A Case of Gastric Glomus Tumor with Bleeing / 대한소화기내시경학회지

A glomus tumor is a benign neoplasm arising from the neuromyoarterial glomus body, a specialized arteriovenous communication. It functions as a temperature regulator, predominantly in the skin. The glomus tumor occurs rarely in the stomach. The common presenting symptoms are upper gastrointestinal bleeding, epigastric discomfort, nausea, and vomiting. This benign tumor is seen as an intramural mass and is most frequently located in the gastric antrum. Because of its highly cellular nature, the frozen section is often misinterpreted as malignant, and an unduly extensive resection is sometimes performed. A 57-year-old woman was recently admitted due to hematemesis and melena for one day. A gastrofibroscopy was performed and a 3 4 cm sized submucosal mass with central ulceration was found on the anterior wall of the antrum. Fresh blood clots were noted on the ulcer base. Due to recurrent bleeding, a hemigastrectomy was performed. Pathologic findings, including immunoreactivity to alpha-smooth muscle actin and vimentin, was consistent with a glomus tumor of the stomach.

A Case of Esophagopleural Fistula Treated by Endoscopic Injection of Histoacryl in Boerhaave's Syndrome / 대한소화기내시경학회지

Boerhaave's syndrome is a spontaneous tear through all the layers of the left lateral wall of the esophagus just above the diaphragm, produced by a sudden increase in esophageal pressure. Boerhaave's syndrome is a rare but grave syndrome, with a mortality rate around 40%. Most affected patients are middle-aged men who experience violent vomiting after heavy eating or alcohol intake or both. Vomiting followed by the abrupt onset of pain, dyspnea, and/or shock are the major symptoms. The most important diagnostic tool may be an upright chest X-ray. However, esophagograms and/or a chest CT may be required to locate the lesion. The management of esophagopleural fistula must be individualized, and both the patient's condition and the specific characteristics of the fistula must be considered. Successful management of patients must include adequate nutritional support and effective therapy of the associated empyema. A case of esophagopleural fistula complicated by Boerhaave's syndrome, which was successfully treated by endoscopic injection of Histoacryl , in herein reported.