A Case of Intussusception Due to a Jejunal Gastrointestinal Stromal Tumor

Intussusception is seen often in children but relatively few cases occur in adults. In many cases, the etiology of intussusception in adults is a tumor, with adenocarcinoma being the most common tumor in the small intestine. Gastro-intestinal stromal tumor (GIST) is caused by a mutation of the interstitial cells of Cajal, which controls the speed of peristalsis by being involved in the autonomic innervation between the bowel wall and the smooth muscles of the gastrointestinal tract, and is rarely a factor in adult intussusception. We reported a case of a 74-year-old male patient who came to our hospital with hematochezia and was found to have jejunal intussusception from GIST.

A Case of Successful Conservative Treatment of Esophageal Perforation from Penetration of Esophageal Wall by a Fish Bone

A 71-year-old man with a history of percutaneous transluminal coronary angioplasty(PTCA) was referred to our clinic with a one-day history of a continuous substernal chest pain radiating to his left shoulder. In retrospect, he experien- ced chest discomfort after eating fish one day before but did not seek medical attention then. An upper gastrointestinal endoscopy was performed. The cause was not visible during the advancement of the endoscope through the eso- phagus, but a small segment of a fish bone protruding from an ulcerative lesion in the lower esophagus was iden- tified while withdrawing the endoscope. The fishbone was immediately removed. A follow-up CT scan revealed pneumo- mediastinum. Now hemodynamically stable, the patient underwent conservative medical treatment including total parenteral nutrition(TPN) and intravenous antibiotic drugs. The patient made complete recovery. We report a case of a 71- year-old male found to have an esophageal perforation from an ingested fish bone, which was managed successfully with conservative treatment. A pertinent literature review is also included.

A case of non-Hodgkin's lymphoma presented only as unilateral pleural effusion / 대한내과학회지

We experienced a case of non-Hodgkin's lymphoma presented only as right side pleural effusion, that is primary effusion lymphoma (PEL), in a 75 year-old male patient in Korea where is the endemic area of tuberculosis. He visited our hospital complaining of exertional dyspnea. He did not have B symptoms. The breathing sound was decreased on the right side chest, but we could not find external lymphadenopathy or hepatosplenomegaly on physical examination. Simple chest radiograph showed right side pleural effusion. The cells of pleural fluid were lymphocyte-predominant and the pH, protein, lactate dehydrogenase, adenosine deaminase of the fluid was 7.31, 38 g/L, 381 U/L, 31 U/L, respectively. The biopsy specimen of the parietal pleura was diagnosed as non-Hodgkin's lymphoma of small lymphocytic type. Computed tomograph of the chest, abdomen and pelvis, and the biopsy of bone marrow were negative for disease. We tried up to 3 cycles of chemotherapy with adriamycin, vincristine, cyclophosphamide and prednisolone and there was a marked decrease in the amount of the pleural effusion.

A case of abdominal actinomycosis simulating Dieulafoy's ulcer / 대한내과학회지

Actinomycosis is a chronic suppurative and granulomatous disease caused by Actinomyces species and characterized by sulfur granule formation. Depending on the site of primary infection, it is generally classified as cervicofacial, thoracic and abdominal type. Abdominal actinomycosis is often difficult to diagnose before operation because of low frequency and no characteristic clinical features of the disease. As it progresses chronically, it can be misdiagnosed such as cancer, inflammatory bowel disease or other abscess. The diagnosis is usually based on histologic demonstration of sulfur granules in pus or surgically resected specimen. In vast majority of cases, treatment has consisted of long-term antibiotic therapy coupled with surgical resection. We experienced a case of colonic actinomycosis initially diagnosed as Dieulafoy's ulcer and confirmed by colonoscopic biopsy. Treatment with intravenous penicillin for 4 weeks was successful independently, and we report this case with a brief review of literatures.