Behçet’s Disease Initially Presenting as a Macular Hole with Exudative Retinal Detachment

Purpose@#To report a case of Behçet’s disease presenting as a macular hole with exudative retinal detachment and an examination of its mechanism.Case summary: A 19-year-old woman presented with decreased visual acuity in her right eye for a month. The visual acuity of the right eye was finger count. Inflammation was evident in the anterior chamber cells and vitreous. Optical coherence tomography revealed a macular hole with retinal detachment. Retinal vasculitis was observed in fluorescein angiography imagery. Vasculitis was well controlled with administration of 1 mg per kg oral prednisolone. Vitrectomy and internal limiting membrane (ILM) peeling were performed with ILM flap creation. The macular hole was closed after the surgery. Behçet’s disease was diagnosed based on a manifestation of genital and oral ulcers during tapering of prednisolone. Subcutaneous adalimumab has been used to control uveitis due to repeated relapse. @*Conclusions@#This is a case of Behçet’s disease initially presenting as macular hole retinal detachment. Uveitis such as that occurring with Behçet’s disease should be considered if the macular hole retinal detachment is noticed in a young patient without posterior staphyloma.

Behçet’s Disease Initially Presenting as a Macular Hole with Exudative Retinal Detachment

Purpose@#To report a case of Behçet’s disease presenting as a macular hole with exudative retinal detachment and an examination of its mechanism.Case summary: A 19-year-old woman presented with decreased visual acuity in her right eye for a month. The visual acuity of the right eye was finger count. Inflammation was evident in the anterior chamber cells and vitreous. Optical coherence tomography revealed a macular hole with retinal detachment. Retinal vasculitis was observed in fluorescein angiography imagery. Vasculitis was well controlled with administration of 1 mg per kg oral prednisolone. Vitrectomy and internal limiting membrane (ILM) peeling were performed with ILM flap creation. The macular hole was closed after the surgery. Behçet’s disease was diagnosed based on a manifestation of genital and oral ulcers during tapering of prednisolone. Subcutaneous adalimumab has been used to control uveitis due to repeated relapse. @*Conclusions@#This is a case of Behçet’s disease initially presenting as macular hole retinal detachment. Uveitis such as that occurring with Behçet’s disease should be considered if the macular hole retinal detachment is noticed in a young patient without posterior staphyloma.

Endoscopic Drainage Through a Duodenal Fistula in a Patient with a Retroperitoneal Abscess that Developed after Acute Pancreatitis / 대한소화기내시경학회지

The incidence of retroperitoneal abscess with fistula formation after acute pancreatitis is rare, but the mortality rate for patients with this condition is very high. The standard treatment for this condition has been surgical removal and drainage. However, recent studies have shown that percutaneous catheter drainage or noninvasive endoscopic abscess drainage with using endoscopic ultrasonography is effective and safe for the treatment of pancreatic and peripancreatic abscess. A retroperitoneal abscess with duodenal fistula that developed after acute pancreas and its endoscopic treatment has never been reported on in Korea. We experienced a 45-year-old man who had been treated for acute pancreatitis at other hospital, and he was then referred to our hospital and diagnosed as having a retroperitoneal abscess with fistula, which communicated with the third portion of duodenum, as assessed by abdominal CT and duodenoscopy. So we treated him with endoscopic double-pigtailed stent insertion through the fistulous tract and we drained the abscess. Endoscopic drainage may be a suitable alternative for the management of the retroperitoneal abscess with fistula that develops after acute pancreatitis.

A Case of Leriche Syndrome Manifested by Anuria / 대한신장학회잡지

Leriche syndrome is an aortoiliac occlusive disease. The aortoiliac junction is the most common sites of chronic obliterative atherosclerosis. Leriche syndrome has a variety of clinical symptoms attributed to the obstruction of the infrarenal aorta. Common clinical symptoms include thigh, hip, and buttock claudication as well as erectile impotence, usually in association with diminished femoral pulses. But acute anuric renal failure as first manifestation of Leriche syndrome is very uncommon. Contrast-enhanced 3D MRA appears to be well suited for assessment of patients with suspected Leriche syndrome. We report a 75-year-old man who presents anuria as first manifestation of Leriche syndrome.