A Hybrid Approach for Thoracic Aortic Arch Aneurysms in Two Patients at High Operative Risk / 대한내과학회지

A large aortic aneurysm invading the aortic arch can be catastrophic if rupture occurs. In the past, the standard treatment was an open thoracotomy followed by total aortic arch replacement. However, open surgery is difficult in patients at high operative risk. Consequently, thoracic endovascular aortic repair (TEVAR) is preferred in high-risk patients. In patients with a short proximal landing whose aortic aneurysm invades the aortic arch, TEVAR is not available because of innominate, left carotid, and left subclavian artery occlusion. We report two cases in which aortic aneurysms invaded the aortic arch, and who were treated with TEVAR after a supra-aortic artery bypass operation.

A Hybrid Approach for Thoracic Aortic Arch Aneurysms in Two Patients at High Operative Risk / 대한내과학회지

A large aortic aneurysm invading the aortic arch can be catastrophic if rupture occurs. In the past, the standard treatment was an open thoracotomy followed by total aortic arch replacement. However, open surgery is difficult in patients at high operative risk. Consequently, thoracic endovascular aortic repair (TEVAR) is preferred in high-risk patients. In patients with a short proximal landing whose aortic aneurysm invades the aortic arch, TEVAR is not available because of innominate, left carotid, and left subclavian artery occlusion. We report two cases in which aortic aneurysms invaded the aortic arch, and who were treated with TEVAR after a supra-aortic artery bypass operation.

A Case of Ischemic Colitis Presenting as Bloody Diarrhea after Glycerin Enema

Enema has frequently been used for diagnostic or therapeutic purpose. However, cases of colitis from physical, chemical, and thermal injury due to enema have been reported. In severe cases, life threatening complications (perforation, rupture, peritonitis, etc.) may occasionally occur. Reports of ischemic colitis after enema is rare and there have been only 1 case of ischemic colitis after normal saline enema reported in South Korea. Sigmoidoscopy on a 58 year old female, presenting with sudden abdominal pain and hematochezia after glycerin enema, revealed ischemic injury of the rectosigmoid colon, which was improved after using antibiotics and conservative therapy.

Two Cases of Russell Body Gastritis Treated by Helicobacter pylori Eradication

Russell body gastritis was first defined in 1998, but not many cases have been reported since then. The exact causes and process of this condition are unknown yet; however, considering the reported cases, it has been highly suggested to have correlation with Helicobacter pylori infection. Russell body gastritis has a non-specific clinical presentation of gastritis such as gastric mucosal edema in the macroscopic view. It can be mistaken as xanthoma, signet ring cell carcinoma, or a malignant lymphoma including mucosa-associated lymphoid tissue lymphoma and plasmocytoma. Russell body gastritis features polyclonal immunoglobulin and is differentiated from Mott cancer, of which immune globulin has monoclonal aspect. Authors report here two cases of Russell body gastritis with examined endoscopic findings as well as a review of related literature on the association of all reported cases of Russell body gastritis with H. pylori infection.

A Case of Esophageal Submucosal Dissection that Developed after Endoscopic Biopsy / 대한내과학회지

The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.

A Case of Esophageal Submucosal Dissection that Developed after Endoscopic Biopsy / 대한내과학회지

The incidence of gastrointestinal complications has increased as endoscopic biopsy has become a standard diagnostic technique. However, esophageal dissection is a rare complication. A 71-year-old man suffered retrosternal pain for 15 days. Fifteen days previously, he had undergone an endoscopic gastrointestinal examination at a local clinic and an esophageal biopsy to obtain microscopic confirmation of esophageal candidiasis. The patient then underwent a subsequent endoscopic examination, which showed features specific to esophageal submucosal dissection. The predisposing conditions for esophageal dissection are coagulopathy, iatrogenic trauma (variceal sclerotherapy), drugs (thrombolytic agents, aspirin), foreign bodies/certain foods (fish, chicken bones), and emesis. However, endoscopic biopsy is a rare predisposing condition. Here, we report a case of esophageal submucosal dissection that developed after esophageal biopsy. We observed the healing process of this lesion with a series of endoscopies as part of a conservative treatment plan.