A Case of the Duodenal Bulb Abscess / 대한소화기내시경학회지

Duodenal abscess is a rarely reported disease throughout the entire world. Duodenal abscesses are developed mostly from the complication of duodenal ulcer perforation, and only small percentage of duodenal abscesses are the result of cholecysto-duodenal fistula which was made by gall bladder perforation. We report a 84-year-old male patient who presented to the emergency department with severe anorexia and generalized weakness for 2 weeks. The upper gastrointestinal endoscopy done and revealed a protruding mass at the lesser curvature of the duodenal bulb. As soon as the mass was punched with a biopsy forceps, a large amount of abscess began to pour out into the intestinal lumen. Abdominal CT scan demonstrated the presence of an air-fluid level the in gall bladder and also abscess in the porta hepatitis which was located between the gall bladder and the duodenum. Because the patient refused any surgical intervention, we treated him conservatively with intravenous antibiotics. Patient's symptom of anorexia was slowly resolved, and patient was discharged 10 days later.

A Case of Enteritis Cystica Profunda in the Duodenal Bulb / 대한소화기내시경학회지

Enteritis cystica profunda (ECP) is characterized by mucin-filled cystic spaces that are partially lined by non-neoplastic columnar epithelium, and these are found in the wall of the small bowel. This is a very rare disease compared to cystica profunda involving the stomach or colon. The cause of ECP is still unclear. Most ECP is related to or it may accompany other intestinal diseases. We encountered one case of ECP of the duodenal bulb that presented as polyp, and this was not related to adenocarcinoma or any other intestinal diseases like Crohn's disease or ulcerative colitis. Endoscopic polypectomy was done and the ECP was later confirmed through histological evaluation.