Biliary Stricture Associated with Common Bile Duct Stone Caused by Endoscopic Snare Papillectomy of Ampullary Adenoma / 대한소화기내시경학회지

Neoplasms of the major duodenal papilla or the ampulla of Vater are rare but are clinically important since they are premalignant. Recently endoscopic snare papillectomy for the ampullary adenoma is being increasingly performed. The procedure is now regarded as a clinically effective treatment, however, various complications such as bleeding, perforation, cholangitis, and pancreatitis have been reported. To our knowledge, biliary stricture of this case has not been reported as a complication of endoscopic snare papillectomy for ampullary adenoma. Also, secondary common bile duct stone was formed by biliary stasis associated with biliary stricture in our case. We performed the balloon dilation at the biliary stricture site and could remove the stone successfully by endoscopic method.

A Case of Measles Pneumonia Complicated by Subcutaneous Emphysema and Pneumomediastinum in an 18-year-old Patient / 결핵

A 18 year-old man presented with dyspnea and a swelling of the neck. On physical examination, maculopapular rashes were noted on the face and the whole body and crepitus was noted at the thorax and upper arms. His chest X-ray showed bilateral interstitial infiltrates of the lung, pneumomediastinum and subcutaneous emphysema. On serologic examination, measles IgM was positive. Under the diagnosis of measles pneumonia, the patient was treated with oral ribavirin, which resulted in a complete resolution of the pneumomediastinum, subcutaneous emphysema, pneumonic infiltrate, and subjective symptoms of dyspnea and swelling of the neck in 7 days. Here we report this case with a brief review of the relevant literature.

A Case of Intraductal Papillary Mucinous Tumor Arising from the Accessory Pancreatic Duct / 대한소화기내시경학회지

Mucin-producing tumors of the pancreas were first reported by Ohhashi and Takagi in 1980. Since then, many cases of intraductal papillary mucinous tumor (IPMT) of the pancreas, which is almost homonymous to mucin-producing tumors of the pancreas, have been reported. IPMTs are generally regarded as tumors with a favorable prognosis. Some IPMTs have invasiveness and this is always associated with a poor prognosis. Most IPMTs arise from the main pancreatic duct and IPMTs arising from the accessory pancreatic duct are relatively rare. Only 6 cases have been reported in the literature so far. Our patient was a 43-year old man who was admitted to the hospital due to recurrent pancreatitis. An endoscopic retrograde pancreatography revealed a patulous minor papilla orifice extruding mucin and a cystic lesion in a branch of the accessory duct. A pancreaticoduodenectomy was performed and a pathologic examination of the resected specimen showed intraductal papaillary mucinous neoplasm, low grade malignancy, in the accessory pancreatic duct and its branch. We herein report this interesting case with a review of the literature.

A Case of Primary Biliary Cirrhosis in Association with Sjorgen's Syndrome Developing Features of Systemic Lupus Erythematosus / 대한류마티스학회지

Primary biliary cirrhosis (PBC)is a chronic inflammatory disease characterized by fibrous obliteration of intrahepatic bile ductules.Although the etiopathogenesis of PBC remains unclear,several studies suggest that a disordered immune response may be involved.This disease is commonly associated with various autoimmune diseases,such as Sjogren's syndrome,scleroderma, rheumatoid arthritis,Hashimoto's thyroiditis,polymyositis,and pernicious anemia.More than 80%of cases with PBC are accompanied by at least one autoimmune disorder,and 40%by two or more. Sjogren's syndrome,defined by dry eyes and xerostomia,may be found in 69 to 81%of PBC patients. However, concurrent coexistence of PBC and systemic lupus erythematosus (SLE)has been rarely described in the literature.We report a 46-year-old female with PBC and Sjogren's syndrome who also satisfied a classification criteria of SLE.