Giant Splenic Artery Pseudoaneurysm Presenting with Acute Kidney Injury / 대한내과학회지

Splenic artery pseudoaneurysm is a rare, but potentially lethal, vascular lesion. The mortality rate may be 75-90%, if the aneurysm ruptures. The risk for rupture of an untreated splenic artery pseudoaneurysm is about 37%. Hence, early diagnosis and prompt surgical intervention are vital to improve survival. However, vague symptoms make early diagnosis difficult. We report here a case of a giant splenic artery pseudoaneurysm presenting with acute kidney injury. The patient had been treated previously for infective endocarditis, and after 4 months, acute kidney injury developed. Imaging studies revealed a giant splenic artery pseudoaneurysm. Splenectomy and distal pancreatectomy were performed. After surgery, renal function was improved.

Giant Splenic Artery Pseudoaneurysm Presenting with Acute Kidney Injury / 대한내과학회지

Splenic artery pseudoaneurysm is a rare, but potentially lethal, vascular lesion. The mortality rate may be 75-90%, if the aneurysm ruptures. The risk for rupture of an untreated splenic artery pseudoaneurysm is about 37%. Hence, early diagnosis and prompt surgical intervention are vital to improve survival. However, vague symptoms make early diagnosis difficult. We report here a case of a giant splenic artery pseudoaneurysm presenting with acute kidney injury. The patient had been treated previously for infective endocarditis, and after 4 months, acute kidney injury developed. Imaging studies revealed a giant splenic artery pseudoaneurysm. Splenectomy and distal pancreatectomy were performed. After surgery, renal function was improved.

A Case of Non-Small Cell Lung Cancer in a Respiratory Bronchiolitis Associated Interstitial Lung Disease Patient / 결핵및호흡기질환

Respiratory bronchiolitis-associated interstitial lung disease is one of the smoking-related interstitial lung diseases. Histopathologically, it shows respiratory bronchiolitis, which is characterized by the accumulation of pigmented macrophages within the respiratory bronchioles, accompanying peribronchiolar inflammation. Clinically, it is presented with respiratory symptoms such as a cough, sputum and dyspnea on exertion. It is well known that the incidence of malignancy in interstitial lung disease is high, but in respiratory bronchiolitis-associated interstitial lung disease the report of accompanying malignancy is rare. Here we report a case of a 60-year-old male heavy smoker presented with a cough, sputum and clubbing finger. A chest computed tomography (CT) of the patient did not show any shadow suspected of malignancy, but adenocarcinoma was found on a transbronchial lung biopsy and on a surgical lung biopsy with respiratory bronchiolitis-associated interstitial lung disease.

A Case of Cap Polyposis Complicated with Idiopathic Retroperitoneal Fibrosis / 대한소화기학회지

An optimal treatment for cap polyposis has not been established. Several treatment approaches, including anti-inflammatory agents, antibiotics, immunomodulators, and endoscopic therapy have been described. Surgical resection of the affected colon and rectum may be indicated for patients with persistent disease. Repeat surgery is indicated in cases of recurrence after surgery. However, symptomatic polyposis may still recur, and spontaneous resolution of cap polyposis is possible. We report a case of recurrent cap polyposis complicated with retroperitoneal fibrosis after inadequate low anterior resection with a positive resection margin. Surgical approaches for the treatment of cap polyposis should be carefully considered before treatment.

A Case of Interstitial Pneumonitis with Acute Live Injury Caused by Herbal Medicine Made from Golden Thread / 결핵및호흡기질환

So far more than 350 drugs have been reported to be the cause for lung injury and the incidence tends to increase. Although infiltrative lung disease is the most common pattern of drug-induced lung injury, it can appear in the form of alveolar changes, vasculitis and other injury. Herbal medicine also has been known as a cause for interstitial pneumonitis, but it is difficult to identify the key herbal medicine because of the complex components of the contents. Till date, there is no report of pneumonitis caused by golden thread. Here we report a case of a 54-year-old male who developed interstitial pneumonitis with acute liver injury caused by herbal medicine made from golden thread.