Subcapsular Hepatic Hematoma after Endoscopic Retrograde Cholangiopancreatography / 대한내과학회지

Endoscopic retrograde cholangiopancreatography (ERCP) is a useful tool for the diagnosis and management of diseases of the pancreas and biliary tract. However, ERCP has a high risk of procedure-related complications compared with other endoscopic procedures performed in the upper gastrointestinal tract. The most common complications are pancreatitis, cholangitis, hemorrhage, and perforation. Extraluminal hemorrhagic complications after ERCP are relatively rare but potentially life threatening and should be identified and treated immediately. We report a case of subcapsular hepatic hematoma after guidewire injury during ERCP in a 64-year-old woman with choledocholithiasis who had undergone ERCP with guidewire-assisted papillotomy for stone extraction. Although subcapsular hepatic hematoma is a very rare complication after ERCP, it should be considered in the differential diagnosis of patients complaining of abdominal pain after ERCP.

A Case of Duodenal Diverticulitis / 대한소화기내시경학회지

Duodenal diverticulitis is difficult to diagnose because it can mimic other common diseases such as cholecystitis and perforated ulcer. Recently, we experienced a rare case of duodenal diverticulitis that was initially suspected on abdominal computed tomography as focal pancreatitis. Although duodenal diverticulitis has been increasingly recognizable before surgery, with the advent of multi-detector computed tomography, misdiagnosis remains problematic since duodenal diverticulitis is commonly not considered in the differential diagnosis of acute abdominal pain. We have to consider this rare disease entity because delayed diagnosis might be a cause of substantial morbidity and mortality.

A Case of Amebic Liver Abscess with Pleural Effusion in an AIDS Patient / 감염과화학요법

Recent studies indicate that there is an increased risk of amebic liver abscess among those infected with HIV, which is associated with cell-mediated immunosuppression. Although Entamoeba histolytica infection is common among HIV infected patients, only a few cases of amebic liver abscess with bilateral pleural effusion have been reported. We present a case of a 44-year-old man who presented with fever and right lower quadrant abdominal pain. Amebic liver abscess with bilateral pleural effusion was confirmed by serologic test, clinical symptoms, and radiological findings. HIV infection was incidentally diagnosed during treatment. The possibility of the presence of amebic liver abscess should be considered in HIV infected patients with space-occupying lesions in the liver, and HIV screening should strongly be recommended in patients with amebic liver abscess.