Spontaneous Regression of an Intraabdominal Desmoid Tumor in a Patient with Total Gastrectomy / 대한내과학회지

Desmoid tumor is rare neoplasm characterized by clonal proliferation of myofibroblasts that do not metastasise, but often exhibit an infiltrative pattern and functional impairment. The etiology of this tumor is unknown, but hormonal, genetic, and physical factors play a role in its development and growth. The clinical behavior and natural history of desmoid tumors remains unpredictable and enigmatic. However, spontaneous regression of desmoid tumors is rare. Here we report spontaneous regression of an intraabdominal desmoid tumor in a patient who underwent total gastrectomy.

A Case of Limited Wegener's Granulomatosis with Gastroenteritis and Mesenteric Lymphadenopathy / 대한소화기학회지

Wegener's granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis.

A Case of Limited Wegener's Granulomatosis with Gastroenteritis and Mesenteric Lymphadenopathy / 대한소화기학회지

Wegener's granulomatosis (WG) is a disease characterized by a granulomatous necrotizing vasculitis of small vessels. Although any organ systems can be involved, gastrointestinal involvement in WG is notably uncommon. We present a case of 67-year-old man who was admitted with abdominal pain and diarrhea lasting for 3 weeks. Colonoscopy and abdominal CT scan revealed vasculitis and multiple mesenteric lymphadenopathy. Jejunum and mesenteric lymph nodes biopsies confirmed limited form of WG. The present case indicates that WG might involve only gastrointestinal tract and the histological confirmation is important for diagnosis.

Successful Endoscopic Papillary Balloon Dilatation for a Patient with Recurrent Sump Syndrome / 대한소화기내시경학회지

Sump syndrome is a rare late complication of choledochoenteric anastomosis, and this caused by the accumulation of food debris, choledocholithiasis, bile sludge and cholesterol crystals in the distal common bile duct. This syndrome is characterized by symptoms such as abdominal pain and fever. The treatment modality for this syndrome has been surgery in the past. However, endoscopic treatment such as endoscopic sphinterotomy is currently regarded as the primary therapeutic approach for this condition. We experienced a patient with a history of choledochoduodenostomy and who developed sump syndrome as a complication of the surgery. Endoscopic sphinterotomy was performed for treatment, but this only produced the recurrence of the disease. The recurrent sump syndrome was eventually successfully controlled by performing endoscopic papillary balloon dilatation.

True splenic cyst producing high levels of cystic fluid CA 19-9 and CEA: A case report / 대한내과학회지

True non-parasitic splenic cysts are rare. Series have reported over 30 cases of true splenic cysts producing elevated serum CA 19-9 levels. A 27-year-old woman presented with a painless mass in her left upper abdomen. Computed tomography (CT) of the abdomen showed a 16-cm cyst in the spleen. The serum CA 19-9 and CEA levels were 432 U/mL and 1.67 ng/mL, respectively. The cystic fluid CA 19-9 and CEA levels were markedly elevated. A splenectomy was performed. The pathology showed a benign true epidermoid cyst, which was negative for CEA. The serum CA 19-9 level returned to normal after removing the splenic cyst. This is the first reported case of a true benign splenic cyst producing high levels of CA 19-9 and CEA in Korea.

A Case of Gastric Suture Granuloma Suspected of Malignant Submucosal Tumor / 대한소화기내시경학회지

A gastric suture granuloma is an uncommon postsurgical complication. When nonabsorbable sutures are used, the inflammation can persist months after the original procedure with the subsequent formation of an abscess around the sutures surrounded by granulation tissue. Suture granulomas are usually asymptomatic, and have clinical importance as a differential diagnosis of a gastric submucosal tumor. The incidence of suture granuloma is low using absorbable sutures in gastrointestinal anastomosis. We report a case of a 70 year old man diagnosed with a suture granuloma. Approximately 30 years earlier, he underwent primary closure due to gastric ulcer perforation. When a gastroscopy was performed to assess upper abdominal soreness, it revealed a submucosal tumor that indicated a malignancy, which was diagnosed as a suture granuloma after surgery.

A Case of Primary Antiphospholipid Syndrome Presenting as Digital Gangrene / 대한류마티스학회지

Antiphospholipid syndrome (APS) is characterized by a combination of arterial/venous thrombosis or obstetric morbidity and antiphospholipid antibodies such as anticardiolipin antibody or lupus anticoagulant. Digital gangrene is an uncommon manifestation of primary APS. A 61 year-old woman was admitted because of acrocyanosis and progressive digital gangrene in both hands for 1 month. Serologically, lupus anticoagulant was positive. Angiography showed obstruction of digital arteries with collaterals, but there was no evidence of atheromatous plaque or vasculitis. Cardiac echogram did not reveal intracardiac thrombosis or valvular vegetations. She had no evidence of other thrombotic disorders, connective tissue disease, infections or malignancy. Treatment of intravenous heparin and prostaglandin E1 led to stabilization of the symptom, and the necrotic digits were surgically removed. Pathological examination of the amputed digital stump showed arterial and arteriolar thrombotic occlusion, proliferation of capillaries, and ischemic necrosis. After oral anticoagulation therapy, she has been followed without recurrence.We describe the first case of primary APS presenting as digital gangrene in Korea and review the literatures.