A Case of Coffee Enema-induced Colitis

A coffee enema, which has been suggested as a part of cancer treatment, is a hazardous derivative of colon therapy and has been misused as a treatment for obesity and constipation among the general population. Its proponents claim that caffeine is absorbed in the colon and leads to vasodilatation in the liver, which in turn enhances the process of elimination of toxins. None of this is proven, nor is there any evidence for the clinical efficacy of coffee enemas. We experienced a patient who presented with abdominal pain and bloody stool after receiving a coffee enema to relieve constipation. We report this case of coffee-associated colitis with a review of the relevant literature.

A Case of Double Primary Cancer of the Esophagus and Duodenum that Induced Hematemesis / 대한소화기내시경학회지

The occurrence of double primary cancer of the esophagus and duodenum is considered to be very rare. Moreover, it is difficult to manage this type of double cancer because esophageal cancer has a biologic tendency towards early metastasis. Yet the development of endoscopy such as endoscopic ultrasonography (EUS), the new diagnostic imaging modalities such as PET/CT and advanced pathologic interpretation can lead to an early diagnosis of these multiple primary neoplasms. Appropriate intervention with various therapeutic tools then becomes possible, so these multiple primary neoplasms are not currently obstinate problems. We experienced one patient with double primary cancer; we simultaneously found esophageal cancer and duodenal cancer via endoscopy, and we wanted to treat them with chemo- radiation therapy and endoscopic submucosal dissection, but we failed to persuade the patient to accept the treatment.

A Case of Large Hepatic Cyst Infected with Salmonella paratyphi A / 감염과화학요법

Salmonellae cause a number of characteristic clinical infections in humans, including gastroenteritis, enteric fever, bacteremia, focal metastatic infection and an asymptomatic chronic carrier state. We report a case of large hepatic cyst infected with Salmonella paratyphi A. A 47-year-old woman was admitted, because of abdominal complains (fullness and pain) and fever. On physical examination, a mass was palpated on right upper quadrant of the abdomen. The computerized tomography of the abdomen showed a large hepatic cyst, but not cystic infection. Aspiration and percutaneous drainage of the hepatic cyst were perfomed for the therapeutic decompression under fluoroscopic guidance. Cultures of the cyst fluid revealed growth of Salmonella paratyphi A. Radiologic contrast media after draining of the cyst fluid revealed no communication between the cyst and bile ducts. Infected hepatic cyst appeared to result from hematogenic seeding. One month later, the patient improved and was discharged without any complication.

A Case of Large Hepatic Cyst Infected with Salmonella paratyphi A / 감염과화학요법

Salmonellae cause a number of characteristic clinical infections in humans, including gastroenteritis, enteric fever, bacteremia, focal metastatic infection and an asymptomatic chronic carrier state. We report a case of large hepatic cyst infected with Salmonella paratyphi A. A 47-year-old woman was admitted, because of abdominal complains (fullness and pain) and fever. On physical examination, a mass was palpated on right upper quadrant of the abdomen. The computerized tomography of the abdomen showed a large hepatic cyst, but not cystic infection. Aspiration and percutaneous drainage of the hepatic cyst were perfomed for the therapeutic decompression under fluoroscopic guidance. Cultures of the cyst fluid revealed growth of Salmonella paratyphi A. Radiologic contrast media after draining of the cyst fluid revealed no communication between the cyst and bile ducts. Infected hepatic cyst appeared to result from hematogenic seeding. One month later, the patient improved and was discharged without any complication.

A Case of Systemic Lupus Erythematosus Presented with Streptococcal Myositis / 대한류마티스학회지

Streptococcal myositis is an extremely uncommon infectious disease caused by Group A streptococcus (GAS). GAS infection spreads rapidly and diffusely through the muscle, resulting in edema and necrosis. Consequently, it results in streptococcal toxic shock syndrome having extremely high mortality. We report a 42 year-old female patient with systemic lupus erythematosus accompanying with streptococcal myositis who initially presented with fever, severe pain, and tenderness on the calf. Her systemic toxic symptoms were aggravated and finally she died of the disease in spite of aggressive management.

A Case of Acute Thrombotic Renal Artery Occlusion Treated with Local Urokinase Infusion

Acute thrombotic renal artery occlusion is rarely identified at premortem. Early diagnosis and treatment are crucial for salvage of renal function. We reported a case of successfully dissolved acute thrombotic occlusion of renal artery of 9 hour duration with intra-arterial infusion of urokinase in a 83-year-old man.

A Case of Primary Malignant Mesenchymoma of the Heart

A malignant mesenchymoma is a rare soft tissue neoplasm that show at least two types of malignant mesenchymal differentiation, in addition to poorly differentiated fibrosarcomatous elements. They grow rapidly, recur frequently, and can be found in a wide variety of location, with most occurring in the extremities. A primary malignant mesenchymoma of the heart is extremely rare, with only 20 cases having been reported worldwide in the English literature up to 2002. We experienced a case of primary cardiac malignant mesenchymoma in a 59 year old female patient, who was admitted due to exertional dyspnea. This case is reported, with a review of the relevant literature.

A Case of Severe Asthma Complicated with Pneumoperitoneum and Pneumomediastinum During AMBU Ventilation / 결핵

Pneumoperitoneum, Pneumomediastinum, subcutaneous emphysema and a pneumothorax are some of the mechanical complications of bronchial asthma. The incidence of pneumoperitoneum during an attack of acute asthma is rare. The pathogenesis is free gas track from the overdistended alveoli, through the bronchovascular sheaths to the mediastinum. If the high pressure is maintained, air can escape retroperitoneally into the abdomen and burst into the peritoneal cavity. A 43-year-old woman was admitted due to a severe asthma attack. She was required endotracheal intubation and AMBU(air mask bag unit) ventilation. Immediately after these procedures, pneumoperiotneum, pneumomediastinum, and subcutaneous emphysema daveloped. She was treated with mechanical ventilation and medical therapy. The pneumoperitoneum was resolved after 27 days. Here, we report this case with the review of the relevant literature.