Acute Liver Failure Secondary to Hepatic Infiltration of Malignant Melanoma

Acute liver failure due to malignant melanoma is uncommon. We presents a case of acute liver failure secondary to hepatic infiltration of a malignant melanoma. An 86-year-old man was admitted with elevated liver enzymes and an increased lactate dehydrogenase level. His condition progressed to acute liver failure, but the etiology of liver failure was unclear. Esophagogastroduodenoscopy was performed to evaluate dyspepsia, which showed signs indicative of malignant melanoma. Based on the endoscopy findings and elevated liver enzyme levels, liver biopsy was performed to confirm the presence of malignant melanoma. Hepatic infiltration of malignant melanoma was observed histologically. However, massive and diffuse liver metastasis is very rare and difficult to identify on imaging studies. If the etiology of liver failure is unclear, diffuse metastatic melanoma infiltration should be considered as differential diagnosis. Early liver biopsy can help to clarify the diagnosis.

Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy of a Renal Mass

Traditionally, tissue biopsies of kidney lesions are usually performed with CT or percutaneous ultrasound guidance, but biopsies using EUS have rarely been reported. In this report, we describe a case of renal cell carcinoma (RCC) diagnosed using EUS-guided fine-needle aspiration biopsy. A 75-year-old woman taking aspirin due to stable angina continued to exhibit weight loss and anemia and visited the gastroenterology department. No bleeding was observed on upper and lower gastrointestinal endoscopy. A contrast-enhanced mass was observed in the left kidney, accompanied by 8.9×10.8 cm-sized necrosis suggesting RCC on abdominal CT. Chest CT showed masses in both lungs. We planned to administer targeted therapy after pathological confirmation using EUS. Aspirin was continued, and we performed fine-needle biopsy using a 22-gauge needle three times. No adverse events were observed after the procedure. Pathological examination confirmed RCC, clear cell type, and the patient is currently undergoing treatment with sunitinib. EUS-guided fine-needle aspiration biopsy is safe for liver, pancreatic, or other tumors accessible from the upper gastrointestinal tract. This technique shows fewer adverse events. To the best of our knowledge, there have been no other reports on EUS-guided fine-needle aspiration biopsy to identify RCC in Korea.

COVID-19 Mimicking Acute Colitis / 대한내과학회지

On 11 February, 2020, the World Health Organization announced that COVID-19 was a novel coronavirus disease first detected in Wuhan, Hubei Province, China. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The complete clinical picture is not fully known. Illness ranges from mild to fatal. The common symptoms include fever, cough, and dyspnea usually developing 2-14 days after exposure. However, diarrhea was present in a few patients with COVID-19. We report a case of COVID-19 mimicking acute colitis.

Endoscopic Ultrasound-guided Fine-needle Aspiration Biopsy of a Renal Mass

Traditionally, tissue biopsies of kidney lesions are usually performed with CT or percutaneous ultrasound guidance, but biopsies using EUS have rarely been reported. In this report, we describe a case of renal cell carcinoma (RCC) diagnosed using EUS-guided fine-needle aspiration biopsy. A 75-year-old woman taking aspirin due to stable angina continued to exhibit weight loss and anemia and visited the gastroenterology department. No bleeding was observed on upper and lower gastrointestinal endoscopy. A contrast-enhanced mass was observed in the left kidney, accompanied by 8.9×10.8 cm-sized necrosis suggesting RCC on abdominal CT. Chest CT showed masses in both lungs. We planned to administer targeted therapy after pathological confirmation using EUS. Aspirin was continued, and we performed fine-needle biopsy using a 22-gauge needle three times. No adverse events were observed after the procedure. Pathological examination confirmed RCC, clear cell type, and the patient is currently undergoing treatment with sunitinib. EUS-guided fine-needle aspiration biopsy is safe for liver, pancreatic, or other tumors accessible from the upper gastrointestinal tract. This technique shows fewer adverse events. To the best of our knowledge, there have been no other reports on EUS-guided fine-needle aspiration biopsy to identify RCC in Korea.

COVID-19 Mimicking Acute Colitis / 대한내과학회지

On 11 February, 2020, the World Health Organization announced that COVID-19 was a novel coronavirus disease first detected in Wuhan, Hubei Province, China. COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The complete clinical picture is not fully known. Illness ranges from mild to fatal. The common symptoms include fever, cough, and dyspnea usually developing 2-14 days after exposure. However, diarrhea was present in a few patients with COVID-19. We report a case of COVID-19 mimicking acute colitis.

Association between Subjective Body Image and Suicide Ideation: Based on 14th Korean Youth Health Behavior Survey / 보건행정학회지

Background@#This study aimed to demonstrate the importance to recognize subjective body image on their mental health on adolescents. @*Methods@#We used the chi-square test and the multiple logistic regression model to analyze the data of the “Korean Youth Health Behavior Survey in 2018” (n=42,259) conducted by the Korea Centers for Disease Control and Prevention. @*Results@#As a result of the analysis, suicide ideation increased when the subject body image is thin and fat. Especially, the suicide ideation who recognized the subjective body image as thin is higher (odds ratio [OR], 1.666; 95% confidence interval [CI], 1.050– 1.295), and who recognized the subjective body image as fat is higher (OR, 1.134; 95% CI, 1.032–1.245) than the group who recognized the subjective body image as normal. @*Conclusion@#When preparing a health policy on adolescent suicide issues, we need to consider the association between subjective body image and suicide ideation.

Two Cases of Successful ERCP during ERCP-Related Iatrogenic Duodenal Perforation / 대한췌담도학회지

Endoscopic retrograde cholangiopancreatography (ERCP)-related perforations of the duodenum are rare but serious complications. Some ERCP-related perforations can be successfully managed without surgery. However, the presence of duodenal perforation may lead to premature termination of the ERCP and need for additional procedure such as percutaneous biliary drainage. If the ERCP-related perforation is identified early during the procedure, primary closure of the perforation can be attempted first or after completion of ERCP. We report two cases of duodenal perforation during ERCP in which ERCP was successfully completed after primary closure of the perforation.

Arteriovenous Malformation with a Retention Cyst of the Pancreas / 대한췌담도학회지

Arteriovenous malformation (AVM) of the pancreas is exceedingly rare, although it may be increasingly diagnosed due to the widespread use of cross-sectional imaging of the abdomen; even rarer is its association with pancreatitis. A 45-year-old male was admitted to our hospital with symptom of epigastric pain. Dynamic contrast imaging scans of the abdomen showed a focal acute pancreatitis and pancreatic AVM. The angiography findings were compatible with pancreatic AVM. The cause of abdominal pain was diagnosed by acute pancreatitis caused by pancreatic AVM, and, for definitive treatment of symptomatic pancreatic AVM, distal pancreatectomy with splenectomy was performed. The histological results confirmed the presence of irregular dilated tortuous arteries and veins, and a retention cyst with epithelial cell lining. We experienced a rare case of a 45-year-old-Korean male who had acute pancreatitis associated with pancreatic AVM. Pancreatic AVM is extremely rare; even rarer is its association with pancreatitis.