A Case of Iatrogenic Rectal Perforation Repaired by Endoscopic Clipping / 대한소화기내시경학회지

Although colonoscopy is commonly performed, it is an invasive procedure that might produce complications such as hemorrhage and perforation. Colonic perforation is an abdominal emergency with high mortality requiring surgical intervention. Sometimes non-surgical teatment can be applied when perforation is small sized, located in the retoperitoneal spaces or surgical approach is impossible. We are reporting a case of colon perforation in 64-year-old female patient. The patient visited our hospital with symptoms of dizziness and dyspnea. She was anemic and we planned to find the possible cause of anemia. Rectal perforation was developed during the diagnostic colonoscopy. However the operation was not applicable due to arrhythmia and cardiogenic shock. Therefore endoscopic clipping was done at the perforation site. Afterwards nasogastric decompression, intravenous antibiotics and total parenteral nutrition were applied. She was treated successfully without any complications.

A Case Report on the Inflation Failure of Distal Portion of Inoue Balloon during Percutaneous Mitral Valvuloplasty in a Patient with Rheumatic Mitral Stenosis

Since Inoue et al introduced a specially designed balloon catheter for percutaneous mitral valvuloplasty (PMV) in 1984, the Inoue balloon catheter has been a popular device for the management of mitral stenosis. During the procedure several fatal complications, such as cardiac tamponade, perforation of a cardiac chamber, atrial septal defect, thromboembolism, mitral regurgitation and death have all been reported in the literature. There have also been several international reports regarding deformities of the Inoue balloon, but few reports in Korea. We recently experienced a case of an inflation failure of the distal portion of the Inoue balloon during a percutaneous mitral valvuloplasty in a 34 year old female patient with a tight mitral stenosis. To the best of our knowledge, a similar deformity of an Inoue balloon has never been reported in Korea.

A Case of Mitral Regurgitation due to Isolated Cleft Mitral Valve

A cleft in the anterior mitral valve leaflet is commonly associated with an atrioventricular septal defect, but an isolated cleft mitral valve is a rare condition. We report a case of a 27-year-old woman with severe mitral regurgitation due to an isolated cleft mitral valve. The echocardiography showed an anterior cleft on the mitral valve, but a normal sized and positioned left ventricular papillary muscle without septal defect. Under the diagnosis of mitral regurgitation due to the isolated cleft mitral valve the patient underwent mitral cleft repair. After surgery, the further echocardiography showed no mitral regurgitation.

A Case of Cavitary Pulmonary Metastases of Primary Cavitary Lung Cancer / 결핵

Many disorders and abnormalities are accompanied by cavitary lesoin of the lung and one of the most common causes of cavitary lung disease are primary and metastatic lung neoplasms. but cavitary formation of primary lung cancer is not frequent and cavitary or cystic pulmonary metastases of this is also rare. We report a case of cavitary pulmonry metastases of primary lung cancer proven by bronchoscopic biopsy and chest CT. The patients was 60 year-old heavy smoker who had never been underlying lung diseases 7 years ago and complained chronic cough. The chest CT showed primary lung cancer in right low lobe with multiple cavitary or cystic metastases in both lungs and multiple lymphatic metastases.

A Case of Acute Myocardial Infarction due to Coronary Microembolism in Bacterial Endocarditis

Spontaneous coronary artery embolization is a known complication of infective endocarditis. However, a microembolism from the aortic valve into the left anterior descending artery resulting in an acute anterior myocardial infarction is very rare. A 44-year-old male patient suffered from chest pain and fever of seven days duration. The echocardiogram demonstrated severe aortic stenosis, aortic root abscess and mobile vegetation on bicuspid aortic valve near the left coronary artery ostium. The electrocardiogram revealed ST segment elevation in lead V1-3 and heart enzyme analysis showed LD 936 IU/L, CK 299 IU/L, CK-MB 7.2 U/L, Troponin I 9.94 ng/mL. Diagnostic coronary angiogram revealed insignificant coronary lesion. Emergent operation was required because of aortic root abscess formation and high risk of recurrent embolization. He underwent surgery for aortic valve replacement and conservative management for acute myocardial infarction. The purpose of this article is to report the successful emergent aortic valve replacement of a patient with myocardial infarction due to coronary microembolism in a case of bacterial endocarditis.