A Case of Successful Treatment for Acute Complication Caused by Ingestion of a Large Amount of Glacial Acetic Acid

Glacial acetic acid, a caustic substance of strong acidity, can easily be found in our daily lives; sometimes, it is drunk for the purpose of suicide, or it can be misjudged as a beverage. Glacial acetic acid is corrosive and toxic, therefore, even a tiny amount may cause fatal damage, such as gastrointestinal injury and systemic complication. A 66-year-old male patient, based on the wrong information, that glacial acetic acid is a healthy beverage, ingested 250 mL of 99% glacial acetic acid. Complications included gastric perforation, hemolysis, disseminated intravascular coagulation, acute renal failure, and liver dysfunction. We achieved successful treatment through performance of emergency surgery and hemodialysis on the patient, who had ingested a more than fatal dose of glacial acetic acid; herein, we would like to report on the case along with a review of the literature.

Endoscopic Foley Balloon Extraction of an Esophageal Foreign Body / 대한소화기내시경학회지

Esophageal foreign bodies should be retrieved as soon as possible, as they may cause complications such as bleeding, perforation, and respiratory distress. Flexible endoscopy is the preferred method, because it is effective and safe, but rigid esophagoscopy or a surgical procedure should be considered if flexible endoscopy fails. Extraction with a Foley balloon is an effective method for removing blunt foreign bodies from the esophagus. The general technique used is to insert the catheter into the esophagus through the nose or mouth, place it in the distal part of the foreign body, balloon the catheter, and remove the foreign body by pulling the catheter out. This procedure is generally performed under fluoroscopy, but a few reports have used Foley balloon extraction during endoscopy. We report a case of an elderly woman with a blunt foreign body in the upper esophagus. After failing to remove the object by endoscopy, we removed it with a Foley balloon under endoscopy.

A Case of Spontaneous Pneumoperitoneum Caused by Giant Bulla / 대한내과학회지

A spontaneous pneumoperitoneum is air in the peritoneal space that is detectable radiologically and can be managed successfully by observation alone or a laparotomy. A 73-year-old man was admitted for low back pain. He had a giant bulla in the left upper lung, detected radiologically 7 years earlier. On admission, he had free air in the subphrenic area bilaterally, while the previous giant bulla was not seen. Based on the physical examination, we thought that the new free air did not indicate a surgical abdomen, and performed additional examinations to rule out other disease. There was no abnormal finding linked to the free air. The free air had almost disappeared on a subsequent chest X-ray. We report a rare case of spontaneous pneumoperitoneum caused by a giant bulla, with a literature review

Transurethral Rescetion Syndrome after Transurethral Resection of Bladder Tumor in 2 Patients on Maintenance Hemodialysis / 대한신장학회지

Transurethral resection syndrome (TURS) is one of the complications of endoscopic transurethral operation with irrigation fluid. TURS comprehensively refer to several clinical symptoms and signs caused by intravascular absorbtion of irrigation fluid, hypertension, bradycardia, arrhythmia, respiratory distress, hypotension, confusion, blindness, seizure, coma, hyponatremia, and hypoosmolarity. TURS is mainly known as the complication of the transurethral resection of prostate (TURP), and rarely found in the procedures such as transurethral resection of bladder tumor (TUR-BT), hysteroscopy, cystoscopy, and arthroscopy. Only a few cases of TURS after TUR-BT have been reported. The patients on maintenance hemodialysis were restricted in the amount of water intake for volume control. They were susceptible to the absorption of irrigation fluid during TUR-BT since they had anuria. We hereby report the 2 cases maintenance hemodialysis patients who were led to TURS after TUR-BT.

A Case of Recurrent C1q Nephropathy Treated by Immunosuppressant Combination Therapy / 대한신장학회지

The definition of C1q nephropathy has been categorized since 1985. However, the clinical correlation and pathophysiology has not yet been fully revealed. Therefore, the treatment of C1q nephropathy has not been established. Our subject was a 23 year-old female patient with both leg edema and oliguria, who was presented with weight gain. Renal biopsy confirmed C1q nephropathy. Prednisolone and cyclosporine therapy was selected for treatment. After 2 weeks of treatment, the patient lost 8 kg of body weight and all laboratory examination results were normalized. Both leg edema and oliguria were resolved. After 21 weeks of regular follow-up, she stopped the medicine by herself. Eight weeks later, the patient came to the Emergency room because both leg edema recurred. Same regimen was administered for 3 weeks, and complete remission was achieved again.