A Large-Sized Phytobezoar Located on the Rare Site of the Gastrointestinal Tract

Bezoars are concretions of undigested material and are most often observed in the stomach. They can occur at any site in the gastrointestinal tract; however, duodenal localization is very rare. We report the case of a 71-year-old male who had undergone subtotal gastrectomy with gastroduodenostomy and experienced severe epigastric discomfort, abdominal pain, and vomiting for a few days. An approximately 7x8 cm-sized mass was found on an abdominal computed tomography scan. On following endoscopy, a large bezoar was revealed in the duodenum and was removed using an endoscopic removal technique, assisted by a large amount of Coca-Cola infusion.

A Septic Abortion Caused by Candida glabrata Chorioamnionitis Following in Vitro Fertilization and Embryo Transfer / 대한내과학회지

Candida glabrata is a yeast that commensally colonizes the upper cervix and vagina and has low pathogenicity in immunocompetent hosts. Here we report a case of C. glabrata chorioamnionitis and septic abortion following in vitro fertilization and embryo transfer (IVF-ET). This case suggests that infection in the upper vagina and cervix should be considered prior to having IVF-ET. We encountered a rare case of C. glabrata chorioamnionitis and septic abortion; therefore, we report this case with a review of the literature.

A Case of Adult-Onset Still's Disease Presenting with Periorbital Edema

Adult-onset Still's disease (AOSD) is a systemic inflammatory disorder of unknown etiology that is characterized by high-spiking fever, arthralgia, sore throat, and skin rash. The typical rash of AOSD is an evanescent, salmon-colored erythema, which is considered to be the major diagnostic criterion. Recently, other cutaneous manifestations of AOSD, such as persistent plaque and urticaria, have been reported. Here, we report a rare case of AOSD presenting with periorbital swelling and erythema. A 47-year-old woman was presented with periorbital swelling, erythema, high fever, arthritis, and a sore throat. One year prior to admission, she was diagnosed with AOSD based on the diagnostic criteria of Yamaguchi. The patient's periorbital swelling and erythema may not have been associated with periorbital cellulitis because they did not respond to antibiotics but did improve after treatment with steroids. Considering all of her signs and symptoms with a history of AOSD, periorbital lesion was suspected as atypical cutaneous manifestation of AOSD.

A Case of Brain Death Due to Asthma Exacerbation in a Noncompliant Patient with Refractory Asthma / 대한내과학회지

Although guideline-based asthma therapy has had a positive impact on fatalities due to asthma over the last few decades, some patients refractory to or noncompliant with asthma treatment remain at risk of fatality. A 45-year-old female with refractory asthma and poor compliance and with a frequent history of hospitalization for asthma exacerbations was taken to the emergency room because of cardiorespiratory arrest. Her family reported that she had suffered from an upper respiratory infection followed by severe dyspnea for a few days. The patient developed status asthmaticus, and in spite of intensive cardiopulmonary resuscitation, she was eventually declared brain dead. The patient had not taken medication for asthma regularly for several months before the attack. Refractory and difficult-to-treat asthma should be aggressively monitored to prevent severe asthma exacerbations, which can be fatal, especially in noncompliant patients.

A Case of Emphysematous Cholecystitis and Pneumobilia after Transarterial Chemoembolization for Hepatocellular Carcinoma / 대한내과학회지

Transarterial chemoembolization (TACE) is reportedly a useful palliative treatment in patients with unresectable or recurred hepatocellular carcinoma. Post-TACE complications are common; however, acute cholecystitis after TACE is rare. We herein report a case of a 73-year-old woman who presented with emphysematous cholecystitis and pneumobilia following TACE. Computed tomography performed for evaluation of her tumor status before TACE incidentally showed gallbladder and common bile duct stones. After TACE, she complained of severe epigastric pain with a positive Murphy's sign. Computed tomography showed emphysematous cholecystitis and pneumobilia. She was successfully treated with emergent biliary stone removal by endoscopic retrograde cholangiopancreatography.