A Case of Choledochoduodenal Fistula due to Duodenal Ulcer / 대한소화기내시경학회지

Spontaneous internal biliary fistulas are not an uncommon complication of primary biliary disease. Almost 90% of the abnormal biliary-enteric communications between the gallbladder and the duodenum are caused by perforation via gallstones into an otherwise normal duodenum. However, biliary-enteric communications that are caused by primary duodenal ulcer disease are much less common. We experienced a case of duodenal peptic ulcer disease that perforated into the common bile duct in a 45-year-old woman.

A case of combined hepatocellular-chloangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection / 대한내과학회지

Polymyositis is characterized by symmetrical proximal muscle weakness, nonsuppurative inflammation of striated skeletal muscle, an elevation of muscle enzymes, and abnormality of electromyographical changes, but its pathogenesis is not clear. In recent years, there has been an increased awareness of the association of malignant tumors with this disorder. Still, the relationship between polymyositis and a malignant tumor remain obscure. Some researchers have suggested that the cause of polymyositis may be due to an autoimmune response induced by aviral infection. However, a chronic hepatitis B virus infection associated with polymyositis is very rare. We present in this report a rare case of combined hepatocellular-cholangiocarcinoma associated with polymyositis and chronic hepatitis B virus infection.

A Case of Non-Hodgkin's Lymphoma in a Patient with Crohn's Disease / 대한소화기학회지

Although adenocarcinoma is a well known complication of chronic inflammatory bowel disease, primary gastrointestinal lymphoma occurring in Crohn's disease is rare. A 40-year-old man with 10 year-history of Crohn's disease had multiple longitudinal ulcerative lesions on descending colon in follow-up colonoscopic examination. Microscopic examination of proximal descending colon revealed peripheral T cell lymphoma and other site of the descending colon was consistent with Crohn's disease. The patient reached complete remission of malignant lymphoma after three cycles of combined chemotherapy. He has been well for 10 months with sulfasalazine maintenance therapy but was admitted to the hospital due to spontaneous bowel perforation of ascending colon. Right hemicolectomy was done, but the patient died of post-surgical recurrent mesenteric abscess and sepsis. To the best of our knowledge, this is the first case of Non-Hodgkin's lymphoma complicating Crohn's disease in Korea which was confirmed by immunohistochemical studies.