The Analysis of Appendiceal Mucocele with Emphasis on the Colonoscopic Findings / 대한소화기내시경학회지

BACKGROUND/AIMS: Appendiceal mucocele is relatively rare disease, however early diagnosis and adequate treatment is important because the rupture of mucocele during operation may results in pseudomyxoma peritonei which is fatal. Colonoscopy is very important tool to diagnose the mucocele of appendix earlier period. METHODS: We retrospectively analysed the medical records of ten cases of appendiceal mucoceles which were suspected by colonoscopy and surgically confirmed from January 1997 to March 2004. RESULTS: There was no gender difference and mean age was 55 years old. The colonoscopic findings of appendiceal mucocele were a type of submucosal tumor and the orifice of appendix was not seen in all the cases. The size was variable from 2.5 cm to 5.0 cm and the shape was spherical in majority, but one case of appendiceal mucocele lately diagnosed as mucinous cystadenocarcinoma had elongated, oval shape. The histologic diagnosis after resection were as follows: mucosal hyperplasia 4 cases (40%), mucinous cystadenoma 5 cases (50%) and mucinous cystadenocarcinoma 1 case (10%). CONCLUSIONS: Colonoscopy is an important diagnostic tool for suspecting appendiceal mucocele. It is important to confirm by surgical resection of appendiceal mucocele which is found even incidentally by colonoscopy.

A Case of Ileal Diverticulitis Causing Small Bowel Stenosis / 대한소화기내시경학회지

Diverticuli may be either congenital or acquired and may affect either the small or large intestines. Recently, the incidence of colonic diverticular disease is increasing in Korea but that of the small bowel, especially ileum, is very rare. We experienced a case of ileal diverticulitis causing small bowel stenosis. A 62-year-old woman was referred to our hospital because of diffuse abdominal pain for several months. Abdominal CT and small bowel series showed thickening of mucosal folds in the distal ileum. Colonoscopic findings revealed edema, mucosal thickening, blood clots, irregular dimpling, and stenosis in the distal ileum. The lesion was resected surgically and diagnosed as diverticulitis with microperforation.

A case of hyperinfection with Strongyloides stercoralis in terminal stomach cancer / 대한내과학회지

Strongyloides stercoralis is an intestinal nematode which infects a large portion of the world's population especially in tropical areas and other hot, humid regions. Because of an opportunistic nature of the parasite, the infection is confined to the intestinal tract in immunocompetent hosts. But, in individuals having immunocompromised state, the parasite is augmented by autoinfection, resulting in hyperinfection and/or systemic dissemination. In Korea, several cases of strongyloides hyperinfection were reported since 1959, especially who had corticosteroid therapy and other immunosuppressive medications. We experienced a case of strongyloides hyperinfection, accompanied with terminal stage of stomach cancer. The patient responded to treatment with albendazole. After one month later, repeated follow-up stool exam revealed clearance of the larvae from the patient' feces. So, we report this case with the literature.

A case of eosinophilic gastroenteritis with terminal ileal obstruction / 대한내과학회지

Eosinophilic gastroenteritis is a rare clinicopathologic entity of an unknown etiology with a variety of digestive symptoms. The clinical features depend on the site of eosinophilic infiltration and affected layer of intestinal wall. Diagnostic criteria include demonstration of eosinophilic infiltration of the affected bowel wall, lack of evidence extra-intestinal disease, and exclusion of various disorders that could mimic similar conditions. We experienced a 54-year-old man with 6 months history of severe intermittent abdominal colic associated with malnutrition and weight loss. Abdominal computed tomography showed mass like lesion at terminal ileum, which caused partial small bowel obstruction. So, we carried out laparotomy, and then segmental resection and ileo-ascending colostomy were done because of small bowel obstrucion. We diagnosed the case as transmural type of eosinophilic gastroenteritis. We report this case with a brief review of the literatures.

Effect of a traditional korean very-low-calorie diet on obese patients / 대한내과학회지

BACKGROUND: There is increasing interest in the use of a very low calorie diet (VLCD) as a treatment regimen for weight loss in obese subjects. This study was designed to investigate the effects and safety of a traditional Korean very-low-calory diet. METHODS: Twelve hospitalized obese patients at Dong Eui hospital in Busan city from May 1998 to December 1998 were selected. Height, body weight, blood lipids, blood insulin level, body fat, lean body mass, subcutaneous fat and visceral fat were measured. A traditional Korean VLCD was supplied for 14 days. RESULTS: Patient's body weight was significantly decreased from 83.8 kg to 78.6 kg, body fat from 32.2 kg to 28.6 kg, lean body mass from 32.2 kg to 28.6 kg, and BMI from 31.4 to 29.5, respectively (p<0.05). Total fat was significantly decreased from 807 cc to 659 cc, subcutaneous fat from 567 cc to 473 cc, visceral fat from 273 cc to 185 cc, respectively. However there were no significant changes in minerals. After VLCD intervention, total cholesterol was significantly decreased from 199 mg/dL to 166 mg/dL, HDL-cholesterol from 42 mg/dL, to 35 mg/dL, triglyceride from 158 mg/dL, to 75 mg/dL (p<0.05). The insulin area under the curve was also significantly decreased from 205 micro International-Unit/mL x 2hr to 168 micro International-Unit/mL x 2hr (p<0.05). CONCLUSION: Above findings suggested that a traditional Korean VLCD is effective and safe for short term use in terms of reducing body fat and improving insulin resistance in obese patients.