Acute Suppurative Appendicitis Following Screening Colonoscopy / 계명의대학술지

There has been a significant increase in the number of colonoscopies being performed worldwide. Moreover, post-colonoscopy appendicitis is a rare phenomenon, with limited clarity about its pathogenesis. Herein, we discuss the case of 41-year-old female patient, who underwent forceps biopsy polypectomy and cold snare polypectomy during a colonoscopy for a routine check-up. However, 6 h later she experienced episodes of lower abdominal pain and vomiting, subsequently diagnosed as acute appendicitis upon revisit. The patient afterwards underwent laparoscopic appendectomy in the general surgery department. There is a significant lack of knowledge regarding the mechanism of occurrence and predisposing factors associated with post-colonoscopy acute appendicitis; however, if a patient exhibits clear symptoms and a typical course of pain, active exploration for appendicitis can be considered, even shortly after undergoing colonoscopy.

Hemorrhagic Acalculous Cholecystitis in Pyogenic Spondylodiscitis Patient / 대한췌담도학회지

Hemorrhagic cholecystitis (HC) is a rare form of cholecystitis that may be caused by the progression of either calculous or acalculous cholecystitis, which has been reported sporadically as case reports. Acalculous cholecystitis is often diagnosed late and can be fulminant. HC without gallstones also can have a poor prognosis and be linked to a high mortality rate. Therefore, early detection, hemodynamic monitoring, and prompt treatment are essential to treat bleeding in cholecystitis. We report a case of hemorrhagic acalculous cholecystitis discovered during the examination and point-of-care ultrasound in a patient with pyogenic spondylodiscitis. The patient was referred with a chief complaint of liver dysfunction without bleeding tendencies or risk factors. Ultrasound revealed focal gallbladder wall irregularity, intraluminal membranes, and non-shadowing non-layering intraluminal echoes. Extravascular contrast leakage was exhibited on the computed tomography scan. The patient underwent emergency percutaneous drainage and subsequent cholecystectomy before developing major complications.