A Case of Cecal Endometriosis Presenting as Subepithelial Tumor / 대한소화기학회지

Endometriosis is a benign gynecologic disease, characterized by the presence and growth of functional endometrial-like tissue outside uterus. This ectopic endometrial tissue is most commonly found in the peritoneum, ovaries and uterosacral ligaments, but extremely rarely there is involvement of the appendix or cecum. Here we report a case of cecal endometriosis presenting as a subepithelial tumor diagnosed by surgical excision.

A Case of Spontaneous Bleeding of Multiple Lumbar Arteries in a Patient with Liver Cirrhosis / 대한소화기학회지

Esophageal and gastric varix, portal hypertensive gastropathy, Mallory-Weiss tear and gastric ulcer are common causes of bleeding in patients with liver cirrhosis. However, spontaneous arterial bleeding without a history of trauma is a rare cause of bleeding which can be fatal. We report a case of a 55-year-old woman with alcoholic liver cirrhosis who developed spontaneous bleeding of multiple right lumbar arteries and died in spite of repetitive transfusion and embolization.

A Case of Lateral Abdominal Wall Hematoma Treated with Transcatheter Arterial Embolization / 대한소화기학회지

Paracentesis is a diagnostic, therapeutic procedure performed in patients with ascites. It is generally thought to be a safe procedure and transfusion of platelet concentrate or fresh frozen plasma is not recommended before the procedure, because the incidence of clinically significant bleeding is very low. We report a case of lateral abdominal wall hematoma due to the injury of the deep circumflex iliac artery after paracentesis in patient with alcoholic liver cirrhosis who was treated with transcatheter arterial embolization.

A Case of Primary Gastric ALK-Positive Anaplastic Large-Cell Lymphoma / 대한내과학회지

Anaplastic large-cell lymphoma (ALCL) is a rare subgroup of non-Hodgkin's lymphoma. Primary gastric ALCL is extremely rare. Patients with anaplastic lymphoma kinase (ALK)-positive primary systemic ALCL are known to have better overall survival than those with ALK-negative ALCL. We herein report a case of primary gastric ALK-positive anaplastic large-cell lymphoma. A 37-year-old woman presented with postprandial epigastric pain for 2 months. Endoscopic examination of the upper gastrointestinal tract showed multiple variably sized, round, elevated lesions with friable crater-erosion on the body and fundus. Pathologic examination revealed atypical large lymphoid cell infiltration in the lamina propria; the cells were positive for CD3, CD30, and ALK. We diagnosed the patient with ALCL. She underwent a cycle of chemotherapy with cyclophosphamide, adriamycin, vincristine, and prednisolone. However, she developed brain metastases. Despite two cycles of palliative chemotherapy with high-dose methotrexate for brain metastases, she died due to ALCL progression.

A Case of Multiple Pulmonary Nodular Pneumocystis jirovecii Pneumonia in an Acquired Immune Deficiency Syndrome Patient / 감염과화학요법

Pneumocystis jirovecii pneumonia (PCP) is a frequent manifestation of Acquired Immune Deficiency Syndrome (AIDS). The classic chest radiographic finding is perihilar ground glass opacities that may progress to more diffuse lung involvement. Atypical radiographic appearances include a normal chest film, lobar or segmental consolidation, cystic lesions, cavitation, pneumothorax, pleural effusion, and solitary or multiple pulmonary nodules. Although PCP is common in AIDS, presenting with nodular pulmonary densities is rare. We encountered the case of a 33-year-old man with AIDS whose chest radiography showed multiple bilateral nodular patterns suggestive of malignancy. We performed a transcutaneous lung biopsy and diagnosed him with PCP by Gomori methenamine-silver staining. Along with fungal and mycobacterial infections, intrathoracic Kaposi's sarcoma, and lymphoma, PCP should be considered in the differential diagnosis of nodular pulmonary disease in AIDS patients.

A Case of Pseudomembranous Tracheobronchitis Complicated by Coinfection of 2009 Pandemic Influenza A/H1N1 and Staphylococcus aureus / 감염과화학요법

An influenza pandemic due to a novel influenza A/H1N1 virus occurred after April 2009. This virus has some characteristics that differentiate it from the seasonal influenza virus. The 2009 pandemic influenza A/H1N1 virus can frequently infect the lower respiratory tract, and it might cause acute tracheobronchitis as well as pneumonia. Viral-bacterial interaction is well known as an important mechanism of the pathogenesis of respiratory complications of influenza. Herein, we report on a case that presented with pseudomembranous tracheobronchitis complicated by coinfection with 2009 pandemic influenza A/H1N1 and Staphylococcus aureus. We also review the relevent literature.

Diagnosis of a Transverse Colon Penetration and Tube Displacement 4 Months after Percutaneous Radiologic Gastrostomy / 대한소화기내시경학회지

Percutaneous radiologic gastrostomy (PRG) is an enteral nutritional method that can be applied to a patient with dysphagia due to cerebrovascular accident, Parkinsonism, dementia, or head and neck cancer. PRG is a safe and cost-effective method with low morbidity and mortality rates compared with surgical gastrostomy, because it require less sedation and less invasive placement technique. PRG complications include wound infections, peritonitis, tube malfunctions, peristomal leakage, bleeding, ileus, pneumoperitoneum, aspiration pneumonia, and bowel perforation. But, bowel perforation after PRG is rare. We recently experienced a case of transverse colon penetration and tube displacement, which occurred as a PRG complication in a 60-year-old male with a cerebrovascular accident.