A Case of Gastric Tuberculosis Presenting with Hematemesis / 대한소화기내시경학회지

Gastric tuberculosis is quite rare and usually combined with pulmonary tuberculosis. Its diagnosis is so difficult as it is often unsuspected. We report a patient with gastric tuberculosis who presented with hematemesis in Korea. Upper endoscopy showed large, deep penetrating ulcer containing an exposed vessel and adherent clot in the body. Gastric biopsies revealed only chronic inflammation and no evidence of granuloma or malignancy. Diffuse mural thickening was noted on abdominal CT. The diagnosis was made postoperatively following gastrectomy for bleeding gastric ulcer. Microscopic examination of resected stomach showed peptic detritus and noncaseating granulomas. However, multiple caseating granulomas with Lagerhan's giant cells were found on the examination of lymph nodes. The patient was treated with antituberculous therapy for 12 months without any complications.

A Case of Infective Endocarditis Complicated with Mycotic Aneurysm of Superior Mesenteric Artery / 감염

Mycotic aneurysm of mesenteric artery is an uncommon complication of infective endocarditis. Early diagnosis is important and surgical intervention is often needed for effective treatment of mycotic aneurysm of mesenteric artery because of the high incidence of aneurysmal rupture. We experienced a case of infective endocarditis complicated with mycotic aneurysm of the superior mesenteric artery in a 54-year old man, who was admitted because of pain on the right lower quadrant of abdomen. Echocardiography showed mitral regurgit-ation and vegetations on the mitral valve and viridans streptococcus was identified from blood cultures. He was successfully treated with ceftriaxone and gentamicin for the initial 2 weeks, then ceftriaxone alone for two weeks more without surgical intervention. To our knowledge, this is the first case of infective endocarditis complicated with superior mesenteric artery aneurysm in Korea.