A Case of Blue Rubber Bleb Nevus Syndrome / 대한소화기내시경학회지

Blue rubber bleb nevus syndrome is a rare disorder that's characterized by multiple venous malformations of the skin and gastrointestinal tract, and these lesions usually cause episodes of occult gastrointestinal hemorrhage and iron deficiency anemia. We report here on a case of a 57-year-old woman who presented with intermittent melena and multiple cutaneous venous malformations. The endoscopic and radiologic examinations show multiple bluish polypoid venous malformations on the gastrointestinal tract, retroperitoneum, liver, mediastinum and lung. We were able to diagnose her as suffering from blue rubber bleb nevus syndrome and we treated her with iron supplementation for anemia. We report this case along with a brief review of the relevant literature.

A Case of Liver Abscess Associated with Duodenal Perforation by a Toothpick / 대한소화기내시경학회지

The ingestion of foreign bodies into the gut is rather common. Most these foreign bodies are passed out spontaneously without complications. Our patient was hospitalized for fever, nausea and vomiting for one week. On the initial endoscopic examination, a toothpick was seen to be impacted in the wall of the duodenal bulb. Air bubbles were noted at the site where the toothpick was removed. The duodenal perforation was treated with endoscopic hemoclipping. Abdominal CT showed free air in the periduodenum and there was a liver abscess. Therefore, liver abscess associated with duodenal perforation by the toothpick was diagnosed. On the cytology of the aspirated materials from the liver abscess, sulfur granule formation was noted and hepatic actinomycosis was diagnosed. The liver abscess was successfully treated with CT-guided abscess drainage and antibiotics. We report here on an unusual case of a liver abscess associated with duodenal perforation by a toothpick, along with a review of the literature.

A Case of Small Bowel Obstruction due to Multiple Trichobezoars / 대한소화기내시경학회지

Trichobezoars are gastric concretions that are composed of hair or fibers. They are more common in children and adolescents and are usually associated with a pica, emotional disturbance, or mental retardation. Trichobezoar is quite rare in Korea. In most cases, trichobezoars tend to form a cast of the stomach. However, in rare cases, portions of the trichobezoar may separate from the gastric mass, migrate distally, and obstruct the small bowel. We report a case of small bowel obstruction due to multiple trichobezoars in a 14 year-old-girl who had a habit of swallowing hairs until 12 years of age. The patient was treated successfully surgically.

A Case of Duodenal Lipoma with Upper Gastrointesinal Bleeding / 대한소화기내시경학회지

Duodenal lipoma is relatively rare, and usually located in the second portion of the duodenum. Most lipomas of the small intestine are asymptomatic and incidentally found. However, epigastric pain, intussusception, ulcer, intestinal obstruction and rarely severe hemorrhage can occur depending on the size or location. Duodenal lipoma is mostly confirmed by surgical removal with histopathologic valuation because it is difficult to make a differential diagnosis of duodenal lipoma from malignant tumor or other submucosal tumor based only on the findings of radiology or endoscopy. Endoscopic ultrasonography can so help for the differential diagnosis of the submucosal tumor. We report a case of duodenal lipoma accompanied by upper gastrointesinal hemorrhage, treated by both endoscopic resection and surgical operation and confirmed by histopathologic diagnosis.