Heterotopic bone formation in normal gastric cardiac mucosa / 영남의대학술지

Heterotopic bone formation in the gastrointestinal tract is a rare phenomenon. Most reported cases were associated with benign and malignant neoplasms, except for a case in which heterotopic bone formation was found in a patient with Barrett's esophagus. The exact pathogenesis of the disease has not yet been established. However, most heterotopic bones found in the gastrointestinal tract were associated with mucinproducing tumors of the appendix, colon, and rectum. Inflammation may also play a role in osseous metaplasia in a case with bone formation at the base of an ulcer in Barrett's esophagus. Here, we report on a patient with heterotopic bone formation in normal gastric cardiac mucosa. A 50-year-old female visited our hospital for a routine health examination. She had no gastrointestinal symptoms, and her physical examination, blood test, X-ray, urine, and stool examination results were normal. A 0.3 cm sized polypoid lesion located just below the squamocolumnar junction was observed on upper gastrointestinal endoscopy. A piece of biopsy was taken. Histologically, a lamella bone trabecula and chronic inflammatory cells were observed in the gastric cardiac mucosa. The follow-up endoscopy performed one month later showed no residual lesion.

Choledochocele containing a stone mistaken as a distal common bile duct stone / 영남의대학술지

A choledochocele is an expanded sac of the duodenal side of the distal common bile duct (CBD), and is categorized as a type III choledochal cyst. Unlike other choledochal cysts, it can be easily overlooked because of its very low prevalence, non-specific clinical symptoms, and lack of distinctive radiological findings. However, a patient having a repeated pancreaticobiliary disorder with an unknown origin, frequent abdominal pain after cholecystectomy, or repeated non-specific gastrointestinal symptoms can be suspected as having a choledochocele, and a more accurate diagnosis can be achieved via endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound. Because it rarely becomes malignant, a choledochocele can be treated via endoscopic sphincterotomy (EST) and surgical treatment. The authors were able to diagnose choledochocele accompanied by a stone in a patient admitted to the authors' hospital due to cholangitis and pancreatitis. The patient's condition was suspected to have been caused by a distal CBD stone detected via multiple detector computed tomography and ERCP, and was successfully treated via EST.

A Case of Idiopathic Eosinophilic Cholecystitis Treated with Steroids / 대한내과학회지

Eosinophilic cholecystitis is a rare disease characterized by transmural leukocyte infiltration composed of more than 90% eosinophils. Eosinophilic cholecystitis is clinically indistinguishable from ordinary cholecystitis, and as a rule it leads to cholecystectomy. We report a case of idiopathic eosinophilic cholecystitis treated with steroids. A 75-year-old woman presented with a classic history of acute cholecystitis and a peripheral eosinophilia of 41.8%. There was no evidence of allergy or parasitic infestation. An abdominal ultrasonography and computed tomography (CT) scan showed an edematous, thickened gallbladder wall, but no gallstones. There was no evidence of eosinophilic infiltration in other organs. Cholecystectomy was not performed because the patient refused surgical management. However, fever, abdominal pain, and peripheral eosinophilia persisted despite antibiotic and conservative therapy. Therefore, we attempted treatment with prednisolone. A week later, the symptoms disappeared and the peripheral eosinophilia normalized.

Praziquantel Treatment of an Eosinophilic Pleuritis Patient Suspected to Be Due to Sparganum Infection / 감염과화학요법

Human sparganosis is caused by the larval tapeworm of genus Spirometra. This parasite commonly invades subcutaneous tissues and muscles. However, infection in the pleural cavity is rare. A 65-year-old male patient, who had undergone surgical excision of subcutaneous masses due to a parasite infection (presumed to have been sparganosis) approximately 10 years ago, showed pleural effusion and peripheral eosinophilia. The anti-sparganum specific IgG antibody levels in the serum and pleural fluid were significantly higher than the normal control levels. Three consecutive doses of praziquantel (75 mg/kg/day) were administered for control of pleural effusion and peripheral eosinophilia. In this patient, sparganosis was suspected, and the probable cause of the infection was ingestion of raw snakes and frogs. Immunoserologic tests using ELISA can be helpful in diagnosis of pleural sparganosis and praziquantel is suggested as an alternative treatment for surgically unresectable cases.

A Case of Melanosis Ilei / 대한소화기내시경학회지

Melanosis ilei is a condition that's characterized by gross greyish-black or brownish-black pigmentation of the mucosa of the terminal ileum. There were several substances that produce gastrointestinal tract pigmentation such as lipofuscin, iron sulphide (FeS), Hemosiderin and exogenous material such as silicates and titanium. We report here on a case of a 58-year-old female who ingested charcoal for a long time, and she was diagnosed with melanosis ilei by colonoscopy. Her condition improved after she stopped ingesting the charcoal.

A case of colonoscopically removed toothpick in the sigmoid colon / 대한내과학회지

Most ingested foreign bodies spontaneously pass through the upper and lower intestinal tract. The impaction of an ingested foreign body in the colon is rare. Foreign bodies swallowed inadvertently often cause serious complications, such as perforation, obstruction, abscess formation, enterocolic fistula, or hemorrhage. Physicians should proceed with routine medical care while considering the possibility of the ingestion of a foreign body In cases where abdominal pain of an unknown origin is observed, particularly in elderly patients who wear dentures, alcoholics, mentally disturbed, or rapid eating, and presenting with altered bowel habits. We report a case of a colonoscopically-removed wooden toothpick that impacted the sigmoid colon and was complicated by the formation of a local abscess with a review of the literature.

Complication of Colonoscopic Polypectomy / 대한소화기내시경학회지

BACKGROUND/AIMS: Colonic adenomatous polyp is known as a premalignant lesion. Colonoscopic polypectomy, using for its removal and prevention of primary colon cancer has been considered as a effective and safe method. This study was conducted to assess its complication and safety of colonoscopic polypectomy. METHODS: One thousand two hundred ninety three polypectomy were done using colonoscopic hot biopsy, snare polypectomy, endoscopic mucosal resection (EMR) and piecemeal polypectomy in 679 patients from 1983 to 1999, and postpolypectomy complications and its rate were evaluated. RESULTS: 1) Postpolypectomy bleeding occured 18 cases of 1293 polypectomies (1.4%), including 10 cases of initial bleeding and 8 cases of delayed bleeding. In 9 cases (0.7%) of them hemostatic therapy were required. In delayed bleeding most cases (75%) of them occured within 66 hours after polypectomy. 2) Postpolypectomy bleeding occured in 10 cases of 982 polypectomies (1.0%) below 0.9 cm in polyp diameter, 5 cases of 242 polypectomies (2.1%) between 1.0 cm and 1.9 cm in polyp diameter and 3 cases of 69 polypectomies (4.3%) more than 2.0cm in polyp diameter (p<0.05). 3) There were no significant correlation between postpolypectomy bleeding and polypectomy methods (p=0.06) and between postpolypectomy bleeding and gross type of polyps (p=0.40) statistically. 4) Postpolypectomy perforation occured in 1 case of 1293 polypectomies (0.1%). Estimated overall postpolypectomy complication rate including bleeding and perforation was 1.5%. CONCLUSIONS: Colonoscopic polypectomy is a relatively safe method in removing colonic polyp and its complication is related to size of polyp.

Three cases of double primary lung cancer / 결핵

No abstract available.