A Case of Crohn's Disease Isolated to the Appendix, Presented with Weight Loss / 대한소화기내시경학회지

Granulomatous appendicitis is a rare condition that accounts for less than 0.1~0.2% of all the cases of appendicitis. The great majority of cases are subacute or recurrent appendicitis and they are treated with interval appendectomy. The remaining causes include Yersinia infection, foreign body reaction, infection by mycobacteria, fungi or parasites, and Crohn's disease isolated to the appendix. Crohn's disease isolated to the appendix has several characteristics such as slow progression, a low recurrence rate and a good prognosis. Crohn's disease isolated to the appendix has recently been called "Idiopathic Granulomatous Appendicitis", and some authors have tried to distinguish it from Crohn's disease involving the appendix. We experienced a case of isolated appendiceal Crohn's disease in a 39-year-old woman and we report on it here along with a review of relevant literature.

A Case of an Anomalous Opening of the Common Bile Duct and Pancreatic Duct into the Duodenal Bulb, and the Patient Presented with Acute Cholangitis and Recurrent Duodenal Ulcer / 대한소화기내시경학회지

There are various congenital anomalies of the biliary system, but an ectopic opening of the common bile duct into the duodenal bulb is an extremely rare finding. Despite the recent improvement in the diagnosis and management of pancreatobiliary lesions, the general lack of knowledge and understanding about these variations is undoubtedly responsible for many of the problems that occur during the medical and surgical management of these lesions. We report here on a case of a 65-year-old man who had an ectopic opening of the common bile duct into the duodenal bulb, and this cause acute cholangitis with bile duct sludge, and also recurrent duodenal ulcer. In this case, we used abdomen CT, MRCP, duodenoscopy, EUS and ERCP for making the diagnosis. The cholangitis and duodenal ulcer was improved with medical therapy, and the patient was discharged without any surgical procedure. We report here on this unusual case and we include a review of the relevant medical literature.

A Case of Hypersensitivity Pneumonitis in an Automobile Paint Sprayer / 결핵및호흡기질환

Hypersensitivity pneumonitis (HP) is an immunologically-mediated disease resulting from repeated exposure to sensitizing agents, such as organic dusts or chemicals. Isocyanate is a volatile and highly reactive chemical that is extensively used in the manufacturing of automobiles, upholstery, and polyurethane foam. Occupational respiratory diseases associated with isocyanate, such as bronchial asthma, are well-known. It is thought that HP is one of the rare diseases induced by isocyanate with a very low frequency worldwide. We report a case of HP in an automobile painting sprayer which appeared to be associated with isocyanate.

Two Cases of Glioblastoma Multiforme in Children

Two cases of glioblastoma multiforme in children are reported. In one case, 2-year and 11 month-old female with the complaints of vomiting and the left hemiparesis for one month, the huge supra-Sylvian cystic tumor was associated with arteriovenous malformation originating from tumor and draining into the superior sagittal sinus. In the other case, 14-year-old male presenting seizure for 6 months, headache and the right hemiparesis for one month, the cystic frontal soft tumor infiltrated to the wall of the lateral ventricle. Wide internal decompression was performed as possible and pathologic reports were proved glioblastoma multiforme.