Duodenal Ulcer Hemorrhage and Perforation in a Child

Owing to the low incidence of peptic ulcers in children, the early symptoms of the disease are sometimes overlooked, which result in grave complications such as a perforation or hemorrhagic shock. Recently, as a result of the increasing use of endoscopy, the incidence of peptic ulcers in children has increased. This means that the disease might have been underdiagnosed in the past. Although some cases of peptic ulcer perforation or bleeding in children were reported, a case of a peptic ulcer combined with a perforation and hemorrhage has not been reported. We experienced a 19 months old patient in shock with a perforated duodenal ulcer and hemorrhage.

A Case Report of Surgical Treatment of Anal Condyloma Acuminata in HIV-Infected Patient

Acquired immunodeficiency syndrome (AIDS) was reported for the first time in the U.S, 1981 and eversince, the number of patients have increased substantially. Similar situation is encountered in Korea, with concordant increase in number of HIV-infected patients requiring surgical management, a high proportion being anal condyloma acuminata, which needs proper evaluation and management due to its malignant potential. Since, we have had a recent case with surgical intervention, we review the pathogenesis and treatment modality of the disease in this paper.

Pyloric Exclusion in the Pancreaticoduodenal Injury / 한국간담췌외과학회지

BACKGROUND/AIMS: Pyloric exclusion has been recommended in patients with severe injury to the pancreas and duodenum. METHODS: A retrospective case review of 8 patients treated with pyloric exclusion following pancreaticoduodenal injury from March 1994 to May 2002 in Department of Surgery, the Catholic University of Korea, Daejeon St. Mary's Hospital. RESULTS: The age range of the patients was from 8 to 31 years. Most of the etiolgy (n=7) was the blunt abdominal trauma and one case due to the iatrogenic injury from the therapeutic endoscopic retrograde cholangiopancretography. The time interval between the injury and the operation varied from 3 to 48 hours. The most common postoperative complication was wound infection (n=8). We found the other complications such as intraabdominal abscess (n=3), pneumonia (n=3), but the complications were treated successfully with conservative measures. There was no mortality cases in these patients. The duration of admission was delayed in the cases of concomitant injury (64 vs 46 days). All patients above 16 years old (n=7) were supported with parenteral nutritional fluid via central intravenous route (mean 32 days). We could not find the spontaneous opening of the pyloric closure at least 4 patients in postoperative 3 months but there was no major complication according to the sustained gastrojejunostomy. CONCLUSION: Pyloric exclusion appears to offer a satisfactory option for the treatment of the severe pancreaticoduodenal injury with minor complication. Do you have any comments about the spontaneous opening of the pyloric closure?

Case of a Spindle Cell Metaplastic Carcinoma of the Breast

A metaplastic carcinoma of the breast is a histologically diverse type of malignancy in which an adenocarcinoma is found to co-exist with an admixture of spindle cell, squamous, chondroid, or bone-forming neoplastic cells. Metaplastic breast cancer is rare and accounts for less than 1% of all mammary tumors. An adenocarcinoma with spindle cell metaplasia is one of the least often recognized variants of a metaplastic carcinoma. The clinical behavior of this variant of metaplastic carcinoma has not yet been clearly defined. Herein, we report a case of spindle cell metaplastic carcinoma of the breast. We also present a review of the literature.