A Case of Non-occlusive Ischemic Colitis of the Right Colon after Percutaneous Coronary Intervention / 대한소화기내시경학회지

Ischemic colitis is the most common form of gastrointestinal ischemic injury. Indeed, many medical conditions and medications can cause reduced blood flow to the colon. The splenic flexure, descending colon, and sigmoid colon are most commonly affected. Involvement of only the right colon is an infrequent occurrence. Ischemic colitis of the right colon usually is associated with low flow states. Given the high morbidity and mortality of this disorder, early diagnosis and aggressive management is critical. Ischemic colitis associated with heart disease, such as congestive heart failure, myocardial infarction, arrhythmias, aortic valve disease, and atherosclerotic cardiovascular disease, is usually due to low cardiac output, or to disease states resulting in dehydration, or to the splanchnic vasoconstrictive effect of some medications. Here we present a case of nonocclusive ischemic colitis of the right colon after percutaneous coronary intervention for unstable angina. The colitis was successfully treated with conservative management.

Clinical Characteristics and Gestational Complications Associated with Acute Hepatitis A in Pregnancy / 대한소화기학회지

BACKGROUND/AIMS: Acute hepatitis A was recently significant increased among women with gestational age in Korea. However, the clinical course and gestational complications have not been fully elucidated in pregnant patients with acute hepatitis A. We evaluated the clinical impact of acute HAV infection in pregnancy. METHODS: Twelve pregnant women out of 85 female patients with acute hepatitis A during 6 years were retrospectively reviewed. RESULTS: The median age of the pregnant group was 26.5 years old. The number of patient with acute hepatitis A were 5 cases in the 1st trimester, 3 cases in the 2nd and 4 cases in the 3rd. 4 cases had significant gestational complications. One case experienced the abortion in 1st trimester and one fetal distress was noted in 3rd trimester. The latter case was delivered of a low birth weight infant (2,390 g) caused by premature rupture of membrane in 36 weeks of gestational age. Other two cases experienced premature contraction and they had been required tocolytic treatment. But, all mothers featured full recovery from HAV infection. Except one aborted fetus and one premature birth, Newborn babies were not affected by maternal hepatitis A. CONCLUSIONS: Acute HAV infection during pregnancy may be associated with the risk of gestational complications. HAV serology and vaccination for women with gestation age should be considered at high prevalence area of acute hepatitis A.

Colonic Stent Insertion Through a Colostomy in a Patient with Recurred Malignant Obstruction / 대한소화기내시경학회지

Colorectal self-expanding metal stents have been used for palliation or preoperative decompression as a bridge-to-surgery in patients with malignant obstruction due to primary or recurred colorectal cancer. The usual attempt to implant of the stent is through the anus under endoscopic guidance, but that is difficult or impossible in patient who have undergone laparoscopic abdominoperineal resection (APR) and who have a colostomy. Especially, to advance and position the stent in the target lesion through the colostomy is very difficult because of the tortuosity and anatomical alteration of the proximal bowel caused by surgery. We herein report on a case of recurred malignant colonic obstruction with stent placement through a preformed colostomy. To date, this approach through a colostomy for the deployment of a stent has not been described in the Korean literature.