ABSTRACT
A 17-year-old man was referred to our hospital because of dizziness and mild dyspnea. He had a history of partial thyroidectomy due to benign mass when he was 10 year-old. His conjunctiva was anemic and acral keratosis was noted. He had a goiter and a previous surgical scar on the anterior neck just below the thyroid cartilage. Blood counts were as follows; Hb was 4.3 g/dL, WBC 5,500/mm3, PLT 366,000/ mm3. Esophagogastroduodenoscopy and colonoscopy showed esophageal acanthosis and numerous variable sized polyps in the stomach, duodenum and colon. The small bowel series showed numerous polypoid lesions in the entire small bowel. Gastric polyps revealed hamartoma and colon polyps revealed inflammatory polyp with lymphoid hyperplasia by pathologic examination. Thyroid ultrasonograph showed multiple nodules and cysts and I131 scintigraphy showed multiple cold and hot nodules in his remnant thyroid gland. We diagnosed the patient as Cowden's syndrome.
Subject(s)
Adolescent , Child , Humans , Cicatrix , Colon , Colonoscopy , Conjunctiva , Dizziness , Duodenum , Dyspnea , Endoscopy, Digestive System , Goiter , Hamartoma , Hamartoma Syndrome, Multiple , Hyperplasia , Keratosis , Neck , Polyps , Radionuclide Imaging , Stomach , Thyroid Cartilage , Thyroid Gland , Thyroid Nodule , ThyroidectomyABSTRACT
So called Brunner's gland hyperplasia is characterized by a nodular proliferation of histologically normal Brunner's gland, accompanied by ducts and scattered stromal element. The clinical presentation vary from vague epigastric disomfort to obstruction and gastrointestinal bleeding. We experienced a case of huge Brunner's gland hyperplasia presented as a huge duodenal polyp. A 28-year-old woman was refered to our hospital because of suspicious ampulla of Vater cancer or duodenal cancer in abdominal CT scan. The patient complained of dizziness and intermittent melena. The side view duodenoscopic examination revealed a huge pedunculated mass originated from the posterior wall of the duodenal bulb. The head of the polyp was placed on the ampulla of Vater with several erosions suggesting recent bleeding. Resection of duodenal polyp was performed by laparoscopic duodenotomy and Brunner's gland hyperplasia was revealed on pathologic examination.
Subject(s)
Adult , Female , Humans , Ampulla of Vater , Dizziness , Duodenal Neoplasms , Head , Hemorrhage , Hyperplasia , Melena , Polyps , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: It is generally known that while alkali ingestion injures principally the esophagus, acid usually spares the esophagus and damages the stomach mainly. The purpose of this study is to evaluate the most common site of upper gastrointestinal tract injury in acid/alkali ingestion based on endoscopic findings. METHODS: We retrospectively evaluated 40 patients who ingested acid/alkali for types and amounts of product ingested, time required to undergo endoscopy, and initial endoscopic findings. Endoscopic lesions were graded according to the criteria suggested by Zagar and were graded at the authors'discretion to compare acid injury and alkali injury. RESULTS: In the acid ingestion group(n=27), the esophagus injury score was 2.55+/-1.18, the stomach injury score was 2.62+/-1.78, and the difference was -0.07+/-1.13, therefore, no significant difference was present(p=0.939). In the alkali ingestion group(n=10), the esophagus injury score was 1.63+/-1.50 and the stomach injury score was 2.63+/-1.20. Stomach injury was significantly more severe than esophageal injury(difference : -1.00+/-1.18, p=0.026, Wilcoxon signed ranks test). CONCLUSION: While no difference exists between injuries of the esophagus and the stomach due to acid ingestion, the stomach was the most common site in alkali injury.
Subject(s)
Humans , Alkalies , Eating , Endoscopy , Esophagus , Retrospective Studies , Stomach , Upper Gastrointestinal TractABSTRACT
BACKGROUND/AIMS: The female sex hormones are thought to affect gastrointestinal function. However, the relationship between female sex hormone and gastrointestinal function has not been identified. The aim of this study was to evaluate the relationship between constipation and hormonal changes in young women and to find the difference of colon transit time (CTT) across the menstrual cycle. METHODS: Two hundred and five students completed questionnaires. CTT as well as serum estradiol and progesterone levels were measured in 15 regularly menstruating volunteers. RESULTS: One hundred and six experienced changes in bowel habit across menstrual cycle. The mean estradiol concentration in the follicular phase was not significantly different from that in the luteal phase (118.0 +/- 28.8 pg/mL vs. 76.9 +/- 10.5 pg/mL, p > 0.05). The mean progesterone concentration in the luteal phase was significantly higher than that in the follicular phase (3.0 +/- 0.9 ng/mL vs. 1.2 +/- 0.4 ng/mL, p 0.05). However, CTT was delayed at the progesterone peak in 11 of 15 (73.3%) women. CONCLUSIONS: Our study suggested a possible role of female sex hormones as a cause of constipation in young women.
Subject(s)
Female , Humans , Colon , Constipation , Estradiol , Follicular Phase , Gonadal Steroid Hormones , Luteal Phase , Menstrual Cycle , Progesterone , Volunteers , Surveys and QuestionnairesABSTRACT
Sarcoidosis is a chronic multisystemic disorder of unknown cause characterized by presence of noncaseating epithelioid granuloma in affected organ It is relatively common In western countries, but it is uncommon in East Asia including Korea. The lung is the most frequently affected organ. Usual radiologic manifestation of thoracic sarcoidosis art readily recognized, but there are extremely diverse manifestation Sarcoidosis rarely causes large pulmonary nodules, and cavitation in such lesion is very rare. We experienced one case of Sarcoidosis with Cavitary nodule of the lung and report it with brief review of the literature.
Subject(s)
Asia, Eastern , Granuloma , Korea , Lung , SarcoidosisABSTRACT
Ruptured aneurysms complicate the course of polyarteritis nodosa only infrequently. Most often they occur in renal or mesenteric vessels. We experienced a case of 48-year old woman with systemic necrotizing vasculitis who developed multiorgan failure and spontaneous intra-abdominal hemorrhage. Angiography showed diffuse narrowing and spontaneous hemorrhage of medium and small sized arteries in visceral and pelvic vasculature. So emergency embolization and removal of hematoma was done. About 3000cc of blood was collected in the abdominal cavity. There were fine small aneurysmal dilatations of arteries with multiple collaterals and they oozed spontaneously. Bleeding small vessels were ligated. Pathologic findings of the involved arteries showed severe inflammation and necrosis of vessel wall. She was treated with corticosteroid and cyclophsphamide for one year and achieved improvement in her clinical status.