A Case of Primary Intestinal Lymphangiectasia Diagnosed by Double Balloon Enteroscopy

Primary intestinal lymphangiectasia is a congenital lymphatic disorder characterized by dilated intestinal lacteals resulting in lymph leakage into the small bowel lumen and responsible for protein losing enteropathy. As a result, generalized edema, hypoalbuminemia, and lymphocytopenia are clinically manifested. We could not find the reason by several examinations. Therefore, we performed double balloon enteroscopy (DBE), and intestnal lymphangiectasia was diagnosed histologically by a biopsy. DBE is a safe and effective method to diagnose small bowel lymphangiectasia. We report a case of primary intestinal lymphangiectasia, which occurred in a 54-year-old male patient with generalized edema and ascites.

Elevated hs-CRP in Patients with Stable Angina Pectoris / 대한내과학회지

BACKGROUND/AIMS: The association between inflammatory markers and the severity of coronary artery disease (CAD) in patients with stable angina pectoris remains controversial. This study explored the relationships between the serum high-sensitivity CRP (hs-CRP) level and severity of coronary atherosclerosis in patients with stable angina. METHODS: The study enrolled 377 stable angina patients (298 males, 79 females) undergoing coronary angiography from June 2006 to August 2010. Based on the coronary angiography results, they were divided into two groups according to the diameter of stenosis (DS): Group I (DS > or = 50%) and Group II (DS or = 3.0 mg/L versus low hs-CRP or = 50% coronary stenosis have higher hs-CRP levels than patients with < 50% coronary stenosis and stable angina. Further study is needed to define the role of hs-CRP in the progression of angina pectoris.

A Case of Intussusception Due to a Jejunal Gastrointestinal Stromal Tumor

Intussusception is seen often in children but relatively few cases occur in adults. In many cases, the etiology of intussusception in adults is a tumor, with adenocarcinoma being the most common tumor in the small intestine. Gastro-intestinal stromal tumor (GIST) is caused by a mutation of the interstitial cells of Cajal, which controls the speed of peristalsis by being involved in the autonomic innervation between the bowel wall and the smooth muscles of the gastrointestinal tract, and is rarely a factor in adult intussusception. We reported a case of a 74-year-old male patient who came to our hospital with hematochezia and was found to have jejunal intussusception from GIST.

A Case of Successful Conservative Treatment of Esophageal Perforation from Penetration of Esophageal Wall by a Fish Bone

A 71-year-old man with a history of percutaneous transluminal coronary angioplasty(PTCA) was referred to our clinic with a one-day history of a continuous substernal chest pain radiating to his left shoulder. In retrospect, he experien- ced chest discomfort after eating fish one day before but did not seek medical attention then. An upper gastrointestinal endoscopy was performed. The cause was not visible during the advancement of the endoscope through the eso- phagus, but a small segment of a fish bone protruding from an ulcerative lesion in the lower esophagus was iden- tified while withdrawing the endoscope. The fishbone was immediately removed. A follow-up CT scan revealed pneumo- mediastinum. Now hemodynamically stable, the patient underwent conservative medical treatment including total parenteral nutrition(TPN) and intravenous antibiotic drugs. The patient made complete recovery. We report a case of a 71- year-old male found to have an esophageal perforation from an ingested fish bone, which was managed successfully with conservative treatment. A pertinent literature review is also included.