Successful management of colonic perforation with a covered metal stent

Self-expandable stents are widely available for the treatment of perforation of the gastrointestinal tract. Because of the risk of migration, there has been no report of the use of self-expandable stents for the treatment of perforation of the colon or rectum. This is a report of successful treatment of iatrogenic colonic perforation during balloon dilatation of anastomotic stricture with a fully covered stent. Fully covered, self-expandable metallic stents can be considered useful tools for management of this condition.

Spontaneous Isolated Superior Mesenteric Artery Dissection Mimicking Superior Mesenteric Artery Syndrome / 대한소화기학회지

No abstract available.

Cytomegalovirus esophagitis presents as chest pain in a renal transplant recipient

No abstract available.

A Case of Anorexia Nervosa Complicated With Strongly Suspected Stress-Induced Cardiomyopathy and Mural Thrombus

Stress-induced cardiomyopathy is a unique reversible cardiovascular disease precipitated by acute emotional or physical stress. It is associated with a high prevalence of chronic anxiety disorder that precedes the onset of cardiomyopathy, as well as comorbid cardiovascular risk factors that are similar to the ST segment elevation of myocardial infarction. A thirty-five-year-old woman suffering from anorexia nervosa visited our hospital complaining of severe general weakness. She was diagnosed with stress-induced cardiomyopathy and mural thrombus using a transthoracic echocardiogram. Therefore, she was given anticoagulation therapy and nutrition with immediate psychiatric interventions. After two weeks of treatment, the follow-up echocardiogram indicated a significant improvement of the left ventricular dysfunction and mural thrombus.

A Case of Pleuropulmonary Paragonimiasis with a Breast Abscess as the Ectopic Site / 대한내과학회지

Paragonimiasis is an infectious disease caused by consumption of raw or improperly cooked freshwater crab or crayfish contaminated with Paragonimus metacercariae. The incidence of the disease has markedly decreased, but it is still a lung disease that requires a differential diagnosis in endemic areas such as Korea and Japan. It is commonly found in the lung but has also been found as extrapulmonary infestations, such as cerebral, spinal, subcutaneous, abdominal, urinary, and gynecological infestations. We report a rare case of ectopic paragonimiasis involving the breast with pleural effusion that was initially misdiagnosed as tuberculous pleurisy and a breast abscess.

Effect of Octreotide on Patients with Malignant Bowel Obstruction / 한국호스피스완화의료학회지

PURPOSE: Malignant bowel obstruction causes gastrointestinal symptoms and leads to diminished quality of life in patients with advanced cancer. Several studies have shown the efficacy of octreotide for the relief of malignant bowel obstruction-related symptoms. The aim of this study is to assess the efficacy and safety of octreotide in patients with malignant bowel obstruction. METHODS: We retrospectively reviewed medical records of twenty nine patients who had suffered from malignant bowel obstruction without clinical improvement of conservative care and subsequently, received octreotide treatment. Initial dosage of octreotide was 0.1 mg/day, and dose was escalated depending on the clinical effect. For each patient, we assessed visual analogue scale (VAS) of pain, number of vomiting episode, and amount of nasogastric tube drainage. RESULTS: Median dosage of octreotide was 0.2 mg/day (range 0.1~0.6), and median duration from initial medication to death was 20 days (range 2~103). VAS before and after octreotide treatment were 5.6+/-1.24, and 2.7+/-0.96, respectively. The numbers of vomiting episode before and after octreotide treatment were 3.6/day+/-2.5, and 0.4/day+/-0.8, respectively. The mean amounts of nasogastric tube drainage before and after octreotide treatment were 975+/-1,083 cc/day and 115+/-196 cc/day, respectively. Statistically significant reduction in VAS, the number of vomiting episode and the amount of nasogastric tube drainage were observed after octreotide treatment (P<0.05). CONCLUSION: Administration of octreotide in patients with malignant bowel obstruction, which is uncontrolled by other medication, was effective and safe. In such clinical situations, physicians should consider to add of octreotide for symptomatic control.

A Case of Intramural Duodenal Hematoma after the Use of the Endoscopic Epinephrine Injection Method for Duodenal Ulcer Bleeding in a Chronic Renal Failure Patient undergoing Maintenance Hemodialysis / 대한소화기내시경학회지

An intramural duodenal hematoma has been mostly reported as a consequence of trauma. It can also result from a hematological disorder, anticoagulant drug use and a post-therapeutic endoscopic procedure. Common symptoms of patients with an intramural duodenal hematoma are vomiting and abdominal pain. An intramural duodenal hematoma is rarely accompanied with pancreatitis and cholangitis due to intestinal obstruction. A diagnosis is made by esophagogastroduodenoscopy and the use of an abdominal CT scan. An intramural duodenal hematoma is mainly treated with conservative therapy but it may sometimes be treated with a surgical procedure. We report one case of an intramural duodenal hematoma after performing a therapeutic endoscopic procedure in a chronic renal failure patient undergoing maintenance hemodialysis.

A Case of Idiopathic Bronchiolocentric Interstitial Pneumonia / 결핵및호흡기질환

Idiopathic bronchiolocentric interstitial pneumonia is one of idiopathic interstitial pneumonia, which has a relatively aggressive course and poor prognosis. It is characterized by diffuse centrilobular nodules radiologically with mainly bronchiolocentric inflammation and fibrosis associated with patchy alveolitis lacking interstitial granuloma histologically. This disorder is a recently classified disease category, and to our knowledge, there is no case report in Korea. We present a case of idiopathic bronchiolocentric interstitial pneumonia. A 62-year-old man presented with exertional dyspnea with a 1 month duration. The radiological findings showed extensive centrilobular lesions at both lungs. The surgical lung biopsy specimen demonstrated a centrilobular inflammatory process with small airway fibrosis and inflammation partially radiating into the interstitium. Therefore, the patient was diagnosed with idiopathic bronchiolocentric interstitial pneumonia. He was treated with immunosuppressants including steroids and azathioprine. However, his symptoms did not improve and he expired 7 months later due to an acute exacerbation of the interstitial pneumonia and probable infectious pneumonia.

Two Cases of Pulmonary Thromboembolism in Young Patients with Hyperhomocysteinemia / 결핵및호흡기질환

Incidences of pulmonary thromboembolism markedly increase with age. Risk factors of pulmonary thromboembolism are surgery, trauma, acute medical illness, immobilization, pregnancy, usage of hormone, and advanced age. In the cases of thrombomembolism occurred in young age, the possibility of thrombophilc state is needed to be investigated. Among many diseases or state associated thrombophilic state, homocyteinemia should be considered a cause of thromboembolism before fifth decade. Homocyteinemia is caused by deficiency of N-5-methyltetrahydrofolate, cystathionie beta-synthase and vitamin B12. The presence of the mutation of 5,10-methyleneterahydrofolate lead to homocyteinemia by deficiency of N-5-methyltetrahydrofolate. Homocysteine is acknowledged the risk factor of cardiovascular event, and storke. Homocysteinemia can be the cause of thromboemboism via damaging endotheial cell. We present two cases of pulmonary thromboembolism in young age which seem to be associated with homocysteinemia precipitated by mutation of 5,10-methyleneterahydrofolate.