A Case of Gastritis Cystica Polyposa Presenting as a Hyperplastic Polyp / 대한내과학회지

Gastritis cystica polyposa (GCP) is a rare lesion characterized by hyperplastic and cystic dilatation of the gastric mucosal glands infiltrating into the underlying submucosa. In most cases, it develops in patients who have undergone a gastroenterectomy, but can occasionally be found in an unoperated stomach. GCP may present as a submucosal tumor or polyp, and rarely as a giant gastric mucosal fold. We experienced a case of GCP that presented as a hyperplastic polyp, and it was unrelated to any gastric surgery. Upper endoscopy revealed the presence of a subpedunculated polyp in the posterior wall of the antrum. The lesion was successfully removed by endoscopic mucosal resection and diagnosed as a GCP.

A Case of Malignant Duodenocolic Fistula Treated with Covered Metallic Stents / 대한소화기내시경학회지

Malignant duodenocolic fistula is a rare complication of colon cancer, and this usually develops as the right-side colon cancer that invades the duodenal bulb. The fistula often results in watery diarrhea, weight loss and feculent vomiting. A barium enema or duodenography have been the most useful diagnostic procedures, and the fistula is directly confirmed by an endoscopic examination. Curative resection is not possible in many cases due to metastasis or local invasion, so a palliative operation can be performed to relieve symptoms, but it cannot completely prevent the vomiting or diarrhea. Seven Korean cases of malignant duodenocolic fistula have been previously reported on, and an operation was performed in six cases. We report here on a case of duodenocolic fistula with intestinal obstruction that arouse from a right-side colon cancer, and this was successfully managed by placing covered metallic stents at the duodenum and hepatic flexure.

A Case of Endoscopic Removal of a Broken off Gastric Balloon from a Sengstaken-Blakemore Tube / 대한소화기내시경학회지

A Sengstaken-Blakemore (S-B) tube, when used approximately, still has a place in the management of acute variceal bleeding, and controls bleeding in 40~90% of the cases. However its use is accompanied by number of complications such as esophageal ulcer, pulmonary aspiration, and malfunction of the tube, which requires replacement. We recently observed a very unusual complication: the remaining gastric balloon of a S-B tube was broken off in the fundus of stomach by the patient's traction. The gastric balloon was easily and safely removed using an endoscopic snare after deflating the gastric balloon with a needle puncture.

Undifferentiated Adenocarcinoma of the Colon with Rhabdoid Features / 대한소화기내시경학회지

Malignant rhabdoid tumors were first described in 1978 by Beckwith and Palmer as a rare variant of Wilms' tumors with a "rhabdomyosarcomatoid" pattern and a particularly poor prognosis. Week reclassified this disease as a distinct disease in 1989 and thereafter, there have been several reports about malignant rhabdoid tumor that occurred in various organs, including the colon. The histologic characteristics of rhabdoid tumor are noncohesive or loosely cohesive cells with high cellularity, an eccentric large nucleus and eosinophilic cytoplasm, and the cytoplasm is usually positive for vimentin and it contain hyaline inclusions. On immunohistochemical staining, the cells are usually positive for vimentin and cytokeratin and they are negative for desmin. This tumor progresses rapidly and it has a very poor prognosis, but survival is better if there is no lymphatic or distant metastasis. We experienced a patient who suffered with undifferentiated adenocarcinoma with rhabdoid features in the ascending colon.

Effect of the G-CSF schedule for harvesting peripheral blood progenitor cells from healthy donors / 대한내과학회지

BACKGROUND/AIMS: Peripheral blood progenitor cells (PBSC) have been used instead of bone marrow cells for allogeneic transplantation. Progenitor cells are mobilized using granulocyte colony stimulating factor (G-CSF). Kinetic studies of G-CSF have shown that the CD34+ cells peak on day 5, although the optimal time for harvesting has not been established. METHODS: We compared two mobilization schedules using G-CSF. In groups I and II, G-CSF 10 microgram/kg/day was administered subcutaneously for 3 or 4 days, respectively, and leukapheresis was performed the next day. RESULTS: In groups I and II, a respective mean number of 5.84 x 106 and 10.76 x 106 circulating CD34+ cells per kilogram of the recipient's weight was collected by leukapheresis. The yield of the two collections did not differ significantly (p=0.386). CONCLUSION: This study suggested that the two mobilization schedules are equally effective. To avoid prolonged exposure to G-CSF, the day 4 collection schedule is the preferred mobilization strategy.

A Case of Eosinophilic Gastroenteritis in a Patient with Traumatic Hypopituitarism / 대한소화기내시경학회지

Eosinophilic gastroenteritis is a rare gastrointestinal disorder that can present with a variety of symptoms such as abdominal pain, vomiting, diarrhea and ascites. It is characterized by eosinophilic infiltration of the gastrointestinal wall. Its incidence has increased recently. However, the etiology and pathogenesis of this disease are not well understood. The relationship between hypopituitarism and eosinophilic gastroenteritis is unclear. A corticotropin deficiency and eosinophilia are observed in approximately 90% of traumatic hypopituitarism. We encountered a case of eosinophilic gastroenteritis with eosinophilic ascites in a patient with traumatic hypopituitarism including central diabetes incipidus. Abdominal computed tomography showed diffuse wall thickening of the esophagus, stomach and small bowel with a large amount of ascites. Cytologic examination of ascites showed heavy dense infiltration of eosinophils. The patient was treated with corticosteroid and responded rapidly. Two months later, she was admitted again with a relapse of symptoms. We report this case with a brief review of the relevant literature.

A Case of Single Fetal Death in Twin Pregnancy / 대한산부인과학회잡지

The antepartum death of one fetus in twin pregnancy is a rare obstetric complcation. If one fetus in twin pregnancy died in uterus remote from term and another fetus did not, the dead fetus will be compressed between the uterine wall and the membrane of living fetus, becomes a fetus compressus or fetus papyraceous. The primary maternal threat when the fetuses undelivered is disseminated intravascular coagulation. Concern for the surviving fetus after death of its co-twin is balanced between the risks of preterm birth and those involving exposure to events in utero that may threaten its well-being. Recently we experienced a case of twin pregnancy complicated by the death of one fe- tus, we report this case with concerned literatures.

A Case of Heterotopic Pregnancy / 대한산부인과학회잡지

Heterotopic pregnancy describes the rare coexistence of intrauterine and extrauterine gestations. The commonly accepted incidence is 1:30,000 but the actual number is significantly higher. This condition remains difficult to diagnose and potentially dangerous to both mot- her and fetus. The incidence has risen after wider use of ovulation induction and the adve- nt of techniques of assisted reproduction. We report a case of simultaneous intrauterine pregnancy and tubal pregnancy.