Two Cases of Colon Polyp Bleeding With Massive Hematochezia in Elderly Patients

The annual incidence of hospital admissions for lower gastrointestinal bleeding in the United States and Europe is 0.02%. Massive hemorrhage from a solitary colon polyp is an extremely rare case. We report two consecutive patients with a single polyp, which was the source of bleeding. The first case is a 68-year-old male patient who visited Daejeon Sun Hospital with the chief complaint of considerable hematochezia. An 1.2 cm colon polyp with active bleeding was observed on the colonoscopy. The second case is a 74-year-old female patient with symptoms of hematochezia. A blood-clot attached, 3.0 cm sized Yamada type-IV colon polyp was examined on the colonoscopy. One case was a sessile polyp, and the other one was a thick-stalked pedunculated polyp. Both types of polyps were supplied with more vessels than other polyps, and both patients were taking aspirin. The two patients underwent snare polypectomy and were discharged without further bleeding evidence.

A Large Symmetrical Esophageal Ulcer Caused by Thermal and Compressive Injury from a Solid Foodstuff Known as 'Song-Pyen' / 대한내과학회지

There are many possible causes of esophageal ulcer, such as reflux esophagitis, pill-induced esophagitis, infectious esophagitis, tuberculosis, syphilis, Behcet's disease, radiation injury, caustic injury, foreign body-induced injury, esophageal cancer, and so on. However, there are only a few cases of esophageal ulcer by thermal injury from food, and most of these were caused by liquids; few are related to ingestion of solid food. We experienced a case of a large symmetrical esophageal ulcer caused by thermal and compressive injury from a hot solid foodstuff known as 'Song-pyen', a traditional Korean food, and report the natural course of healing by conservative treatment, with a review of the few available reports regarding such injuries.

Pathological Findings of a Renal Biopsy Showing Chronic Hepatitis B in A Patient with Acute Hepatitis A / 대한내과학회지

Hepatitis A is usually a self-limited liver disease that is treated conservatively. Acute renal injury complicating acute hepatitis A in the absence of fulminant hepatic failure is rare. We experienced a 33-year-old man who was healthy, and did not know that he was a hepatitis B virus (HBV)carrier with non-fulminant hepatitis A. He developed an acute kidney injury that necessitated dialysis therapy and a renal biopsy. He recovered within about 1 month. Pathologically, the renal biopsy showed acute tubular necrosis. It also showed IgA nephropathy and mesangium proliferation with glomerular nephritis, which are seen in chronic viral hepatitis B. We describe the association of acute hepatitis A with acute kidney injury and report the pathological findings of a renal biopsy related to chronic hepatitis B in an acute hepatitis A patient discovered by chance.

A case of deep, wide drug-induced esophageal ulcer / 대한내과학회지

There are many possible causes of esophageal ulcer, including reflux esophagitis, the ingestion of foreign bodies or caustic agents, radiation exposure, viral infections, tuberculosis, Candida infection, Bechet's disease, and esophageal cancer. Patients with drug-induced esophagitis typically have a history of ingesting medication with little or no fluid immediately before going to bed. Here, we present the case of a 31-year-old man complaining of dysphagia and odynophagia for 4 days. The patient reported taking oral medication for acute sinusitis 12 days prior. Endoscopic examination revealed a large, deep esophageal ulcer consistent with esophageal cancer or cytomegalovirus esophagitis. The exam also revealed several esophageal erosions resembling herpes simplex virus esophagitis. However, based on the patient's history and subsequent histologic findings, drug-induced esophagitis was diagnosed and the patient was successfully treated with a proton pump inhibitor. Lesions showed improvement upon follow-up endoscopy 1 month later.