A Case of Spontaneous Mediastinal Hemorrhage in Patients on Chronic Hemodialysis / 대한신장학회잡지

Spontaneous hemorrhage in the patients undergoing hemodialysis is the ralatively common problem, but spontaneous mediastinal hemorrhage in such patients reported only few cases. We experienced a case of spontaneous mediastinal hemorrhage in chronic hemodialysis patient who complained of continuous pleuritic chest pain and mild dyspnea. The diagnosis was made dy chest computed tomography,magnetic resonance imaging and percutaneous fine needle aspiration of liquified dark reddish old blood material guided by ultrasonography. Treatment is usually conservative, with blood volume replacement and intensive hemodialysis using regional heparinization. We report on a patient undergoing hemodialysis due to endstage renal disease who developed spontaneous mediastinal hemorrhage.

Two Cases of Hyperparathyroidism Presenting as Acute Pancreatitis / 대한내분비학회지

The relationship between hypercalcemic crisis and pancreatitis, first described in patients with hyperparathyroidism, still remains controversial. Acute pancreatitis may complicate the clinical course of hyperparathyroidism, particularly when the degree of hypercalcemia is severe. The incidence of hyperparathyroidism presenting as acute pancreatitis appears to be steadily decreasing, possibly reflecting the earlier diagnosis of asymptomatic hyperparaparathyroidism due to widespread application of screening methods. Here, we report two patients with primary hyperparathyroidism manifesting clinically as acute pancreatitis. One patient died of progessive pancreatitis and uncontrolled sepsis. The other patient was fullly recovered by emergent parathyroidectomy followed by medical management of hypercalcemia.