is associated with a number of extraintestinal complications, including the infrequent occurrence of thromboembolic disease. Cerebral venous thrombosis is an extremely rare and fatal complication of ulcerative colitis. A 38-year-old woman presented with sluggish mentation and left hemiplegia. Ulcerative colitis had been diagnosed 3 years earlier by colonoscopy and biopsy, and had been controlled with a mesalazine. On admission, a brain computed tomography revealed a high density area in the right frontal lobe, and T2-weighted magnetic resonance imaging demonstrated an abnormal signal in the right frontal area, suggestive of a hemorrhagic cerebral infarction. She was managed with a decompressive craniectomy and conventional treatment for ulcerative colitis.

A Case of Adult onset Henoch-Sch?nlein Purpura with Acute Renal Failure / 영남의대학술지

Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

Two cases of Vibrio vulnificus peritonitis after ingestion of seafood in patients receiving continuous ambulatory peritoneal dialysis / 대한내과학회지

Peritonitis is the most common infectious complication of continuous ambulatory peritoneal dialysis (CAPD). However, CAPD-related peritonitis caused by Vibrio vulnificus is rarely reported. V. vulnificus is marine bacterium and opportunistic human pathogen. In an immunocompromised host, e.g. with chronic liver disease, end-stage renal disease, hemochromatosis, and other iron-overload disorders, this organism has been associated with the development of life-threatening primary septicemia and severe wound infection. However, CAPD-related peritonitis caused by V. vulnificus has not been reported, except for one case in Hong Kong, China. We report on two patients receiving CAPD who developed peritonitis caused by V. vulnificus after ingestion of seafood, for the first time in Korea.