Colonic Diverticulitis Complicating Colo-ovarian Fistula and Tuboovarian Abscess Formation in on Old Woman

The inflammation of colonic diverticulum, diverticulitis, is occasionally accompanied by several complications, such as bleeding, bowel obstruction, fistula and abscess formation. Both colo-ovarian fistula and tuboovarian abscess formation, as complications of diverticulitis, are rare. Here, we report a case of colonic diverticulitis which ultimately resulted in colo-ovarian fistula and tuboovarian abscess formation. A 76-year-old female was presented with lower abdominal pain, diarrhea and intermittent hematochezia for about 1 month. According to the abdominal computed tomography, tuboovarian abscess was shown to adhere to the inflamed sigmoid diverticulum. Sigmoidoscopy revealed pus flowing from the opening of the diverticulum at the sigmoid colon. Hence, the patient underwent oophorosalpingectomy and low anterior resection. Thereafter, she was treated with bowel rest and broad spectrum antibiotics, and finally recovered. Although rare, colonic diverticulitis may result in colo-ovarian fistula causing tuboovarian abscess formation in postmenopausal patients. Early recognition of the condition and appropriate treatment, including surgery and antibiotics, are necessary in order to achieve full recovery from complicated diverticulitis.

A Case of PICOLIGHT Powder Induced Thermal Injury of the Gastric Mucosa

There are many reports about causes of corrosive agents such as acids and alkaline and occasionally hot food in either liquid or solid forms as causes of upper gastrointestinal mucosal injury. However, there have been no reports on bowel preparation solutions as a cause of upper gastrointestinal injury. We describe a case of bowel preparation solution (PICOLIGHT powder) induced thermal injury of the gastric mucosa with a review of the literature.

Two Cases of the Norwegian Scabies-Infested Patients with Chronic Disease in Elderly Care Unit

The scabies mite is an ectoparasite, which is able to infest humans. The incidence of scabies decreased during the past 20 years in Korea. However, the incidence is likely to increase again, and may be delayed or missed diagnosis recently. Its clinical presentation is typical, although in a host with compromised immune system, like the mentally retarded and elderly patients, the clinical presentation may be altered. Because a delay in diagnosis may induce rapid spread of the scabies mite, immediate diagnosis and treatment are necessary. We report two cases of scabies in elderly patients from different nursing homes. These patients were transferred to our center for treatment of pneumonia and chronic renal disease. They revealed pruritus and skin rashes after the treatment of further underlying diseases. We consulted to a dermatologist because of worsening symptoms, despite an application of medication with antihistamine and topical steroid, scabies was diagnosed. The symptom improved with topical 1% gamma-benzene hexachloride, an effective scabies drug. We suggest that geriatrists should suspect scabies who presents with pruritus that is persistent or resistant to conventional treatment, especially patients transferred from nursing homes.