Risk Factors for Retinopathy of Prematurity Requiring Laser Treatment in Preterm Infants Born Before 28 Weeks of Gestation

PURPOSE: To investigate the risk factors for retinopathy of prematurity (ROP) requiring laser treatment in preterm infants born before a gestational age (GA) of 28 weeks. METHODS: This was a single-institution retrospective case-control study of high-risk preterm infants (GA ≤28 weeks) with ROP who were, born between January 2008 and December 2016. Patients who underwent laser treatment for severe ROP were enrolled. Infants in the control group were matched to preterm infants with a similar GA and mild ROP who, did not require laser treatment. Various prenatal and postnatal risk factors were compared between the two groups. RESULTS: One hundred and twenty-two infants were included in this study (61 cases and 61 controls). The average birth weight was similar between the two groups (895.2±172.9 g vs. 938.5±168.0 g, P=0.164). There was no significant difference in the duration of invasive ventilation; however, the duration of noninvasive mechanical ventilation was significantly longer in patients (with ROP) who underwent laser treatment (P=0.036). The proportion of infants at a postnatal age of 28 days who were receiving oxygen treatment was significantly higher (60/61 [98.4%] vs. 51/61 [83.6%], P=0.004) in the severe ROP group. However, the rates of oxygen treatment for infants with a GA of 36 weeks were not significantly different (59%, for both groups). Other prematurity-associated morbidities were similar between the two groups. CONCLUSION: Altogether, a judicious reduction of oxygen therapy might reduce the incidence of laser treatment. Early diagnosis and treatment through periodic ophthalmologic examination are necessary in preterm infants receiving oxygen treatment at 28 days after birth.

A Case of Endovascular Stent Grafting for an Aortoesophageal Fistula / 대한내과학회지

An aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. The standard treatment of an aortoesophageal fistula is surgical, because conservative management results in very high mortality. Nevertheless, the mortality related to the surgical treatment ranges from 30 to 60%. Recently, endovascular stent grafting has become an alternative to open surgery in selected patients. We report an aortoesophageal fistula treated with endovascular stent grafting in an 84-year-old female with hematemesis and abdominal pain. Endoscopy showed a 5-cm pulsating esophageal mass with central ulceration and bleeding. Computed tomography (CT) of the abdomen revealed a descending thoracic aortic pseudoaneurysm. Being at high risk in open thoracic surgery, she underwent endovascular stenting. We suggest that endovascular stent grafting is an alternative treatment of aortoesophageal fistula, instead of open surgery, in selected patients.

A Case of Postpolypectomy Coagulation Syndrome Had a Hemicolectomy / 대한소화기내시경학회지

Colonoscopy is commonly used as a screening tool for colorectal polyps and cancer. It also offers a chance to remove polyps via the polypectomy technique. Colonoscopic polypectomy is a relatively safe procedure, yet there is the possibility of serious complications such as perforation and bleeding. Postpolypectomy coagulation syndrome presents with pain, fever, an elevated white blood cell count and signs of peritoneal irritation, and usually within 12 hours of the procedure. No free air is seen on plain films or a CT scan, which is different from frank bowel perforation. The management of postpolypectomy coagulation syndrome includes fasting, antibiotics and intravenous hydration. We report here on a case of a 53-year-old woman who underwent right hemicolectomy because she presented with fever, signs of peritoneal irritation and shock after colonoscopic polypectomy. The final diagnosis was postpolypectomy coagulation syndrome as there was no perforation in the resected specimen.

A Case of Tracheal Capillary Hemangioma in an Adult / 결핵및호흡기질환

Capillary hemangioma of the trachea is an extremely rare benign tumor in adults. We present the case of a 28-year-old woman with hemoptysis owing to a tumor of the proximal trachea. The tumor was removed by rigid bronchoscopy. The resulting specimens showed capillary hemangioma without any signs of malignant transformation. This presentation is the first case in Korea. Although tracheal capillary hemangioma is a rare disease, we should consider it as a possible cause of hemoptysis in the young adult.

Endoscopic Removal of an Impacted Fishhook That Was in the Esophagus for Two Months / 대한소화기내시경학회지

An esophageal foreign body has clinical significance because it may cause serious complications such as esophageal perforation, mediastinitis and/or aorto-esophageal fistula. A prompt attempt to remove an esophageal foreign body via flexible endoscopy should be made when the shape of the foreign body is especially sharp and long as it can easily lead to esophageal perforation. We report here on a case of endoscopic removal of an impacted esophageal foreign body, a fishhook, that hade been present in the esophagus for two months, and there were no serious complications from the procedure.