A Case of Bleeding from Rectal Dieulafoy-like Lesion Treated by Endoscopy / 대한소화기내시경학회지

Dieulafoy-like lesion is a relatively uncommon disease which is a potential source of life-threatening gastrointestinal bleeding. The lesion comprises mainly of an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is frequently found at distal portion of gastroesophageal junction but may occur anywhere in gastrointestinal tract including small bowel, colon and rectum. Moreover bleeding from dieulafoy-like lesion of rectum is very reae. It has been reported that rectal Dieulafoy-like lesion is very rare source of lower gastrointestinal bleeding and its pathogenesis may be associated with constipation. Recently, endoscopy has an important role in the diagnosis and treatment (including injection and coagulation therapy) of bleeding from Dieulafoy-like lesion. We herein report a case of a patient who presented wih massive hemorrhage from a small rectal ulcer with adherent blood clots. Bleeding was controlled with endoscopic treatment by utilizing bipolar electrocoagulation without complication and recurrence.

A Case of Disseminated Mucormycosis after Allogenic Bone Marrow Transplantation / 감염

Disseminated mucormycosis is a rare fungal infectious disease with a high mortality rate and is infrequently diagnosed ante mortem. It is most frequently seen in immunocompromised hosts such as diabetes mellitus, hematologic malignancies, or in the long-term use of steroids or chemotherapeutic agents. Tissue invasion by the hyphae of mucormycosis must be seen microscopically to establish the diagnosis. Treatment consists of correction of the predisposing condition, surgical debridement, and amphotericin-B therapy. A 35-year-old man was admitted through the emergency room due to fever and the right flank pain. He had received an allogenic bone marrow transplantation eight months ago and had been medicated with prednisolone and cyclosporine since the procedure. He was diagnosed with disseminated mucormycosis that involved the spleen, right kidney, and right lung. He is being successfully treated with amphotericin B, flucytosine, and liposomal amphotericin B.

A Case of Churg-Strauss Syndrome with Appendicitis and Lower Gastrointestinal Bleeding / 대한소화기내시경학회지

Churg-Strauss Syndrome is a disorder of hypereosinophilia and systemic vasculitis in subjects with asthma and allergic rhinitis. Clinically, a multiple organ system can be involved with various manifestations of disease of lung, heart, skin, musculoskeletal system, nervous system, gastrointestinal and hepatobiliary tract. We experienced a case of Churg- Strauss syndrome presenting as the appendicitis and the lower gastrointestinal bleeding in a 37-year-old male patient with acute lower abdominal pain. He also showed peripheral eosinophilia, bronchial asthma, and mononeuritis multiplex. He initially received a high dose corticosteroid and was maintained with low doses of corticosteroid, cyclophosphomide and exchange plasmapheresis.

A Case of Alstrom Syndrome / 대한내분비학회지

The Alstrom syndrome is inherited autosomal recessive disorder, characterized by obesity, diabetes mellitus, pigmentary retinal degeneration, normal intelligence, sensorineural hearing loss, baldness, acanthosis nigricans, male hypogonadism, hyperuricemia and hypertriglyceridemia. There is no reported case of Alstrom syndrome in Korea yet. We experienced a 29-year-old female patient with clinical characteristics similar to Alstrom syndrome who was admitted due to poorly controlled diabetes mellitus and diabetic retinopathy with hemorrhage. We report this case with the review of literatures.