Case Report of a Double Common Bile Duct with Gallstone Cholecystitis / 대한내과학회지

Anatomical variation in the bile duct system is relatively common. Nevertheless, a double common bile duct is an extremely rare asymptomatic variant. Recognition of this anomaly is important clinically, because it can lead to complications, including choledocholithiasis, cholangitis, pancreatitis, and upper gastrointestinal malignancies. A correct diagnosis of this rare anomaly is also important because complications can occur in surgery if the anomaly is not recognized preoperatively. Recently, we encountered a very rare case of a double common bile duct associated with gallstone cholecystitis. A 33-year-old female was admitted to our hospital complaining of epigastric pain after meals. She had single biliary drainage from double common bile ducts with communicating channels. We report the case and review the literature on double common bile ducts.

A Case of Variant Angina Developing Transient Collateral Circulation During Vasospasm

Variant angina is characterized by spontaneous episodes of angina, usually occurring in the morning and having ST segment elevation on the electrocardiogram. However, in the case presented here, vasospasm and angina was shown by ergonovine without ST elevation. The patient was a 60-year-old man who presented with a 2-year history of frequent chest pain. There were no abnormalities in coronary angiography. When ergonovine (100 microg) was injected, total occlusion of the proximal right coronary artery was seen, without ST elevation at the electrocardiogram. The cause was collateral from left anterior descending artery to distal right coronary artery at the left coronary angiography. Therefore, in a patient with variant angina without ST elevation, a transient collateral circulation during vasospasm should be considered.

NK-T cell lymphoma manifesting as acute respiratory distress syndrome / 대한내과학회지

Primary pulmonary lymphoma is a rare disease, and non-B cell lymphomas (T-cell and natural killer cell lymphomas) involving the lung parenchyma are uncommonly reported. The most common radiological feature of pulmonary parenchymal lymphoma is a single mass or nodule. A 49-year-old woman with dyspnea was referred with suspicion of severe pneumonia. A chest radiograph showed diffuse nodular infiltration in both lungs. Acute respiratory failure was severe and rapidly progressive, so she was managed with a mechanical ventilator under the impression of acute respiratory distress syndrome (ARDS). A bronchoalveolar lavage and lung biopsy by video-assisted thoracic surgery revealed NK-T cell lymphoma. We report a case of extranodal NK-T cell lymphoma presenting as ARDS.