Appendiceal Mucocele

PURPOSE: An appendiceal mucocele refers to an abnormal dilatation of the appendiceal lumen by mucus. It is a rare clinical entity with a reported prevalence rate of 0.2~0.3% of all appendectomies. The purpose of our study was to identify the clinical characteristics of and the proper surgical management for appendiceal mucoceles. METHODS: The hospital records of 24 eligible patients were reviewed. We analyzed demographic data, and pathological and clinical data. RESULTS: There was a significant difference in size (P<0.009) between simple mucoceles (mean, 1.95 cm) and cystadenomas (mean, 3.6 cm). While ultrasonography was the most commonly used test to establish the diagnosis (14 patients), computed tomography and colonoscopy also provided fundamental information in 5 and 2 patients, respectively. An appendectomy was performed in most cases (20 cases, 83%). A cecectomy was performed in 3 cases, and an ileocecal resection was performed in only one case. Among the cases requiring a cecectomy, a laparoscopic cecectomy was performed in one case. A synchronous tumor was present in 5 cases. Three patients had gastric cancer, 1 patient had gallbladder cancer, the other one had endometriosis. CONCLUSIONS: Our study shows that appendiceal mucoceles most frequently present as acute appendicitis and that preoperative diagnosis is difficult to make. All mucoceles should probably be removed to eliminate the chance of progression to malignancy. Also of note was the elevated incidence of associated neoplasms, especially gastrointestinal carcinomas. Some recommend surveillance colonoscopy in patients with a diagnosis of an appendiceal mucocele. We had three cases accompanied by gastric malignancy. Therefore, we suggest that surveillance gastrofiberscopy may be indicated.

Two Cases of Unilateral Transient Sialoadenopathy after Gastroscopy / 대한소화기내시경학회지

A case was experienced involving submandibular salivary gland swelling (sialoadenopathy), developing after gastroscopy in a 15-year-old female who was suffering from epigastric pain & diarrhea and a case of parotid salivary gland swelling after gastroscopy in a 25-year-old female who was suffering from dyspepsia and epigastric pain. Both patients were the first two cases among about 5,000 gastroscopic examinations of the stomach conducted by the authors. As soon as the gastroscope was withdrawn, unilateral swelling, which was neither painful nor tender, was found in the left submandibular salivary gland area. This swelling disappeared spontaneously in about few hours later.

A Case of Trichosporon beigelii Esophagitis Presenting Hematemesis with a Large Amorphous Material / 대한소아소화기영양학회지

We experienced a case of Trichosporon beigelii esophagitis in a 16-month-old boy who was presented with hematemesis with a large amorphous material. A spit-out material was silky, 10 x 1.2 cm in size and like a part of hollow viscus organ. Emergent gastrofiberscopy revealed that this silky material was teared up from upper and to lower esophagus and was threw with hematemesis. It was suggested that pseudomembrane on esophagus was peeled off followed by mucosal bleeding. Pathologic study revealed this material was pseudomembrane with esophageal mucosa of T. beigelii esophagitis and was teared at lamina propria level from submucosa.

A Case of Secondary Hemochromatosis Revealed in Gastrofiberscopy / 대한소화기내시경학회지

A patient who underwent a transfusion due to an aplastic anemia subsequently experienced secondary hemochromatosis, which is very rare in Korea. The 56 year old female was admitted to our hospital with complaints of general weakness, fatigue, a brown-colored facial complexion, dyspnea upon exertion, and abdominal distension. Laboratory examination disclosed functional impairment of the liver and echocardiography revealed a congestive heart failure pattern. Gastrofiberscopy revealed brown colored gastric mucosa, and a fundal mucosa biopsy revealed a hemosidt pigment in iron stain.

Mass Screening for Stomach Cancer by Gastrofiberscopy in 1865 Employees of a Car Manufacturing Company / 대한소화기내시경학회지

Background: Stomach cancer is the most commonly diagnosed malignant tumor in Korea. Early detection by mass screening very important to increase survival rate of stomach cancer, because the prognosis of early gastric cancer is excellent, and specific symptoms and physical findings are rare with early gastric cancer. Methed: 1865 car manufacturing company employees were examinined by gastrofiberscopy at a dispensary of the company from May 6, l992 to July 13, 1992. Results: 1. Number of cases with normal finding was 1262(67.7%), gastritis 422(22.6%), gastric ulcer 47(2.5%), gasrtric cancer 4(0.2%), duodenitis 39(2.1%), duodenal ulcer 63(3.4%), combined ulcer(gastric & duodenal) 2(0.1%,), post operative state 6(0.3%), and others 4(0.3%) in total 1865 examinees. 2. Of 422 cases with gastritis, cases with superficial gastritis were 171 (9.2%), atrophic gastritis 138(7.4%), erosive gastritis 94(5.0%) and hemorrhagic gastritis 19(1.0%). 3. Of 4 cases with stomach cancer, 1 case was advanced stomach cancer and 3 cases were early gastric cancer(two cases of IIc and one case of IIc+III) by macroscopic classification. Conclusion: Mass screening provides an excellent opportunity to detect gastric cancer in populations without symytoms or with nonspecific symptoms. It should be recommended to undergo screening exam for high risk group of stomach cancer.

The gastrofiberscopic findings in pediatric patients

We observed 240 cases ranging in age from 3 months to 15 years seen by gastrofiberoscopy in the department of pediatrics of Seoul Red Cross Hospital from March 1990 to October 1992 and following results were obtained. 1) The male to female ratios in total cases and in 89 patients complaining of abdominal pain for more than one month were 0.94:1 and 1.02:1 respectively. The most prevalent age group was 10~12 years in both groups. 2) The indication in the order of frequency were chronic abdominal pain (37.1%), acute abdominal pain (32.5%), vomiting (7.9%), hematemesis and melena (5.4%), follow-up study (6.3%), further evaluation (3.8%), chest discomfort (2.5%), foreign body removal (2.1%), nausea (1.2%), dysphagia (0.8%) and abdominal mass (0.4%). 3) The common endoscopic findings in the 225 cases excluding follow-up ones were gastritis (34.7%), duodenitis (14.2%), ulcer (11.6%), esophagitis (7.6%) and foreign body (2.2%). 4) The common endoscopic findings in cases of chronic abdominal pain were gastritis (42.7%), duodenitis (16.9%) and ulcer (7.9%). 5) There was no complication except mild sore throat.

Gastrofiberscopic findings and helicobacter pylori gastritis in children with recurrent abdominal pain

No abstract available.