Résumé
Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of striated skeletal muscle, an elevation of muscle enzymes, and abnormality of electromyographical changes, but its pathogenesis is not clear. In recent years, there has been an increased awareness of the association of malignant tumors with this disorder. Still, the relationship between polymyositis and a malignant tumor remain obscure. Some researchers have suggested that the cause of polymyositis may be due to an autoimmune response induced by aviral infection. However, a chronic hepatitis B virus infection associated with polymyositis is very rare. We present in this report a rare case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection.
Sujets)
Auto-immunité , Carcinome hépatocellulaire , Hépatite B chronique , Hépatite chronique , Inflammation , Faiblesse musculaire , Muscles squelettiques , PolymyositeRésumé
Appendiceal stump bleeding is a rare, but occasionally life-threatening complication. Significant lower gastrointestinal hemorrhage from an ulcerated appendiceal stump may occur after uncomplicated appendectomy. The common management includes ligation of the bleeding vessel or cecal resection by either emergency laparotomy or laparoscopy. Angiographic embolization of the bleeding vessel is an alternative therapeutic option. We report here on a case of gastrointestinal hemorrhage from an appendiceal stump, and this occurred six days after appendectomy. The bleeding was controlled endoscopically by placing hemoclips on the distinct vessel. The patient recovered thereafter without further intervention. Endoscopic hemoclipping is an effective and safe procedure, and it can replace emergency laparotomy, laparoscopy or angiographic embolization for treating appendiceal stump bleeding.
Sujets)
Humains , Appendicectomie , Urgences , Hémorragie gastro-intestinale , Hémorragie , Laparoscopie , Laparotomie , Ligature , UlcèreRésumé
Although adenocarcinoma is a well known complication of chronic inflammatory bowel disease, primary gastrointestinal lymphoma occurring in Crohn's disease is rare. A 40-year-old man with 10 year-history of Crohn's disease had multiple longitudinal ulcerative lesions on descending colon in follow-up colonoscopic examination. Microscopic examination of proximal descending colon revealed peripheral T cell lymphoma and other site of the descending colon was consistent with Crohn's disease. The patient reached complete remission of malignant lymphoma after three cycles of combined chemotherapy. He has been well for 10 months with sulfasalazine maintenance therapy but was admitted to the hospital due to spontaneous bowel perforation of ascending colon. Right hemicolectomy was done, but the patient died of post-surgical recurrent mesenteric abscess and sepsis. To the best of our knowledge, this is the first case of Non-Hodgkin's lymphoma complicating Crohn's disease in Korea which was confirmed by immunohistochemical studies.