Aneurysm of the inferobasal wall and ventricular septal rupture complicated with inferior myocardial infarction / 대한내과학회지

The incidence of left ventricular aneurysm following acute myocardial infarction is 5 to 10 percent. Eighty % of aneurysms involve the anteroapical wall of the left ventricle: They are four times more frequent in this wall than in the inferior or posterior wall. Anterior myocardial infarction causes aneurysm in the anteroapical wall of the left ventricle, while inferior myocardial infarction causes aneurysm in the posterobasal wall of the left ventricle. Yet the aneurysmal complications in the interventricular septum after myocardial infarction are very rare. A 74-year-old woman with inferior myocardial infarction presented with both an aneurysm of the inferobasal wall and a ventricular septal rupture, and these were detected by two-dimensional and Doppler echocardiography. The aneurysm originated from the inferobasal portion of the left ventricular wall. The short-axis view of the two-dimensional echocardiography revealed an abrupt discontinuity of the junctional area of the inferoseptum and the inferior segment, and a large aneurysm at the inferior portion of the left ventricular cavity. The communication orifice was 4 cm wide. Color Doppler echocardiography showed a left-to-right shunt flow from the aneurysm to the right ventricle. We report here on a case of an aneurysm of the inferobasal wall and a ventricular septal rupture, and these lesions were detected by two-dimensional and Doppler echocardiography.

Two Cases of Ectopic Gallstones Treated by Endoscopic Therapy / 대한소화기내시경학회지

Two cases are herein reported involving patients with ectopic gallstones which were discharged into the stomach and duodenum through a cholecystoduodenal fistula and successfully removed by endoscopic therapy. In the first case, a 75-year-old man was admitted with epigastric pain. Simple abdomen film demonstrated a round laminated calcification and air biliarygram in the RUQ. Endoscopic examination revealed a fistula on the posterior wall of the duodenal bulb and a brown stone (about 5 cm in diameter) was found in the second portion of the duodenum, It was demolished through endoscopic electrohydraulic lithotripsy (EEH1) and discharged with the stool. In the second case, a 55-year-old man was admitted with epigastric pain. A CT scan revealed an ovoid laminated calcification in the dependent portion of the stomach. Endoscopic examination revealed a fistula on the anterior wa11 of' the duodenal bulb and a black pigmented stone (about 2.5 cm in diameter) was found in the stomach. This stone was removed orally by an endoscopic snare. These patients were discharged and remained asymptomatic.