Portal and Splenic Vein Thrombosis Successfully Treated with Anticoagulants in Acute Pancreatitis / 이화의대지

Splanchnic vein thrombosis arising from complications of acute pancreatitis is very rare. It usually occurs as a form of portal, splenic and superior mesenteric vein thrombosis, either in combination or separately. It could develop portal hypertension, bowel ischemia and gastrointestinal variceal bleeding. Treatment of splanchnic vein thrombosis includes anticoagulants, thrombolysis, insertion of shunts, bypass surgery and liver transplantation. In some cases, anticoagulation therapy may be considered to prevent complications. However, the standard protocol for anticoagulation in splanchnic vein thrombosis has not been determined yet. We report a case of 43-year-old man who had portal and splenic vein thrombosis in acute pancreatitis. The patient was successfully treated with oral anticoagulants following low molecular weight heparin therapy.

Surgical Correction of Whistle Deformity Using Cross-Muscle Flap in Secondary Cleft Lip

BACKGROUND: The whistle deformity is one of the common sequelae of secondary cleft lip deformities. Santos reported using a crossed-denuded flap for primary cleft lip repair to prevent a vermilion notching. The authors modified this technique to correct the whistle deformity, calling their version the cross-muscle flap. METHODS: From May 2005 to January 2011, 14 secondary unilateral cleft lip patients were treated. All suffered from a whistle deformity, which is characterized by the deficiency of the central tubercle, notching in the upper lip, and bulging on the lateral segment. The mean age of the patients was 13.8 years and the mean follow-up period was 21.8 weeks. After elevation from the lateral vermilion and medial tubercle, two muscle flaps were crossed and turned over. The authors measured the three vertical heights and compared the two height ratios before and after surgery for evaluation of the postoperative results. RESULTS: None of the patients had any notable complications and the whistle deformity was corrected in all cases. The vertical height ratios at the midline on the upper lip and the affected Cupid's bow point were increased (P<0.05). The motion of the upper lip was acceptable. CONCLUSIONS: A cross muscle flap is simple and it leaves a minimal scar on the lip. We were able to reconstruct the whistle deformity in secondary unilateral cleft lip patients with a single state procedure using a cross-muscle flap.

A Case of Ectopic Sebaceous Glands in the Esophagus

Most ectopic sebaceous glands have been reported in the organs of ectodermal origin such as the lips, oral cavity, salivary glands, nipples, palms & soles, and genitals. Ectopic sebaceous glands in the esophagus are extremely rare conditions, because esophagus is an organ of endodermal origin. Whether the histogenesis of these lesions are embryological misplacement or acquired metaplasia remains unclear. We report a case of ectopic sebaceous glands in the esophagus diagnosed by endoscopic biopsy, with a brief review of the histogenesis. This case was followed up after 1 year. There were no significant changes, but the lesions had increased slightly in number compared with the last examination. When the number of lesions increase as in our case, acquired metaplasia is the most likely cause.

A Case of Ectopic Sebaceous Glands in the Esophagus

Most ectopic sebaceous glands have been reported in the organs of ectodermal origin such as the lips, oral cavity, salivary glands, nipples, palms & soles, and genitals. Ectopic sebaceous glands in the esophagus are extremely rare conditions, because esophagus is an organ of endodermal origin. Whether the histogenesis of these lesions are embryological misplacement or acquired metaplasia remains unclear. We report a case of ectopic sebaceous glands in the esophagus diagnosed by endoscopic biopsy, with a brief review of the histogenesis. This case was followed up after 1 year. There were no significant changes, but the lesions had increased slightly in number compared with the last examination. When the number of lesions increase as in our case, acquired metaplasia is the most likely cause.

The Effect of Nasal Packing with Rolled Silastic Sheet after Closed Reduction of Nasal Bone Fracture

PURPOSE: Nasal bone fracture is the most common type of facial bone fracture and most of nasal bone fracture is combined with septal fracture frequently. Nasal septum is important to support the distal nose and to maintain the nasal airway. But nasal septal fractures are usually unrecognized and untreated at the time of operation. Recently, various materials were using for nasal packing after closed reduction, however these materials are not focused on the correction of nasal bone and nasal septal fracture and many patients are suffered from nasal packing materials. Thus, the purpose of this study is to compare routine packing materials and rolled silastic sheet with respect to postoperative effect of correction of nasal bone fracture and discomfort of nasal packing materials. METHODS: We examined 320 patients treated nasal bone fracture from January 2008 to December 2010. For Group I(n=92), Merocel(R) was used for nasal packing, for Group II(n=152) vaseline gauze was used, and Rolled silastic sheet(RSS) with vaseline gauze packing(VGP) was used for Group III(n=76). Under the general anesthesia, all patients were operated by closed reduction and nasal packing was done using three kinds of packing materials. At the time of postoperative 7 days, packing material was removed and studied for pt's satisfaction and postop. complications. RESULTS: In patients with RSS with VGP, the complaints (nasal obstruction, foreign compressive sensation and discomfort during food ingestion) of keeping the nasal packing were decreased(p0.05). CONCLUSION: Postoperative nasal packing with RSS with VGP was more comfortable to the patients and it was more effective method to correct the nasal bone fracture and nasal septal fracture.