Incidental Carcinoid of Appendix in Borderline Mucinous Ovarian Tumor / 대한산부인과학회잡지

A case with carcinoid tumor of the appendix was encountered incidentally during an elective abdominal surgery for borderline mucinous ovarian tumor in a 16-year old female. Carcinoid tumor of appendix is the most common neoplasm of the gastrointestinal tract in childhood and adolesence. They are usually regarded as a benign neoplasm and an uncommon source of metastasis and recurrence. We report this case with reference to the value of grosss examination of the appendix and incidental appendectomy during gynecologic abdominal operations.

A Case of Lipoleiomyoma / 대한산부인과학회잡지

Uterine lipoleiomyoma are rare benign tumors consisting of smooth muscle and mature adipose tissue. Because of their rarity, fat content, and variable gross morphology, they may be mistaken on radiodiagnosis for the much more common benign cystic ovarian teratoma. The key to differentiate these lesions is the identification of the organ of origin. A mass that arises from the uterus is most likely a lipomatous uterine tumors. Because malignant degeneration occurs in 1-2% of benign cystic ovarian teratomas, their differentiation can be clinically significant. While these tumors are treated by surgical excision, asymptomatic lipomatous uterine tumors and benign pelvic lipomas may require no therapy. The fatty nature of the lipoleiomyoma was demonstrated with standard spin-echo Magnetic resonance imaging (MRI) and further supported using fat- suprressed inversion recovery MRI. MRI also clearly depicted the intrauterine location of the tumor. We report a case in which a preoperative diagnosis of a uterine lipoleiomyoma was made with MRI and fat suppressed MRI.

A Case of Ovarian Leiomyoma accompanied with Ovarian Serous Adenofibroma / 대한산부인과학회잡지

Ovarian leiomyoma is a rare mesenchymal tumor, accounting for only 1% of all benign ovarian neoplasm. Most patients are asymptomatic and the tumors are usually found incidentally during operation or at autopsies. Ovarian adenofibroma is a rare benign tumor which originates from the germinal lining and the stroma of the ovary. This tumor may be solid, semisolid or cystic, depending on the relative amount of the epithelial and stromal component. We have experienced a case of ovarian leiomyoma accompanied with ovarian serous adenofibroma in a 42-year-old woman and report this case with a brief review of literature.

A Case of Incomplete Femoral Nerve Neuropathy after Total Abdominal Hystrectomy / 대한산부인과학회잡지

Total abdominal hystrectomy is the most common surgery of Gynecology. It's complication are taken very important. Although neuropathy, especially femoral nerve injury, is rare, recently we have experienced a case of femoral neuropathy after total abdominal hystrectomy. We present this case with a brief review of literature.

Efficacy of Blood Urea Nitrogen/Creatinine Ratio in Distinguishing Upper from Lower Gastrointestinal Bleeding / 대한소화기내시경학회지

BACKGROUND/AIMS: When stools containing altered blood are the sole evidence for acute gastrointestinal bleeding, the bleeding source is uncertain. Because the absorption of blood products via the small intestine is responsible for azotemia after gastrointestinal bleeding, patients with colorectal bleeding rarely become azotemic. Therefore the blood urea nitrogen to creatinine ratio (BUN/Cr ratio) is believed to reliably discriminate upper gastrointestinal bleeding (UGIB) from lower gastrointestinal bleeding (LGIB). This study was conducted to evaluate the BUN/Cr ratio for distinguishing an upper versus lower source of gastrointestinal bleeding. METHODS: Charts of patients who were admitted to Maryknoll hospital with the diagnosis of gastrointestinal bleeding from August 1994 to August 2000, were retrospectively reviewed for source of bleeding, initial blood urea nitrogen (BUN), creatinine (Cr), BUN/Cr ratio, hemoglobin, and hematocrit. RESULTS: A total of 298 patients were eligible for inclusion, 210 (70%) of whom were male. A total of 168 (56%) patients had an UGIB. Gastric ulcer disease (42%) and esophageal varices (27%) were the most common causes of UGIB, whereas malignant neoplasm was etiologic in 29% of LGIB episodes. The mean standard deviation BUN/Cr ratio was significantly higher in UGIB than LGIB (34.1+/-12.9 vs. 12.2+/-; p<01). CONCLUSIONS: The BUN/ Cr ratio may be a useful tool in distinguishing upper from lower sources of gastrointestinal bleeding, especially in patients with an uncertain source that could be upper or lower in origin.

A Case of Massive Upper Gastrointestinal Bleeding from a Duodenal Diverticulum / 대한소화기내시경학회지

Duodenal diverticulum is well-known pathologic entity. The incidence of duodenal diverticulum varies from 5% to 23% in the general population. Most of diverticula are asymptomatic and have been incidentally observed in upper gastrointestinal series or upper gastrointestinal endoscopy. It usually occurs in the second portion and the medial side of duodenum. The complications of duodenal diverticulum are rare but often result in significant morbidity. They include obstruction, cholelithiasis, ascending cholangitis, ulcers, hemorrhage and perforation. Major gastrointestinal hemorrhage resulting from an inflamed or ulcerated duodenal diverticulum is an uncommon event and it can be treated endoscopically. We report a case of massive upper gastrointestinal bleeding from a duodenal diverticulum which was treated endoscopically.